She's a character, she has opinions.

Your Lumbar Puncture and You. (Or me, as it were.)

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Now, all this near-fainting blew my valium plans right out of the water. There was no way I was taking that while feeling so terrible, and the warning about vomiting if I did take it had me scared. So I went to the lumbar puncture in full-on panic mode, though it was tempered quite a bit by my fasting and loss-of-blood spaciness.

I’d been prepared for the procedure by a tech who called me the day before and–even better–by one of my sisters who has had one before. Best of both worlds, right? I had all the medical knowledge and advice and all the practical knowledge and advice. And I had My Very Able to Advocate for My Needs Self. (Which if you don’t feel able to do for yourself, you should totally bring someone with you who will do it for you because it will make everything into a much more pleasant experience for you.)

When I was told to undress fully and put on a johnny I told the tech I’d be keeping my sweatpants on and would remove them in the procedure room if required. (My sister’s procedure was done with elastic-waisted pants on, mine was also.) I also brought my own bathrobe and put that on over my johnny. I may as well have been fully dressed, which made me the exception in a waiting room full of physically exposed and therefore emotionally vulnerable people.

Then they brought me into the procedure room and a tech gave me all sorts of forms to read and sign, and once again went over the procedure with me. She then introduced me to the tech who would be assisting who introduced me to the resident who would be performing the procedure and to the supervising doctor. I think every person I met explained the procedure to me and answered any and all questions I had. And I had many, so that was good. I also had the tech go through the list of things they would be testing my spinal fluid for–funnily enough, I knew some of the abbreviations she didn’t know, because I’m more familiar with my illness and other suspected illnesses than she is. Between the two of us we were able to identify just about everything. (I don’t know how necessary this was to know, but I like to be fully aware of absolutely everything going on with my health. Just know if you ask, they will tell you.)

So let’s talk about the procedure itself. It’s about what you think. You lie on your stomach on a table (my sister had hers done lying on her side). (If you feel cold at all, or in any way uncomfortable or vulnerable, go ahead and ask for a sheet or blanket to cover yourself. I was comfortable in my sweatpants, but did make sure I could keep the shawl another sister crocheted for me at the pillow so I could hold onto it. Trust me, it helps a lot to have something to cling to.) They clean your back thoroughly with antiseptic. Then they numb the spot on your back where they are going to insert the needle. Lidocaine, the numbing agent, works really fast, but it also burns for a few seconds when it’s injected. Your first shot wiill be PINCH BURN, your second Pinch Burn, and your third you might not feel anything at all. Then they put a cloth over your back to isolate the spot of the surgery.

The hospital where I had my LP done uses a series of x-rays to position the needle. This isn’t necessary, the procedure can be done in a doctor’s office with no x-ray at all, but I really like that my hospital does it that way. I felt much, much safer. Basically they take an x-ray, put the needle in, take another x-ray, adjust the needle or push it deeper, another x-ray, etc. You will feel some pressure and/or pain while they are inserting the needle. The resident told me it is not uncommon to feel a “zing” down one leg or the other when the needle gets to the right place to extract fluid. I didn’t feel that, but I did feel something I described as “more than pressure, less than pain” when they reached the correct spot.

Here’s where I stress: Do not be afraid to say “ouch” if it hurts. They need to know what you’re feeling so as to adjust what they’re doing. Don’t be stoic and try to get through it. At one point I felt very warm and sweaty and started to feel light-headed so immediately asked for a cool towel to put under my forehead. The supervising doctor told me that was a normal feeling and then monitored me to make sure I felt better and did not pass out. The towel helped almost immediately.

The procedure felt like it took forever, but I think it only took about an hour. Once the needle is in place and they start withdrawing fluid the procedure can either speed up or slow down. That depends on your body and on how your fluid flows. They could tilt the table to make it flow easier. For me, it apparently went quite well. I am an extremely hydrated person and I think in this case it helped. I didn’t feel any pain or pressure at all while this was happening, except for a low-grade headache they told me was normal. I even laughed once at something the supervising doctor and I were talking about.

Once it was done, they cleaned me off again, and since I wasn’t bleeding I didn’t even need a bandage. I rolled off the procedure table onto a stretcher and they wheeled me out into the hall to lie flat on my back to recover, during which time my husband fed me crackers with peanut butter like I was some tiny, baby bird, and held a cup with a straw so I could sip water. (I know, right? He will neither confirm nor deny that he shoved cracker in my mouth whenever he thought I was getting too worked up over something.) I was also told that drinking something with caffeine might help, which was fantastic since by the time all the stress was over I was dying for a cup of coffee. After about an hour they checked on me, had me sit up very slowly, and once I regained my balance they let me go home.

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Written by tldegray

November 12, 2010 at 9:15 am

2 Responses

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  1. This is so helpful and so descriptive! Thank you so much – I always run the risk of having to have this procedure whenever I go into the doctor because they still don’t know what virus exactly caused my PHN so if I have a cold sore they would like to run it occasionally and it is so great to have all of these pointers available… especially the part about the pants! ALWAYS WEAR PANTS! Thank you so much for this… I always have a blanky with me whenever I have to go to the hospital… I may be 32 but I need comfort too! 🙂

    dana

    November 13, 2010 at 9:28 am

  2. I’m glad you think it’s helpful. I wrote it this way because before my procedure I went searching for anything at all that would give me an idea what to expect and found nothing.

    Always wear pants is my major hospital rule! Sweatpants, leggings, whatever I have with no metal and an elastic waist. Those and spandex camisoles make me feel dressed under a johnny.

    tldegray

    November 13, 2010 at 2:34 pm


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