I wouldn't have believe it if I didn't see it for myself.

First of all, if you live anywhere near New York and you need to get a Spinal Tap, go to Dr. Merchandani of Methodist Hospital in Brooklyn, in the Radiology Department. What a sweetheart.

He met us in the morning and Alan says to him "Don't forget to give me lots of novocaine". and the doctor replied "Novocaine, we don't use novocaine anymore, and the nurse said "that's right, don't we hit them over the head with a piece of iron or something? Alan burst out laughing. Took away all the tension.

Dr. Merchandani explains that he has this x-ray machine that he uses to locate where he will do the Spinal Tap and he uses Lidocaine and etc. etc. and so we say our goodbyes, and I wait until Alan is wheeled right past me (about 90 minutes later). His LP took longer than usual because Alan has severe spinal stenonis and the doctor changed needles to a much smaller, thinner one to get the spinal fluid out. He spoke to Alan during the whole thing apologizing if he was hurting Alan and Alan said "you're not hurting me" (Alan told me the whole story on the way home).

When it was over, as I'm waiting in the waiting room, the doctor approaches me and says "He did fine, the fluid was clear and he went on to explain about what it means if it is cloudy or has blood in it, but he said "his fluid was nice and clear". What they look for ar markers, etc. I told him, "yeah, I learn lots of stuff from the Neuropathy Boards on the internet. He said "oh really, that's great".

Then I see Dr. Goldfarb, and I had the opportunity to ask her about my concern about his taking zoloft and the cymbalta and about Seratonin Syndrome. She told me not to worry. So I won't worry about that.

Alan will see Dr. Goldfarb in about 10 days.

Then they wheeled him before me on the way to recovery. Alan is lying on his stomach. Since it was better for his PN for him to lie on his stomach, the doctor said "No problem". So there was Alan lying flat on his stomach with his head down turned to the side telling me "Melody, this guy is great, I didn't feel a thing". I was amazed.

Then he went to recovery until 1 p.m. and they gave him juice and took real good care of him. He was able to walk down to get on the access-a-ride and he just now ate a bagel and some crystal light (with splenda) no aspartame.

The doctor told him as he was looking at the x-rays, he said "Alan, I will tell you this, you have a severe degenerative spine. The stenonis was so severe he told him "only surgery could fix this".

So if we need to, they have an arthritic spine specialist on another floor. This hospital has everything. Alan wouldn't hesitate to go any place else.

So he feels good. They told us what to do about not raising the head too high and too fast and just relaxing the whole day. So far, he's doing good.

He is a very good patient. I don't think I would have been that calm. I had heard all sorts of horror stories about spinal taps but it seems in Alan's case, it was not painful. How cool is that???

Melody

Could anyone have asked for a better outcome? I am very glad to hear everything went so well. Please tell Alan he's a soldier, and I'm releived the spinal turned up clear.

Have a great day Mel

I got a really good feeling that we are going to finally find out why this man has PN and mainly it will be from the stenosis (I mean if such a thing is possible to find out).

Now whether they can do something about it or not, well, that remains to be seen. But I'll tell you something,

I AM SO GLAD THIS IS 2007 AHD NOT 1907.

I mean the technology, the machines, it's all really impressive. Want to know what really impressed me today at Methodist Hospital? This I have never seen before. Usually when a person is wheeled back into recovery, well, it's always cold. They never have the room warm enough (I guess it's because all the computerized stuff needs to be in a cold environment).

Well, everytime I've been hospitalized, or Alan has been hospitalized, we always froze until somebody bought us another blanket and then it was always some thin stupid thing.

Well, as they wheel him around the corridors, everybody was saying "jeez, it's cold in here (of course, it's cold, it's NYC and about 9 degrees outside). So they wheel him into a room and it was COLD. So I ask the nurse, can she please get another blanket for him and she says "Oh, how silly of me, he doesn't need a blanket" and she goes over to this machine on the wall (I think it was called Bear Claws or Bear Something or other). and there's a long tube connected to it. She turns it on and nice warm air comes out of the end of the tube and she places it under his top sheet and it warmed up the whole area. I said 'when did they discover this thing". and she laughed and said "isn't this the neatest thing?".

Never saw that before. I wonder if other hospitals use this contraption??

Melody

Melody...

Both about the painless spinal tap and the personal space heater! I am always freezing in hospitals. I would have killed for something like that after my c-section....I was so cold and shivering, I though I was going to drop my new baby!!!

Ann

This is really a common cause of pn, as I discovered only after I was diagnosed with it myself. I would not be surprised to learn that most people with "idiopathic neuropathy", that group that gets it in their 50s and 60s, isn't made up to a large extent of stenosis folks.

That's why I put MRI on the lizajane charts. Spinal stenosis needs to be evaluated in all of us with pn.

Psoriasis is accompanied by psoriatic arthritis. Psoriatic arthritis is almost always marked by severe arthritis in the spine. This I know because I have the gene for psoriasis, even though I don't have it, and the docs keep thinking maybe I have psoriatic arthritis without the skin problems.

So it's going to be very important for Alan to be followed by a spine surgeon to make sure this doesn't progress to a point where there is permanent damage. And since it's psoriatic spinal arthritis, it can be quite bad.

Good you've found such thorough doctors for him.

Hi Mel, I am glad to hear that it was all clear for him and he got a real pro that done it for him, and by the sounds of it, no wonder he was getting relief from the neuro/chiropractor guy.
all the best
Brian

--complete with the frutiless jabs by technicians trying to find the canal, etc., it ended with me being brought down to radiology and the procedure being done under floroscopy. They wre able to quickly find the proper place to stick, numbed the area, drained the fluid (which they never found anything in, BTW); whole thing was over in 15 minutes.

Since the previous attempts had been such a pain, literally, in the you-know-where, I asked the staff why everyone didn't have the puncture done by flousocopy. The answer, of course, was money--insurance doesn't like to pay for the additional cost of the imaging and the people doing it.

Later, I gave the insurance companies an earful about the whole thing, along with others, as an example of penny wise/pound foolish--if they had started with the procedure under floroscopy, I wouldn't have been in the hospital as long, as they wouldn't have had to pay for that.

Glad to hear the Alan had no trouble with the procedure; let's see if they learn anything diagnostically from his fluid. It's possible, given his blood results, they may see a similar increase in his IgG synthesis there, but that probably won't be diagnostic of anything specific. The fact that they said it was clear is a good sign, doubtful there's any blood or infection in it.

Hope Dr. Goldfarb has all the results in 10 days; if they're trying to culture bacteria, sometimes full results take a little longer than that. But any autoimmune analysis should be done in that time.

Liza Jane:

Alan has been to two spine surgeons. About 5 years ago, he went to Dr. Goldstein in NYC who ordered an MRI and promptly told Alan he should think about getting a medtronic device.

Then sometime this year, Alan went to see Dr. Elowitz, a neursurgeon who operates on Spines. We took the MRI films to him.

He called us in and said sadly, "I cannot operate on Alan".

So I don't understand why ANOTHER SURGEON might see something different and go "Okay, let's go, let's get to this spinal stenosis and fix you up".

But then again, I often watch the Discovery Channel and see where people with these hamangiomas growing out of their nose, where no one will touch them, and another guy comes along and does it for free.

I guess it's all in the guy you find? Right?

Melody

P.S. Alan feels so good he just asked me if he could go to the gym. I sat on top of him. lol

Mel-I'm not advocating for surgery for Alan; I have no idea when one operates and what they have to look like. I just know that spinal stenosis can cause pn. When it's really severe, it can cause cauda equina, which is potentially awful. Doesn't kill you, but isn't fun.

If his docs are following his spine, and knowing YOU, they're following closely, I"m sure all is just fine.

It's just good to be able to put things together. I had an "Aha!" moment, realizing that Alan has spine disease PLUS psoriasis, and that the two go together.

Alan has just told me that he would only consider a procedure called an endoscopic dichectomy. It's very non invasive and can only be done in certain circumstances. I have no idea if Alan meets these circumstances.

He told me "if anybody tells me I need a fusion, well, forget that, I'll just say "okay, no more", and I'll continue to go to my chiro-neurologist and do whatever I can do at the gym"

So he's not gung ho for any big time surgery.

You would not believe this guy had a spinal tap yesterday. No puncture mark on his back, no headache (thank God for that).

He took some naps and he's good to go. The whole thing hit me last night while watching American Idol (It must have been 8:45 p.m.) I just rolled over and went to sleep (without taking my pill, believe it or not). and woke up this morning at 7:45 a.m. This, I rarely do. I think all the anticipation of the spinal tap, etc. did me in.

Right now, it's so cold in my apartment, (all day). Heat comes up in the morning and the old lady who lives downstairs is always hot so she shuts off the boiler at 10 a.m. AND SHE OPENS HER BASEMENT WINDOWS!! Can you imagine??? So I freeze. It measured 60 degrees and the thermostat is set at 70. I had my landlord come in (he's 80 and healthy as a horse and smokes at least 4 packs a day) he lives next door and owns the two homes. And the first thing out of his mouth is "how can you be cold, this apartment is warm?)" Seems SOMEONE turned on the boiler downstars 5 minutes before my landlord came in. Some co-incidence. I marched him over to my thermostat and said "look, what does this say?". He said "oh it says 60, but it can't be 60, because it's really warm". I made him feel my hands and he said "I don't know why you are cold". Once the heat began coming up, of course I warmed up. I HATE THE WINTER, MY ARTHRITIS HATES THE WINTER. UGH.!!!!

I cannot wait until April.

melody