Finally, February 16th came along. This was the day of the lumbar puncture and the first dose of IV steroids. Both would take place at the same neurology clinic I’d visited previously. The LP was scheduled at 10 and the first infusion at 1. I had lab on Wednesday mornings, but I had arranged with my instructor to switch to the Friday morning lab instead. I explained my circumstance to her, and she agreed to let me change without skipping a beat. That was the first of many positive interactions with my teachers that semester.
I was anxious to get the steroid infusions going. My eyesight was horrible, and my headache on the right side above my eye was a killer. I couldn’t read or write without a struggle. I wasn’t able to drive anymore. One evening we went out for food, and we stopped behind a line of cars at a red light. I closed my left eye and looked at the back of the car in front of us with the bad one. I couldn’t see the red brake lights glowing in the twilight just 15 feet from my face. Nothing was there but a little blurry color around the periphery. Mostly I saw the white haze that was now there all the time. Maybe pictures would describe this better… The second image is the closest I can simulate the white haze.
The LP was a different story. I dreaded it. I’d heard some stories about the resultant headache. My parents offered to take me to the hospital and stay with me during the procedure. Knowing this gave me the fortitude to go have it done, and I’m eternally grateful for that.
We arrived at the clinic and worked on a crossword puzzle together until my name was called. All three of us followed the nurse out of the waiting room. There was nothing special about the room in which we landed. I expected a more sterile environment, not a regular exam room. A part of me suspected that the room served merely as a rendezvous point and that we would soon be led to the final destination for the procedure. This was not to be, of course. I guess a needle prick doesn’t require an OR.
As the neurologist walked in, I got worried. He was young. I don’t know about you, but when someone will be jabbing a needle anywhere near my spinal cord, I’m looking for some gray hair and wrinkles. He sat down and explained the process, answered a thousand questions from us, and assured me that he’d done this many times successfully. I was satisfied. It didn’t sound like such a big deal.
While I got in position and prepped for the procedure, my dad went to get water and coffee. It’s amazing how dry a mouth can get when it’s nervous.
My mom stayed with me and stood next to the exam table the whole time. She made sure I wasn’t cold and kept my legs covered with the thin, white cotton blanket. I was lying on my left side facing her. She helped me get my shoulders in the right position.
The doctor sat behind me on a little round stool. He put a large drape over my back and hips with a cut-out for access to my spine. He felt around my lower back to find the right place and sterilized the area. The first shot would be the lidocaine. I guess he just moved the same needle around injecting deeper gradually. This took a couple of minutes. It didn’t hurt, but it wasn’t exactly pleasant either. It felt like the sting of a tiny wasp. The next injection would be the needle that would drain off the CSF.
He told me to take a breath or exhale, I can’t remember which, as he slid the needle in. Okay, wait. Shoved the needle in fits better. Apparently, there has to be substantial force pushing the needle to pass it between the vertebrae and surrounding tissues. It hurt enough to make me recoil. He said with disbelief, “did you feel that?” “A little,” I said. I lied. That needle skidded across bone or some other part of me that didn’t much care for the touch of sharp metal. After some fishing around, he got it into the right spot. This took 5 minutes or less.
For the next 40 minutes, he drained off 24 milliliters of CSF. It’s a slow drip. I’m glad I couldn’t see the needle perched there in my back. Knowing it was there was enough to think about. There was a lot of one-sided small talk during this wait. I asked him questions about his life and education. I wanted to get to know the person that had me in this compromised position. I couldn’t speak beyond one word answers or quick questions. I couldn’t muster the attention or divert any effort away from subduing an all out panic. My primal urges were begging me to reach around and pull that thing out of my back and run for the cave.
Finally, there was enough fluid to run all of the tests. He capped it off, pulled out the needle, and put a bandage over the insertion point. He directed me to stay horizontal there for 45 minutes to an hour and told me that hydration, caffeine and lying down were the best ways to recover and treat the potential headache. He also explained that it would take about a week to get the results. As he stuck labels to the vials, my mother and I marveled over the little tubes with clear fluid in them. It looked like the purest water. All that was left to do was get the samples to the lab. “I’ll carry them there myself,” he said gesturing to the vials, “because this is liquid platinum.”
As the doctor left, my dad reappeared with drinks. He’d been waiting outside the room. I had gotten thirsty, and my back had a dense and heavy ache already. Not what I would describe as painful, simply a constant reminder of what had occurred.
My parents and I chatted and sipped coffee for the next 45 minutes until someone came to tell me I could go across the hall to the little infusion room. I got dressed slowly and headed over. Mom and Dad went out to the main waiting area. The infusion would take an hour.
Someone quickly drew some blood from my right arm and disappeared. Then a nurse helped me get comfortable in the reclining infusion chair and carefully tucked a pillow behind my lower back. She adeptly started the IV in my left arm and programmed the infusion rate into the machine. I watched the saline slip down through the tubing until drops started to fall from the bag of Solu-Medrol. I wondered how my body would handle a gram of steroids.
In the car with my parents on the way home, I was excited. I think we all were. I wondered how long it would take for the steroids to have an effect. I hoped my eyes would pop open in the morning good as new. Deep down, I knew that wouldn’t happen, but I didn’t say that out loud.
Later that night, my husband was dying to see the place on my back. I didn’t want to uncover it. To me, it was a gaping battle wound. I told him to check to see if it was oozing. No sign of that. Reluctantly, I agreed to remove the bandage. When I took the band-aid off and looked at it, there wasn’t even the tiniest spot of blood. Definitely, not such a big deal.
For those curious… this website sums up the LP more succinctly than I can.