Monday, November 19, 2007

Lumbar punctures hurt

In case you were wondering.

Anyone who tells you that they are no big deal are big, huge, enormous, dirty, rotten, liars.

To backtrack a little, my husband has learned something about me through all of this. I will say that things are no big deal and then resent the fact that he is not there to hold my hand.

When I originally went to the emergency room about five or six weeks ago, I firmly told him that I was fine. And then felt put upon that he had not shown up anyway. Now, to be fair, when I say that I am fine, at that moment, I generally mean it. It is later that I realize that I really wanted the help.

So when I went to the neurologist, I told him, and meant it, that he did not have to come, but I admitted that I needed hand holding for the lumbar puncture. That morning, I told him that he didn't have to come, and he wisely ignored me. He took the afternoon off and we drove out to the office. In order to be efficient, we get there a little early and I get five more vials of blood drawn and an x-ray. We go upstairs to get the LP (that is a lumbar puncture for the uninitiated).

I don't know why I didn't know that the neurologist was the person to do the procedure, but I wasn't aware of that. It had come to me, slowly, over the past week that someone was going to stick a real needle in my real spine. I was not looking forward to it. I was trying hard to not be scared. My goal was to not make an utter spectacle of myself.

I asked him if he had received the notes from Dr. P and if he had seen all of the images on the MRA. No to the first, and yes to the second. He had seen my arteries and saw nothing wrong.

So, just to be clear, you think that my arteries are completely normal? Yes, he says.

Great. now I need a third opinion. One of my neurologists is not very competent I fear. Please let it not be the one who is going to stick a needle in my back and risk paralysis and brain herniation.

Your brain can herniate during a spinal tap. Just so you know. It is very rare and they monitor your spinal fluid pressure, but your brain can get sucked downward. I think it is fatal.

So, the neurologist and the medical student who is going to observe leave the room and I get dressed in the backless gown. I elect to leave on my underwear, but if I had been thinking about it, I probably would not have worn the bright green undies. At least they were clean.

I get draped and betadined and it is explained to me that they will numb the area first.

You know how when you get dental work done how the novocaine injection is painful all by itself? The same was true for the lidocaine, too. I curled up into a little ball and they injected the painkiller. I would like to say that the idea was worse than the test, but I think I would be lying. My sympathetic nervous system kicked in and I sweated so heavily that I thought that I was going to slip right off of the table. I finally had to ask my husband to put his hand under my feet to keep my legs from slipping apart. My nervous system was not fooled by the lidocaine.

This is what the procedure looks like.

But more creepy.

Anyway. I got through it all right and an eternity and four vials of CSF later, we are done. After each vial is filled, I can feel the slight jerk as it is removed and can hear it being capped.
What is funny is that we are handed the bag with the vials, just like it was a Happy Meal and were told to take it downstairs to the lab. The physician handed me the bag with the vials of precious CSF and I promptly dropped it. Because I have been dropping things a lot.

I looked at my husband and he looked genuinely horror-struck. I don't think I have ever seen that look on his face before, but now I know what expression he will have if one of my limbs drop off or something. I think that he thought that they had shattered. However, the vials are made of plastic and no harm was done.

The CSF is crystal clear and surprisingly pretty. It looks like water. I had thought it would be cloudy, but it isn't I get one more blood draw down stairs and we are done for the day.

We stop and have delicious fish tacos at the place where I used eat when I was a graduate student. I am laying as flat as I can, because my sister has admonished me to stay flat. Both of them have called to see how I am. I don't have a headache, but I am thirsty, but I think that is psychosomatic.

So, that was last week. I am now all caught up to real time. Tomorrow I get my last tests, the MRI and MRA. My back is still sore from the LP, but now it just feels bruised. It hurt for longer than I would think, given the fact that it is just a little puncture. The neurologist told me I could go right back to work but to avoid heavy lifting.

I was in Wal-Mart two nights later, bent over, lifting a 12 pack of Diet Dr. Pepper, and I had an image of my back springing a leak like a garden hose. I unobtrusively felt my back, but it was dry.

I am in a lull right now. My symptoms are pretty much gone, which the neurologist would say is consistent with MS -- symptoms for about a month, and remittance.

If this is as bad as it gets, I think I will be fine. I am tired, but maybe the physician will put me on speed or something and I will lose weight and be more peppy!

A girl can dream.


Rowan said...

Ah! and ooorgh! That is empathy, rather than sympathy, btw. Was going to try to post as Deanna Troi, empathic betazoid and impossible lycra-jumpsuited chocolate mousse aficionado, but blogger is only just willing to recognise me as Rowan. Poo tee weet!

I was wincing fur ye when I heard about the LP, but could only make an unhelpful meep noise, and say something disassosciatey.I knew I would be much more help afterwards. I have had three spinal anaesthetics, two with epidurals added, the other a spinal block. It is almost the same procedure, apart from the goal is not to give you a spinal tap, but stop a nanomilimitre away from the cerebrospinal fluid and fill you with, I guess, more lignocaine.(Yeek at the LP brain herniation worry! I did not have that element to consider.>-<)

The initial non-numby lignocaine...with you. And the unexpected sensation of thumping aboot...with you. And the time they take... Time for the sympathetic nervous system to kick in like something out of a Bruce Lee movie. I thought..."I will talk to Bob about this afterwards. If she doesn't want to, will wait till we are stravaiging aboot somewhere, grab he by the coat sleeve, shout,'Spinal tap' followed by a loud WAAAA! Then run headlong along for about twenty yards, and hit the nearest Starbuck's." (I will only do the latter if they tell you your artery is okay after-all, and you can raise your heart-rate.) Will this be the case, if your artery is considered fine? Is the neurologist getting a third opinion for you from a colleague? Hope you get an answer on this one soon.

I am glad the neurologist did your procedure. That is good. They are highly-skilled. When it came to my third spinal block, the consultant anaesthetist and her intern were round behind me, poking about for some time. the day after the op, the consultant came to check my mobility. Another lady in the next bed, a lecturer I had become friends with, could not move her nether regions to get out of bed. (She kept in touch, and I will tell you her follow-up story, sometime.) The intern had done her procedure. "Oh, I did yours, the consultant said, meaningfully, raising her eyebrows. After-all, it is your third..." :/

It does feel sore and bruised and a bit stiff, for a whiley, so I think you did well, with your twelve pack of Dr Pepper! That is heeaveee.

Deanna McTroi is off to see what she can replicate for a low-calorie lunch. Trader Joe's chocolate tea will feature.

With you in spirit today, Dr Bob, my friend. Wishing you all the best for your scans. keep yer havering sistahs posted.

Bama said...

Okay my dear...I have lots of reading to do to catch up! Ack!

I did read this post, and first: Haha! You dropped the vials. That's precious. I don't know why, but that, combined with my imagined view of your hubby's so funny to me. I know it probably wasn't all that funny for you...or him...but your re-telling is F-U-N-N-Y!

Second: Yay to you for getting through all that! And yay to your hubby for being there!

I'm thinking of you everyday...and praying for you still! I hope you here about the results soon.

Rowan said...

Bama - yeah, yay to Bob and Mr Bob for getting through all of that, and a great big yay to no vial breakage! Reading that part gave me a flashback to how I felt when I thought the OB who had just completed two and a half hours of surgery my my plumbing was missing an earring...

Bob - glad you two enjoyed your fish tacos. You certainly deserved a lovely meal.

Ba said...

Happy Thanksgiving Bob. I won't be here the rest of the week and wanted to wish you and your family a happy Turkey Day.

Rowan-wish you were here for all the turkey and pies!

Bama said...

Uhh...that was supposed to say "Bama"...not "Ba"!

Oh yeah, I ordered a laptop yesterday so pretty soon I'll be back on the 'net at home! Yay! More time to haver with friends!

Luv y'all!

Rowan said...

Happy Thanksgiving to everyone! I have googled it, and it is tomorrow. Hope you guys all have a lovely time. Wikipedia says that you have a lovely turkey dinner and (spoken in hushed awed whispers) pecan pie. Yeeeummmee. Some cyber pie please. The calories might fall off during teleportage.

Wikipedia also says y'all give thanks for nice things. Am giving thanks for my cool Havering sistahs!

bama - that's groovy about the laptop!

Dr. Bob said...

Bama, I still think that dropping the vials of CSF is _extremely_ funny. The look on my husband's face makes me snicker.

Rowan, I think I prolly need a third opinion. The earring thing made me laugh out loud.

Y'all are the best.

The Singing Patient said...

i will add this to the list of horrible medical procedures, only in this case, I hope to avoid ever having one. it reminds em of the bone marrow draw i had. i screamed bloody murder.
and what about my treatment changed? nothing.

doctors don't like this, but i often research something before i go have the procedure done, and then i jsut don't do it. esp after the bone marrow thing and the EMG that i couldn't make it through.

my current dr wrote me and RAx for a mammogram. i've heard how awful they are but i've also read that annual mammograms can build up radioation in the boobies and CAUSE breast cancer! no thanks, i'll just squish in the shower, old school.

i can't afford, financially or health-wise not to question the doctors sometimes. they killed my grandmother with an iodine test. my granfather then drank himself to death.

they took out ym dad's bladder because they said it was cancerous. turns out it waqsn't and now he pees through a tube and has kidney failure (which started soon after the bladder removal).

these decisions are part ours to make too. we are the ones who live with the consequences.

shelley said...

Hello..As Queen of "I Have No Idea What I'm Talking About But I'm Going to Say It Anyway"...I feel compelled to ask...have you been tested for West Nile?

I'm sure that's been covered...but my choir director contracted this a few years ago and it wreaked havoc on his muscles and autonomic nervous was very hard to diagnose.

I'm thinking and praying for you, Bob.

A mom in the 'burbs said...

Ow, ow, ow, ow owwwwwie!! That is about all I can say about that!

I totally gasped when you told me about dropping the freakin' vials! What a moron doctor to hand them to the PATIENT with neuromuscualar problems!!!! ACK!!

p.s. spinal fluid should be clear. if it isn't, it's because there is an infection. Just so you can all win at Trival Pursuit some day.

Dr. Bob said...

Singing patient -- thanks for your comments. I read your top least favorite medical procedures and it made me cringe.

Dr. Bob said...

Ohg, and Shelley, I think that I might be tested for WNV. Will double check. Always good to ask, I think.

The Singing Patient said...

heheh yeah dr bob your LP description made em cringe too.
LP... i will choose to think of turntables and happy records. there is a needle involved but it never touches me!
oh yeah a lyme disease test while you're at it. lots of overlap with lupus. test is cheap.