you might be wondering "why did meg have to get a spinal tap? aren't we past the diagnostic phase?"- in fact, part of me wonders the same thing. besides a desire to torture me, the doctors wanted to rule out any additional players in the ring- ie Lyme disease (there is also a blood test that is more commonly done) and a jillion other infections or neurological conditions. these are detected by analyzing the fluid that circulates around your brain and spinal cord (doctor speak acronym=CSF.) you don't get the report back on the spot. the tubes are taken to the laboratory, where they play around on those little shaking machines and spit out random numbers. magically they turn into a results sheet and you get a nondescript piece of paper in the mail.
at first i scoffed at the order, but my internist reassured me that the team is only looking out for my best interest. patients with chronic diseases sometimes get pigeonholed into one exclusive diagnosis, overlooking other serious, and sometimes life-threatening, conditions. (when she put it this way, i backed off.) but i was quite nervous about the LP (doctor speak for spinal tap). mainly because the last time i had one performed was my senior year of college, when i wound up in the ER from a piercing headache that was totally debilitating. all i remember was that an incredibly hot resident was subjecting me to the most excruciating pain of my entire life. (my roommate sandy was there for moral support, but she wasn't much of a comfort during the procedure- she was too focused on His Hotness. gee thanks slam!) in the end, they determined i either had aseptic meningitis or a strain of West Nile virus (which elle eagerly shared with our entire poli sci small group.)
but this time around there was not a hot resident in sight. instead, i was stuck in a dollhouse sized room (maybe 6'x10'?) that was at least 80 degrees, with a doctor i had only met once before. i can't even pronounce his last name! instead, i just call him "dr. carl". my blood pressure was 138 over 85- it's never that high. i was biting my lip like a madwoman (a bad habit of mine when i'm nervous) and twisting my hands continually. even mom ditched me! she didn't want to have to watch the huge needle, or see me be hurt, so she scooted out to the waiting room. (it was actually a good move, considering she wouldn't have been able to fit once the doc and nurse arrived!)
dr. carl did a great job of explaining everything- "first i'm putting XYZ on your back- it will be cold." and "i'm just feeling around for the precise spot on your spine." the nurse assigned to the room was a woman who has treated me before, tammy, and we've bonded over her son who is currently in Iraq during previous visits. she had to keep reminding me to breathe, and gave me mini pep talks throughout the procedure. "you're doing such a great job meggie!" and "almost done sweetie, just a little bit longer." (i felt like i was 10 years old- but i have to admit, it worked!)
regarding post procedure "rules", dr. carl stressed the importance of laying flat on my back as much as possible and advised against picking up any heavy items. he also explained the possibility of experiencing a few side effects, most common of which is a persistent headache (1 in 4 patients.) if this occurred, he recommending drinking caffeine as much as possible (you don't have to tell me twice!) the discomfort should not last more than 5 days, but if it does, they would perform a blood patch for relief.
he found the magic spot, and cleaned the area surrounding it with a super cold liquid- it gave me the chills. once my back was prepped, he inserted a needle filled with numbing agent (i think this was lidocaine?) into the area where the fluid was to be drawn from. note- this was the most painful aspect of the procedure. it felt like 25 bees were stinging me simultaneously- all on the
same spot! i immediately gasped and jerked, and could feel tammy shoving my shoulders back down towards my knees. once the drug did its numbing duty, a hollow needle was inserted into that same spot. although i was numb, and did not feel any pain in the typical sense, i felt a large weight of pressure. (since the needle has to be placed in that one specific spot, the doctor has to move it in and out several times to locate the opening. this movement is what is creating the pressure.) it was very uncomfortable, and i kept biting my lip and clenching my teeth, trying not to think about it. poor tammy, i think my fingernails were digging into her waist. because the needle is hollow, it provided a "pipe" for the fluid to be collected, and drained into the 4 tubes. after the 4th tube was filled (longest 7 minutes of my life), dr. carl removed the needle. and that was it!! tammy helped me to lay flat on my back, and hooked me up with a pillow and blanket. then she was off to deliver the fluid to the lab, and fetch that promised diet coke! mom snuck back in, relieved of her worrying duty, and i filled her in on the gory details. i had to wait an hour before i could leave, just for basic observation. during this time, the resident vampire (aka phlebotomist) stopped by to suck more fluids out of me- he was after my blood, demanding another 4 tubes to be tested alongside my spinal fluid in the lab! his name was either bryan or bobby, and he has a 3 month contract as a traveling phlebotomist. this gig sounds like an ideal job- you get to travel to various parts of the country (basically whoever has the opening), with all expenses paid by the hospital (furnished apartment, meals, etc.). not to mention a higher salary since you are always on the go. since you are only there for 3 months, you don't have time or reason to put down roots- think of all the money you'd save from getting out of baby showers and weddings! anyway, he was super chatty, and quite skilled with the needle. finally, my hour was up, and i was free to go.
looking back, the anxiety and stress that preceded the tap was WAY worse than the tap itself. i swear, scouts honor. i mean, it's not the most enjoyable way to spend a sunny afternoon. i'd rather be drinking margaritas with k8 at mexicali blues and critiquing fashion faux pas by the snooty girls of northern va. but it's all over within 10 minutes- and you get to drink TWO diet cokes (or coke, if you prefer those sugary additives) afterwards.
but 2 days out, that's another story. don't worry, i don't think this is typical, but i'm not doing so hot. i was the 1 out of 4 to get stuck with the headaches- and let me tell you, these are wicked headaches. they are similar to migraines, but much sharper around the edges. i know dr. carl said to drink caffeine, but i can't drink that much coffee or soda in one day. i'm getting a bit nauseous just thinking about it! but to make matters worse, i'm also dealing with extreme pain in my lower back, surrounding the area of the fluid drainage. the pain was so intense last night, that i started screaming from the sharp stabbings and shooting pains that occurred when i attempted to walk to the bathroom. i've been alternating ice packs for heating pads throughout the day, and laying down as much as possible, but it just seems to keep the pain stable.
the intensity and persistence of the both the headaches and back pain prompted me to email my internist and MS nurse practitioner- both of whom ordered me to be seen in the ER for evaluation. who in the hell wants to go to the ER to be treated? and even worse, who wants to go to the ER at 6 in the evening, when everyone is doing their shift change and all the daytime docs have clocked out? no. way. i then called marylee, who as everyone knows, is our junior M.D.- but she echoed their advice, and sent me on my way to the ER! so mom and dad, being the troopers they always are, loaded up the car and drove me to danville (all of 15 miles away)... again.
long story short, there is not an infection at this time. my body is just in a very sensitive state, given my many neurological issues, and will take more time to heal from any procedure. i was given more percocet (like i need more narcotics) and sent home with strict orders to rest, and continuing monitoring the symptoms. oh, by the way, finally a hot resident entered the picture. he was soooo adorable. but i'm sure my extensive medical history is a total turn-on.
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