Yeah. I know you were thinking Spinal Tap the band as opposed to spinal tap the thing someone stuck into my spine this morning. One of them is funny. One of them is not that funny, but not that bad.
I ventured into the neurology clinic this morning for my procedure. This was my reward for having my white blood cells increase. In the clinical environment, we like to refer to spinal taps as lumbar punctures or LPs if you are really well versed.
The procedure goes a little bit like this.
- Get bloodwork done to make sure you aren’t going to bleed out.
- Lie down on the bed facing the wall and curl up into a ball with your knees as far in as possible.
- Nurse starts to feel your hips and spine for the correct insertion point.
- Nurse finds and marks insertion point.
- Nurse wipes area down with betadine – that horribly staining stuff.
- Nurse inserts needed with lidocaine to numb the top area. This part pinches and the lidocaine burns.
- Nurse inserts another needed further in with lidocaine. This also burns and you feel some pressure.
- Nurse finally goes for it with the needle into your spine. You feel slight pressure, but it is more scary than painful.
- Nurse measures your spinal fluid pressure.Increased CSF pressure can indicate congestive heart failure, cerebral edema, subarachnoid hemorrhage, hypo-osmolality resulting from hemodialysis, meningeal inflammation, purulent meningitis or tuberculous meningitis, hydrocephalus, or pseudotumor cerebri.Decreased CSF pressure can indicate complete subarachnoid blockage, leakage of spinal fluid, severe dehydration, hyperosmolality, or circulatory collapse. Significant changes in pressure during the procedure can indicate tumors or spinal blockage resulting in a large pool of CSF, or hydrocephalus associated with large volumes of CSF
- If all is good, nurse starts to collect spinal fluid.In my case, this took about 15 minutes because they were also banking some of my fluid into a bank for research.
- When collection is done, nurse pulls needle and cleans you up. You get a little bandage that you are to remove in 24 hours. Voila. Done!
The risks of doing a lumbar puncture are post spinal headache with naseau. I was told that this only happens about 5% of the time and mainly with the hospital punctures. The reason that they happen more in hospital as opposed to clinic is that the needles that they use in hospital are a lot bigger than what they would use in an MS clinic like I go to. This is largely in part because doctors in hospitals don’t perform lumbar punctures all the time, so they need bigger needles to hit the spot. The bigger needles perforate a sheath that the smaller needles simply push apart. This results in some spinal fluid leaking out and giving you a headache. Scary, right?!?