Hey There,

I don't post much, but your anxiety is totally understandable given the bad experience you had the first time..let alone Spinal Taps alone are just plain scary.

It sounds like this Tap is being done under Fluroscopy which is great...it means the Dr will be able to see exactly where s/he is inserting the needle during the whole procedure, so there should be no multiple sticks or jabs...

When I need a Tap I always insist on Fluroscopy, and I also ask that the tap be done by Neuro-Radiologists...I don't know what type of MD is performing your Tap, and it may be too late to ask, but Neuro-Radiologists are experts in diseases of the central and peripheral nervous system, spine, and head and neck and perform Taps very often..so something to think about for future.

Regardless of what type of MD is performing your Tap tomorrow, you've got the Fluroscopy, and that is the best tool available to ensure a safe Tap...so take a deep breath and squeeze the heck out of the nurse's hand (she's used to it, trust me)...

You're going to do just fine

:)

Also another huge tip is let the doctor know what you are feeling and about your bad experiences in the past. A good doc will talk you through it and make it easier, they may also give you some anti anxiety meds to take the edge off or numb you extra. Deffinetly talk to them through the procedure so they know if they come near nerves as they can't see those silly thinks on the fluoroscope and rely on us to tell them so they can either numb it or move the needle. I have had a bad tap and a better one the better one the doc talked me through everything and explained the point where I was just going to have to power through the discomfort which wasn't that bad compared to other taps and then he got through that part quickly because of the fluro as he could see and let me know he was done moving the needle, made sure I was able to relax and then we were able to chat and have a nice convo while we waited for my csf to drain and the sweet relief of normal pressure to come. It can be a good experience. I had myself worked up before that LP and let him know that and he helped calm me down and make it easier. I still don't wAnt another but if I have to will request him. Hope this helps.

Thanks for the encouragement. I thought I had read in one of the post here the other day that anxiety meds could possibly mess up the reading of the opening pressure? Is that possible. Or do they just add so much to the opening pressure depending on how much anxiety meds they give?

I am SO sorry to hear about horrible first LP experiences - and I add my own to the mix. They are usually done when we are in pain, scared, usually with some sort of brain fog (so we do not completely understand all that's going on around us), and with general uncertainty by doctors who "have done plenty of these" (according to them). The difference when done under the fluroscope are dramatic and amazing. I had 5 lp's under the fluro. Going in for the tap, and being prepared in advance makes a HUGE difference. Four of them were so much easier - I have a lot of scar tissue and arthritis in my lumbar region which was only made worse by repeated taps. The interventional radiologists were very willing to talk me through the taps and explain what was happening as it was occurring.
If you notice anything unusual during the tap, make sure you tell the dr. During the last tap, the needle was along one of the nerve bases for my leg and as the fluid was drawn up the nerve was tangled and caused some problems. I am fine now - but the doctor needed to know why I was trying so hard not to squirm all over the table. :-/
As for anxiety, some hospitals give an iv for lp's under the fluroscope - you may want to call your doctor and tell them your concerns and see what they recommend. And for the post care - to avoid the blasted head pain - still be sure to stay down, drink lots of fluids, and let the nurses know you have had a post-lp headache in the past - they tend to not push you out the door as quick that way.
Will be thinking of you!

Hiya Soccergirl

I don't know if anxiety meds can affect the reading of your opening pressure or not, but, I tend to avoid any meds that affect cognition during a Tap...it's important that you are aware and alert...as was mentioned, you need to be able to sepak up if you feel pain and tell the Dr where you feel it quite quickly, and I have found benzos,can keep you a little less sharp-minded...or make you a bit sleepy
That is just my experience, everyone is different.
With fluroscopy, I never had any nerve pain, and once I got tipped off on having Neuro Radiologists (they usually work in teams...one observing the screen and verbally guiding the Dr performing the procedure so he never has to take his eyes off of you) I barely even felt taps...
So again, everyone is different, and the choice is yours.
However, I think most will agree that a Tap under Fluroscopy makes a huge difference, and it the world of Spinal Taps, if it's possible, you will be 'pleasanty' surprised :)

Again take a deep breath and squeeze the nurses hand really hard...she won't mind

You're going to do just fine

All the best,

Sorry to hear about your anxiety. No fun, to say the least. For what it's worth taps can and usually do go really well. I've had just two, one sitting up by an ER doc and one under fluoro by a neurorad and both went well. Zero pain, just a bit of pressure that feels a little yucky and both were "champagne" taps, over with in a couple of minutes. I didn't have any sedatives, at my hospital they are typically given in the ER for taps but I declined as I was already feeling dizzy. Just tell yourself - this test is for YOU, for the benefit of YOU. Your part is to be still, as calm as you can be and get it over with as optimally as you can. Maybe that sounds funny but I've been through a variety of tests the past few years and focusing on that kind of logic helps me through the tougher ones.

I tend to recommend meditation for anxiety. I was introduced to it through biofeedback and later a class called mindfulness based stress reduction. It can really help. My favorite is a CD that has mini-meditations, some of which focus on breathing and other techniques. If you are open to this, I'd recommend buying it on iTunes or something to start using now, and then maybe you can try to focus on your breathing during the LP.

http://www.amazon.com/Guided-Meditations-Busy-People-Bodhipaksa/dp/0972441433/ref=sr_1_4?ie=UTF8&qid=1389706571&sr=8-4&keywords=bodhipaksa

Now I will admit, I have had trouble with pain AFTER my LPs. I managed it by taking some leftover Percocet. Hope you've got some on hand, and if not, don't hesitate to call your doctor and ask for it if you have any significant back or head pain.

Best wishes - you can do it!

Good luck tomorrow morning. We'll be sending good thoughts your way.

fluoroscope = much easier!

I've had bad taps before, including hitting a nerve over 10 times in 1 tap during one where I had no x-ray, no anti-anxiety meds, nothing. Afterwards I told the nurse she did a fine job, and I have no idea why I did that b/c it was horrible. Oh, yeah. Now I remember. She kept bragging about no blood in the csf fluid.

Using x-ray makes it a piece of cake. The worst part was the local anesthetic, and that wasn't too bad. Last time I had a really cute young-guy medical assistant in the room who obviously worked out with free weights because he looked like he could lift the entire room with one arm. He was so happy to offer to hold my hand. I said no because I didn't think I'd need it. My mistake! I should have held it anyway! lol

Thank you Twisted, Love, RN & Sea for responding to my post. I have calmed down a lot. Trying to stay that way.
Sea, you just gave me a great laugh to go to sleep with about your good looking med-assistant!!! After all of you telling me to hold the nurses hands bc they're use to it. I will take the advice and go with it!
I went to the chiropractor and was told I have muscles sprain in my lower right side back area. I will tell them. Hopefully that wont cause a problem. Thanks for the good thoughts/prayers and remembering me. I'm glad I came across this site when I was searching for answers!! I don't feel so alone.

I am back home from my LP. It has been a long day. I had to be there at 7. This experience was so much better then the ones before. My opening pressure was only 20 an closing was 13. I have been a lot higher before... but this PA told me that since Ive been on the meds and what not what is normal for others (20) might be high for me. BC as soon as she finished my the pain behind my eyes relieved and I thought I could see pretty good before I can see a whole lot better now. When I got back from radiology my nurse was thinking I was out of it bc I was like hey they need to repaint over some of the chips in ceiling and she was like ya its been that way for a while. I was like it wasn't that way this morning. And then there was this light right above me and it had a piece of small tape in it with some writing and I was like hey theres some tape there with writing and initials.... she is like are you seeing things now? Nope just look for your self. She is like wow! your eyesight must have been way off bc that Ive never seen and two that is a special affect light. Two other nurse came in to double check that both my nurse and I had seen this piece of tape.LOL she was like you had some major issues girl glad we could fix you up today.

Glad to hear that it went well and that it improved your symptoms so much!!

Thank you RN :)

So glad today was productive! It's nice when we can get such immediate results! :-)

And now, not to sound too bossy but...

Please, do yourself a favor, rest for at least the rest of today (shouldn't be too difficult) and try to keep things light and easy for the next couple of days. Drink lots of fluids. If you need to, drink some caffeine. As weird, and personal, as this may sound, don't push when going (sorry, it's weird I know, but I wish someone had told me).

Again, so happy all went as well as it did :-)

yeah the pushing is a valsalva which we should all be avoiding, always. valsalva is bearing down with toileting, coughing, sneezing, even laughing, crying, singing, shouting, holding your breath. lifting weights. even talking, really.

wow, that is really crazy that an ICP of 20 affected your eyesight so much! just goes to show you that they really don't know what a normal pressure is and shouldn't be making judgments based on it if all the other pieces point to IIH. did they do it with you on your side or laying on your stomach? because if they do it with you on your stomach they need to add the length of the needle which is 6 cm. so if they didn't do that then your ICP was really 26.

Resting, check. Sneezing equals horrible. And I was laying flat on my stomach and I heard the PA tell the recording person opening pressure was 20 and closing was 13. And then the PA said I got a total of a 11 off? what do that mean? the math between 20 and 13 doesn't add up and neither does adding 6 to the 20 in I was laying flat on my stomach. Im confused.