The past few days have been a whirlwind of medical activity. Even after cervical surgery last year, I’ve experienced continuing pain in neck, shoulders, and arms along with number and tingling in the fingers. We knew that there were bone spurs pushing on nerve roots as they couldn’t remove those during the first surgery which was from the front (anterior). And a physical therapist working on my hips and legs suggested that some of the symptoms might be related to spinal nerve issues. So off to the neurosurgeon I went and he wanted to see the entire spine.
On Wednesday, I spent the entire day at the hospital from 6:30 a.m. to 4:30 p.m. This was a scheduled myelogram (injection of contrast), CT scan, and follow-up appointment with the neurosurgeon. The contrast injection is done by a radiologist under the guidance of x-ray machines called fluoroscopes. After three numbing lidocaine injections that were each deeper into the spine, he inserted a needle and slowly injected the iodine contrast into the cerebral spinal fluid (CSF) that bathes the spinal cord and brain. The table is rotated up and down to get the contrast to move around the entire spine. This process was relatively painless. I was then wheeled into a CT machine for a series of images. I then spent a few hours in a recovery area for observation before heading to the appointment with the surgeon. The images revealed the bone spurs in the neck and an additional herniated disc in the lumbar region. The surgeon recommended that surgery was not warranted for either situation. This is good news but fails to help with the bothersome symptoms. I have an electromyography/nerve conduction test with my neurologist later this week to try to find more answers.
Upon returning home that evening, a headache began to build. This was expected and I remained lying down as much as possible and drank plenty of fluids. The next day the headache pain became unbearable and excruciating upon standing or sitting upright. It was accompanied with ultra sensitivity to any stimuli along with dizziness. The pain was much worse than any migraine I’ve ever experienced. I finally called the radiology on-call number and the doctor immediately sent me to the emergency room where I was hooked up to an IV and given fluids along with Dilaudid narcotic pain medicine. The ER doctor suspected that I had a spinal fluid leak from the previous day’s puncture. But he had to rule out an infection – meningitis. In order to do that, he drew lots of blood and conducted another spinal puncture in order to draw CSF for testing. After about an hour the doctor came back and said that they found a small amount of white blood cells in the fluid where there should be none. He also said that if there was an infection, the white count would likely be in the thousands. He was in a quandary on what to do as a culture of the fluid would take 24-48 hours. So he gave me two heavy duty antibiotics which took over three hours to infuse. By then a microscope examination of the fluid showed no visible bacteria. After consulting an infectious disease, neurologist, internist, and anesthesiologist, the ER doctor decided that I likely did not have an infection, discharged me, and wanted me to come back the next day for a spinal blood patch.
After a fitful night of sleep, I returned to the hospital to the surgery center. I was in serious pain and could not sit in the waiting room. I threatened to lay down on the floor! I was taken to a procedure room and an anesthesiologist put in an IV and conducted a third spinal puncture. This time the needle went into the epidural space just outside the spinal cord. He then took out about 20 ml of my blood from the IV and then slowly injected it into the spine. When the blood clotted, it would form a patch over the hole that was leaking the CSF. I could feel the pressure build as the blood went in and pain began to form around the spinal cord and corresponding nerves into the hips and legs. This was actually the most intense pain of the three days and they injected a few doses of fentanyl narcotic. I had to lay flat on my back for two hours.
After about 36-48 hours, the pressure and pain in my head are slowly subsiding. It’s been a tough few days and I’m glad it’s behind me. Now to figure out what all is contributing to the continued pain, numbness, and muscle weakness and how to proceed.