THE LUMBAR PUNCTURE
So what is this Lumbar Puncture after all? Basically they put small cotton plugs up your nose called "pledgets." Then, they inject radioactive dye in the base of your spine - yep, a spinal tap. After that, several hours pass and you have to get Nuclear Imaging X-rays.
The theory to this test is, the radioactive fluid travels up your spine, into your brain cavity, and if you have a crack, it leaks either into your ears, nose, throat, and/or stomach. (Of course, having to pass through your sinus cavity first to get to these other body parts.) If this is the case, the fluid will collect on the pledgets, which are stuck up your nose.
After collection, they test these pledgets for radioactivity. If there's radioactivity, then there's a leak. Depending on where the pledget is placed in your sinuses, and the amount of radioactivity on the pledget, it helps the doctors determine the exact location of your CSF leak.
So, the appointment was made and I was off (again...) to the hospital at o'dark thirty in the morning. (Oh, by the way, Doc Three never showed up the entire day. Not once throughout all my testing... I saw 3 different docs throughout the day! Who is keeping track of how I'm doing anyway???)
After a long uncomfortable time inserting about eight pledgets in various points in my nose, I was off for the "puncture" part of the Lumbar Puncture test. I don't know what it was, maybe the loss of "control" and the difficulty breathing with cotton in my nose and sinuses, but I was again spooked with another anxiety attack like I had at the MRI (made better by a sedative - God bless 'em!). Although not painful, it was exceedingly uncomfortable having those pledgets in my nose. It reminded me of waking up from that earlier sinus surgery with that packing up my nose. Hard to breathe.
Well, time for the puncture. Not too bad, well, until they hit a nerve and my leg started flopping around. After the test, I was told I needed to lay flat on my back for an hour. This made it even harder to breathe. After another anxiety attack and another sedative, I was back in shape.
I had to wait all day so I could get the Nuclear X-rays every couple of hours. All day I had to keep wiping my nose with tissues. I guessed that my cerebral spinal fluid was extra full from the injection or that maybe the cotton pledgets in my nose triggered some mucous gland. I don't know. Either way, I was wiping my nose every 30 seconds it seemed.
Well, I had the Nuclear x-rays of the left, front, right and rear of my head, and also my stomach. During the x-ray of my stomach, they were checking to see if any of the radioactive dye had come into my sinuses, down my throat and into my stomach.
The technicians positioned and repositioned the machine and couldn't quite get it placed correctly. I really don't remember the exact sequence of events, but they had me take off my belt, move my gown up, then they finally noticed the tissues. Well, I had laid down and absent-mindedly put the tissues (that I'd been wiping my nose with) next to my stomach on the gurney. Apparently they were getting a "hot spot" or "radioactive" spot on the x-ray. I heard one say "oh, it's the tissues." My wife was in the room and could see the computer screens. She could see the "hot spots" where the tissues were AND where my spinal cord, brain, sinuses, nose and throat were. She said between that and the technicians giving her sideways glances, she had a bad feeling.
I said "I guess I've got a leak" (because it seemed logical to me).
They had the Nuclear Medicine Doctor look at the x-rays and told him about the tissues. He looked at me and said, "I'm sorry. I guess you know now that you have a leak."
They then sent me to another doctor to remove my pledgets so they could be tested. Then, I went home and waited for the official results to come back. Doctor Three called the next day...