Just so J-Dubya doesn't think he's the only one that struggles at times....
2130-- get a call for an epidural. 21 yo, 4cm, primip, healthy except for the fact that she cries every time someone touches her. Get to the hospital, place the epidural, have her laid down by 2215. She's 5'8", 190#. Catheter went in easily, but she did bleed from the puncture site when I pulled the tuohy out. Stopped after about 3 min of pressure over the puncture site. Lay her down, start dosing my usual 4cc of .25 bupiv, then 2cc fent and 2cc bupiv, then another 4cc bupiv. She looks more comfortable, but has no discernable level on the R. About t-8 on L. I give another 4cc .25 bupiv with her on her R side, start infusion of .125 bupiv with 2mcg/ml fent at 10cc/hr, leave her on R side. Re-check in 20 min and she's sleeping, contracting, levels t-6 bilat. I figure I'm OK, go to the lounge and go to sleep.

Get a call at midnight from Family Practice doc doing delivery. Baby's tired, need a section. So, what do you do -- the epidural is working well, but initial set-up was decidedly one sided. Do you replace it, retract it, pull it and do spinal, or dose it as is?

I'll follow up after I take a nap.