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Friday, December 02, 2005
 
A PERSONAL BLOG ENTRY - MY MYELOGRAM

Of the hundreds of thousands - maybe millions of blogs on the Internet - huge numbers are used as little more than personal diaries. From time to time, I myself have included personal items on this commentary blog which have had little to do with observations of the passing parade. For example, in October of 2003, I included an ancient piece of fiction that once appeared in an ABC Television House Organ that I wrote and edited a lifetime ago. And there have been other such deviations from contemporary commentary over the past 33 months.

Many years ago, at a relatively young age, I had an operation that is usually thought of as a procedure that is common in elderly males. Before the operation I tried to read up on what to expect but it wasn’t easy to find any useful material. This was in the days when there was no Internet, so searching for information was time consuming and not very fruitful. What information existed was written in a stilted fashion, more suited for a medical professional than a layman about to go under the knife. I determined, after the operation, to create something that could be used by others facing the same kind of surgery and indeed I put something together in readable form that I thought would be extremely useful to other patients. I was never able to do anything with it in terms of getting someone like a pharmaceutical company to distribute it to surgical specialists around the world. And I’m not that sure that it would have served its intended purpose because individual experiences of the same operative procedure vary.

Still, I think it’s helpful for laymen to describe their experiences of various medical procedures rather than leave professionally produced explanations by medical people as the only source of information when one is doing a search - in this day and age of course on the Internet.

Yesterday, I underwent a myelogram of the lumbar spine, which I researched on line for days before the procedure. Here is a typical site chosen at random that is full of information that differs somewhat from my personal experience. There are hundreds of such sites. Just type in myelography or myelogram and up they pop.

Most sites say that you will be given all kinds of instructions and warnings before you appear for your test. It didn’t happen for me but that may have been an oversight of the hospital. If so, I’ll come back and correct this segment. The doctor performing the test did give me a consent form to sign before the test and quickly ran through a few of the risks that are listed at many of these sites.

From my perspective, it was a reasonably benign procedure. My test began with being positioned face down on the table with a pillow under my belly, a pillow - later replaced by a soft towel under my head to get my shoulders closer to the table - and some soft material under my ankles and feet that I requested for comfort and placed there without question. They wanted me in a particular position and to be able to hold it and I must admit it wasn’t the most natural position one would select to lie face down - but then again I wasn’t there to take a nap - I was there to be in the best position to get contrast dye injected and take pictures.

The procedure begins with numbing the skin. Contrary to what is described in many of the web sites I checked, I did not have to pull my knees up under my chest or sit on the edge of the table. The numbing injections - which the doctor said were the "worst" part of the test, were done while I was lying face down on the table. There was nothing bad about the numbing injections. What the doctor described as a "bee sting" that I would feel for the first injection was more like a pin prick. There are multiple injections to get the numbing effect deeper and deeper and I only felt the pin prick of the first one.

What takes the most time in these tests - and mine was no exception - is finding the right pathway to get the contrast dye injected into the cerebrospinal fluid. It’s often trial and error and it was in my case. The first selected site didn’t work because there was some bone in the way and the doctor had to try another level of the lumbar spine to get the spinal needle in place.

Most all of the sites say a couple of things about the spinal needle. One is that you may feel "pressure" as it’s inserted. Yeah, maybe. I really wasn’t sure when it was being inserted. Certainly I didn’t feel it going in. The other is that you may feel a "sharp pain" while the doctor is positioning the needle and this gives the impression that there may be a "sharp pain" at the needle injection site. I did have a couple of "sharp pains" that lasted perhaps a fraction of a second - but they were in my legs and more like a sudden electric shock. And when I say legs I don’t mean both at the same time. When the doctor was trying to insert the needle at the first site, I got a momentary shock in my left leg and it happened in the other leg when she was trying an alternative site.

I must emphasize that this is not "pain" that one has to "endure." It happens suddenly and is over so quickly that it doesn’t have time to register as "pain" - and the first time it happened , the doctor said "good - that means I’m in the right position."

After a good path to the subarachnoid space was located, in went the contrast material which I didn’t feel going in at all. I had to ask what was going on. The doctor asked me if I felt anything - like heat - and the answer was no. I felt absolutely nothing. The spinal needle then came out and the picture taking - which takes very little time - began. I wasn’t strapped onto the table and it wasn’t tilted every which way as the various sites describe. The only "titling" was when they took a close to upright position picture. The table was tilted upwards and I was more or less standing on a protruding ledge at the back end of the table with the rest of my body still pressed against the table, For all other pictures, I was placed in different positions rather than the table being tilted.

I can’t say that my personal experience was typical of what the average patient undergoing myelography will experience, but if they asked me what to expect, I would tell them that it’s a pretty benign experience and nothing to be worried about. I was somewhat apprehensive in the days before my test and waiting for it to begin. I wouldn’t be in the least apprehensive if I had to undergo it a second time. I had a similar experience a year or two ago when I had two series of epidural injections to try to relieve my sciatic pain. Before the first injection, I was tense and apprehensive. For the second I was loose as a goose.

After my myelogram, I was taken for a CT scan while the contrast material was still in my body. This doesn’t happen after every myelogram but it was what my doctor had ordered. After that was finished, I had to lie down for a couple of hours before they’d let me go home which I guess is routine. Some sites talk about many more hours and some talk about having to "lie flat for 24 hours." From my experience, I doubt that that happens - or if it does, that it’s a rare happening.

I didn’t get a headache or have any other kind of reaction. I did feel a little tired and slightly unsteady for a while as I was leaving the hospital but it soon passed. It is after all an invasive procedure and I’m a senior citizen . Someone a lot younger might not feel in the least bit bushed.

A and that’s my personal story for today - and most likely the last of this year.

Incidentally, if you didn’t click on the above link to view an earlier sample of "personal" blogging, you’re missing something worth while. After all these years, it’s still one hell of a cute short story.