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From fear to freedom: A journalist’s journey with lumbar puncture

Journalist Vanessa Gonye

WHAT started as a normal reaction to insulin proved otherwise as my condition worsened by the day.

I was having incessant headaches since January and for a night, I slept at the casualty section of Parirenyatwa Group of Hospitals and despite all effort to find the root of the problem, none was found and I was discharged the following day.

For several months, I endured pain and it worsened in April.

A visit to the doctor and some tests gave me the chills as I was told my headache challenge was likely to cause blindness.

My prolactin level was double the normal one.

Doctors suggested admission which I quickly agreed to as I feared the worst.

After some scans and tests, they still couldn’t find anything amiss, but the discomfort continued and I was told to go for a Magnetic Resonance Imaging (MRI) scan.

I couldn’t afford the cost of such a scan and I resigned to fate while at the same time hoping a miracle could happen so that I could raise the money.

Friends, colleagues and relatives joined forces to help to raise the much needed money.

I managed to go for the scan after three months, but unfortunately, the results were not impressive.

That was the beginning of another challenge as I was told the next route was a lumbar puncture.

The Johns Hopkins Medicine says a lumbar puncture or spinal tap, is a diagnostic and/or therapeutic procedure while the National Institutes of Health refers to it as a commonly performed procedure that involves obtaining and sampling cerebrospinal fluid from the spinal cord.

It was developed by Heinrich Quincke in the late 19th century.

It is the gold standard diagnostic procedure for meningitis, subarachnoid haemorrhage and certain neurological disorders, including headaches.

Based on my condition, it was the most appropriate.

But I was reluctant and afraid to go through it.

Growing up, I had heard horrific stories about the procedure and my first instinct was to refuse, yet at the same time I wanted to be healed.

I explained my worries to the doctor, who assured me that I was going to be okay.

Banking on that, I agreed to be admitted to hospital, but inside, I was hesitant.

All the people who spoke to me quickly highlighted the dangers associated with lumbar puncture.

What was more chilling about the perceived effects of the procedure was I would die within a short space of time or would be crippled for life.

However, many medical experts have dispelled these misconceptions, especially given the major advancements in the health sector.

A medical specialist, preferring anonymity, said: “Years back, people would visit health centres already terminally ill and when doctors tried to do investigations, lumbar punctures included, some would die even before receiving medication. Relatives would then conclude that it was because of the procedure.”

The specialist also said a factor that could lead to a lumbar puncture being fatal was that of raised intracranial pressure (ICP), hence it is recommended that before performing the procedure, a computerised tomography (CT) scan be done to rule out raised ICP, space occupying lesions like tuberculoma, lymphoma and toxoplasmosis.

If a CT scan is not done and the procedure is done on patient with a raised ICP, it is fatal because it causes herniation.

And the brain collapses.

I did extensive research before braving up and accepting to go through the procedure.

Medical practitioner Admore Jokwiro said a lumbar puncture was a safe and scientifically validated procedure that involved accessing cerebrospinal fluid (CSF) to diagnose and manage various neurological conditions, including infections such as meningitis.

“The procedure carries minimal risks, with the most common complication being a post-lumbar puncture headache, which can be effectively managed with simple analgesia. Despite its proven safety, lumbar puncture has been unfairly associated with serious complications, including death,” he said.

“This misconception stems from the fact that many patients undergoing lumbar puncture already have severe underlying conditions, such as meningitis, which can be life-threatening if left untreated or diagnosed late.”

Jokwiro said it was crucial to distinguish between the procedure itself and the underlying condition being diagnosed.

“Lumbar punctures are not the cause of adverse outcomes. Rather, they are a critical tool in identifying and treating potentially life-threatening conditions. Moreover, lumbar punctures play a vital role in administering spinal anaesthesia during surgical procedures, providing effective pain management and reducing complications.”

In my case, the attending physician was good enough to explain everything to me until I understood.

Contrary to beliefs, the procedure is quite simple, one only needs to adhere to instructions.

It wasn’t painful except for a stinging sensation when the needle was inserted and collecting the fluid from the spine.

I felt the impact of the procedure after it had been done because I adhered to the instruction that I should lie on my back all the time and limit movement.

Results of the procedure linked the challenge to my diabetic condition and an occipital nerve block was suggested and I agreed.

The Barrow Neurological Institute describes occipital nerve blocks as a type of therapeutic pain procedure that involves injecting a local anaesthetic in the area around the occipital nerves.

The occipital nerve is a branch of C2-C3 nerve roots, exiting the spinal cord and extending up to the back of the head and towards the top of the head. These nerves are often involved in migraine and other headache disorders, such as occipital neuralgia.

Occipital nerve blocks relieve headaches by blocking pain signals that the occipital nerves send to the brain.

Since undergoing the procedure, I haven’t had any headache challenges or sight problems.

Courage paid at last though I feared the worst and only had the determination to be healed as my driving force towards the frightening  procedure.

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