Tag Archives: Spinal Tap

The wonderful amazing blood patch!

As I said in my last post, I was one of the lucky 40% that get to experience skull splitting headaches as an aftereffect of my spinal tap.  Basically, either the puncture hole in the dura is still leaking, or they just took out so much fluid that the fluid pressure inside the sack is too low.  This includes not just the spinal cord but all the way up to your brain as well.  When I laid down, I was fine.  But when I would sit or stand, within a few minutes I would have the most intense and painful headache that I have ever experienced in my life.  The fascinating thing was that when I would lay back down, the headache disappeared almost instantly.  If only all headaches could be relieved so quickly and simply.

After the spinal tap, they suggest that you lay around and rest for 24 hours.  With the headaches I was told to take another day and drink a lot of strong coffee.  It didn’t work.  Several days into it, I was still getting horrible headaches anytime that I would sit or stand for more than a few minutes.  Doc Fundamental suggested a blood patch.

I was able to get away with working from home, which meant from bed in this case, without anyone knowing about the procedure.  It wasn’t worth having to come up with answers as to why I needed a spinal tap.  But I wouldn’t be able to work from bed forever, so I certainly hoped that this blood patch, whatever it was, would work.

The blood patch is pretty simple but ingenious at the same time.  First, they stick a needle in your arm to drain the blood out.  Then, they stick a needle into the cavity in your lower spine where the dura is punctured and pump your blood into it.  This puts pressure on it, stopping the leak.  Additionally, as the blood coagulates it forms a patch, sealing up the puncture hole in the dura.  Eventually the body absorbs back the blood.  Hopefully by then, the dura has healed.

It worked immediately!  Like a miracle.  I took it easy the rest of the day, but that was the last of the headaches.

This is Spinal Tap – A lumbar puncture and multiple sclerosis

A spinal tap, also called a lumbar puncture, sounds scary.  However for most people, it is not anything to be particularly worried about.

Along with blood tests, your neurologist may order a spinal tap when they are trying to diagnose a neurological disease.  In my case, Doc Fundamental performed the LP right in his office.  The doctor will anesthetize the area around your lower back and have you sit on the table, leaning forward.  He will then insert a needle into your spine, puncturing the dura mater and draining some of the spinal fluid from inside of it.  The dura is a tough sack encasing the spinal cord and brain.

When someone has multiple sclerosis, it is believed that their immune system attacks the myelin coating on the nerve cells.  When this happens, the breakdown of the myelin creates certain antibodies as a byproduct.  The antibodies don’t stay in your spinal fluid for too long so if the spinal tap result comes back positive for these antibodies, it indicates that your immune system may currently be attacking the myelin.  In my case, the results were not off the charts and horribly abnormal, but they did show the presence of the antibodies.

A positive result  by itself does not mean that you have MS and a negative result does not clear you from it.  There are significant type 1 and 2 errors for you stats folks.  It is just one more piece of evidence leading towards a diagnosis, one way or the other.

Post puncture they will have you lay still for a couple of hours.  You will be instructed to drink a lot of fluids and to take it easy for the next 24 to 48 hours.  However, a lucky 40% of us develop severe headaches when we sit or stand upright after the procedure.  Unlike the EMG, I’m not sure that this one does beat a sharp stick in the eye.  Thankfully, there was a creative treatment and that will be the topic of my next post.