Prostaglandin E2

And that was all I needed.

Just a little bit of Cervidil.

A little bit of Cervidil, and there we were.

Done.

So how long was your labor? Seven hours.

Yeah, that's a great nuanced answer because it's not really fair.

I asked you a question that is almost impossible to answer, but I was... curious what your answer would be and you really do answered in a great way because you you gave the nuances how we would like to see it and the work that's necessary for it but you also gave some mechanistic insights what would be necessary because i'm thinking not just the resolution path is important but also the initiation path we need uh prostaglandins leukotrienes essential for biology and more and more studies also on spm show out that if if those PGE2 or LTP4 is missing, you won't have resolution.

It's not in a good way.

And we also know babies get prostaglandin E2 in baby milk.

I'm probably just setting myself up for failure.

We get there and they started off with, I think Cervidil or I think that's what it is to dilate the cervix.

And I did something in my cheek, just like a pill in my cheek to start that process.

I think before the midwife left at like midnight, somewhere around there, I think they started Pitocin.

So what they measured is creatine kinase, which is a marker of muscle damage, lactate dehydrogenase, again, another marker of inflammation and damage.

Prostaglandin E2.

Prostaglandins are an inflammatory, very fat-based, from my understanding, inflammatory marker.

I hope I'm right on that.

Okay, that makes sense.

Simultaneously, topical anti-inflammatories work to inhibit key inflammatory mediators, specifically prostaglandins like PGE2 and cytokines like interleukin-1 and TNF-alpha.

And what happens if you don't block those?

By chemically blocking these signaling pathways, you halt the inflammatory cascade.

And then we'll see you at five.

So, so they put the Cervidil in and about six o'clock, the nurses changed shifts.

And so I got a new nurse.

Her name was Courtney and she was so sweet.

So she's kind of part of the reason that I got involved in birth work myself, because it really showed me what a difference having that kind of support could make.

So my induction, it was pretty straightforward.

They did the Cervidil and then they started me on Pitocin.

They had to keep raising it and lowering it because I would have contractions for like 10 minutes straight.

But the body doesn't just let the kidneys die, right? Th-there has to be some sort of backup plan to keep that plumbing open.

There is, and it introduces a critical biological hero into this story, prostaglandins, specifically a type known as PGE2.

PGE2.

Okay.

What do they do? When the kidneys sense that they are being starved of blood flow, they start locally synthesizing these prostaglandins.

The house has great water pressure.

Exactly.

But in our ultramarathoner, whose kidneys are entirely dependent on PGE2 to keep the afferent arterioles open, taking ibuprofen effectively kicks the crutch out from under the kidney.

Um, but I declined any other medications.

I think they offered to do Cytotec, um, or maybe Cervidil, one of the two.

Um, along with the balloon.

And I was like, no, let's just start here.