6 ms·
The lumbar puncture that changed my life
- DontchaKnowit 3y agoMy father had spinal meningitis and they took a spinal tap and fucked it up by sitting him upright too soon and he ended up leaking fluid. Nearly killed him. Could barely move his head. Couldnt walk, could only crawl for a long time. He was unable to work for like 9 months or something. He ran a fever over 100 for like a year and a half. Got him to quit drinking though. Still gets dizzy and neasous easily.
- jtotheh 3y agoI had a CSF leak caused by a bone spur on my spine poking a hole in my dura.long story short, spinal surgery to remove the spur and seal the dura , which involved fusing three thoracic vertebrae. The “positional headaches” were horrible(when I was leaking). I consider myself lucky that it was treated as successfully as it was. This was over five years ago.
- legalnomads 3y agoThanks for sharing my article. I wrote a more updated piece about the mental side of this big life change here, if anyone is interested: https://edition.cnn.com/travel/article/jodi-ettenberg-legal-nomads-csf-leaks-wellness-cmd/index.html https://edition.cnn.com/travel/article/jodi-ettenberg-legal-... I've yet to learn of or meet a patient with my facts who's gotten sealed and stayed sealed. For now, just hoping for medical advancements that can benefit those of us in that position.
- fragmede 3y agoThank you for sharing your story!
- noduerme 3y agoI got 1/3 into this and had a panic attack. Literally nothing gives me the willies like the thought of losing spinal fluid. Good on her that she's recovering.
- MichaelRo 3y ago>> In retrospect, I realized that many of the aspects of the puncture—the position (curled over the side of the bed), the needles (18g, very large), the type (cutting needles), and that it wasn’t done under guidance—all contributed to my leak being complex but to the fact that I obtained a spinal leak from the procedure. >> The hospital’s advice to lay down that evening and then just carry on as normal also prevented self-healing after a procedure with all of those risk factors. I did not know that many of the things I did—like shaving my legs in the shower, bending in certain ways, lifting a jug of milk, etc. were all things that likely impeded my healing at a critical time. Well I did get a lumbar puncture when I was a kid, hospitalized for mumps. I recall being upright, on a chair, hugging the chair's back seat, didn't hurt excessively. But reading the story, the difference was that after the puncture I laid flat in bed for a long time, further scared by the doctors that moving around will make me sick. Which, I guess it's true, this is the first time I hear of a CSF leak.
- philjohn 3y agoI also had a lumbar puncture as a child (Viral Meningitis was diagnosed by it) and mine was like the author's, lying on my side in a foetal position. I don't remember it being painful, but in retrospect, my head felt like it wanted to explore from the Meningitis, so it could have just been the more "pressing" pain. I do remember being told I could try and walk, but when I did, I felt a horrendous pain in my back, so didn't do that again.
- lcuff 3y agoI know of someone who was paralyzed after a lumbar puncture. Eek times 10. Something to avoid if at all possible.
- monero-xmr 3y agoMy mother in law woke up one day, couldn't stand. Everything was spinning. She said it was like the most intense carnival ride of her life, endless spinning. Closing her eyes didn't help. She began vomiting, and didn't stop. 12 hours later she went to the ER. They tested for everything they could, specifically to rule out stroke. The only thing that came up was a small bit of fluid buildup near her ears that appeared on an MRI (maybe it was in her ears, I can't remember, this was several years ago). Doctors gave her steroids and antibiotics. After a week of feeling like being on a carnival ride (and endless puking), she could close her eyes without spins, and she went home. It took another week to be able to open her eyes without the spins and focus, but it was still very wobbly, like a seesaw back and forth. She went from being a marathon runner to essentially hobbled. Every day was a tiny bit better. After a month she could watch TV. After 2 months she could walk without assistance. She wasn't fully better for 6 months. You never know what life will bring. One day you wake up and you are on a carnival ride that never ends.
- tomcam 3y agoBeautifully written. In equal parts poetic and depressing.
- el_benhameen 3y agoThat’s absolutely terrifying. Did she ever get a definitive diagnosis?
- monero-xmr 3y ago"Viral infection" was the best they could say.
- Yodel0914 3y agoMy wife had something similar - though slightly different symptoms (migraines, memory loss, paralysis, seizures). It was a bumpy 2 years, to say the least, until she was 80% functional. Now, about 7 years from the first ocurrance, she's pretty much 100%. The best we've figured is an infection (she was sick as a dog beforehand) interacted weirdly with her (then undiagnosed) familial hypercholesterolemia and inherited predisposition for migraines. My take away was not only how vulnerable we are, but also how useless modern medicine is in some situations. We went through a bunch of specialists - only one helped at all, but the side-effects of the drug he prescribed were almost worse than the symptoms. We ended up making the most progress by experimenting with diet, exercise and supplementation (which makes more sense now that we know about the FH).
- whimsicalism 3y ago.
- crote 3y agoUnfortunately that also demonstrates why a lot of people - especially women - have developed a serious lack of trust in medical professionals. Doctors often believe they are the second coming of Christ, and if there's something which doesn't neatly fit into their preconceived notions of what it should look like, they will reject the possibility that they might be missing something and just jump to the conclusion that the patient is faking it. Lying to patients is also extremely common - just ask any woman who had an IUD placed if it really was "just a pinch".
- blindriver 3y agoI had a lumbar puncture about 5 years ago because I got meningitis. Thank God I didn't have any issues with CSF, this poor lady's life sounds like a nightmare. I feel terrible for her and I hope she gets better, it's not fair that she had to go through this.
- Glyptodon 3y agoI had what I'd guess were around a dozen spinal taps as a kid/teen. Had issues with back pain at the spot that took some years fully go away. One of the times I thought I was pretty much recovered around three or four days later and went off a small jump with a Razer scooter. Got one of the worst (and weirdest) headaches of my life and it lasted for like a week. Can't imagine dealing with that for years. They are infinitely less of a pain the thinner the needle is.
- klipt 3y agoScary story and I sympathize. I assume this is pretty rare though, which is probably why it's hard to treat in the first place (there haven't been that many patients to research better treatments on). E.g. doesn't every mother getting an epidural while giving birth effectively have a lumbar puncture? And most of them turn out fine. Maybe the bed rest after labor helps. The fact that CSF pressure is too high after patching makes sense, I guess the body ramps up CSF production to combat the leak. This probably also makes healing harder because there is constant increasing fluid pressure, which pushes fluid out, which makes any hole resist closing. This suggests a better treatment might be actively tapering down the flow? E.g. instead of attempting to close the hole completely in one go, install some kind of controllable shunt and gradually reduce the flow over a longer time, then once reduced to nothing, close the hole?
- kelnos 3y ago> instead of attempting to close the hole completely in one go, install some kind of controllable shunt and gradually reduce the flow over a longer time, then once reduced to nothing, close the hole? That would only work if they can find the hole. According to the article, it often doesn't show up on imaging, and even if they know roughly where it is (as in the case of a lumbar puncture gone wrong), it's still incredibly difficult to pinpoint, and patching it usually involves trial and error. It wasn't completely clear from the article, but it sounds like often they don't ever really pinpoint the hole, even when they are able to successfully patch it. The patching process seems more like "spray and pray": do some patching (she had 22 patches done, I think I read), and once it seems like the leaking has stopped, they assume they got it. Not sure if this is true, but that's the impression I got.
- legalnomads 3y agoFor clarity, I had 4 rounds of targeted patching done, but I wanted to be clear that there were a total of 22 needles — it wasn't a high volume EBP, but smaller, directed patches with blood+fibrin. Puncture leak sites rarely show on imaging, it's true. At Duke, Cedars, or other leak centers they have techniques for CTMs or DSMs that yield leak sites but that's usually for spontaneous CSF leak patients or post-surgical, not us puncture people. They're using a PCCT machine to find CSF venous fistulas at Mayo and at Duke, but again to my knowledge puncture leaks remain a needle in a haystack even on that quality of imaging.
- kelnos 3y agoAs soon as I saw the bit about many people with recurring CSF leaks also having connective tissue disorders, my heart sank. Sure enough, after reading a follow-up[0], it seems she has Ehlers-Danlos Syndrome. The experience I have of this is a bit off the beaten path: a kitten we adopted a few years ago ended up having the feline version of it... she was such a sweet, affectionate, energetic little girl, but we lost her to complications after only a year and seven months; she had very weak skin and slow healing, and the disease damaged her heart. (It's been a year and a half, and I still miss her dearly. She made a huge impact on my life in such a short time.) EDS is uncommon in humans (and even less common in cats), and hits in varying levels of severity (there are a few different subtypes of the disease, caused by different genes). It affects the entire body, since there's connective tissue more or less everywhere, that depends on correct collagen packaging to function well. But it's rare enough that it's unlikely we'll find a cure, or even particularly effective treatment, for quite some time. I can't help but be impressed by people who manage to live full lives, while dealing with its effects for decades on end. I don't know if I'd be strong enough, in their position. [0] https://jodiettenberg.com/connecting-dots/ https://jodiettenberg.com/connecting-dots/
- appplication 3y agoJust two weeks ago I found out my sibling has Ehlers-Danlos, and that it was the likely (undiagnosed) disease that killed my dad and grandpa each at a young age. I found out yesterday I have some sort of congenital (but hopefully benign) heart condition, the Dr thinks may be also related to the same. Reading that in the article and then your comment feels very surreal. I understand Baader-Meinhof, but this timing is particularly strange.
- jhogendorn 3y agoAs a person with EDS, i would counter that it is way more common than realised. As its a systemic genetic driven inability to produce collagen correctly, the only cure will be when we can rewrite and organisms genetics wholesale, which we are not exactly close to. Treatments are poor, the condition itself and its systemic effects are almost unstudied. Most doctors either dont know about it or their knowledge stops at 'flexible'. Some doctors (surgeons esp) may even decline to work with you if you disclose EDS. CSF leak, either from a lumbar puncture, or from things like chiari malformation and other cervical abnormalities are a well known phenomenon within the community. A person complaining of persistent postural headaches usually gets csf leak as the first response from said community. It is however, incredibly difficult to get a doctor to be willing to diagnose it, to have it competently found, and then patched.
- nonameiguess 3y agoMan, I need to become a blogger! Been there, Jodi. Probably been worse, much worse, but further along and I can tell you it's entirely possible to come back and do relatively normal things. One of the advantages, I suppose, of a high-deductible PPO is not needing referrals. I can't remember the last time I saw a general practitioner and don't have a primary care provider. I've always gone straight to a specialist, but the bad news with spine problems is, even when a care provider has a pretty good idea of what is wrong, or even a completely clear idea, it still may be difficult and take many years to treat. For reference, I experienced spinal disc degeneration in my mid-30s coming out of the Army. It was never particularly clear why, but probably just genetic. I've been abnormally susceptible to herniations since I was a teenager and my mother and two of my sisters are as well. I used to receive epidural cortisone shots every three months for years, but never had a CSF leak from that. I did have a CSF leak after a microdiscectomy, though, back in 2016. It set me on quite an odyssey. Like her, I was bedridden for a while, could eat nothing but saltine crackers and lost 20 pounds, told to drink a lot and try to self-heal. It appeared I did, but appearance can be deceiving. Rather than straight busting back out and experiencing headaches and nausea again, I instead grew a cyst on my spinal cord composed of excess fluid pushed into a sac that did not quite burst, but grew to nearly grapefruit size. I couldn't lay or sit in particular ways, couldn't let anything touch it because of how badly it hurt. I needed a walker to be able to move. When I finally got an MRI, they were so worried they pencilled me in for emergency surgery only eight hours later. So I got the patch she's talking about this time, but much more directly since I had to be cut open. I also had a laminectomy during the same procedure. That did end up being the end of the CSF leakage, but not quite the end of the spine problems. My discs had been so beat up at that point that I'd lost an entire inch of height and was living virtually bone on bone. The sciatica was so bad I felt like I was walking on electrical wires and constantly being shocked with every footfall. I eventually needed a bilevel interbody fusion where they remove the discs entirely and replace them with metal cages seeded with a bone graft sawed off from the pelvis, held in place with titanium rods and screws while the bone grows around it. Today, my lumbar spine is mostly one solid bone, a huge bone you can feel from outside. The resulting limitation in lumbar mobility also leads to hip and hamstring tightness. In middle school, I used to come in 2nd every year in the Presidential fitness contest's sit and reach competition. Today, I can't even sit upright, can't even get to 90 degrees if my legs are straight out in front of me. Nonetheless, I did come back. It took a lot of patience, starting with physical therapy, eventually striking out on my own and working out very diligently. For a long time, this meant resistance bands and walking and not much else. But progress compounds. 8 years later, I've got a power rack, barbells, C2 rower, and I lift and either run or row at least 6 days a week, sometimes all 7. It doesn't always feel great. I'm still stiff and aching all the time. My joints swell and lock up. I'm not very strong considering how much lifting I do. I'm not very fast considering how much running I do. But 8 years ago, I didn't believe I would ever lift or run again. I still needed a walker. I couldn't pick up my cats. I couldn't put my own shoes on. Patience, persistence, and hope. It may or may not happen for any particular person, but you can come back from this. There's a lot to be said for still being relatively young.
- rpaddock 3y ago"She added me to a private CSF leak group on Facebook with several thousand leak patients from around the world." My late wife joined that group when it was 800 people in ~2011. Today we are closing in on 9,000 people. Back in the beginning a few people though that my late wife Karen started that group. She didn't. She was just a prolific poster there helping a lot of people as she learned about Leaks in her medical studies. Part of Karen's saga, and mine, is published on the CSF Leak Foundation website here "When Pain is Relentless" : https://spinalcsfleak.org/when-pain-is-relentless/ https://spinalcsfleak.org/when-pain-is-relentless/ A few years later Karen's saga also became part of the documentary Pain Warriors. Which can be watched for free on Amazon Prime, TubiTV and Youtube. It is also on iTunes. Our goal is to raise awareness of CSF Leaks and the devastation they cause to families like mine. Karen took her own life due to the pain from CSF Leaks and being poisoned by the flourquinilone antibiotic Levaquin (NEVER Take that or Cipro et.al. which I can back up with FDA data, I want to focus on Leaks here). The top doc in the world Dr Schievink [1] has estimated that just under 100% of people that have CSF Leaks have some type of under lying Connective Tissue Disease. Karen saw him and the docs that are mentioned in the parent article that were there at the time in the 2011-2013 time frame. I had Karen's spin exhumed and it was sent to Duke to be studied. Much was learned from it to help those that came later. Sadly not nearly enough. All of this is documented in what has become known as Karen's Journal. Free to read on Karen's website. Any profit from the sale of physical books go directly to the Spinal Leak Foundation. [2] I also get nothing from the Pain Warriors Documentary. [3] 1: https://spinalcsfleak.org/schievink-surgical-history/ https://spinalcsfleak.org/schievink-surgical-history/ 2: Sadly the certificate expired so please ignore the scary warning until I get that fixed. I also need to fix a link that I see is broken to the PDF that was used in the documentary. http://www.kpaddock.com/book http://www.kpaddock.com/book 3: Pain Warriors on YouTube: https://youtu.be/WB60ZCiYwgk?si=PAVsDOVDcEdoJ-jC https://youtu.be/WB60ZCiYwgk?si=PAVsDOVDcEdoJ-jC Just typing this has me crying yet again. What we desperately need is better imaging technology. When it comes to finding Leaks with today's methods we are still in the Stone Knives and Bearskin era. CSFluid is almost identical to water making it hard to differentiate unless the leak is large. It does not take a large leek to cause devastating headaches. If you have any ideas, please speak up.
- m2024 3y ago