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Patched Up

by Tom on November 28th, 2009

On Tuesday I wrote to Dr Norman to describe the litany of symptoms that have been ailing me for the last few weeks; that evening he responded that he would have some extra time Wednesday morning before his first patient, and that I should come by to see him.

His suspicion was that my correlating digestive disfunction with the headaches was merely coincidence, and that the nature of the headaches indicated that the lumbar puncture sites hadn’t sealed up completely. A slow, tiny leak of spinal fluid can cause a decrease in pressure around the brain. The brain depends upon the spinal fluid pressure to stay in the right position. If the support is weakened there can be all kinds of pain, described as a post dural puncture headache. Since it had been constant for the last few weeks it seemed that it wasn’t intending to heal on its own. For some faster relief, Dr Norman called in some favors and assembled a team that could perform an epidural blood patch later that day.

But first, he scheduled another MRI just to make sure. He was “selling his soul” to arrange all of this stuff same-day, and I really appreciate it.

After the consultation with Dr Norman I went over to Audiology to get some data on the significance of my hearing loss. My left ear is pretty much unchanged from a month ago, but my right ear shows significant hearing loss in ranges above 2kHz. High-pitched noises don’t make it into my brain so well right now, and I’ve got a constant high-pitched whine coming from inside my head on that side. It’s like a stuck pixel on a monitor; the sensors that detect high-pitched sounds are stuck in the “on” position, so they don’t actually hear real sounds. I’ll be seeing someone again soon to learn about the chance that it could improve again. That would be nice.

Next was the MRI, which was just as (honestly) relaxing as I remember. My favorite scan noise sequence: “bzz bzz, bzz bzz, bzz bzz… click click click click click… bzz bzz, bzz bzz, bzz bzz… click click click click click click”. I think I want to write a song with that as the base, but maybe not with the MRI machine as the instrument.

MRI results were clean. Still have a brain, and nothing bad is hanging out in there.

After the MRI was the procedure for the blood patch. The doctor had me lay on my side and tuck my knees up toward my chest to give my back a good arc shape. He then injected some lidocaine to numb the needle’s path.

There were actually two procedures performed: the first was a normal lumbar puncture and collection of a CSF sample, just like I’ve had before (but with my laying on my side instead of sitting up). For the lumbar puncture, the needle passes through the epidural space and them through the tough layer of dura mater that surrounds the spine.

The second procedure has the needle actually stop in the epidural space; the same place that is used for delivering epidural anesthesia. In this case, once the needle was placed, a nurse placed an IV in my arm and drew about 5cc of blood. The blood was then injected into the epidural space, where it helped restore more normal pressure in the CSF and started patching any holes in the frequently-punctured dura mater.

After having me lay back for a few minutes I got up and walked out on my own two feet. There was already some relief to my headaches, and in the last day they’ve abated even more!

Now I’ve just got to make sure that these hints of Bell’s Palsy (big ear pain, slight facial motor impairment, facial twitching) don’t turn into a full-fledged episode. Prednisone and ice packs to the rescue. Cold packs have, this time, seemed like a helpful (and non-narcotic) way to relieve the ear/bone pain caused by facial nerve inflammation. It’s actually kinda addicting; Jana has had to make me take breaks, so I don’t just fall asleep laying on the towel-covered ice pack! And ice packs are tough to keep in the right position when you’re trying to sleep.

Bottom line: my headaches are 90% better. Winner!

From → Treatment Phase

One Comment
  1. Karen permalink


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