I am suppose to have a lumbar puncture done on wednesday and am so afraid of having it done and what they might find. The neurologist is doing it because the lab work he has done came back normal and my symptoms have been progressing. I was diagnosed with Sensory-Motor Peripheral neuropathy in July after the findings on the nerve conduction study came back abnormal. Something is causing damage to the mylen covering and the axons. He has not done another NCS but no wants to go with the LP.

Follow all pre-procedure and post procedure directions TO THE LETTER!
This is an intro to the procedure? but there is more to it...
http://www.webmd.com/brain/lumbar-puncture And this?
http://www.mayoclinic.com/health/lum...ncture/MY00982
Thing is? Most don't tell you to be HYDRATED before the procedure? I would slurp a gatorade pint bottle the day before...just in case...
Next? Once you are done w/the testing? THIS IS IMPORTANT.. get home and go into your bed and sleep! A good nap and intermittent naps afterwards plus hydrations can help minimize any side effects immensely! DO NOT expect to go to work or lift anything over 2 lbs w/o residual pains? So don't do anything for at least a day and a 1/2! Ultimately? You will come out of it feeling as if you've been hit w/a 2"x4"x8' for a couple of days.... After all? This IS an invasive procedure... However? It's often a necessary one to get some PN's diagnosed properly.
About 1 in a 1,000 docs get it wrong in doing you? Just be sure and KNOW that your doc does this OFTEN! Well more than 10 times a year...ASK! Demand!
Mostly a bad headache can result if you move too much after the LP and or don't rest enuf... or at worst it was done wrong. And..? It IS ONE BAD HEADACHE... warm or cool packs and tylenol are usually the only things that can help if it's bad...BUT if that doesn't help? Call the doc that did the procedure ASAP! But try and be concise about the pains/headaches or other problems bugging you. You have to be careful and accurate in describing that additional problem!
Be brave and do it! I for one? Am soo glad I did! Hope and 's !!! - j

I had a lumbar puncture, aka spinal tap. it really was no big deal. no pain while it was being done. Dahlek covered it well, i would just add, dont let them rushyou out of wherever you are getting it done. you should lay down afterwards at the place you are getting it done for at least 45 minutes. dont let them rush you out! if you can use a car where you can either lay flat in the backon the way home or where the seat goes back pretty far. the longer you can lay flat and the more you do in the few days after the less of a chance of you getting the headache. dont be afraid of the procedure, plus it can get you answers that you need either by finding something or not finding something. mine was totally negative.

One problem has come up with my insurance that the procedure is subject to my deductable which is pretty large. I called my insurance company to find out what the allowed amount is roughly for this procedure, they told me I would have to call the hospital. The hospital said it is around $1200.00 I don't think that includes charges from the lab that will be doing the testing. I still owe another hospital for a tubal pregancy surgery back in 2008. So I am just stuck on what I'm going to do. I may be able to negotiate with the hospital on payments. I can't exactly afford that either, on top of everyday bills. I'm suppose to have the LP on wednesday. And I do not like the neurologists staff, she said that he really needs me to have the test and if I can't to let them know so he doesn't show up at the hospital. It was her tone that bothered me like I am studip.

As long as its a neurologist, infectious disease doc, or radiologist, its pretty likely that they perform these fairly routinely. I performed well over a 100 of these in my first year of training. The most common side effect is a headache. As mentioned above, stay hydrated and try to lie down for the first hour. The various hospitals I have worked at would monitor patients between 1 and 2 hours. Otherwise, I would take it easy on day one and then resume activities as tolerated. You will have local tenderness at the procedure site. The degree of the tenderness will depend on how easy the puncture is to perform. If you're fairly young and your back is in good shape, it should be relatively easy. The harder the puncture, the more it will depend on the doc performing the procedure.

If you do get a severe headache, the best way to treat is with a blood patch. They take some of your blood and inject it by the lumbar puncture site in order to form a clot at the puncture site. This stops the minor CSF leak that is thought to cause the severe headache. Staying well hydrated prevents the headache by compensating for the fluid loss. Some studies indicate caffeine to help with the headache, although this evidence is very limited.

Many radiologists perform these and they are already at the hospital. We use fluoroscopy, which makes getting access easier as we are not doing it blindly. You would just need the order for the study, plus the lab orders on the CSF. This way you're not dependent on the neurologist, other than for orders.

When I'd first started tests rite after onset? Nerve conduction studies and basic anti-body counts were either normal or only slightly off. With my lumbar? By then? The NCS's and the blood work were noticeably getting worse. Essentially I'd gone from total numbness in the hands/wrists & feet to below knees to arms at the elbow and legs almost to the midriff. These are symptoms that definately led to all the initial testing then the Lumbar and a trip to a hospital hematology dept where I was 'blood-let' of about 15 vials of blood! I truly wish that I'd been internet savvy then? Because I'd sat up for about 20 minutes before taking the spinal fluid w/me to the hospital hem. dept for the bloodworks.
I was essentially 'upright' for 3+ hours after that lumbar...good thing I'd the sense to take a serious NAP once I'd gotten home!
I was very lucky in that I'd not gotten a headache [those kinds can be killers!] and only felt as if I'd been hit in the back mildly w/a 2x4"x6'.
Soo? Definitely plan on someone driving you home! And plan to eat very lightly [soups and broths?] until all other side effects go away. Then? You'll be truly and mightily hungry! Plus keep up hydration [water, or if needed gatorade or the like...not coffee or tea tho!] until you get back into a more balanced state.
Just give yourself a day or so to recover.. likely? You will be just fine after it all! Now? Waiting for results? THATS another matter...takes weeks, which feel like years at times! I'll cross my fingers that you get a good result to get the best of treatments. I'll be waiting to hear from you as well, once you get results. Just be careful what you wish for? You know what I mean...
's!!!!!!!!!!!! - j
PS Yes! Insurance can be a pain? But...Once you hit the yearly or catastrophic deductable? Things get a lot easier... Usually my hospital is just inbetween the billing and payouts and I have to pay more for a hospital procedure? But mostly I get a refund check a couple of months later..
Just check your 'explanation of benefits' as they clear thru the insurance company... That's the guide as to WHAT you really should pay! And, YES It truly IS a PAIN!

[QUOTE=kwinkler;748058]As long as its a neurologist, infectious disease doc, or radiologist, its pretty likely that they perform these fairly routinely. I performed well over a 100 of these in my first year of training.


What exact field are you in? I have had blood work done Protien, total protien level, Organic tests not sure what that is, diabetic test, thyriod, B12, folate,sed rate ect. all were normal. He did one nerve conduction study that showed sensory-motor peripheral neuropathy that he believes is systemic, that was seven months ago. Now he wants to do the LP. Because my symtoms are more constant not getting any better. He will not perform another NCS to compare the first one to and that concerns me. I am not sure if all the major stress I have been under for the past 2 years has caused this or just aggrivated a condition I already have. I have had on and off sensations in my right foot for 3 to 4 years. I also have Degenerated Disc Disease which I did have a herniation at L4/L5 and L5/S1 back in 2007 that was seen on the mri. They said it was a large broadbased measuring at least 8mm x 15mm at at L5/L4 with extrusion . My back issue started when I was about 26, but he said that is not whats causing the problem. I am really scared about all of this.

The neurologist will be performing the LP himself not a radiologist.
Thank you Kwinkler and all others for your help.

I am a radiologist, so most of my clinical (i.e. not anatomic) knowledge of PN is based off of what I learned in medical school plus additional reading based on my own battle with PN. If your symptoms are just in a foot or feet, it could be because of you disk disease. Your MRI info on your disk disease is not specific enough. They should be able to tell you if it narrows your central spinal canal, lateral recesses, or neuroforamen. If so, they should grade the severity of the narrowing and whether or not the disk is directly impinging a nerve root or not.

I typically do LPs at L2-L3 or L3-L4, so your degenerative changes based on your MRI should not make the LP any more complicated.

Hope this helps.

[QUOTE=kwinkler;748172]I am a radiologist, so most of my clinical (i.e. not anatomic) knowledge of PN is based off of what I learned in medical school plus additional reading based on my own battle with PN. If your symptoms are just in a foot or feet, it could be because of you disk disease. Your MRI info on your disk disease is not specific enough.

The neurologist thinks my PN is being caused by a systemic problem not my spine issues.

This is what is stated on my MRI report.

At L4/L5 there is early disc degeneration. There is a large broad-based posterior central, right patacentral disc protrusion with extrusion and significant impression upon the thecal sac, measuring at least 15 x 8mm in diameter, abutting against the right nerve root of L5. There is associated hypertrophy of the posterior ligamenta flava and synovia of the respective articular facets but the width of the spinal canal is still considered normal.

At L5/S1 this is also evidence of a posterior central, right and left paracentral radial annular tear with at least an 8 x 5mm posterior focal central disc protrusion without extruson and impression upon the thecal sac, abutting againts both exiting right and left nerve roots of S1 without displacing it.

This was a high field 1.5 tesla mri. Multiplanar, multisequence images were obtained revealing normal vertebral bodies height, and narrow disc spaces at L4/L5 and L5/S1 with diminished signal intensity at those respective levels and high signal intensity on the T2WI within the respective inferior, superior vertebral end-plates indicative of degenerative discs.

Kwinkler if you can make any since of this report from 4 years ago, The regular GP was not very imformative. He just said i had herniated discs and arthritis. that was pretty much it. The thing I am trying to figure out is the hypertrophy of the synovia of the respective articular facets. All I found was imflammatory, osteo is not a imflammatory issue.

For my PN it is also in my lower legs and the left the sensations go right above my knee. My PN was diagnosed in July 2010. My hips have started to give me problems. I had a plain film xray that showed minimal bowing of the periarticular fat planes on the left hip. The radiologist said it could be related to joint fluid in his report. This xray was just done in November.

Thanks for your help.