Spinal Headache (aka Postdural Pucture Headache)

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Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2283
   Posted 10/14/2008 9:08 AM (GMT -7)   
Anyone got any tips or tricks for dealing with these evil things?

I got one a week ago after an epidural & it's a killer. My PM is on vacation (yet again) until next week so blood patch is off limits until next Tuesday. I've tried caffeine in the past, but it's not helping me this time.

Has anyone tried anything else that's helped, even a little bit? I'll try absolutely anything that's legal.
I'm soooooo miserable. I can't stand up straight or the nightmare pain sets in & it's getting really uncomfortable walking around hunched over all day.

Please help! confused

frances

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 10/14/2008 9:27 AM (GMT -7)   
Why is the patch off limits? Most ER docs can do them.
In the meantime, the best thing to help with the headaches is caffeine and lots of it. Cola, coffee, tea, whatever type of beverage you want to drink that has lots of caffeine in it...
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.


Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2283
   Posted 10/14/2008 9:48 AM (GMT -7)   
The last time I went to the ER they botched it up pretty bad b/c a Student was treating me (which is common) & I had to get it re-done a couple days later. Plus, I got this huge lecture from the Attending about how a spinal headache is not an emergency & the ER docs are not well trained to do them & that I should have waited to get in to my PM (who was the one who had recommended I go to the ER in the first place since it was Friday night after hours).

I guess I'll just keep trying the caffeine. Thanks!
frances

d2parrotperson
Regular Member


Date Joined Aug 2008
Total Posts : 320
   Posted 10/14/2008 9:49 AM (GMT -7)   
Are you sure this isn't a spinal fluid headache? Sometimes, no matter how careful the dr is they can cause spinal fluid to leak. This will cause horrible headaches. If you're not sure you may want to be checked.
150mg Azathioprine, Lomotil, Iron, Nexium 2/day, Fentanyl patch, Oxycodone, Baclofin
Crohn's, Fibromyalgia, Several bulging discs, Bone spurs, Osteoarthritis, Osteopenia, Reflux, Stenosis, Strictures, Dengenerating facet joints
2 resections
 
Stephanie
When I am weak, then am I strong


Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2283
   Posted 10/14/2008 10:35 AM (GMT -7)   
Yes. That's exactly what it is.
Same thing, various names -- spinal fluid leak, spinal headache, post dural puncture headache -- they all mean that the epidural needle actually tore the dura & that CSF is leaking out. My PM has already diagnosed me with that. It was rapid onset (minutes after the injection) because he said there must have been an air bubble in the epidural needle. Somehow that speeds up the time it take to get the headache from 24 hours to almost immediately after the shot. I got the headache before I even left his office, so we already know what it is. He really wants me to wait the 7-8 weeks it usually takes for this to go away on it's own, but I'm much more miserable than normal so I'm thinking I'm gonna press for the blood patch when he returns to his office next week.

The only thing is that it keeps getting worse by the day (yes, my PM knows that as well) & the caffeine hasn't been helping, but I will try drinking even more of it and maybe that will do the trick. My doc told me to try lying on my stomach, but that is the most horrible head pain ever in my life except for when I had my craineotomy; so I thought if there was something that would help I would try it so I can be more comfortable lying on my tummy waiting for this evil thing to heal itself.

As Winnie the Pooh would say "oh, bother!". rolleyes

frances

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 10/15/2008 2:20 PM (GMT -7)   
Frances,
I have NEVER heard of a doctor asking a patient to wait 7-8 weeks for a spinal puncture or dural headache to go away...that is ridiculous.
Does he have anyone to cover for him? If he does, I would be calling his office and demanding that they do something for this.
If he does not, go to the ER, they can have the radiologist do the blood patch. Or a doctor in the ER, not a resident, but someone who knows what the heck they are doing, perform the patch. It is well within your rights to request that, in case you don't know.
It is not good to wait that long for the leak to heal itself. If it is going to, it will do so in the first few days. It does not take that long.
Truly, if you are in that much pain, then by all means, seek out care of a competent physician now.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 10/15/2008 3:58 PM (GMT -7)   
Frances,
I wish I knew something about this subject, but Sandi always has "right on" information. Can I foolishly ask - what is a blood patch? I think I understand the puncture issue, but don't know anything about the solutions.

But hey, if you're not feeling well don't worry about educating me! That can wait.

Sending you positive thoughts. Wish I could do more.

PaLady

mommyofthree
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 10/15/2008 8:26 PM (GMT -7)   
I had one before as well after a pain pump trial procedure which was done on a Friday so I had to deal with it all weekend.  Lying flat on my back helped alot as well as drinking tons of Mt. Dew.  I hope you feel better soon :)

d2parrotperson
Regular Member


Date Joined Aug 2008
Total Posts : 320
   Posted 10/16/2008 9:05 AM (GMT -7)   
The last person I knew who had this wound up in the hospital adn eventually had to have surgery.
150mg Azathioprine, Lomotil, Iron, Nexium 2/day, Fentanyl patch, Oxycodone, Baclofin
Crohn's, Fibromyalgia, Several bulging discs, Bone spurs, Osteoarthritis, Osteopenia, Reflux, Stenosis, Strictures, Dengenerating facet joints
2 resections
 
Stephanie
When I am weak, then am I strong


mommyofthree
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 10/16/2008 10:31 AM (GMT -7)   
Was the surgery from the spinal headache or the pain pump?

d2parrotperson
Regular Member


Date Joined Aug 2008
Total Posts : 320
   Posted 10/17/2008 9:28 AM (GMT -7)   
If you are directing your ? to me, mommyofthree, it was from the spinal fluid leak. If not, oops!
150mg Azathioprine, Lomotil, Iron, Nexium 2/day, Fentanyl patch, Oxycodone, Baclofin
Crohn's, Fibromyalgia, Several bulging discs, Bone spurs, Osteoarthritis, Osteopenia, Reflux, Stenosis, Strictures, Dengenerating facet joints
2 resections
 
Stephanie
When I am weak, then am I strong


kara487
Veteran Member


Date Joined Mar 2008
Total Posts : 637
   Posted 10/17/2008 11:07 AM (GMT -7)   
Frances , I had a spinal headache from a myelogram I found laying flat helped me alot and my dr also gave me pain meds for the headache I also had naseau with mine and he gave me phenegran for that. They also told me to drink lots of caffeine . I feel for you it is the worse headache I had in my life. I hope you feel better soon.
Lortab,ambien,elavil,reglan and neurontin.
 
spinal conditions: Scolosis,herniated discs,spinal blockage,Spinal stenosis,bursitis and arthritis


mommyofthree
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 10/17/2008 12:22 PM (GMT -7)   
I found that the pain meds did nothing for the headache only lying flat and then 3 days later I finally had a blood patch done which was like a light switch - it just turned off.  The nauesa pills did help me alot though but they were very expensive my copay was $100.00

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2283
   Posted 10/17/2008 2:34 PM (GMT -7)   
thanks so much for the suggestions.
I have been trying to go to work as much as I can (even though I have to lean forward in order to keep from crying out in pain). Maybe it would be better to try to rest more.

To top things off, we had a fire drill at work yesterday. I work on the 5th floor. One of my clients saw me from across the parking lot & called the paramedics on her way to check on me because I looked so pathetic. Fortunately, one of the attorneys I work for argued to get me a special exemption in the future, but that doesn't help for now.

As far as getting one of his partners to provide any sort of medical care, that's not going to happen. It would seem his partners are the virtual equivalent of witch doctors. They don't do anything except write refills on meds during his absence. Even when I've been admitted to the hospital, they won't write any new meds or order a PCA pump & I have to suffer through the weekend until I can get treatment. Sadly, my insurance, though it pays everything for in-network docs does not have much in the way of choices for in-network PM docs. There's the clinic I go to & a couple of others I've looked into that won't write fentanyl for non-cancer patients ever (even though I've literally tried EVERYthing else & am allergic to all the alternatives - and yes, there are a lot of alternatives) so I'm kinda stuck with my current doc. Don't get me wrong - mostly I really like him. He spends time & listens to me. He's familiar with a lot of meds & is willing to write for them. He doesn't get mad on the rare occasions when I run through my pain meds in less than a month & knows how to get the insurance to pay to get me early refills. I know I'm luckier than most, but this really is miserable.

I really don't have the money to go to the ER even if I thought they'd get it right this time, so I was hoping for some kind of home remedy to get me through (I will try to lie down more, hopefully that will help). I will really press next week when my PM returns to get him to give me a blood patch. I don't know what his deal is, but I think this is insane that he won't treat me. I don't understand how doubling the dose of pain meds I'm on is a better treatment plan than a simple blood patch. I asked my PM, but his lips are sealed. Kinda makes me wonder if he's trying to hide something. That's probably just me being crazy from all the pain & hard core meds, but I still wish he'd just be honest & forthright with me. Maybe that's too much to ask for in today's overly litigious society?


To whoever asked about what a blood patch is -- they take blood out of your arm & inject it into your back. Somehow the blood magically finds its way to the hole & covers it up. Then the spinal fluid doesn't leak out anymore. When it's done properly, it really does work almost instantaneously & gets rid of 90% or more of the pain related to the spinal headache; the residual pain, if any, is usually gone after a good night's sleep.


Wishing you all a sunshine-y day,
frances
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