Getting Closer

Hit by another debilitating headache, I finally agreed to go to the ER last night. Given the amount of pain I was experiencing, it might surprise you that it took any amount of convincing whatsoever. So what was stopping me?

I didn’t want to disturb my doctor on a Sunday night. Didn’t want to appear unable to handle pain. Didn’t want to leave the hospital without any real answers. And a part of me was scared that the doctors were going to stop believing me. After all, I’ve read “The Boy Who Cried Wolf.”

After being paged by her service, my doctor though that this sounded like a PDPH (post-dural puncture headache) and sent me to the ER for an epidural blood patch, which has a 91% efficacy rate. A PDPH is a leak of spinal fluid from the membranes surrounding the spinal cord and is a potential complication following a spinal tap. I had two of those! An epidural blood patch is exactly like it sounds. A patient’s own blood is put into the epidural space to patch up the leak in a manner similar to patching a leaky tire. That’s me: one big, leaky tire.

The ER doc, however, wasn’t convinced that I had a PDPH and called for an anesthesiology consult. Which took HOURS because on a Sunday night, as you might imagine, there is only one anesthesiologist on call — and he was in the midst of brain surgery.

He finally arrived and was not positive that an epidural blood patch was warranted. On the other hand, he wasn’t certain that it wasn’t warranted. He wanted to see how I was feeling in the morning and take it from there.

Came home and, following his instructions, took two vicodin and slept flat on my back. It worked like a charm! I awoke pain-free for the first time in memory. Got up to visit the lav and take my meds…and the pain promptly returned. Which ended up being a good thing (I KNOW!) in that it gave the doctor the information which he was seeking when he CALLED this morning. (Not even my doctor and he called me.) The pain was positional. Meaning that the headache appeared when gravity drew out the fluid out of the spinal column. So an 11:00 procedure was scheduled, and it seemed as though relief was insight.

Arrived at the surgical centre and as they began the pre-op activities, it was suddenly called off. Elevated white count and low-grade fever indicated some infection in my system. With my recent history of meningitis, this procedure would place me at an elevated risk for another run of meningitis and even encephalitis. Though I agreed that the risk did not outweigh the benefit, that realization did not prevent the tears. I couldn’t imagine returning home with no relief.

Luckily, the anesthesiologist at the ER had chosen this particular doctor because he is also a pain management specialist. He really “gets it” when it comes to the fear of pain in addition to the pain itself. He told me that if the pain medication wasn’t working, then it wasn’t the right pain medication. Novel idea.

New plan. I am on a new cocktail of meds. Drinking a lot of caffeine. And flat on my back for seven days, wearing an abdominal binder. The binder applies proper pressure and the bed rest helps deal with the leakage problem. It is a good possibility that the leak will heal itself as a direct result of the bed rest. And it will certainly give me time to fight this new virus. Should the problem not correct itself at the end of this time, then we’ll go ahead with the blood patch.

The binder is not comfortable. And staying flat on one’s back is also not comfortable. But it’s only a week of my life. Well-worth the discomfort if it takes care of the problem.

So that’s all the news that’s fit to print.