Spinal Tap

I've just had what I estimate to be my 27th spinal tap.  

Lumbar puncture, IT, spinal tap, intrathecal... a rose by any other name would smell as shit. 

For those of you who don't know, these play a big role in my treatment, as unpleasant as they are. 

What It Involves 

The procedure involves sitting on the edge of a bed and bending forward, so that the lumbar vertebrae of my spine open up. A doctor then prods and pokes around to find a good spot, then injects local anaesthetic into either side, to numb the flesh. Once numbed, the doctor inserts a needle into the gap between my vertebrae to puncture the spinal cord and collect spinal fluid. 

This is then swapped for a syringe if the chemotherapy drug methotrexate, which is injected into my spinal cord. I then need to lie down for around 30 minutes so that the chemo can "slosh around" in my spine. 

Why I Hate Them

Due to the number of these procedures I've had, it's not always straightforward and because of having had so many needles in it, the lumbar section of my back has formed tough scar tissue. This means that it has become increasingly hard to penetrate with a needle, each procedure now usually takes several attempts, sometimes by numerous doctors, and a few bent needles. As you can imagine, this makes these procedures more painful and lengthy than they should be. 

Because the spinal cord is surrounded by nerves, this also serves a problem, as if the needle hits a nerve it sends a painful "electric shock" through your body, which is very unpleasant. Sometimes, after an intrathecal, I'll be fine and able to carry out my daily activities. Other times, I'll be struck with a bad backache or headache, which means I'll have to recline or lie down for a few days, and restricts me a lot with what I can do, until it has passed. 

All of these, combined with stories of other people's experiences, have made intrathecals a cause of great anxiety for me, and so I always have somebody accompany me to appointments and take sedatives, as well as gas and air, to help me relax for the duration. 

Why They Are Important

The blood system and the central nervous system work independently. However, in some cases, leukaemia can transfer from the blood into the CNS. This is why spinal fluid is collected, to be examined, and chemotherapy is then administered as a precaution, to kill any leukaemia cells which may be present and to prevent any leukaemia cells from transferring. 

Because I presented with headaches and visual disturbances at diagnosis, the doctors were extra cautious with me, and gave me an intrathecal every week for the first 5 weeks of my treatment, which is probably why my scar tissue is so bad. Now that I am on maintenance treatment, I have them every 12 weeks, as per the standard protocol. 

And Finally... What To Do If You're Expecting

If you are reading this and you are due to have the same or a similar procedure, please do not be put off by what I have said. Everybody's experiences are different, many of my friends have gone through the same thing without any complaints, and most of the problems which I face with intrathecals are due to the abnormal amount of them which I have had. If you are worried or anxious at all, don't be afraid to discuss sedation options with your doctor, or to take somebody with you. 

To find out more about lumbar punctures, check out the NHS Choices website. 

Pete