Pain test for Expectant Mums

Jodi - posted on 05/19/2011 ( 22 moms have responded )

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Women preparing to give birth may soon be able to have a genetic test that predicts how much pain they are likely to experience and the sort of painkillers they will need.

Professor Alex Sia, an obstetric anaesthetist at Singapore's KK Women's and Children's Hospital, said studies had shown that people's perception of pain and reaction to different painkiller drugs varied according to genetic make-up and ethnicity.

He said a study of about 1000 Chinese, Indian and Malay women that measured how much pain they reported after a caesarean section, found that Indian women complained much more about their pain than the Malay and Chinese women. The Indian women also consumed much more morphine as a result.

Furthermore, the research showed that all women with a particular gene variation, regardless of ethnicity, reported significantly higher pain than the other women. In some cases, these women consumed three times the amount of morphine compared to the others. There was also an association between the genetic variant and how much a woman experienced side effects of morphine, including nausea and vomiting.

Professor Sia said the research was an exciting step in the discovery of links between genes, pain and individual responses to different painkillers. Although there were many other factors in pain perception, including one's psychological state, he said the research could lead to a genetic test for doctors to take a blood sample and tailor anaesthetics and painkillers.

He said the aim is to be able to identify the full range of genes associated with pain. ''That would mean that if someone comes in for surgery we could take a drop of blood to know ... their requirement for analgesia and pain relief,'' he said, adding such a test could be in use within five to 10 years.

Professor Sia said this would be particularly helpful in maternity wards because there was a strong association between pain during and after child birth and depression, often affecting a woman's ability to look after herself and her baby.

He said understanding individual responses to powerful drugs such as morphine could also improve patient safety.

Dr Sia cites respiratory depression, a potentially lethal complication that can result in patients given morphine.

''For some people, the dose that leads to respiratory depression in someone else is not enough to relieve their pain,'' he said. ''There has to be an explanation for this and that is what we're hoping for.''

Professor Sia presented the research to the Australian and New Zealand College of Anaesthetists annual scientific meeting in Hong Kong.

http://www.stuff.co.nz/life-style/wellbe...

What are your thoughts on this? Would you want the test? Why or Why Not?

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Sneaky - posted on 05/19/2011

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I worry that it would send a message to some women, making them think that they have a high pain tolerance and need minimal pain relief so they feel like failures if they do not conform to what is 'expected' of them coping wise during birth and afterward.

But that's just me - I always have to look for the down side.

April - posted on 05/20/2011

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the problem i have with such a test is that it subliminally says to women, "you are weak. you have no power. you can't get through labor without medicine." I do understand how it would help to prevent women from being over-medicated, but i also think it just trivializes what women can do, what we were built for.

Nikki - posted on 05/19/2011

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I think this is really interesting too. I would be keen to know what it says about me, or if it's right. I already know I have a relatively high pain threshold. In my experience hospitals like to give out more pain killers than needed.

Erin - posted on 05/19/2011

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It could have the opposite affect too Tracey, and women may dose themselves to the eyeballs unnecessarily based on this test.

I wouldn't take the test. It assumes all women require pain relief during labour and birth, which is clearly not the case.

Dana - posted on 05/19/2011

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Wow, I think this is really interesting.

Laura, I"m confused, you wouldn't want to take drugs after a C-section but, you wouldn't want to take the test either? That makes no sense to me.
Wouldn't you bet better off taking the test so you weren't over medicated?

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Sharon - posted on 05/20/2011

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It wouldn't matter to me.

I have a very high tolerance for pain, I use far fewer painkillers than most people I know and my issues are bigger than theirs.

However, I don't like anticipated pain. its a psychological thing. I become very unhappy and very apprehensive, once the pain begins to kick in it only ramps up.

I had my 3 perfect epidurals and if I ever needed it again, I'd go that route. ZERO pain.

I was emotionally & physically satiated.

Nikki - posted on 05/20/2011

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I have had abdominal surgery and it wasn't as bad as I thought it would be. I was really nervous about them taking the morphine away the next day but it didn't bother me too much. They replaced it with tremadol which I was allergic too, after that I just had a few panadols. I still had pain but it was by no mean unbearable. Having my wisdom teeth out were worse too.

User - posted on 05/20/2011

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I think a lot of how we deal with pain is more to do with our state of mind at the time.

In many cases childbirth is over medicalised as it is and I speak as one who had an emergency section. I don't think we need to add in any more pressure from doctors than already exists.

Amanda - posted on 05/20/2011

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Great now people will have a medical excuse why they abuse prescription drugs.

Jodi - posted on 05/20/2011

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"Sherri- You wouldn't take pain meds after a c-section? Have you ever had abdominal surgery? It's excruciatingly painful. Unbearable."



Stephanie, I have had abdominal surgery (not a c-section, but same as you, for endometriosis), and the only pain killers I had were the ones they gave me before I woke up. I actually have a high tolerance to pain and didn't feel the need for any. And I WILL say that my wisdom teeth surgery was worse.... :P



I think everyone is different, and I don't think we know until we get there. But i don't think I'd like to know in advance. I'd prefer to educate myself AND my partner on my options, and make decisions personally rather than on the result of some test.

Merry - posted on 05/20/2011

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Dana, I wouldn't refuse meds all together, but I'd just not want a 'standerd' amount or anything. One of those buttons like Ashley talked about would be fine, if I needed it I'd use it.
I wouldn't want the test cuz I don't think it sounds too reliable...my sister and I are closely related as possible, but our pain tolerance is so very very different it's ridiculous. I don't think genetics is the biggest factor in pain tolerance.

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Nikki S, they doctors and nurses thought i was crazy, as i refused all pain relief after the morphine drip was taken out.I had her half 4 in the morning.Which was a tuesday.The drip was out wednesday 5 in the morning.It was like a watch on my arm..i had to press it down to release the morphine..i never did.I woke up one morning and the nurse was pressing it down..lol they always did it.I was like i just had the c-section not you.I have to say i saw many moms in agony and crying after there c-sections.We all recover and deal with pain so differently.

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I'm good with pain, always have been.Even after my c-section i wasn't in much pain.I had the drugs taken the next morning and needed no other pain relief.Home 2 days after the c-section.Actually walking hours after the c-section.Which was great and i was not expecting to be so well.

I just get on with it.Even my natural birth wasn't as painful as i though.Although i was waiting for it to get worse..so i took pain relief out of fear.lol



Actually out of all that, the pain i found very unbearable was being stitched up after the first natural delivery.I think i nearly broke the nurses hand, while daddy was holding his little princess.lol

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I've never had a c-section but I did have surgery for endometriosis and cysts and omg it was horrible. The pain is like nothing I've ever felt in my life. I had 2 natural births and the first was a 44 hour labor. I would do that 100 times over rather than have another abdominal surgery.

Elfrieda - posted on 05/19/2011

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Wow, that's really interesting! Imagine if it is true - would it be common knowledge, so at the dentist you don't get freezing if you have high pain tolerance, and you get put in the emergency exit aisle in airplanes because you might be able to keep your head without being crazed by pain?

I don't know if I'd want to know. I like to just assume that I can take whatever gets thrown at me! When I was trying to prepare myself for childbirth, I was worried, because I freak out when I get a splinter in my hand, and once when I got hit in the nose with a baseball, I cried. But it actually wasn't as bad as what they show on tv, with the screaming and swearing. I mean, it hurt, but it wasn't an "Ow, I'm being damaged!" kind of pain.

I think I'd rather not know, just so that I can continue to think of myself as some kind of tough cookie instead of the delicate flower I sometimes suspect myself to be!

[deleted account]

Tracey- Exactly what I was thinking!

Sherri- You wouldn't take pain meds after a c-section? Have you ever had abdominal surgery? It's excruciatingly painful. Unbearable.

Sherri - posted on 05/19/2011

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I wouldn't take the test and I wouldn't do the pain meds afterwards anyways.

Katherine - posted on 05/19/2011

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That is really cool actually. I would want to know. Both of my labors were horrid and I would want to be prepared.

Bonnie - posted on 05/19/2011

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If I have never given birth before, I wouldn't want to know. Everyone knows the pain is usually unbearable. That would be enough info for me. I don't need to know how bad it is.

Jodi - posted on 05/19/2011

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I don't believe they are only talking only drugs for c-section, but vaginal birth too, such as gas, pethadine and epidural, etc, and tailoring pain relief in accordance with the results of this test.

Merry - posted on 05/19/2011

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I'm assuming an epidural would do the trick for the actualy surgery, I think the morphine would be post op

Mrs. - posted on 05/19/2011

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If I was having a c-section, I'd worry more about not having enough painkillers to numb someone cutting into my belly and going into shock like a Civil War solider or something...you know, instead of the whole bfing thing..

But that's just me.

Merry - posted on 05/19/2011

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No thank you! But I'm a homebirth type anyways. If I needed a c section I'd want least drugs possible to keep it out of my milk....

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