My First Lumbar Puncture (Spinal Tap)

The weekend that just passed I was in the hospital Immediate Admissions Unit as I had been declining quite rapidly last week and the final straw was waking up with an EPIC headache. Worse than any I have ever had and I have had some choice migraines that come to mind.

Among other tests they performed a lumbar puncture, a spinal tap in the US of A) to check cerebrospinal fluid pressure (CSF) pressure, diagnose infections such as meningitis, and check for the presence of blood in situations such as subarachnoid haemorrhages. They do this by putting a needle into space between two vertebrae and then collect fluid in vials for testing. Similar to the way they take blood from a vein but a bit more extreme.

My mum has idiopathic intracranial hypertension, meaning the pressure in the fluid around her brain is generally at high pressure, so I am very aware of LPs – what the procedure entails, possible after effects and what to expect. Mum now has a lumboperitoneal shunt that continuously lowers her pressure without the need for a lumbar puncture, and it works great for her.

Anyway, I’m waffling. Back to my lumbar puncture.

They had to double check my MRI’s a couple of times as the way they find the space for entry of the needle is checking spinous processes and finding the area they want. However, my back as you know has some metalwork between L5 and S1 as well as Spina Bifida Occulta on L4, L5 and S1, so I lack spinous processes on those vertebrae. Once they were happy with the positioning, we were ready.

I lay on my side with my legs curled up in a modified foetal position but with my back straight from the skull to tail. Oddly comfortable. The area is sterilised, and then they mark where they are going for it.

There is local anaesthetic injected to the area both on the surface and deep to the spine. This is stingy and uncomfortable. I’m not going to lie, it hurt, but it is over quick.

Once the local has done its magic the needle is inserted. This bit was odd. Pressure like they are trying to push you along the bed and my left leg twitched like I was in the River Dance, but you need to stay still – I realise this sentence makes no sense – trust me it is the same when it is happening! Trying to remain still but your leg is shouting “No! I will do an interpretive dance of my feelings!”

Then the doctor drained the fluid he needed from the outlet. This bit is fine. Not sore or even feeling the pressure. I just lay perfectly still and occasionally answered questions. Oddly about 5 minutes into this my headache started to ease a little. Bonus!

The needle was then removed, again pressure and uncontrolled dancing, and it was done!

Afterwards, I felt so much better. Clearer thoughts and less pain. I had to lie flat for 30 minutes then gradually sit up over the next 30 minutes.

Overall the experience was positive. Not much pain, a little uncomfortable, very odd when the Dr can induce limbs to move on command. Since the procedure, my headache and eye pressure have entirely resolved. I still have a niggling headache at the back of my head from my craniocervical instability but no other headache. It is insane.

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