Spinal headache, failed blood patch, now what?

[Amyloo]

Hi all, Got the nasty headache, had a blood patch done on Friday.  Worst thing I have EVER been through, that blood patch.  It was worse than the tap.  Anyway, it did not work. (I am flat on my back as I type this thanks to my trusty laptop and a bunch of pillows.)  What now?  Do I just wait it out?  It's getting pretty old.  I even asked for vicodin, which I never take but the pain is unbearable.  I'm so bummed.  Amy

[Sheila4444]

I will never do a blood patch either, I was screaming in pain.

[HVAC]

May be some pain medication. Sometimes if the pain receptors are set off for a long time they get used to it and you have to break the cycle. I went to my GP and went on Oxycotin for a couple of days.

Alex

[Sheila4444]

I too need answers, have has a 30 day headache after am lumbar facet block and had a blood patch on Thurs. The headache is back, help I am losing hope of ever having a normal life again. I will never do a blood patch again, I was screaming at the top  of my lungs even with sedation, what else can i do?

[WeakButStrongInside]

The radiologist bungled my spinal tap, hitting a bundle of nerves, causing me to lurch, which then likely enlarged the entry hole.  They only kept me flat for about 45 minutes and sent me home where I was nauseated and vomiting despite remaining flat for days.  Incredibly, they couldn't relate my sickness to its obvious reason - the spinal tap.  On my third ER visit after the spinal tap I demanded a blood patch.  They followed poor technique to get the blood, starting higher up on my arm and working their way down until they finally got into a vein - which collapsed after their taking just a little blood.  I worried that might not be enough blood to cause the desired clotting - but, fortunately, it was enough.  Again, I got up soon after the blood patch (an hour later) but within 20 minutes of getting the blood patch I knew it was a success because I felt the symptoms subsiding.  What may have happened with your initial blood patch was possibly not enough blood was injected.  I will NEVER have another spinal tap!!

[indischekunst]

I recently had a routine epidural procedure involving cortisone to relieve herniated disc symptoms and review several benign spinal tuors, using a contrast material (dye).

Unfortunately my practitioner nicked the dual and I ended up in Accident and Emergency Department for 36 hours lying on a gerny waiting for a blood patch. Initially, they thought it was chemically induced Meningitis (from the contrast material). After a battery of tests including MRI, blood work and multiple doctors consulting (neurological specialists and anathetatists) they decided to do the first blood patch. 25cc of my own blood injected back into around the affected area (just below).

Within a few hours I felt some improvement and they released me the next morning. I took it easy for a day and then being an architect went back to work. I didn't carry out anything too strenuous (that I was aware of?) but within another 3 days I was back in A and E Department waiting for a second blood patch.

I agree with everyone here. They are excruciating procedures. I had 25cc of my own blood injected into around the affected area (this time a little higher with the thinking the blood will trickle down due to gravity and collect on the Dura.)

Again I found relief. But there was far more consultation the second time around. The anathetatists were reluctant to carry out a second procedure for the following reasons:

With every procedure there is a risk of infection in a precarious location of the body. An infection here can be catastrophic.
The presence of cortisone negates the effects of the blood patch. The cortisone is there to avoid inflammation and yet the blood patch relies on clotting.
As a male with large inter-vertabrae spaces, the likelihood of clotting is less. The clotting relies on tighter spaces to collect and congeal.
The cortisone lowers the immune response.
The cortisone masks the initial symptoms making detection slower.

But with so many other risks like continual CSF leakage creating pressure on the brain, bruising and potential blood clots and stroke... I finally yielded to the second patch.

It's early days, as it's currently Monday and the patch was put in on Saturday night. But there is improvement. I spent almost all of Sunday on my back. I will try sitting up today but advised not to do any heavy lifting for at least three weeks (<3kg). The anethatists suggested longer. But the neurological specialists suggested 3 weeks and then ease back into things. The patch should have taken by then. But to drink lots of water (hydrating the brain), lots of coffee (as it is suggested to reduce the production of CSF) and try to avoid anything strenuous.

There is still pressure on my lower back which is considered normal. In fact it's critical that there is... Ideally, with this pressure the clot will eventually form over the Dura. There is a little neurological irritation which is typical too. Some tingling in the buttocks and lower back. Nothing debilitating though. All should subside in a week?

The whole ordeal has been almost two weeks. The headaches, photophobia and nausea associated with the initial leak were awful. We all know that from what I have read here. For what it's worth I can truly empathize. Let's face it, if the headaches were mild none of us would have endured such an excruciating procedure as a blood patch. No way!

But the statistics for the initial patch working is around 80%. But that doesn't take into account the presence of cortisone. A second patch success rate is around 90%. Again, not taking into account the presence of cortisone. But there are some alarming statistics on infection with more and more procedures.

I was in some way lucky to be treated through our public system here in Australia. Even though I am a private insurance holder. I truly believe it was better to be treated publicly. I had access to more doctors, more equipment and tests in a shorter space of time, I still go a single room ALL at no cost! Yes, that's the beauty of the public system in Australia. MRI's, bloods, two procedures, countless IV's, doctors and specialists around the clock and quite frankly, pretty darn good care by all. I asked myself why I would use private again after all this? It was in a private hospital where the initial procedure which created this whole problem occurred. It was the private hospital staff that ushered me away to the public Accident and Emergency Department when things appeared very wrong. It was in a public hospital where it was more carefully attended to... And hopefully, the second time around?... Resolved. The Australian public health system in this instance was very good. Sure there was more waiting involved. But the care, attention and no out of pocket expenses was reassuring.

I have even more pressure to be well as after 10 years of saving and planning my wife and I have a ski trip to Canada in February. It's end of November now. With a bit of luck, the patch takes and I can try to recommence training for the trip? Otherwise, it's out for me and I will no doubt spend the rest of my days cursing these past two week's events. Sighs.

I feel so much better reading this forum and all of the accounts. I can truly empathize. Despite having slightly different circumstances, there are similarities to take heart from.

I sincerely hope we all make a full recovery without complications. I will keep you posted on progress if it assists anyone else through their trials and tribulations?

What I understand is any Epidural procedure requires surgical precision and very specific techniques to avoid damage to the spinal cord and dura. It can be achieved with high success rate... But we all know here that if you're in the other side of the percentages, it's little consolation.

I know that for any patch to work aggressive rest and horizontal positioning for at least the first day is critical. Avoiding strenuous exercise is also critical for the first week. But while experienced in the symptoms I am simply paraphrasing the advice of the practioners regarding the post-procedural recovery.

I have fingers and toes crossed.

I will not have a third a blood patch. Instead, consider passive, non-invasive alternatives. The risks are too high for me.

I hope this helps others here?

Regards,

Raj.

[WhitleyDrew]

I had a myelogram done last week and it was terrible. Having the needle in my spine to inject dye was awful, the hole never healed and I started leaking spinal fluid. I got really sick for a few days and ended up in the emergency room. They had to do a blood patch on me. I stayed in bed for many days because I was in so much pain. My headaches got a bit better. I am still not feeling the greatest. Today was my first day up and about and I am completely exhausted. I am hoping my patch holds because I do not want to go through that again. I go back to work tomorrow and I am nervous a bit because I do not know how my body will handle working (I work in childcare). I would not wish this on my worst enemy.