September 21, 2009

Maybe It's Me: My L.P., or, How to Win a Free Juice Box

I signed on to YouTube.com and began typing in “lumbar puncture” into the search box (this was only after I had typed in “Spinal Tap” and received hundreds of videos about a fictional hard rock band - already a self-proclaimed rock star, I decided to focus my efforts on the actual medical videos of spinal taps).

In less than twelve hours I was scheduled to have my very first LP. The only lumbar punctures I’d ever witnessed were ones on television medical shows where the person having the LP usually ended up frothing at the mouth, having a seizure, bleeding from the eyes, etc. I was thinking this probably wasn’t realistic, so I decided to do some investigating.

The first two options that came up for “lumbar puncture” on YouTube was an instructional video on how to correctly perform one (this demonstration was done on a plastic doll) and of a small child getting one done. I clicked on the latter of the two and hunkered down for the eight minute long show.

I only made it about three minutes in, before I, now sobbing hysterically, shut my computer off and called my mom.

“What’s wrong?!” She asked.

“I . . . I . . . I’m scared about tomorrow.”

There was a pause. “What did you do?”

“What do you mean, ‘what did I do’?” I asked defensively, hiccupping through the tears.

“You were fine and then you weren’t. So what did you do?”

I wiped my nose on my sleeve. “Well, I may or may not have looked up videos on YouTube of people having lumbar punctures. And there was this kid! And he was howling like he was having a limb ripped from his body! I can’t do this!”

My mom paused again. “Are you dumb?”

I paused. “What?”

“Are you dumb? Why would you do that?”

“I wanted to know what it looked like,” I responded sheepishly.

I could actually hear my mom rolling her eyes through the telephone. “Take some Tylenol PM, go to sleep, you’ll be fine tomorrow. You’re a rock star.”

This, as previously mentioned, wasn’t news to me. I hung up, took a fistful of sleeping aids, and went to bed.

The next morning came, and after picking up my mom from her house, we headed to the neurologists. Upon arrival we were escorted to a sterile looking room divided into three sections by curtains. The far right “room” was empty, while in the middle “room” a man smiled passively as we settled into the left “room.” I hopped up on the bed, my mom taking a seat next to me.

A nurse came in and introduced herself quickly as she placed the blood pressure cuff around my arm, and a heartbeat monitor on my finger. She rattled through a clearly practiced list of questions I’m sure she asks everyone every day.

“Are you pregnant?” She asked, looking at the monitors on the wall.

I guffawed. “Pfffffft! HAH. NO. C’mon!”

My mom started laughing, and the nurse paused from her obvious nurse-patient routine, looked at me directly and smiled. “Well, then.”

“There are girls ten years younger than you that can’t answer that fast,” my mom chimed in.

“Well, ya know, it’s the life of a spinster.” I shrugged indifferently.

The nurse took the cuff off my arm. “You’re twenty-four? Aren’t you technically a bachelorette? I don’t think you become a spinster until you’re thirty-four. You got ten years. Enjoy it.”

This was the best news I had heard in days. I smiled at her, “Cheers!”

The nurse took my file in her hand, studied it for a moment, and then looked up at me. It was like a switch had flipped: her eyes were gentler, her demeanor much more empathetic. The finely tuned machine of pumping people in and out of the place was suspended for a moment as she looked at me like I was a real patient.

“Why’re you here?” She asked kindly.

“Like, in the grand scheme of things?” I paused.

“Physically, not metaphysically,” she grinned.

“Well, then . . . it’s cause they think I have MS.”

Her face softened, she looked down and shook her head. “You’re too young,” she whispered.

Having previously heard this exact statement, spoken in the exact saddened tone by the neurologist who sent me to have the LP, I put my hand on hers. “It’s okay. I know.”

She cleared her throat, and quickly turned away to exit the room.

A door opened down the hall and an elderly woman left the examination room. She was being helped by two people – a different nurse and a very attractive twenty-something, I assume one of the lab technicians – to the middle “room” where the quiet man had been waiting for her. She was doubled over, her face contorted in pain.

“Annnnnnnnnd, we’re leaving!” I announced to my mom, who placed one hand firmly on my shoulder to prevent me from getting up.

The attractive twenty-something left the room, looking over his shoulder at me before going back into the examination room where he, and who I assumed was Dr. Owen The Pain Inflictor were cleaning up. The nurse who had helped the elderly woman into the room next to me, popped around the corner suddenly.

“Hi there! How are you!?” She cheerily asked, pulling out needles and a tourniquet.

“I’m alright. I guess. How . . . uhh . . . how’re you?”

“I’m great! We’re just gonna take some blood, okay? Ohhhhh isn’t that cute?! You have tattoos. What does that one mean?” She asked, pointing to the 75% on my ankle.

My insides hardened. I don’t like terminally happy people. I don’t like terminally happy people in my personal space. I don’t like terminally happy people in my personal space when I’m having a serious medical procedure done. “It’s a long story.” I curtly responded.

My mom spoke up for me, “Her sister and she have matching ones. It’s some genetic fact she learned in college science.”

“Awww, that’s precious!” The lady cooed as she finished taking blood. “Alright, we’ll see you in there in just a few minutes!” She retreated back into the room where the attractive twenty-something was sitting on a stool checking me out.

I hissed “She thinks I’m twelve, Mom,” my eyes unabashedly staring back at the twenty-something.

“I tried to help you. I threw the college bit in there.”

Just then, Dr. Owen came in and shook my hand. “Steff? I’m Dr. Owen. Thanks for coming to see me today!”

I glared at him. “Oh, dry humor. That’s cute. Yeah, I’m not sure I want to see you, I’ve decided.”

His playful smile faded. “What did you do?”

“What do you mean, ‘what did I do?’”

He stared at me unflinching. I’m sure there was guilt oozing out of every pore from my face. “Okay, well, so, I may or may not have watched some videos on YouTube last night of people getting lumbar punctures,” I admitted. “I wanted to see what they looked like.”

The doctor, without hesitation asked, “Are you dumb?!”

“Yes. Yes, I am. There were children screaming and crying, and now I’m not so sure I wanna hang out with you today, Dr. Owen.”

He pointed to the edge of the bed, “May I?” I nodded and he sat next to me.

“Let’s talk about this,” he smiled warmly. “The reason why the kid in the video was howling was because he probably had leukemia. So, while he was getting an LP, he was also probably getting medicine injected as well, and it burns. Kids usually cry, just because they can feel everyone in the room’s tension. When we do spinal taps on teens, we put them under completely – they’re too crazy to deal with otherwise. And adults, to be honest, especially young, fit ones deal just fine. You will be just fine.”

He then launched into how the procedure was done, and I was instantly comforted. The needle was very small, he mentioned, and not some enormous tool of torture. “We insert the needle in the base of your spine after numbing the area. Yes, you’ll feel it go in,; yes, you’ll feel it go out, but it’s very, very small. We leave it in there until we’ve collected all the fluid that we need. And we’ll talk to you through the entire thing to try and help take your mind away from what it is exactly were doing.

Now,” he continued, “there’s two ways we can do this. You can sit in a chair and bend over; we’ll inject the needle into your spine that way. Or, you can lie on a table, pull your knees to your chest in a fetal position, and we can do it that way.”

“Okay,” I responded, thinking both sounded pretty uncomfortable in an already uncomfortable situation.

“Or, we can do it my way,” and he grinned. “I’m from California and we’ve been doing spinal taps just a bit differently than you East Coast folks. In my way, we’ll lie on your stomach; I’ll take an x-ray of your spine and then put the needle in your back. We’ll then roll you to your side and let the fluid drain out of you naturally. It also is less likely you’ll have any risks from the procedure, like a headache.”

“Works for me,” I said.

He nodded, scanning through his charts again. “Any questions before we go do this?”

“Would you be able to tell if the fluid coming out isn’t normal just by the way it looks.”

“Well, if it’s green, then yes, obviously,” Dr. Owen offered.

I rolled my eyes. “No, but if it’s cloudy or has trace amounts of blood in it, can you look at it and know that there’s something unnatural, unhealthy going on?”

“First of all,” the doctor looked from my mom to me, “the fluid won’t be cloudy, because if it was, you’d already be in the ICU or dead. We do these tests to examine levels of things like proteins, glucose, etc.”

I took a deep breath and pushed myself off the gurney. “Let’s just do this, already.”

What happened over the next hour I wish a film crew had captured.

I went into the room where the terminally happy person and the attractive young lab tech were waiting for me, took off my shoes, and hopped up onto a table. I laid on my stomach and the nurse hiked up my shirt, then yanked down my pants to reveal my back so that Dr. Owen could take the x-rays.

“How’s my spine? Is it pretty sexy?” I asked.

“It’s one of the sexiest spines I’ve ever seen. I was thinking about printing out a picture for you to keep to celebrate its sexiness. Would you like that?” Dr. Owen said, unwrapping a needle.

“I hope you’re not joking with me right now, because all I want is a picture of my spine signed by the three of you so that I can always remember this moment.”

“You ready, honey?” The nurse asked. Before I could think of anything witty to say, there was a flash of cool on my lower back before I felt a thin piece of steel prick my skin and then slide into my spine.

“I FELT THAT!” I blurted out.

“Are we ready, doctor?” The nurse looked at Dr. Owen and I picked my head up from the table to look at them.

“Now what?”

“Now, we roll you over to your side, so the fluid can . . .”

Before he could finish, I had pushed myself up and was getting ready to settle myself on my side when I felt three pairs of hands hold me down. “What’re you doing? WHAT’RE YOU DOING?!” I started raising my voice, as the three set of people in the room started physically rolling me over like I was a beached whale. “HOW MANY PEOPLE DOES IT TAKE TO ROLL SOMEONE OVER?!? I CAN DO THIS MYSELF!”

As they rolled me over to my side, I realized that my back was facing Dr. Owen and the nurse, and my front was facing the cute twenty-something. My hand instinctively reached for my shirt, to pull it back down over my stomach, pudgier than normal since I had been indulging on ice cream.

“Keep the shirt up, honey, the needle’s already in,” the nurse said, patting my arm.

I closed my eyes and grimaced.

“Are you in pain?” She asked.

“My pride is,” I replied, unable to look at the lab tech hunk who had one hand on my hip to steady me from moving around.

“Things I neglected to mention,” Dr. Owen started. “Because this part of the spine has an incredible amount of nerves, there’s a good chance that the needle is close enough to them that if you move at all, it might hit a nerve, and you might feel, what feels like, an electric shock shooting through a part of your body. Your limbs might also uncontrollably and spastically move . . .”

As he was saying this, my leg twitched violently.

“. . .Hah, just like that. So, alright, here we go . . .”

As the fluid dripped out of my body, the doctor and nurse asked me questions about my life to keep me mentally busy, I imagine. What they didn’t know, though, was I was only superficially with them. Beyond the surface of pleasantries was the sickening acceptance that my butt crack was in the doctor’s face, and worst yet, my giant, wobbly gut of ice cream lard was exposed for the sexy lab tech to view in its full glory.

“Usually, I’m a lights off kind of girl,” I finally looked up at the twenty-something, the only one I could see. He looked down at me quickly, registered what I said, smirked and awkwardly looked away again.

“What’s that honey?” The nurse asked; I could feel Dr. Owen switching out test tubes as he continued to collect my spinal fluid.

“Just wondering if the lab tech here likes Doritos,” I lied.

“What?” He asked, looking down at me again.

I nodded over to his computer station where three bags of Doritos lay empty. He looked over his shoulder. “Oh! Um, yeah, I like Doritos, I guess,” he blushed and turned away again.

“Alright, so no showering for twenty-four hours – absolutely no water can get near this open wound, which essentially is what it is. Also, drink lots and lots of water. We are, after all, draining some important fluid from you. Because you’re so little, there’s a good chance you’re going to get exceptionally tired, so take some ibuprofen, put an ice pack on your back, and sleep,” Dr. Owen remarked. “Also . . .”

He couldn’t finish his thought, though, because the train, which ran adjacent to the building (probably only ten or so feet away) started rumbling past. Everything in the room began shaking, including the table I was laying on. Electric shocks began to shoot through my body as my limbs began to jerk spastically.

The three people around me started laughing uncontrollably.

“You won!” Dr. Owen said.

“What?!” I asked through gritted teeth.

“Every single time we do a spinal tap, like clockwork, the train shows up. We’ve done three other LP’s today so we knew it was only a matter of time. So, congrats! You’re the winner.”

“Did I win Doritos?”

The lab tech’s grip on hip tightened. Dr. Owen laughed. “I have something you’ll like more, I think. Also . . .you’re done.” I heard him cap the final test tube.

And then, one of the most intense feelings of my life incurred: he slowly slid the needle out from my spine, and I could feel every nerve in my body ignite on fire. It literally felt like a cold plug was being pulled from my belly button through my spine, through my muscles, out of my skin.

“I FELT THAT! I FELT THAT A LOT!!!”

I bounded off the table, yanked my shirt down and looked at three of them accusingly. “I FELT THAT!!!”

“And now we’ll help you off the table, because you shouldn’t be making any drastic or sudden moves,” Dr. Owen said dryly, looking at me with arms crossed in front of his chest.

“What did I win?”

Dr. Owen opened a small cooler filled with organic grape and apple juice. “You won juice of your choice.”

“. . . Does this usually work with your patients?”

He laughed reaching for an apple juice box. “It does with the under ten and the over seventy.” I followed suit and took an apple juice as he lifted my shirt up and place a heavy duty bandage on the open LP wound.

“I’ll call you later to check-in and make sure that you’re doing alright,” Dr. Owen shook my hand and I took a long drink out of the juice box.

“Enjoy your Dortios!” I yelled over my shoulder to the lab tech, who blushed again, and scurried away. My mom met me in the hall and together we walked out. “Juice box?” She asked, raising an eyebrow.

“I WON THE CONTEST, OKAY?!” I snapped at her when we were outside. “Yeah, so, he definitely lied to me,” I said, as my mom opened my car door and I gingerly slid into the passenger seat. “I felt it. I felt it being pushed into my spine, and I felt it being jiggled free from my spine. And I felt it. But I have juice. So that’s cool, I guess.”

“I’m so sorry,” my mom empathetically said, backing out of the parking lot and back onto the main street. “What did the doctor say about recovery?”

“He said to take it easy, no showering, lots of water, and giving into my urges for sl . . . ARE YOU DOING THAT ON PURPOSE?!” I yelled as my mom hit three potholes in a row.

“I FORGOT!”

“HOW COULD YOU FORGET? WE JUST LEFT THE DOCTORS!”

“You’re fine, stop whining.”

I looked at my mom indignantly. “What? You got a juice box, you’re all set,” she remarked, a grin beginning to creep up the side of her face. I shook my head and stared out the window.

Ignorance is bliss, and education is power. Maybe it’s me, but I’m beginning to find that sometimes, ignorance really is power, and education is, well, just dumb (according to my mother and my doctor, that is). Perhaps going into certain situations with absolutely no information is the best option there is. We live in an era where a simpleton can become well-versed on any topic thanks to the wealth of information readily available on the internet; but, too often do we pick and choose which information is relevant to us at that point, and neglect to register the other, possibly more pertinent information available with a few more clicks of a mouse.

Looking back, I wish I had gone into the LP with no information outside of things that I had assumed about the procedure or had picked up through bad TV shows over the years.

Signing on to YouTube to watch graphic videos of an LP probably wasn’t the best way to prep me, as it ended up scaring the crap out of me. But if I liked the video I saw of the LP, YouTube highly recommends videos such as “My Excellent Colonoscopy” and “How to Perform a Painless Liver Biopsy” for my viewing pleasure.

Y’know, if push comes to shove, I might just watch that colonoscopy video.

Don’t have one of those scheduled for a couple decades at least.