Spinal Tap

Posted under Cancer

A spinal tap, also called a lumbar puncture, removes a tiny amount of cerebrospinal fluid (CSF) for laboratory analysis. CSF is the clear, watery fluid that surrounds the brain and spinal cord. Spinal taps can be used to help detect or treat diseases such as cancer, and are also used to measure CSF pressure.

A spinal tap may be used to help diagnose or treat certain cancers:

• Lymphoma. Lymphoma cells often spread into the spinal fluid, allowing physicians to diagnose diseases such as non-Hodgkin lymphoma (THAT’s ME) and eye lymphoma (which can spread to the brain).

Spinal taps also may be used to administer chemotherapy medications designed to treat or prevent brain and central nervous system cancers. In this procedure, known as intrathecal chemotherapy, the drug is injected directly into the CSF and flows freely to the brain and spinal cord.

Intrathecal chemotherapy may be beneficial for some patients to counteract the natural barrier between the bloodstream and the central nervous system. Chemotherapy given with this method may be used to destroy leukemia or lymphoma cells, as well as reduce their growth in the spinal fluid. It may be provided on a daily or weekly schedule depending on the patient’s condition.

 

Well that about sums up why I had so many spinal taps.   I’m guessing around 20 or so.  Usually they would take place right when I was checked in.  Before I even went upstairs to the Oncology floor I would go back to a examination room, take my shirt off, lay in fetal position and then some doctor would handle the procedure.  Sometimes I would get one maybe the next day after I started a treatment and a doctor would come to my room and say it was Spinal Tap time!!! and then I would do jazz hands and we would skip off to a procedure room down the hall.  

One time this doctor came in and I went with him and when I walked into the procedure room there was a group of interns standing there ready to watch.  It was really uncomfortable but what was I suppose to do?  So I got in fetal position and felt like some sort of circus freak show. 

I understand now that they were there to learn, and by them learning and having that experience with me, that it would continue on to help the next child down the road, and then the next, and then the next through as many generations as neccessary  until one day cancer will be cured.  I wish I could have understood it then, because maybe that pain of them watching me in such a vulnerable moment wouldn’t have been necessary.

The spinal taps were always excruciating. My skin was numb so I never felt the initial pinch  but then the needle would go in between my muscles that were corded around my spine and sweat would already start beading up on my forehead as I tried to lay so still and not move although my body only wanted to buck free of that pain.  I would grip the nurses hand so tight and I would cry.  Every time.  It would last about 7-10 minutes as the fluid was collected and the chemo injected.  It seemed like eternity. 

One day as I was getting ready to check out after a chemo treatment my nurse came in and told me that I hadn’t received my spinal tap treatment yet.  So I went with her to the procedure room.  There was two doctors.  One that I was pretty comfortable with and an intern.  The one doctor introduces me to the intern and says that he’ll be doing the spinal tap and is that okay?  Again what am I suppose to say so I say yes. 

I laid down and the intern rubbed numbing ointment on my vertebrae and then they all talked about different things, things that mattered in their lives, while they got the rest of the equipment ready.  After about 10 minutes the intern wiped the ointment off and tapped my spine with his finger.

“Can you feel that?”  his voice sounded a little nervous

“No” I said

My nurse came to my side and I held her hand.  I remember looking up into her face and she smiled at me and winked.  I closed my eyes and waited. 

I could hear the doctor moving to stand behind the intern.  Then the initial prick of the needle.  I heard the slight pop of it entering my skin and then it moved further into my muscles.  The pain took over and I tightened my grip on the nurses hand.  She held on as I tried to transfer it to her.  Then it got worse.  Worse then I’d ever felt and my voice found the pain and tried to release it in a scream.  Tears flowed down my face and mixed with the sweat.  I tried so hard not to sob because knowing that once my body started to move it wouldn’t want to stop.

The intern was scared.  He said something to the doctor and the doctor reassured him in a quiet voice and told him how to move the needle around through my muscles until he found the pocket of fluid.  The needle moved and the attack continued, wave after wave hit me.  I bit my lip, I clawed the nurses hands, I was scared that it would never end and the pain would get to a point when eventually it would end in death. 

Finally I heard the intern release his breath as he withdrew the needle.  Fluid was collected. Chemicals had been infused.  Mission complete.  My body felt the release and twitched involuntary and I continued to cry.  I tried to roll onto my stomach and bury my head into the table so I could l release my cries and not be as loud. 

They felt bad, and guilty.  I could feel it in the room all aound us and because of the guilt they didn’t want to comfort me.  They wanted me to take it back.  Tell them it didn’t hurt, that it wasn’t their faults. 

The intern came around to my side and he was holding a little laminated sign. 

He told me to point to how I felt.  I can imagine a class called “Pain Scale 101″ that they give to doctors and they teach them if a patient is allowed to point to a sign that shows how bad they feel then the pain will be magically transferred into the cute little frowny face and be felt no more. 

I pointed to “10 HURTS WORST” and looked him in the eyes.  Take it.  I felt pain under your hands.  Say I’m sorry I hurt you.  Say it. 

He smiled sweetly  and says “I’m sure it wasn’t that bad”

That’s when I needed a  man in the room who loved me so much that he would knock this guys teeth out for saying that.  He would grab the intern by the collar of his white coat and throw him against the wall and say between gritted teeth

“LISTEN YOU SWEAR WORD SHE SAID IT SWEAR WORD HURTS!  APOLOGIZE NOW!” 

 and then shove him to the floor and come to the table where I lay, gather me in his arms and take me away.  We would drive all night to Mexico for alternate treatment where spinal taps are non existent, the only thing that would be on the plan would be to lie on the beach sipping fruity drinks and holding hands. 

The intern continued smiling at me and held the sign at my eye level.  He wanted me to point to a lesser pain but I couldn’t.  I closed my eyes and just wanted to go, get out of here, go home.  The intern walked away dejected, he had wanted me to forgive him but I couldn’t when he had never wanted to take the responsibility of what he had done.  

My head hurt from crying so hard.  The nurse helped me up and back to my room.  I laid on the bed and watched TV until it was time to go.  As I walked out to the car with my mom the headache got worse. 

 

To be continued.