My headache got a lot worse yesterday. The fact that this was day 9 was pretty worrying, so I decided to drive myself to the ER at Vic General around lunchtime. By the time I got there the headache was so bad that I was squirming in the chair at the admissions desk, and my blood pressure was 200-over-something. They got me into a bed within about three minutes, and after telling the ER doctor what was going on I almost immediately fell asleep, presumably from the exhaustion of so much pain and stress.
About half an hour later an anesthetist came to introduce himself, and explained that he would be giving me an epidural blood patch, whereby he would draw approximately 20cc of blood from my arm and inject it near the site of my lumbar puncture. The purpose of this is to "plug" the hole from the LP, and restore the spinal fluid pressure, since the pain was caused by my brain "sagging" due to the spinal fluid leak.
The procedure took about fifteen minutes, and afterwards I was instructed to lie flat on my back for while they monitored my blood pressure and pulse. I fell asleep again but woke up several times when the blood pressure machine kicked in. Each time the numbers came up on the screen they were lower, so that was good!
After an hour I was allowed to leave, and lo-and-behold, when I stood up and walked to the car, my headache was gone! The only thing that remained was a very stiff lower back, but that was an acceptable trade-off for the severe debilitation that had taken over my life for the past nine days.
I am frustrated a great deal by these events. Not only because I was immobile for more than a week (during a time when I was planning to exercise to prepare for my stem cell transplant) but also because when I was at Vancouver General Hospital on Thursday for my stem cell collection I asked about an epidural blood patch and was told "Oh we've never really done those here, but keep lying down and if your headache gets worse when you're back in Victoria definitely go to the emergency room."
Don't get me wrong - the nurses and doctors showed great concern for my headache, but short of giving me pain meds (which didn't help) they were unable to offer any solution.
It is also important to note that as a chemotherapy patient I am at a much higher risk of developing deep vein thrombosis. It's important that I move around and walk as much as I can to minimize the risk of a serious blood clot, so the fact that I spent the greater part of 10 days lying flat on my back was a pretty bad move. But what can you do when lying flat on your back is the only reprieve?
The anesthetist in Victoria told me that it's unusual for an LP headache to persist beyond 2-3 days, and if it does, the standard procedure is a blood patch. He seemed a bit surprised that nothing was done on day 7 when I was in Vancouver.
So now I am left wondering why I was given an LP in the first place if the hospital had nothing in place to deal with the consequences of an extended spinal fluid leak. Going through something like that for nine days is completely unacceptable.
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