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    Old 11-29-2014, 12:06 AM   #1
    Michele0789
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    Lumbar Puncture

    Hi everyone, Those of you who have had LPs will you give me some advice? I thought I would go in, have it done, lay still one hour and go home. The hospital called to pre-register me, ask questions and explain things. She said to prepare to spend the day with them. They will do lab work that day and not begin procedure until they get results that certain things are stable and my blood will be able to clot. This was also the first time a medical professional told me to drink lots of fluids, water and caffeine. She explained the caffeine. After lab results they will do procedure with me laying on stomach. I will have to stay in same position 4 hours. I can then come home as long as I stay in bed and only get up for restroom. She explained this was to avoid continued spinal fluid leaking and "the headache". My first question, is this normally how LP's are done? The following day should I plan on going to work? I am a therapist and sit most of day. What is difference between LP and spinal tap? The experience of just laying there an hour and leaving was 15 years ago when doc thought I had meningitis and did spinal type. Just curious. I appreciate any feedback. Thank you. Michele

     
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    Old 11-29-2014, 05:46 AM   #2
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    Re: Lumbar Puncture

    Hi Michele,

    A spinal tap and LP or Lumbar Puncture are the same thing.

    It appears that wherever you are having it done, is taking extra precautions these days. What they are telling you is actually correct, in the sense that they really SHOULD do blood work to be sure you dont have a clotting disorder- and you really should be laying down for 4 hours afterwards before going home and taking the rest of the day off your feet. Its just that most people dont do this.

    There are two ways to perform the LP- one is curled up in a ball on your side, with your spine exposed to the doctor. The other is laying on your stomache, with your spine exposed to the doctor. Either is the same thing really. It sounds like the person who pre registered you hasnt had either done and didnt know how to explain to you that its exactly the same. Ive had several. I had one doctor lay me down on the table and roll away from him. I had another lay me down across the table, on my tummy.

    As far as laying down for 4 hours. They may be having a rash of people showing back up for blood patches. This is when the blood doesnt coagulate right, a person gets up too soon- does too much and gets the dreaded headache. By keeping you in one place for 4 hours before releasing you, they can actually eliminate that possiblity. By telling you to go home and lay down and only get up to pee (which is correct) they eliminate the possiblity of the headache further.

    The cafffeine and liquids are obviously there to A. counteract the headache and make sure they can withdraw the fluid and you arent dehydrated.

    Although this sounds lousy- I assure you by doing it as they have it spelled out, you WILL be able to go to work the next day! You shouldnt have any complications at all....they are being overly cautious, but its for your benefit.

    Does this help? Really does sound like they are taking every percaution in the world to help you...Im sure it will go well.

    The old days- they took the fluid, had you lay there for 20 minutes and sent you home with instructions to drink lots of caffeine, not to get up for 8 hours and lay flat on your back....its essentially the same instructions, only they are keeping you to make sure you follow them! Youll be fine. Just dont look at the needle!!!
    Best to you.
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    Old 11-29-2014, 07:33 AM   #3
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    Re: Lumbar Puncture

    Hi Michele,

    I had my Lumbar Puncture in the "old days." Mine was done inpatient, I was in the hospital for 48 hours. I had the LP as well as a Myelogram. I had to spend my time in the hospital bed with the bed elevated 90 degrees.

    It sounds like where you are having the LP done is trying to avoid the reasons some end back up at the hospital (ER) after having this procedure. Have patience and take care.

    Last edited by Administrator; 03-23-2015 at 11:27 PM.

     
    Old 11-29-2014, 09:24 AM   #4
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    Re: Lumbar Puncture

    Michele,

    My first LP was as an in-patient because that was require, but that was 1982. Fast forward to 2002 when I had a second one at it was done in the doctor's exam room. I stayed there on my side for an hour or so after the procedure. I then went home and was resting as flat as I could be for 12 hours.

    Yes, you only want to getup for the rest room to avoid the possibility of a spinal headache. Drink some fluids before and definitely have caffeine afterwards.

    If you have had a good solid 12 hours, then the following day you should take it easy as you get back into things. If you work on your feet during the day, you should take it easy and you might take the following day off.

    The spinal tap you had 15 years ago is the same as the LP. The doctor will be taking the same amount of fluid and checking for various mimicries. Remember that the LP IS NOT a specific test for MS. You should think of it as a mimicry elimination test. 85% of MSers who have chosen to have an LP have elevated o-bands, but the elevation of o-bands do not confirm MS.

    Take it easy, follow the instructions, and everything should be fine. For me, the LP in 2002 was much nicer than 1982!
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    Old 11-29-2014, 02:47 PM   #5
    Michele0789
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    Thank you for your replies. It does sound like they are being extra cautious. I prefer that than ending up back in the ER. they told me to start drinking caffeine and water the day before and to continue after. Fortunately, after a MVA and many surgeries I'm fine with needles. When I had first one the doctor showed me the needle. My toughness went away a little while but it came back. I realize this isn't a diagnostic tool. I guess I'm hoping this with lesions and symptoms can get us on the right track in figuring out what's going on. Although they refer to one lesion as a MS lesion and the other as ischemic (dead from lack of oxygen and blood). I am more concerned about the ischemic lesion. Both neurologist can't figure out cause and said they have to wait and see on follow up MRI if this area grows. Sorry to get off topic. It just bothers me that part of my brain is dead. I really appreciate all of you!

    Michele

     
    Old 11-29-2014, 08:02 PM   #6
    MSJayhawk
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    Re: Lumbar Puncture

    Michele,

    Some MSers will develop "black holes" where the area of the lesion is cut off and reabsorbed by the body. Your body has the ability to re-wire and develop new neuro pathways. If you would follow a solid white line approximately 52 miles, you would have the length of your nerves. Along that stretch a single pencil mark would be a lesion. When you see it this way, a single lesion is really insignificant- OR NOT. A single lesion where in the body does not re-wire and bypass it, can leave you with a debilitation which never goes away. There simply is no guarantee.

    If you were to look at my MRI, there would be too many lesions to count, and yet I am still moving, still enjoying life. Yes, it is not like 1977 or 1982, but I am aging too That said, lay aside all your fears and let the doctors do their thing. You need a diagnosis so you can get moving forward and not stuck in limbo land. If you do have MS, no worries- it is not fatal, only chronic.
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    Old 12-05-2014, 11:32 PM   #7
    Michele0789
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    Thank you! Your analogy makes a lot of sense and does put things into perspective. Thank you for sharing. I apologize for late reply. I go through phases when depressed/overwhelmed that I try to disconnect from the world. I'm working on not doing that so much.

     
    Old 12-06-2014, 08:23 AM   #8
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    Re: Lumbar Puncture

    Michele,

    Not to worry. Did you or have you experienced the depression or being overwhelmed prior to all of this? Depression can be a bane to some MSers, but it can also mimic MS. Being overwhelmed can too. Your doctor should be made aware of these issues. You might also find counseling to learn how to better cope such as ways to channel these feelings into a positive outcome. Exercise is also good, but if you have MS, it should be low impact and done in moderation.

    I withdraw to my "man cave" where I can recover from stress and relax my brain. When I start to mix words, slur, or stutter, these are signals that my mind needs a break. Ignoring the signal only worsens the problem and exponentially increases recovery. When I notice the first signs, I take a break.
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    Old 12-07-2014, 09:11 PM   #9
    Michele0789
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    I have had problems with depression most of my life. I see a psychiatrist and therapist regularly. I need to practice taking better care of myself...giving myself permission to take breaks instead of pushing myself and making things worse. This is a difficult mindset for me to change. I recently started my own business right before symptoms started. So, I am trying to change my thinking.....that although taking a break and seeing fewer clients one day.....it is better than pushing myself and having to be out an entire day or more. It's challenging to balance things.

    Last edited by mod85; 12-08-2014 at 04:09 AM.

     
    Old 12-07-2014, 10:33 PM   #10
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    Re: Lumbar Puncture

    Michele,

    Starting your own practice is not without stress. The stress could have been sufficient to trigger a cascading reaction. If you are seated and working in a calm environment, I should think that long term you should have a good career. We are often the hardest on ourselves.

    Re-setting my benchmark for normal helped me eliminate the grieving process. I had about a 3 day pity party, and then I got back in the game of life. I have re-set my benchmark several times over the years.
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    Old 12-07-2014, 11:09 PM   #11
    Michele0789
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    My mother also passed away at the end of march, a week later the business I worked for...for 8 years closed and I started my own business. Not long after is when symptoms started. My PCP was very thorough with lab work and we did discuss it being related to stress, my psychiatrist thought it was stress, my neurologist, who also treated my mom thought it was stress and initially didn't order test. When he did order MRIs all doctors were shocked when 2different lesions showed up. I was also surprised. I think the stress definitely exacerbated my symptoms. I do sit most of day.....calm not all the time. I do need to work on creating a new baseline and setting and sticking to new boundaries I set for myself. My greatest fear is that the lesions will affect my cognitive functioning to the point where I am not able to work. That is on my list to discuss with my doctor. Thanks again for all the support!

    Last edited by mod85; 12-08-2014 at 04:10 AM.

     
    Old 12-08-2014, 08:48 AM   #12
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    Re: Lumbar Puncture

    Michele,

    Combining the two stress events you experienced, I would say that was a major trigger! The holidays can cause a renewed grief too due to your mother's absence. December, for me, is a seasonal trigger and I usually am confined pretty much to rest for a week to 10 days.

    Cognitively, for me, I am better than I was in 2002. When I pulled my youngest out of school to home school him I improved my cognition. I found that mental exhaustion is a hurdle, but it is avoidable or more properly, something that can be eliminated with mental rest. Most of my cognition problems are stemmed from multiple stimuli. If I am speaking to one person without other stimuli present, I can stay focused. When I teach a Bible Study class with discussions, I last about an hour before the signals tell me to rest.

    When I taught my son, I took a two hour break between morning and afternoon classes. I did my heavy mental work in the morning (Mathematics, Science, etc). In the 3.5 years it took him to complete his schooling, I know that cognitively I was able to grow leaps and bounds. As he was underage, I chaperon him on campus. I continue the cognitive exercises, but only have a slight understanding of his subject matters. LOL.

    There are some brain exercise games which were developed and have objective data to back up the results. I play these games on my iPod and on the video console at home. These games work, I think, at least for me. In Japan they were developed and studied among the elderly in nursing homes.

    If you can maintain a balance, other than the possibility of fatigue, there really should be no reason to have to stop your work. As your business grows, you should delegate things like scheduling and accounting, and insurance etc to someone else and focus on your main job. I was a GM when I had to take disability and while I had employees under me who handled many tasks, I had to ultimately handle them through audits and reviews.....I know I could not do that again. Delegating chores/tasks to a level where I could manage was liberating.

    Part of it was having contingency plans which I wrote when I was having a good day. Depending on how I am doing, I have my priority "to do" list. I found that I do best when I have a task which I can fully accomplish rather than having many things which I can barely budge.
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    Old 12-09-2014, 08:49 AM   #13
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    Re: Lumbar Puncture

    I came here to report on my LP and give you some advice but I see that's no longer needed! I will say that I was a nervous wreck before mine and I had a really hard time during the procedure ONLY due to being so anxious. I took two Ativan before the procedure (which proved to be too much for me!) and I think it just made things worse because I had to fight against the feeling of being altered mentally as well as the procedure. It didn't' relieve my anxiety, just made it harder for me to cope. Live and learn, right?

    As Jayshawk said, the info your hospital gave you is good. At the hospital I had it done at, they had you just lay there for one hour, then go home and stay laying down for the rest of the day. I slept for the rest of that day and most of the next (thanks, Ativan!) and followed the directions to stay flat to a T. I didn't get any headache.

    The procedure itself was pretty close to painless. I felt the freezing which was an interesting sensation but not painful. And when the actual needle for the LP went in, I just felt a bit of pressure. Seriously I've had more painful blood tests in my arm before.

    Good luck with yours, I am really happy I did mine because it helped me rule out some other things.

     
    Old 12-12-2014, 11:41 AM   #14
    Michele0789
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    I appreciate everyone's support! I just met with neurologist and I am beyond frustrated. I evidently had a "traumatic puncture"...leading to blood in fluid and contaminated results! He wants to repeat LP second week in January...explained we need to wait to make sure there has been time to replenish the spinal fluid. The results he had combined with MRI etc would lead to a MS diagnosis. I do respect that he doesn't want to diagnosis me when he can't be sure results are accurate. He is going to consult with my first neurologist who referred me to him and a MS specialist. And I get home to the bill from contaminated LP is in my mailbox!

     
    Old 12-12-2014, 11:44 AM   #15
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    Re: Lumbar Puncture

    Oh no I'm really sorry to hear that! I was lead to believe that at first my sample was unusable and I was SO mad. It turned out to be fine but I remember feeling so upset that I went through all that for nothing. It is however always something that can go wrong. I'm sorry it happened to you.

    I hope your next one is better and equally pain-free.

     
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