Lumbar Puncture - the good, the bad, and the very painful

It's been a month since I had my lumbar puncture. It has taken me a while to feel "normal" again - although my normal and a healthy persons normal are two very different things.

I wanted to get my experience about my LP out there because if one other person can learn from my experience, then I feel like my experience was worth it.

Let me start by saying the lumbar puncture itself went great. I didn't feel a thing. It really was one of the easiest tests I've ever had done. I would even say it was easier than a CT, just because I didn't have to take off all my jewelery. I was having a lumbar puncture to rule out Pseudotumor Cerebri, aka, Idiopathic Intracranial Hypertension. IIH is increased spinal fluid that can trigger Migraines. I had quite a few of the symptoms: no trigger Migraines, tinnitus (ringing in the ears), headaches or Migraines upon waking, preventives that did not work, or worked for a short time, neck and shoulder pain, pain behind the eyes and nausea.

So I have the LP which, as I stated went very easy. Actually, the test itself was fantastic. I get back to my room feeling great. I'm laying down, which I was told I would have to do for at least two hours until they would release me (I did this as an outpatient in a hospital, which is where most of these tests are done).

I was feeling fine for the first hour or so.....then the pain started. The head pain was not like my typical Migraine or Tension Headache pain, this was different. It felt like the cloggy feeling you may experence when in a plane - but to the extreme. I let the nurse know and she wanted to give my Tylenol - yeah, Tylenol. I don't even take that for a TTH, much less THIS! I thought it would pass or not get worse. The nurse left and I took a Vicoprofen that I had with me.

On the way home (the hospital I went to was about 45 mins away from my house), the pain increased. I had Shawn stop for a bagel and some tea, so I could at least eat for the first time that day (it was about 1 or 2 pm by then) and also have some caffiene. My doctor had said caffiene may help with the spinal headache.

I rested the rest of the day - the Vicoprofen did nothing. The next day, Saturday, I felt a little bit better - at least for a while. By Sunday, I could not lift my head off the pillow without getting sick. The pain in the back of my neck and head upon standing was so intense, I would vomit almost immediately.

I spoke with a friend of mine who I knew had some difficulties with this test and she said go to the ER and get a blood patch. I called my doctors office and spoke with the covering doctor, who said my doctor would be doing rounds in the morning, and if I could wait, go to the ER first thing Monday.

Monday morning we were back at the hospital. I could hardly stand or walk and the only way I felt halfway comfortable was laying down flat.

The doctors took me in right away - pretty much as soon as I was checked in. I got some Zofran to start with an IV and went up to have the blood patch. For those who don't know, a blood patch is when they go back into the spine, just above where the LP was done, and inject your own fresh blood back into your spine to help stop the spinal fluid from leaking. Most of the time your body will heal quickly and close over the hole from the LP, but if not, a blood patch can fix that.

I was told to sit upright with my legs hanging over the bed. I crouched over and hugged a pillow as the doctor numbed the area with lidocane. By now, I had an IV in my right arm and the doctor was taking blood from the side of my left arm. He injected 20 CC's of my blood into my spine and said I may feel pressure when he does this. I felt the pressure, but also relief. My head was feeling better, or so I thought.

Again, I though I was "good to go". I returned to the ER - now taking 2 full bags of saline in less than an hour and a half. I was so dehydrated from getting sick all day, every day, for the last 2 days. I went home and rested thinking I would go to work on Tuesday and everything would be fine. Wishful thinking!

I went to work on Tuesday - even drove myself! I felt ok in the morning, but by about 11 a.m. I could tell I should not have attempted working. I was bent over my desk between trips to the bathroom to get sick. I called Shawn to pick me up. I stayed home on Wednesday and again thought I was o.k. to return to work on Thursday. Wrong again! I had called my doctor during all of this - and spoke with a covering physician. I did speak with my doctor on Thursday, and by that time, I was out of my mind. I was hysterical and didn't know what to do. She told me "go home, stay in bed, and don't even think of moving until at least Monday". And that is what I did.

My doctor also called in a prescription of Prednisone, to help get rid of the spinal headache. I was to be on a Prednisone taper for about 16 days, taking one less pill every four days until there were none left.

By about Wednesday that week, a week and a half after my lumbar puncture, I was finally starting to feel like I was human again.

I wanted to get my story out there to let anyone who has similar side effects know - if you feel as bad as I did after your LP, call your doctor and get a blood patch. Don't wait like I did. I wish I had known earlier, I could have saved myself a lot of pain and money by acting earlier than I did.

So I'm sure you want to know the result of my LP as well, right?

As it turns out, I don't have Pseudotumor Cerebri. My opening pressure during my LP was only 14. Even with the Diamox that I take, that is on the normal side. This was a disappointment to me at first. I thought that having IIH that it would answer so many questions about my Migraine Disease. I thought if I only had IIH, then I can finally treat my Migraines in a different way and know what some of the cause of my Migraines were.

Although I am happy that I don't have IIH, I knew I had to have this test to know for sure if I did or not. The only way to be tested for IIH is with a lumbar puncture.

I do not regret having this done. I would do it again if I had to, but maybe would be quicker and realizing my symptoms were not the norm for the test. Only about 10% of patients who have an LP get a spinal headache. It really was hell for a week and a half, but at least now I know 100% with no question, that I do not have Pseudotumor Cerebri.

Cymbalta and a night in the ER

My neuro and I discussed a new preventive Migraine medication for me last week. We decided on Cymbalta. I thought great!, Cymbalta is weight neutral, if not that, it may help me lose a few lb's....low libido side effects, and can help me to not have Migraines! Where to I sign up??!!

So Dr.G gave me a nice supply of samples, a months worth to be exact. I thought this was great. I went to dinner at my in-laws that night....had a great night, came home and took my first dose of Cymbalta. I went to sleep with no problems at my normal early bird bed time of 10 p.m.

Then everything changed. I woke up from a dead sleep at midnight and could feel the color drain out of my body. I had the worse nausea I've ever had in my entire life!!!! I got up, ran to the bathroom to get sick and didn't leave the bathroom for four hours straight!!!

I woke up Shawn at 4:45 in the morning to have him take me to the ER. By this time, I'm in some sorry shape. I was in the "bargaining phase". I would have given up my right arm at this point just to stop vomiting.

Got to the ER (one that my doctors work for) and there was no one in registration. Being that I know my way around, I walked into the ER and just asked for help. I was stark white. Now for some of you who know me, you think "what else is new, you're pale!" But no, this was different. I had NO color. It was almost as if my freckles were gone too!!!

I get to my hospital bed and Nurse Julie comes in to take my vitals and info that I didn't get to give at registration. In goes an IV - blood work, then saline. Everything came back normal. I get 2 doses of Zofran and I'm out the door.

I get home, get a little rest.....call my boss, the insurance company and my doctor that scripted the Cymbalta. The nurse says Dr. G will call me back.

Ten minutes later, the nurse calls me back and says Dr. G says cut the pill in half and try that. Um, hello....I was just up all night violently ill from this drug and you want me to keep taking it!!!???!!! Then I say I can't cut it in half, it's a capsule with little beads or powder in it. The nurse goes to double check - yep, cut it in half.

I was shocked! The packaging says "Do NOT crush, split, open or bite. Swallow Whole". So now I don't know what to do. I have not taken the Cymbalta since, and have called the pharmacist who also says not to split it.

Since this happened, I also got curious to see if anyone else had this type of reaction. OH YES! I found a forum of sorts that all the drug reps can go and chat......the Eli Lilly reps, the company who makes Cymbalta - well the reps nicknamed the drug CymBARFa because of it's nasty little side effect.

No wonder I would lose weight on this drug - I can't keep anything down!!!!!

So Cymbarfa, oops! Cymbalta - is not the drug for me. I am scared to try it again because I don't want to end up back in the ER.

I am back with no preventive for the time being and also some wacky ear infection (well, the dr. said it's only fluid but gave me an antibiotic anyway). Since this happened I've been having odd Migraines. They are not ping ponging (switching sides each Migraine), they are all on the right and the pain goes down to my shoulder. I really hope the ear issue is the reason behind this and that it stops quickly.

Also, I should mention - there are a lot of people out there who get great relief from Cymbalta, both as a Migraine preventive and as an antidepressant. I'm just not one of those people.

What you do when it all comes crashing down.

So I had a great run this time. I went 17 days migraine free. I was not even done with my "migraine euphoria" post yesterday when I felt the beast start to dig it's claws into my head.

I have to say, it was not as bad as I thought it would be, head wise....but the nausea - oh man - all day long!

The one this I was really upset about was I actually had plans last night - yes, me - LEAVING THE HOUSE plans!!! Shawn and I still went out....my migraine had calmed down by then, but I still had the side effect of my postdrome.

Ok raise your had if your flesh aches after taking Frova!!! I swear it is the strangest side effect ever for me, I can take it considering that the Frova attacks my head and knocks out that migraine in a matter of an hour, but why does all of my flesh hurt after????

Sounds strange right?? It used to just be the back of my arms ached - now I noticed it's all over that I ache after taking it. I used to only get achy if I had to take two doses, now I notice it on one.

Please dear God don't make the Frova stop working!!! That is my biggest fear!!!! I can take the flesh pain!!! Yeah, all of my skin, and under it like the meat on my body aches when I touch it....I don't know...it's gone today and so is the migraine so I'm happy about that.

Ok, well onto some other exciting things. Yes, I'm going to plug some of my friends here so consider yourself warned!!!

We went to see our friends Insouciant Play last night - you guys please check them out - they are really good!!!! We had such a great time!!!

Also - My husbands band Annoying Customer is going to be heading into the studio to do some recording next weekend!!! Yippee!!!! I am so excited about this!!! Check them out too!!! I am especially fond of their new song "Mongoose"!!!! So please take a listen to both of them!!!

And last but certainly not least - we have Daina over at Somebody Heal Me Who announced her blog carnival yesterday!!! So for all who are interested please check out her site for details. The topic this time around is "strategies for coping with headaches and migraines". The deadline on this is midnight April 11, 2008 - so if you are interested, please go check her blog out for more info.

Ok kids, that about wraps it up for today!!!

Until next time - take care of yourself and be kind to each other.