I had the lumbar puncture I’ve been dreading today. I was sort of hoping I’d never need one, but with all the balance and gait and motor skill impairments on top of the worsened brain fog, I see why my neurologist wanted the CSF (cerebrospinal fluid) tests done.

During my intake at interventional neuroradiology, the neurosurgeon described the sensations of the Lidocaine shot like a burning, pinching sensation and the placement of the hollow needle and manometer like a feeling of pressure. And yet again, I can’t emphasize enough how the standard descriptions of pain never do justice to the experiences they’re meant to describe. As in, they vastly undersell exactly how terrible and strange these interventions feel.

That said, the lumbar tap itself wasn’t that bad. The neurosurgeon used a 22G atraumatic needle (the smallest gauge possible for a diagnostic spinal tap), was relatively quick with measuring the opening pressure, and—judging by the length of the procedure once the needle was in—my CSF drained quickly. Which it should have, considering the vast quantities of water I drank prior to arrival. Even with my POTS regimen, I am never so hydrated as I am before a surgical procedure.

Poeticizing the Pain of a Lumbar Puncture

• Instead of burning and pinching: A proboscis relentlessly twisting toward sustenance.
• Instead of pressure: A stiletto inventing an air pocket in a space otherwise incapable of intimacy.
• Instead of spinal/post-dural puncture headache (PDPH): Vise-like fingers insinuating themselves into the skull and encircling the brain, every bubble in their wake a potential air embolism, not-yet and yet already crushing its soft mass.

I’m still dreading the spinal headache, but so far, so good!

I was hoping to more clearly confirm intracranial hypertension as a result of the bilateral jugular compression, but if symptoms are anything to go by, I went to the hospital with a pounding sensation throughout my skull, occipital pain, and a cervicogenic headache behind my left eye, and as soon as my spine was tapped, all those sensations vanished and (knock on wood) haven’t returned, which strongly suggests that my CSF is backing up like a clogged drain due to poor venous outflow and my brain has just been sitting in dirty toilet water since at least the date of symptom onset, so…. for at least 20 years.

Someday I’m going to have the time and bandwidth to be furious about how all this got overlooked. Today I’m just glad the LP was quick, gave me a reason to think about language, and hasn’t sprung a leak. Yet.