Spinal Tap, Part I

My spinal tap is scheduled for Thursday. Professionals call it a lumbar puncture, which makes it sound like a mere inconvenience, a quick, relatively painless poke, much like a blood draw. So I’m stubbornly sticking with spinal tap because the process is no joke. I’ve read descriptions of the procedure and watched videos where it’s being performed. A radiologist will use fluoroscopy (live x-ray) to guide the needle to the right place in my spine to extract cerebrospinal fluid (CSF) for examination. I understand the process. Besides having to get into a hospital gown and be exposed anyway, which is truly the worst, my fear is not so much about the procedure but about what happens after. Immediate concerns include whether I will get the excruciating spinal headache in the days to follow that so many people describe. It is caused by leaking CSF, and if the puncture site doesn’t heal on its own in a few days, a blood patch must be administered back at the hospital, where blood is drawn from the arm to be injected into the site to close the opening.

I’m most worried about the results. One of the things measured in a tap is the number of oligoclonal bands (o-bands) in the CSF. O-bands are immunoglobulin proteins that indicate inflammation in the central nervous system. Normal people will have no o-bands or perhaps just one. Blood is also tested for o-bands to see if the numbers match up; if the numbers are the same in the CSF and the blood, it usually indicates an infection or autoimmune disease. MS patients usually have more o-bands in their CSF, though up to 20% of MS patients will have no o-bands at all. Several studies have shown that higher numbers of o-bands in the CSF correlate to more severe progression of MS. So I’m hoping that the number is low.

This tap has been on the books for two months now, and the dread only increases as the date nears. My only comfort is that it will be behind me at this time next week, when I also hope to be up and around and back to life as usual. I’ll report back then.

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