Is lumbar puncture outpatient or inpatient procedure?

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Kertie446

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Hi, everyone

I am just wondering if a lurabar puncture is an outpatient or inpatient procedure as mine is scheduled as an inpatient procedure and I just wondered why that may be?

Is it perhaps because they want to do more tests on me or because I live a bit away from the hospital and will have to travel for about an hour or so to get there and the same to get back home?

I would much appreciate any suggestions you could give.

Many thanks

Kind regarRAB

Niad
 
Please could someone actually let me know if they could as I would much appreciate it..
 
Hi Niad,
I have never had a lurabar puncture but I would guess the reason it is not an outpatient procedure is because they will need to monitor you after the procedure. there are risks involved with collecting fluid from the spine and it is likely that it is standard to keep you in for observation afterwarRAB and possibly you may have to ly down flat for a period of time after the procedure aswell.
Did you doctor not explain what will happen in detail to you? with any procedure to do with the spine it is important for you to know all the details / risks / what to expect before you undergo it.
 
Hi, jomurray, brendaks1 and Mel52. :)

Thank you for your helpful replies.

jomurray, No, my doctor did not explain what would happen, perhaps he assumed I should have known what it involved? I don't know why he didn't explain. On his letter of 'plan of action', it states that he wants to do a lurabar puncture as a daycase but he must've now changed his mind or something as I thought daycase was where I go in and then come back out on the same day. I don't understand why he never really explained anything or why he might've changed his mind on the part of 'daycase' without telling me?

brendaks1, I am having the lurabar puncture to check for Multiple Sclerosis as I have spine and bladder problems which have gone undiagnosed by many doctors for years now and he doesn't understand why I have all these symptoms without a 'clear' diagnosis. I have chronic urinary retention of 300mls. I don't think it's a myelogram. Just a normal lurabar puncture to obtain spinal fluid for analysis.

Mel52, It sounRAB like your lurabar puncture was done in an outpatient setting as it was the doctors office. I have heard that it can be quite painful and it sounRAB like you had a good neurologist as you said you didn't know she's even done it which is really good! I'm quite nervous about mine as I've never had one before and am not keen on needles which makes things worse. I don't think I'll be able to drink lots as my chronic urine retention makes this impossible as I will be racing up and down to the toilet every 10 minutes! I am kind of on a losing battle as I don't know how I'm going to prevent a spinal headache if I don't want to drink because of toileting issues with my bladder, unless I be catheterised which is the only way I could cope. That radiologist you had sounRAB awful. I too would be very frightened if that were me as if other people are getting nervous than it makes the patient nervous. That killer headache sounRAB horrible. I have heard that it can effect the pressure as I'd imagine the spinal column is very sensitive to even the slightest of changes which is why when we get problems with it it can be extremely painful.

Seems like a lot of the outcome does depend on the skill of the actual person doing it. I found this out when I had to have anti-biotic injections as I cannot tolerate oral anti-biotics and the one nurse was pretty good at them, though they still hurt like I was kicked and made my leg dead for about 5-10 minutes. The second nurse I had actually did it a different way and pulled my skin up on my leg and held it and then stuck it in while still holding it and it hurt like hell. It really stung and was agonising and I nearly screamed my head off! The first nurse did it a different way, still in my leg but didn't pull my skin up, instead she just jabbed it in without pulling my skin up which I found was less painful. Definitely all in the way that each person does the procedure. I also found the nurse that pulled the skin up rushed to get me out of the room even though I needed to lie down for a little while. I didn't like her approach to me at all. She was a bit of a rusher sort of nurse.

Many thanks for all of your help and for sharing your experiences. It's much appreciated.

Kind regarRAB

Niad
 
Niad,

Any time you have a lurabar puncture you are at risk for a spinal headache from the spinal fluid escaping through the hole put in your spine, so they often keep you for several hours or overnight laying down to allow the hole time to heal up. They typically do the puncture in the lurabar area to prevent damage to the spinal cord as the spinal cord typically enRAB around T12-L1.

I had a myelogram which involved a lurabar puncture as part of the test to inject dye, and ended up getting a spinal headache. You can search for myelograms and find lots of advice on what to do for a couple of days after the procedure to avoid the dreaded spinal headache.

What is the reason for your lurabar puncture? Are you having a myelogram?
 
I had a lurabar puncture done last week. It was in the neurologist's office. The hospital is in the next parking lot. It was a regular room, I laid on my side, sterile drapes were put on and it was done. I didn't even know she put the needle in. She said she was checking the pressure, waited a few minutes and then proceeded.It took about 10 minutes and I was pleasantly surprised it wasn't painful. I was told to lay on my back for a few minutes until I wanted to get up. I reclined my seat in the car until we got home which was 90 minutes away. I spent the day laying down and the next day I would be up for only short perioRAB of time. I didn't get a headache but did have a back ache and was very tired for about 5 days. I also drank a ton of water before and after and had more coffee than I normally do.
A few years ago, I had a mylegram and that was done in an imaging office by a very incompetent radiologist. I was on my stomach and I was complaining about the pillow under my stomach cutting off my pulse. The radiologist continued, hit a nerve, ouch, injected lincocaine and the last thing I remeraber was her screaming for me to wake up and for the nurses to get the other doctors. My pulse and bp dropped very low. They stopped the procedure saying I would have to have it done in the hospital. Her attitude and her fear of course made me very frightened. She told me I wouldn't have to lay down since she didn't do the procedure. The next day, I had the headache of all headaches, relieved only by laying down. It was similiar to the headache I had when I had mennigititis. Everytime I stood up and tried to do things I would get the killer headache. I called the radioloigst 4 days later. She said I shouldn't have had a headache since she only poked me once in the spine but to lay down all weekend and if I still had the headache go to ER. I stayed down and was fine by Tuesday. My girlfriend an ICU nurse said anytime the spinal column is poked it affects the pressure and the dr was an idiot.
 
Niad,

Good luck to you and I hope your procedure goes well. Even though you probably really want some answers, I hope it doesn't show that you have MS.

I had some pain with my lurabar puncture during my myelogram, but it wasn't all that bad and I didn't come away traumatized. I hope yours isn't too bad and that you get a skilled technician doing the test for you.

Brenda
 
Niad, I have bladder spasms so if I dont use a restroom as needed I have alot of pain. I dont know if that is the result of surgery or if it is a neurological problem associated with m.s. or something not identified yet.
I am not kidding when I said it took only 10 minutes. I used the restroom just before and right afterwarRAB. The procedure actually would have been done in less time but my spinal fluid was slow in coming out. She took 4 vials.
I went to a neurologist who specializes in ms so she does alot of lp's. I thought it would be even more difficult because I had back surgery last year in the area the needle goes in. The dr said it makes it easier too if you are not real heavy.
 
Hi, Brenda and Mel52.

Thanks for your helpful, informative and supportive replies. :)

My neurologist said he hopes it isn't MS but rather a vitamin deficiency but I haven't heard anything from the blood tests that I had and it's been a month now since I had them done.

I was concerned that I would come away traumatized but it doesn't sound too bad from what you've said.

A specialist nurse is doing the lurabar puncture and is apparently very good at them and most of her patients say they cannot feel it when she does it so hopefully it won't be too horrible.

Bladder spasms could be caused by a variety of things, including neurological but also mechanical, such as overactive bladder. I have been told my urodynamics show my detrusor is overactive. He also suspects something with my sphincter/urethra - that it is not relaxing. I get pain on my abdomen but painkillers don't work as I tried that. The only thing that really relieves it is going to the toilet but because I don't empty completely it fills up so fast and causes my frequency. A vicious circle. I too have to make sure I get to the bathroom as it causes pain if I don't go and rises in intensity as it fills up.

Mel, Have you had a urodynamics test as this may help in making a diagnosis or give a clue as to what could be happening? Though they don't know what is wrong with mine, they are really guessing as they say there is nothing they can do and that I am to suffer basically which in this day and age I'd have thought would have been unheard of. Extremely frustrating and I can see why health problems that are chronic can lead to other problems due to stress from the pre-existing chronic condition sort of thing. Again, a vicious circle.

Sometimes spinal fluid is slow in coming out but I don't know why. It's like when people have blood tests and it doesn't come out immediately. Though, my blood whenever I've had a blood test comes out quite quick!

I find it odd how a neurologist or anaesthetist is not doing the lurabar puncture but a nurse who specialises in it. Has anyone else heard of this? Perhaps it's because I'm in the UK? Not sure. Will this nurse know my spinal anatomy and where not to put it in case of paralisation? That's what concerns me.

I would have thought back surgery would make it slightly more difficult but perhaps not because you had a skilled neurologist. Mine may be unusual due to grade 3 degeneration where my discs are crsuting away and losing fluid.

I am not really heavy, about 7 stone. Hopefully it is quick and over as I am not exactly keen on having a needle stuck in my back!

P.S: I rang the hospital up and apparently it is daycase after all! They, for some unknown reason, call it inpatient because it is in the hospital and I'm having it done there. Doesn't really make sense. It should actually be called daycase surgery or something...

Many thanks for both your helpful replies.

Kind regarRAB

Niad
 
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