Spinal Tap

This past week, I had a Continuing Professional Education (CPE) seminar. The credits earned from which are necessary to remain in good standing with my CPA license. This particular CPE was held at a hotel in a Boston suburb which I, and apparently a lot of other attendees, had never before been to. The hotel from the outside was massive and there was an event board front-and-center in the lobby which was conveniently silent to the room I needed to find. It seemed a lot of others were also noticing this, as there were about ten middle-aged men standing around said board in silence, just staring at it. 

"Excuse me?" I said rather audibly to a passing hotel worker. "Which way is the accounting seminar?"

"All the way down the hall on your left," he replied.

In a flash, all ten men rushed to cut in front of me towards the hall on their left, speed walking to the room I had just been given directions to as if asking for help was their idea.

How badly I wanted to yell after them! "YOU'RE WELCOME!" But I didn't -- I decided to save my sass for another day.

On the long walk down the hall, I got to thinking about why so many of us have such difficulties asking for help or advice. I thought a little further about my own recent experiences and noted this seemed to be even more difficult to do when it came to medicine or our health. For instance, I was so nervous to have my spinal tap done yet could only muster the confidence to ask my friends for advice -- not the doctor or nurse. Worse, I was hesitant still to ask follow up questions to the minimal advice that I actually got. Therefore, in hopes of helping someone out there who is also too timid to ask, I am going to walk you through my experience* with a spinal tap.

Upon arriving to my spinal tap appointment, which for me was an outpatient procedure, the nurse at my neurologist put me in a large room with two chairs and a hospital bed. I brought along my husband because I am, in fact, a big weenie and the extra chairs seemed to be there for this very reason. The nurse asked me to undress and put on a hospital gown with the opening to the back and told me I could leave my underwear on if it made me more comfortable, which it did. I was also thankful to have shaved my legs at this point (don't laugh, it's winter!) as my jeans were a no-go. My nurse asked if I wanted a blanket, which I originally declined, but thankfully she knew better and brought it anyway. Never turn down a blanket in a hospital setting! Even if you get sweaty when you worry, like me, you will eventually be freezing. 

Next, my neurologist came in to give me some papers to sign, to talk with me a little about what I could expect after the procedure, and to let me know that he would be performing the spinal tap himself. He had me sit on the bed facing away from him and pushed on my hip bones and spine with his hands in order to locate the exact point the needle would be inserted. He then marked a few spots on my back with a marker. As pathetic as this is, the pressure on my hips and back was already making me queasy -- for some reason, I don't typically feel queasy from pain but only from being examined in a medical setting...I know, I'm a weirdo. Anyway, at this point I asked to lay down on my side and told him I was feeling lightheaded. It is important to note that usual me would NEVER have spoken up about this -- I would've just dealt with it. However, the fear of passing out with a giant needle in my back was greater than the fear of sounding like a wuss -- so I said something. Luckily, the doctor said I could lie down on my left side and that he could do the procedure with me laying down as well as sitting.

If you get queasy easily, it's probably best for you to stop reading now :-)

I told the doctor that I am an over communicator, and I like to know what's going on at all times (see previous post about perfectionism, type-a-ness, etc.). This was important for me because I obviously couldn't see what was going on back there. He let me know that he was going to numb the area with smaller needles and that it might sting a bit. It did sting, but only mildly.

Now with the area was numb, the doctor let me know that he would be inserting the larger, hollow needle and that it sometimes took a minute to get it to where it's supposed to be. He also noted that it would be important for me to let him know if I feel any "zings" down either of my legs, as that means he bumped in to a nerve and knowing which leg the zing occurred in would help him reroute to the correct location.

I honestly didn't feel the needle itself going in at all -- thank God. I did feel a good amount of pressure, which was unsettling, and some of those "zings" the doctor talked about, which were super weird and uncomfortable. I spoke up about the zings and he was able to get the needle in place within a minute or two at which point I felt a small "pop". These few minutes were probably the hardest part of the entire procedure. Although I didn't feel pain, per se, I did feel extremely uncomfortable and was death-gripping husband's hand. Important note -- I once again would not have spoken up at all about these zings if the doctor hadn't asked me to. I would have figured they were part of the procedure and just something I had to suck up and deal with. 

At this point, naive me thought I was home-free. "How long does the needle need to stay in," I asked. "About ten to fifteen minutes time is needed to collect the fluid," the doctor said. WHAT? I thought. I can't make fifteen minutes with this thing in my back! I asked husband and the doctor to talk to me. "Tell me a story," I said. And they did -- we talked about pizza and ice cream and migraines and med school and why the heck Massachusetts is so expensive and before I knew it, the fifteen minutes were up. I was warned before the needle was removed from my back but didn't feel a thing. 

I was then asked to lie on my back for thirty minutes on the hospital bed. It was at this point that the blanket I was adamant about not wanting came in oh-so-handy. I asked the doctor what the purpose of laying on your back was and he told me it was a great question. Apparently, the field of medicine is superstitious, you see. Years ago, neurologists thought that laying on your back after a spinal tap would decrease the subsequent and dreaded low-pressure spinal headache. However, this thought has never been proven and the practice is followed more out of superstition than factual medical evidence. After thirty minutes were up, I got dressed, made my follow-up appointment, and was treated to ice cream by hubby. I'm glad hubby was there because this procedure is not really something you want to drive yourself home from.

For the first 24 hours after my procedure, I felt great, cured, like I could take on the world! Around hour 24, I started to develop a headache that worsened when I stood and got better when I lay down. This type of headache is known as a low-pressure spinal headache and is caused by the removal of some of the spinal fluid. For the next 26 to 48 hours, the headache became so bad that had to call out of work and could not be in anything but a horizontal position. For a six hour span within this time frame, I couldn't eat or drink anything, even water, without it coming back up. After hour 48, I felt leaps and bounds better and could walk around the house or even take a short drive to get groceries. I took it easy through the weekend as my lower back was pretty sore and by the one-week mark, I was feeling as normal as I could remember feeling -- I had no residual side-effects from the spinal tap and my eye and head problems were subsiding, with the help of my new medicine. 

I'm hoping that you never have to experience a spinal tap but if you do, I'm confident that the above will help you navigate it. Don't ever be afraid to speak up about what you're feeling or to ask questions, whether in a medical setting, at an accounting seminar, or during whatever else life throws your way.

*I am definitely NOT a medical professional of any type and this blog entry is meant to be purely anecdotal.