View Single Post
Old 06-28-2012, 08:07 AM
Dr. Smith's Avatar
Dr. Smith Dr. Smith is offline
Senior Member (**Dr Smith is named after a character from Lost in Space, not a medical doctor)
 
Join Date: Oct 2010
Location: Lost in Space
Posts: 3,515
10 yr Member
Dr. Smith Dr. Smith is offline
Senior Member (**Dr Smith is named after a character from Lost in Space, not a medical doctor)
Dr. Smith's Avatar
 
Join Date: Oct 2010
Location: Lost in Space
Posts: 3,515
10 yr Member
Default

Quote:
Originally Posted by Susanne C. View Post
I wondered this myself. Even my neuologist at Johns Hopkins suggested a spinal tap next IF I wanted one. He admitted it was likely to be unrevealing,and agreed with my decision not to pursue further testing,but it is a pretty standard follow-up to the EMG/NCS, brain scan, blood tests and skin biopsy. In case of a possibly treatable neuropathy, why not?
Hi Susanne,

It is an invasive procedure, and all invasive procedures carry some inherent risks. (Google: lumbar puncture risks) The biggie (from my experience participating in chronic pain support groups) is (Google: arachnoiditis), but there are others as well. In articles about lumbar puncture, the risk (if mentioned at all) is stated as extremely rare, however in articles about causes of arachnoiditis, lumbar puncture is included right up there with spinal surgery/trauma (because it is a trauma. There is a risk any time the arachnoid mater is disturbed). Of the people I've met with arachnoiditis, about 1/3 got it from multiple surgeries, 1/3 from this procedure, and 1/3 from other causes.

Quote:
In recent years, myelograms have come under scrutiny as being a possible cause of this condition. A myelogram is a diagnostic test in which a radiographic contrast media (dye) is injected into the area surrounding the spinal cord and nerves. This dye is then visible on x-rays, CT, or MRI scans and used by physicians to diagnose spinal conditions. There is now a concern that exposure (especially repeated exposure) to some of the dyes used in myelograms may cause arachnoiditis. Similarly, there is concern that the preservatives found in epidural steroid injections may cause arachnoiditis, especially if the medication accidentally enters the cerebral spinal fluid.
http://www.spineuniverse.com/conditions/arachnoiditis
My personal feeling/view is that a spinal tap is one of those tests (like a CAT scan) that I would only submit to if absolutely necessary and there were no other way of determining whatever they're looking for. They wanted to do one on me when I went into the ER for a level 10 headache (the only time I've ever rated pain that high) "IF I wanted one" because they were concerned about meningitis. However I did not present like meningitis (and knew it) so I was able to put them off for an hour while they tried an IM injection, and since the pain began to subside (to a 9) from that, they were able to rule out meningitis and backed off on the spinal tap. It took several more hours to bring the pain level down to where they would release me.

Whenever a doctor mentions a test/procedure followed by, "IF you wanted one" it kind of sets alarm bells off in my head that they're hinting that there could be something they're not telling me -- probably not to elicit undue fear -- but something they're not mentioning anyway. Any time I've pursued it, they've gotten that "uncomfortable" look before evading the question.

I think everyone with chronic spine pain and/or spine issues should read up and be aware of all the various tests & associated risks we may be looking forward to. Some sites (and doctors) do not mention all of the risks (just as they don't with some medications). It's not always easy, but necessary to make truly informed decisions concerning our care & health.

Doc
__________________
Dr. Zachary Smith
Oh, the pain... THE PAIN...

Dr. Smith is NOT a medical doctor. He was a character from LOST IN SPACE.
All opinions expressed are my own. For medical advice/opinion, consult your doctor.
Dr. Smith is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
ger715 (06-28-2012), ginnie (06-28-2012), glenntaj (06-29-2012), Kitt (06-28-2012), mrsD (06-28-2012), Susanne C. (06-28-2012)