"Spinal leak" Post LP

[shepardsun]

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"A spinal fluid leak derailed my life of travel and food, but taught me to find beauty in the small things"

"Will I ever be sealed again? I don't know.

During this leak journey, specialists confirmed that I have two genetic conditions that complicate my prognosis, one affecting the immune system, called Mast Cell Activation Disorder, and the other a heritable connective tissue disorder called Ehlers-Danlos Syndrome."

Gotta say I've never heard of said spinal CSF leak syndrome as like a chronic pain condition.

Weirdest thing to me about the entire story is that multiple hospitals denied her a blood patch. I'd be like "sure former lawyer lady, whatever you want."

 

[dabears505]

Steve Kerr the coach of the warriors in the NBA had a dual tear during spine surgery and had crippling headaches for a long time.

 

[IMGASMD]

It was from a diagnostic LP!
I found even more fascinating was the fact, Duke or any institution that has months long waiting listing for patients to be seen and treated for the said condition.

 

[PainDrain]

Ohh, she is an EDSer. That explains so much here. Now, my favorites are those with 20+ allergies and a diagnosis of EDS based on some vague symptoms who saw a genetic counselor for testing which came up as negative but the counselor then writes some BS saying “May still have EDS based on fact our testing only screens for the 30 known EDS genetic errors.” Most diagnostic LP kits are a 20G needle and you are telling me this caused a chronic CSF leak leading to debilitating symptoms? I will file this with the sero-negative RA, fibromyalgia, chronic arachnoiditis, etc patients and say that you will never be fixed.

 

[DrOwnage]

One of my partners will not do EBPs on anyone who got their dura violated by anyone except anesthesia partners. He will especially not do neurology taps. He refers those to IR. The chance of something being wrong to begin with (why they were doing the procedure) and the EBP making it worse puts you at risk for malpractice litigation.

 

[GassYous]

I wish I could think of some bs diagnosis so I can quit my job and live on government dole forever

 

[Mman]

Most diagnostic LP kits are a 20G needle and you are telling me this caused a chronic CSF leak leading to debilitating symptoms?

it sounds like they made swiss cheese of her dura and I have placed EBPs in people like this that had more poke holes than I could count

 

[D P356]

I’m of the opinion that if my group didn’t cause it, I’m not inclined to do the blood patch. I have no desire to muddy the clinical picture and potentially cause further neurological complications.

 

[IMGASMD]

I’m of the opinion that if my group didn’t cause it, I’m not inclined to do the blood patch. I have no desire to muddy the clinical picture and potentially cause further neurological complications.

I remembered a spontaneous dura tear for a patient….. no one would touch her. And it was something like in the thoracic level. Radiology wouldn’t touch her either, since they only does diagnostic procedures (or whatever the rationale was). One of the attending, with huge balls, volunteered to patch it.

I’ve patched someone’s puncture; people have patched mine. I guess we’ve all learned to fix our own complications; when it’s someone else’s mess, it feels yucky.

 

[GassYous]

I remembered a spontaneous dura tear for a patient….. no one would touch her. And it was something like in the thoracic level. Radiology wouldn’t touch her either, since they only does diagnostic procedures (or whatever the rationale was). One of the attending, with huge balls, volunteered to patch it.

I’ve patched someone’s puncture; people have patched mine. I guess we’ve all learned to fix our own complications; when it’s someone else’s mess, it feels yucky.

To be fair if I hit the carotid or something I wouldn't be able to fix it so I'm happy to help my fellow physician when they need it

The liability angle is something that I haven't thought about but I think I'd still do it if I thought it would help the patient

 

[nimbus]

I remembered a spontaneous dura tear for a patient….. no one would touch her. And it was something like in the thoracic level. Radiology wouldn’t touch her either, since they only does diagnostic procedures (or whatever the rationale was). One of the attending, with huge balls, volunteered to patch it.

I’ve patched someone’s puncture; people have patched mine. I guess we’ve all learned to fix our own complications; when it’s someone else’s mess, it feels yucky.

If it’s a spontaneous tear, how do you know where it is or how big it is? Sounds like a shot in the dark.

 

[IMGASMD]

If it’s a spontaneous tear, how do you know where it is or how big it is? Sounds like a shot in the dark.

I think the patient had some imaging studies done (?). What I remembered was that I thought he would do a thoracic blood patch, but he still did a lumbar epidural and still worked.

 

[Arch Guillotti]

I’m of the opinion that if my group didn’t cause it, I’m not inclined to do the blood patch. I have no desire to muddy the clinical picture and potentially cause further neurological complications.

I'm not inclined either but if there is no one else to do it doesn't leave me much choice.

 

[Mman]

I'm not inclined either but if there is no one else to do it doesn't leave me much choice.

I will happily place the patch. I'd rather not get roped into doing all the LPs.