rblog

Today I went to see Dr. Emily Ho, MD, PhD for a lumbar puncture. Lumbar Punctures, also known as Spinal Taps, are used to examine the cerebrospinal fluid that surrounds the spinal cord. From the web - "High protein levels in the fluid indicate damage to the brain, the spinal cord, or a spinal nerve root, which is the part of a spinal nerve next to the spinal cord, but they do not indicate the cause of the damage. Abnormal antibodies in the fluid suggest multiple sclerosis. Low sugar (glucose) levels suggest meningitis or cancer. Blood in the fluid suggests a brain hemorrhage. Many disorders, including brain tumors and meningitis, can increase the fluid's pressure."

In my case, we are looking for MS antibodies as well as the high protein levels that would indicate damage to the spinal cord. The fluid obtained from the LP would not indicate the cause of the damage, but it would give us an indication as to where to continue looking (and imaging).

So, I showed up, feeling reasonably calm for someone who is about to have a needle inserted in their back and knowing that if they move they could sever their own spinal cord. But hey, if pregnant women having contractions can do this (an epidural is just a spinal tap in reverse, although faster) I can manage.

I didn't even make it through the anesthesia! The anesthesia (xylocaine, or Lidocaine) is injected as a series, each going a little deeper - just to make the LP more comfortable. After the second, I began to get dizzy, I felt nauseous, and my ears were ringing. I then began to convulse a little, so I shifted to a lying down position and within seconds I felt much better. My face was pale and my blood pressure was low, but after a bit of a rest, I was much better. After an hour or so, I was released - went to Starbucks, had an apple fritter and felt wonderful (best apple fritter ever).

What happened is not entirely clear - some possibilities:
* Reaction to the xylocaine - however, I am pretty sure I have had this for dental work
* Vasovagel reaction - basically an anxiety reaction causing a blood pressure drop. Fits the symptoms but I didn't seem overwhelmingly anxious to me. But what do I know, I am only me :) .
* Reaction to the iodine uses to clean the area - But I think they use iodine all the time when I give blood - but perhaps they don't.
* Blood flow cutoff due to the position I was holding my head (in a very bent over position) - I replicated this in the gym (not to the level of convulsion though), but it is my own personal theory.

So, the next step is to reschedule the LP but with a different anesthetic. Ugh :).