Friday, 11/11/11 was not a “lucky day” for me personally. I got to experience the joys of having a cerebral spinal fluid test (CSF), or as it is more commonly know, a lumbar puncture or spinal tap.
If you have never had one, I don’t recommend the experience. Not that it was particularly painful, but in my case it was just time-consuming, and a tad bit embarrassing. I will explain.
When you go in for a lumbar puncture (LP) the first thing they do is spend 20 to 30 minutes explaining the procedure, and what all it is testing for. There are several disorders that a LP will test for, and some results will be back in a few days and others take a couple of weeks. The doctor explains the risks, possible infection, headache, paralysis and then they have you sign a consent form.
After the explanation, you get to strip down to the waist, and then skooch down you pants to where you look like a plumber working under a sink. For some that would be okay, for others, such as myself, it’s not a pretty sight. Then you get to lay on a table facing a wall with your knees pulled up to your chest and your chin tucked in, the famed fetal position.
The doctor then makes you backside look like Snookie, covering you in layer upon layer of poviodine-iodine to disinfect the area. Then come the needles. I for one HATE needles. I was stabbed through the hand once with an ice pick, and would take that any day over getting a shot with a needle.
First comes the lidocaine to numb the area. They do it slow, so the numbing spreads to the deeper tissue, this allows the doctor to go deeper into your back without causing you to come up off the table. Once you are numb from skin to spine they take a 20 gauge needle and insert it into you lower part of the spine and collect the fluid. Excluding the caveats that they go through prior to the test, the entire procedure should take less than a half hour. But, since it was me, that was not the case.
Dr. Dave, the resident that did the LP, was a really sweet and wonderful young man. Probably in his early 30’s and in his third year of neuro residency, he assured me that he had done numerous LPs and this wouldn’t take that long. He started with the lidocaine, and slowly the area of my lower back numbed. Then came the harpoon, and about two-thirds of the way to the spine I came off the table. More lidocaine. Lots more lidocaine. Then another try with the harpoon. This time I all I felt was pressure, and he pushed it in further to try to tap the mother lode. No luck.
Okay, since we didn’t get anything there, let’s try another space in the spine. More lidocaine and another stab at it. Again no luck. About this time Dr. Nick, one of the supervising doctors in neurology came in and asked it if was okay if some med students sat in and watched. So there I lay with my “assets” hanging out like some middle-aged plumber, and three med students getting to watch all of this. Of course it couldn’t be three guys, nope. It had to be two very cute young females (you know the types you would see in some TV medical show) and one guy (it was kind of like when I had my vasectomy, but that is a story of another time). Dr. Dave tried again in a different spot, again with more lidocaine and then the big stick. No matter where he put the needle to draw fluid, he couldn’t seem to hit the right spot. He did hit a nerve, and my left leg started to tingle like it was getting zapped with a 110 current.
After about an hour of hit and miss, okay – miss, Dr. Nick came in, and struck oil on the first time. They collected the four vials of fluid, cleaned me up as best they could and stuck a bandage on the hole. Dr. Dave told me lie there for a bit, so as to not get a headache, and he packed off my brain juice for the lab. After about ten minutes Dr. Nick came in and said the magic words, “Go home.”
They drew some blood, you would think that the brain juice would have been enough, and sent me on my way. By the time I got home, four hours after the start of my adventure, I felt like crap. My left leg felt like it had disappeared and my head was pounding. So off I shuffled to bed, and slept for four or five hours. When I got up I still had a headache and no leg, but it wasn’t near as bad as it had been.
The numbness in the leg finally started to dissipate on Sunday, and the headache was nearly all gone by Monday morning. I know that, hopefully, this test will bring some answers. But I really don’t want to have to do this again.
On a humorous side, as I lay there on the table, putting my best side forward, I found myself tapping on the wall. When I realized what I was tapping, all I could think was, “I hope there’s no one on the other side, otherwise they are going to wonder what’s going on.” What was I tapping? Morse code – dot dot dot, dash dash dash, dot dot dot. Here’s the Morse Code translation table, see if you can figure it out.