Lumbar Puncture

A spinal tap/lumbar puncture is performed in your lower back, in the lumbar region. During lumbar puncture, a needle is inserted between two lumbar bones (vertebrae) to remove a sample of cerebrospinal fluid.

Information gathered from a lumbar puncture can help diagnose:

  • Serious bacterial, fungal and viral infections, including meningitis, encephalitis and syphilis
  • Bleeding around the brain (subarachnoid hemorrhage)
  • Certain cancers involving the brain or spinal cord
  • Certain inflammatory conditions of the nervous system, such as multiple sclerosis and Guillain-Barre syndrome

Source: Mayo Clinic

 

But, is it safe? Yes, although you’ll certainly panic a little. After all, a huge needle is going directly into a very delicate part of your body with only local anesthetic. Mine was done in a hospital and I was unable to work for the better part of a week due to a headache, soreness/discomfort and the inability to lift more than a few pounds. Also, I found myself having to lie flat very often to relieve a headache it caused. Even normal activities like walking my dog in the park had to be temporarily taken over by someone else. It was a frustrating experience.

I had mine done because my neurologist and I have reached a point in my illness that it became necessary. I have been skirting by on palliative medications for too long with no real answers as to why all of these things are happening and nothing is helping. My tremor has reached a point (without medication) where I just look so sad and uncomfortable in my own body, and I certainly feel that way. It’s off-putting to see my 26-year-old body act like a 90-year-olds. I’ll admit I am no spring chicken, to begin with, but this is a whole new low of inactivity. Writing by hand is almost illegible and takes me 3x the time. Along with the increase in tremor intensity, I have been getting random and severe nerve pain in my feet, knees and sometimes fingers. And the seizures have never stopped. So, we decided to move forward. I needed this test along with the neuropsychological evaluation, a DAT Scan, another EEG to be safe, an MRI with and without contrast, and I still need to be seen by a movement disorder specialist. I’ve got 5/6 done, I don’t have high hopes for the specialist. I think it’s mainly because I am comfortable with the neurologist I have now and I find seeing other doctors a task because you never know if they are going to be an asshole or not.

The main illness my doctor is worried about me having is MS. We’ve ruled out Parkinson’s which was a great relief, and we ruled out any kind of infections, cancers etc. MS is still up in the air until I go see the movement disorder specialist for a more thorough evaluation. One of the tests required in making a diagnosis of this nature is a lumbar puncture. It’s an unavoidable procedure.

Of all the tests, surgeries and hospitalizations I have been through the lumbar puncture was the most nerve wrecking. It’s one of those procedures that makes you think “damn, I wish they would just knock me out” because it’s difficult to explain the weird panic you have. When you get checked in and in your lovely hospital gown they start drawing your blood to test for some crazy stuff. Like viral meningitis.

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This was my before picture, just after my blood draw. I was making that face for fun, I promise. I was actually in an okay mood at this point.

While they were drawing my blood I was expecting them to start an IV to put some fun relaxing drugs in because I was about to have a giant needle shoved into my spine. But no, nothing. The panic really set in once the nurse left, I thought there would be something. After that, you get the usual vitals and questions about symptoms, meds, etc. Then it’s time to get pushed around in the gurney to wherever the procedure is being done. For me, it was an x-ray guided spinal tap so I was taken down to radiology in a giant procedure room with the fanciest x-ray I have ever seen.

Up until I was in that room I had my sister and boyfriend by my side, they walked down with me and the lady pushing me. I was still holding out hope for some drugs, trying not to panic and my tremor had kicked into high gear. But, then the guy that was explaining the procedure to me killed all hope of that happening. He was very nice and told me exactly what would happen. It was an odd atmosphere because there was reggae playing along with 5 other people present and just chatting in their full-on protective radiation vests not including the doctor performing the procedure. By the time the doctor had come in I was lying on my flat on my stomach, some stranger covering my ass with a blanket and couple people prepping all of the equipment including the giant needle.

When the doctor came in he looked confused and asked if I was an emergency case, but I explained why I was there and he kind of got quiet. I think he saw the tremor and heard it in my voice because he was very nice and reassuring. After that, it went so quickly I didn’t know it had happened. I figured out later, after my panic, the doctor was quiet because he was shoving a needle in my spine. The only things I felt was the cold iodine to clean and prep the area and then a couple of sticks with the numbing medication. I didn’t feel a damn thing. They did have to place a hand on my back a little firmly to hold me still because my tremor was making it almost impossible to be completely still.

Before I knew it the doctor was showing me my spinal fluid and it was over! It was perfectly clear by the way, which is a good sign. After that, it was sealed in a pretty biohazard bag and I was instructed to log roll back onto the gurney. This is where it gets tedious because you have to follow so many rules. Before I rolled over back onto the gurney, the guy who had been talking me through everything got serious and said I had to be careful because I could make the little hole they just made larger and spinal fluid would leak out, I would get the worst headache of my life and they would have to do another procedure similar to what I had to fix it all. So, I was as stiff as I could be. And the moment I made it to the bed without incident they were poking my feet and asking if I could feel them. I said yes, and the guy covered me with a lot of warm blankets and gave me the thinnest pillow in the world. I was only allowed one and I had to stay flat for 2 1/2 hours. I even caught a glimpse of the x-ray they took while the needle was in. It looked insane, the needle was easy to see from a distance without my glasses on.

Once I was situated, I was wheeled back to the little bay I was held in where they took my blood. The nurse was so nice and quiet and asked me if I needed anything to eat or drink. After that, she had me move slightly to check my little bandage, checked the feeling in my feet and shut off the lights and told me to be still and rest. The intermittent checking of my feet was a little unnerving, but every time I felt it I considered it a success. After about fifteen minutes of being alone in the dark relaxing and sort of napping, the numbing medication started to wear off and my back was tingling for a bit. And then it was uncomfortable. The only way I know how to describe it is that you know for a fact, that there was a giant needle there. It’s a really dull ache, but a deep ache. The nurse would come in periodically to check on me and after an hour she saw that I was not going to sleep and told me she would go get my sister and boyfriend to keep me company the rest of the time.

This is a facepalm moment, she couldn’t find them the rest of the time. Eventually, she had to call my sisters’ cell phone to tell them to come to get me. Turns out, they went and got breakfast and then sat down in the wrong waiting room expecting the nurse to call them back. They were on the wrong floor too, not even close to where we were. But, I am ok with them not being there because they are loud people and gradually I was becoming a bit sensitive to noise and light. Also, I was in general uncomfortable and not ready to handle a normal conversation. And my boyfriend doesn’t do too well in hospitals, my sister had to have a moment with him prior to the procedure telling him to either calm down or she was going to make him go back out to the waiting room. He is very excitable.

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And a lovely candid photo of the after. I was cold, uncomfortable and everything was loud. I was preparing to leave, so they sat me up and made me wait another 15 minutes before getting dressed.

Finally, it was time to go home. I needed some help getting dressed but other than that it was just the same nagging dull ache and a slight headache. And as per usual in a hospital, I got wheeled out and the guy was so sweet he helped me into the car and made sure I was buckled in properly.

The next few days were uncomfortable, filled with intermittent headaches and spent trapped in bed. I usually can spend an entire weekend in bed no problem, but this time was different. I wanted nothing more than to get up and go outside, but after a few minutes the dreaded headache they warn you about set in and the only way to really remedy that is to lie back down as flat as possible. Tylenol, Motrin and believe it or not caffeine help as well. So I was drinking small cups of coffee and soda to help, which it did. But it kept me awake and extra aware of how uncomfortable and sore I was.

Also, just for laughs, anyone who came to check on me would poke my feet to mess with me. To be honest, I would do the same.

After all of that, the results were normal. A part of me is relieved, but a bit upset that again, nothing was found to explain my issues. But, I’ve been told it’s not conclusive evidence to rule out a few things (what they are, no idea).

That’s what my experience was. Have you had one?

 

 

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