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Is This Normal Why It Took Almost 30 Minutes To Collect The Spinal Fluid?
Question: Hi,
My wife recently had a lumbar puncture done. The first puncture resulted in some bleeding and was considered to be traumatic.
Initially it was thought that a second puncture would be done after assessing whether the fluid was ok but it was then decided to just take a second sample from a different spot and another puncture. Upon looking at the skin it seems that more than punctures were done. Based on the image attached is this correct?
I am not sure why it took almost 30 minutes to collect the spinal fluid from the second puncture. Is this normal?
Also there is still some soreness in the lower pelvis and left thigh. Is this to be expected a day after the procedure?
Thank you,
Regards.
My wife recently had a lumbar puncture done. The first puncture resulted in some bleeding and was considered to be traumatic.
Initially it was thought that a second puncture would be done after assessing whether the fluid was ok but it was then decided to just take a second sample from a different spot and another puncture. Upon looking at the skin it seems that more than punctures were done. Based on the image attached is this correct?
I am not sure why it took almost 30 minutes to collect the spinal fluid from the second puncture. Is this normal?
Also there is still some soreness in the lower pelvis and left thigh. Is this to be expected a day after the procedure?
Thank you,
Regards.
Brief Answer:
Few punctures are acceptable.
Detailed Answer:
Hi.
Thanks for your query.
Noted the history, seen the photographs.
one puncture can be for the local aesthesia. Other ones can be for lumbar puncture. In some cases it may be necessary to have few punctures if the first one does not get the results. The Might have tried the upper or lower site to get a proper entry to get a sample.
From cleaning, draping of the site - to get an actual sample can take some time. Only the Doctor who did the puncture can tell us the time .
Soreness in pelvis and left thigh is usually not related to lumbar puncture. Very rare if at all such a thing occurs.
I hope this answers all your queries.
Please give feedback and ask for any further relevant queries
Dr T Chandrakant.
Few punctures are acceptable.
Detailed Answer:
Hi.
Thanks for your query.
Noted the history, seen the photographs.
one puncture can be for the local aesthesia. Other ones can be for lumbar puncture. In some cases it may be necessary to have few punctures if the first one does not get the results. The Might have tried the upper or lower site to get a proper entry to get a sample.
From cleaning, draping of the site - to get an actual sample can take some time. Only the Doctor who did the puncture can tell us the time .
Soreness in pelvis and left thigh is usually not related to lumbar puncture. Very rare if at all such a thing occurs.
I hope this answers all your queries.
Please give feedback and ask for any further relevant queries
Dr T Chandrakant.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr. Chandrakant,
Thank you for the reply and for reviewing the images.
I understand that it is possible that more than one lumbar puncture may have been done. I believe that at least two punctures were made. I was bedside at the lumbar puncture and it was clear that the puncture took around 30 mins for the fluid to be gathered not including the preparation time. i was a little surprised that the procedure was done in the ward on the bed. Is this usual practice for this procedure?
I observed that my wife felt pain during the first lumbar puncture and the pain was felt down the leg as the needle was positioned during the procedure. The pain felt initially appears to be related to later soreness or numbness down the left leg and in the pelvic area.
My wife is also having a post LP headache which is at its worst when sitting, a bit better when standing and ok while lying down. At what point is further assessment and treatment for the headache indicated? I have heard that the blood patch is a possibility but are there any potential complications with this?
Thank you.
Thank you for the reply and for reviewing the images.
I understand that it is possible that more than one lumbar puncture may have been done. I believe that at least two punctures were made. I was bedside at the lumbar puncture and it was clear that the puncture took around 30 mins for the fluid to be gathered not including the preparation time. i was a little surprised that the procedure was done in the ward on the bed. Is this usual practice for this procedure?
I observed that my wife felt pain during the first lumbar puncture and the pain was felt down the leg as the needle was positioned during the procedure. The pain felt initially appears to be related to later soreness or numbness down the left leg and in the pelvic area.
My wife is also having a post LP headache which is at its worst when sitting, a bit better when standing and ok while lying down. At what point is further assessment and treatment for the headache indicated? I have heard that the blood patch is a possibility but are there any potential complications with this?
Thank you.
Dear Dr. Chandrakant,
I would like to follow up with a further question.
My wife is noticing a brown vaginal discharge now when it is usually clear or light. Could this be related to the lumbar puncture? There seems to be a greater urge to go to the toilet for urination or bowel movements but these can still be controlled. Are any of these symptoms concerning?
Thank you.
I would like to follow up with a further question.
My wife is noticing a brown vaginal discharge now when it is usually clear or light. Could this be related to the lumbar puncture? There seems to be a greater urge to go to the toilet for urination or bowel movements but these can still be controlled. Are any of these symptoms concerning?
Thank you.
Brief Answer:
Why and when was the lumbar puncture done?
Detailed Answer:
Thanks for your feedback and observations.
I can understand your concerns.
Every symptom may not be connected to lumbar puncture.
Spinal headache as it is called is a main concern.
She needs to be lying down, full rest is needed.
Plenty of oral fluids.
Control of diabetes and hypertension.
When was lumbar puncture done?
Is she at home or at the hospital?
I do not think the vaginal discharge is related.
Urge for urination and bowel movements can be due to pelvic inflammatory disease or there can be many other reasons that your Doctor can tell on proper examination and relevant investigations.
Aseptic precautions are most needed and depending upon the need and practice at your hospital the place of procedure is decided. Please find out the routine at this Hospital.
If the need is thin it takes a lot of time for collection of the fluid.
I hope this further helps you.
Take care for your wife. Ask for Gyne opinion.
Why and when was the lumbar puncture done?
Detailed Answer:
Thanks for your feedback and observations.
I can understand your concerns.
Every symptom may not be connected to lumbar puncture.
Spinal headache as it is called is a main concern.
She needs to be lying down, full rest is needed.
Plenty of oral fluids.
Control of diabetes and hypertension.
When was lumbar puncture done?
Is she at home or at the hospital?
I do not think the vaginal discharge is related.
Urge for urination and bowel movements can be due to pelvic inflammatory disease or there can be many other reasons that your Doctor can tell on proper examination and relevant investigations.
Aseptic precautions are most needed and depending upon the need and practice at your hospital the place of procedure is decided. Please find out the routine at this Hospital.
If the need is thin it takes a lot of time for collection of the fluid.
I hope this further helps you.
Take care for your wife. Ask for Gyne opinion.
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
Dear Dr. Chandrakant,
Thank you for the reply and information.
It is Sunday today and the lumbar puncture was performed on Tuesday afternoon. We are at home. The procedure was done to assist with diagnosis of what appears to be right orbital apex inflammation on the MRI. My wife is better when standing but oddly, not so well when seated and can't sit for more than 10-15 minutes without quite a serious headache developing. We will continue to monitor the situation. We are also advised to take caffeine but the issue is that it affects sleep and overall may not lead to a better outcome.
Regarding fluid collection from the puncture, I am not sure if the pressure of the fluid was correct or if there is any further significance.
We will try to see a gynaecologist for further opinion regarding the discharge and also pre-diabetes.
Thank you for the advice and well wishes.
Regards.
Thank you for the reply and information.
It is Sunday today and the lumbar puncture was performed on Tuesday afternoon. We are at home. The procedure was done to assist with diagnosis of what appears to be right orbital apex inflammation on the MRI. My wife is better when standing but oddly, not so well when seated and can't sit for more than 10-15 minutes without quite a serious headache developing. We will continue to monitor the situation. We are also advised to take caffeine but the issue is that it affects sleep and overall may not lead to a better outcome.
Regarding fluid collection from the puncture, I am not sure if the pressure of the fluid was correct or if there is any further significance.
We will try to see a gynaecologist for further opinion regarding the discharge and also pre-diabetes.
Thank you for the advice and well wishes.
Regards.
Brief Answer:
As detailed
Detailed Answer:
HI
Thanks for your feedback.
6 days now. She will improve soon.
Sitting is not at all good in patients with spinal headache.
Bed rest in lying down allow the best healing and relief /cure from spinal headache.
Caffeine helps, can be taken in day time.
In our olden days we used to give Codeine in low dose. ( May be banned in your country or may be available on prescription, hence discuss with your Doctor /Nurse/Pharmacist). Codeine can cause constipation (constipation is not good in spinal headache, straining at stool is not allowed).
Right orbital apex inflammation on the MRI. - Quite rare. Any final diagnosis?
As detailed
Detailed Answer:
HI
Thanks for your feedback.
6 days now. She will improve soon.
Sitting is not at all good in patients with spinal headache.
Bed rest in lying down allow the best healing and relief /cure from spinal headache.
Caffeine helps, can be taken in day time.
In our olden days we used to give Codeine in low dose. ( May be banned in your country or may be available on prescription, hence discuss with your Doctor /Nurse/Pharmacist). Codeine can cause constipation (constipation is not good in spinal headache, straining at stool is not allowed).
Right orbital apex inflammation on the MRI. - Quite rare. Any final diagnosis?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Chandrakant,
Thank you for the follow up and advice.
The headache appears to be getting slightly better now. Codeine is available by prescription where we live. I think we would consider using stool softener in case we used the medicine as it is not known what effect it might have on the stool.
We haven't received any final diagnosis but the preliminary view is that the right orbital apex syndrome could be an idiopathic inflammatory process where the cause is unknown but it seems like this diagnosis would require further tests to arrive at.
Thank you.
Thank you for the follow up and advice.
The headache appears to be getting slightly better now. Codeine is available by prescription where we live. I think we would consider using stool softener in case we used the medicine as it is not known what effect it might have on the stool.
We haven't received any final diagnosis but the preliminary view is that the right orbital apex syndrome could be an idiopathic inflammatory process where the cause is unknown but it seems like this diagnosis would require further tests to arrive at.
Thank you.
Brief Answer:
As detailed
Detailed Answer:
Some good news.
Strict bed rest in lying down position, proper hydration are the basics.
Codeine only if required by prescription only.
Check for BP and Sugar.
Hopefully will recover faster.
Also hope that she never had hyperthyroidism.
Please send me the report of MRI and any other relevant investigations.
Which country do you live in?
Any problem with eyes?
As detailed
Detailed Answer:
Some good news.
Strict bed rest in lying down position, proper hydration are the basics.
Codeine only if required by prescription only.
Check for BP and Sugar.
Hopefully will recover faster.
Also hope that she never had hyperthyroidism.
Please send me the report of MRI and any other relevant investigations.
Which country do you live in?
Any problem with eyes?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Chandrakant,
Thank you kindly for the advice. The headache is getting better.
We have checked the thyroid function through blood tests and all looks to be ok.
I have attached the copy of the most recent MRI report and also the report from the specialist.
We are living in Australia. There is some vision loss on the right eye with the colour vision loss, field of vision is affected and there is dimness with vision.
Thank you.
Thank you kindly for the advice. The headache is getting better.
We have checked the thyroid function through blood tests and all looks to be ok.
I have attached the copy of the most recent MRI report and also the report from the specialist.
We are living in Australia. There is some vision loss on the right eye with the colour vision loss, field of vision is affected and there is dimness with vision.
Thank you.
Brief Answer:
Consult Dr XXXXXXX Pearl Hospital at Trichy XXXXXXX Online Consultation
Detailed Answer:
Gone through the records that you submitted.
I think about one great ENT Surgeon who can deal with such problems Endoscopically. You can give my reference and talk to Dr Janakiraman directly. Online consultation is also available. This may really help your wife to get a definitive diagnosis and proper management. https://www.google.com/search?q=Pearl+Hospital+Dr+Janakiram+Trichy+tiruchirapalli&rlz=1C1RXQR_enIN1090IN1090&oq=Pearl+Hospital+Dr+Janakiram+Trichy+tiruchirapalli+&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIJCAEQIRgKGKABMgkIAhAhGAoYoAEyCQgDECEYChigAdIBCjI1NDczajBqMTWoAgiwAgE&sourceid=chrome&ie=UTF-8
Give me the follow up
Consult Dr XXXXXXX Pearl Hospital at Trichy XXXXXXX Online Consultation
Detailed Answer:
Gone through the records that you submitted.
I think about one great ENT Surgeon who can deal with such problems Endoscopically. You can give my reference and talk to Dr Janakiraman directly. Online consultation is also available. This may really help your wife to get a definitive diagnosis and proper management. https://www.google.com/search?q=Pearl+Hospital+Dr+Janakiram+Trichy+tiruchirapalli&rlz=1C1RXQR_enIN1090IN1090&oq=Pearl+Hospital+Dr+Janakiram+Trichy+tiruchirapalli+&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIJCAEQIRgKGKABMgkIAhAhGAoYoAEyCQgDECEYChigAdIBCjI1NDczajBqMTWoAgiwAgE&sourceid=chrome&ie=UTF-8
Give me the follow up
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Chandrakant,
Thank you kindly for the referral. We will consider the online consultation option with Dr. XXXXXXX I understand that this will be to discuss the possibility of a nasal biopsy to get a tissue sample of the inflammation around the right orbital area. A lacrimal gland biopsy is another option presented by the ophthalmologist and we will consider this option as well.
Thank you.
Thank you kindly for the referral. We will consider the online consultation option with Dr. XXXXXXX I understand that this will be to discuss the possibility of a nasal biopsy to get a tissue sample of the inflammation around the right orbital area. A lacrimal gland biopsy is another option presented by the ophthalmologist and we will consider this option as well.
Thank you.
Brief Answer:
As detailed
Detailed Answer:
Dr Janki is a wonder-man in diagnosis and treatment too.
His advise will help you the best.
With best wishes.
As detailed
Detailed Answer:
Dr Janki is a wonder-man in diagnosis and treatment too.
His advise will help you the best.
With best wishes.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
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