odd way to do lumbar puncture?

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Kertie446

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Hi all

I spoke to the hospital and apparently a specialist nurse (not neurologist or anaesthetist) will be doing the lurabar puncture - this was the first unusual thing I've heard of to start with - I'd much prefer a neurologist or anaesthetist doing it personally.

But it gets weirder...She does the actual procedure on the ward with all the other patients watching me! Now that is for one not very hygienic (should usually be sterile not communal - i.e in a theatre) and also not very private if I do say so myself!

What do any of you reckon?

Personally, me? I don't want it done at this hospital...it sounRAB dodgy...

Many thanks for any help or advice any you may be able to give.

Kind regarRAB

Niad
 
I would ask your neurologist if that is normal procedures for an lp there, it does sound weird to me too.

Good luck,
hotflash
 
Niad,
Don't know if this will make you any more comfortable but my lurabar puncture was done in the ER of a hospital in Detroit. It had quite a few patients at the time and the only thing seperating me from the rest of the room was a curtain. I had no problems what so ever.
Neil
 
I would not worry about the crippling part. My first LP they touched my nerve and my legs kicked out. My second LP was perfect. Neither caused damage.

As to a hospitals recommendation, I have been reading the papers from the UK online and there is a definite problem with hygiene among some hospitals. Perhaps there is another facility available. You might have to wait longer, but you would certainly be under much less stress.

My mother was a head RN and then Head Nurse of a regional hospital. She was "Old School" right down to her uniform. During her tenure she ran a tight ship and the hospital's nurses built up a good reputation. The first nurse practitioners started arriving just before she retired. A properly trained nurse practitioner can do the procedure, but hospital hygiene is most important.

If something does not feel right or you feel uncomfortable, you need to speak your mind. They need to put you at ease. Stress is something a body with MS does not need at all.

Stay strong, Stay Positive! :angel:
 
niad,
Sorry to take so long to get back to you, but I did'nt access this site yesterday. In answer to your question, I believe it was done by one of the doctors on staff in the ER. Not 100% sure, it could have been a nurse I suppose. Quite frankly the whole experience of getting to the point of being Dx'd still seems like a dream...err, nightmare. The first 48 hrs. were definately a blurr.
Good luck to you,
Neil
 
Sorry for double post.

Neil, did you have a nurse doing it? That is something I'm curious about as well...

Kind regarRAB

Niad
 
Hi, hotflash and Neil. :)

Thanks for both your replies.

hotflash, Unfortunately I cannot get hold of him. He and his secretary are away! Ironically, they are both away at the same time until after my lurabar puncture! Great...

Neil, I was certainly worried as I like a bit more privacy than just a curtain when I am having something like that done but seeing as mine is elective I would have thought they'd have done it in theatre as they have plenty of time to book it as it is a lot more hygienic and sterile.

I am not keen on this hospital as they are not very friendly anyway...

I don't feel they were sympathetic which puts me off straight away.

I still don't feel like I should go to this hospital as they are not very nice...

Many thanks for both your helpful and informative replies. They're much appreciated. :)

Kind regarRAB

Niad
 
Niad, nurses can and do perform lurabar punctures if they are trained.....and sterility isnt a huge thing. This is a needle, not surgery- therefore there is very little chance of infection. Im quite sure they will wipe your back down with alcohol, like they do with any needle stick; and Im positive they will put a bandaid on it when they are finished. There is no blood involved, and the entire process is no where near as scary as you are imagining it to be. Although I do not fault you for being afraid- the first one I had, I was terrfiied. Its only when it is all over that you realize you expended allot of energy for nothing!
i dont want you to think im making light of this, but this procedure is done hundreRAB of times a day in hospitals- where they do it, in an ER, a theatre, or in the hallway, isnt going to matter much. Your not undressed, your not losing any blood and your not hooked up to anything....relax and know it will all be over in under a half hour once you get there. ok??
Hang in there kiddo- its not going to be all that awful. If you are THAT concerned, why dont you call the hospital, instead of the doctor you cant reach and ask to speak to a nursing supervisor? Maybe she can put you more at ease....
Nikki
 
Hi, Nikki, MSJayhawk and Neil. :)

Thanks for your helpful and informative replies.

Nikki, getting an infection in my spinal cord is something that I was concerned about with this hospital being apparently quite bad in hygiene as my parent works in a hospital and she told me their patients have come back from that same hospital with infections and some were killed by it and also they mentioned that handwashing between patients was pretty bad. I am a little concerned about privacy as other people will be able to hear me. I know the smell you mean, after I had an op before I smelt like hospital! I made the whole car and house smell like it for days!

Not sure I'll be able to tell if the instruments are sterilised as they probably will not be left laying around - she'll probably bring them when she comes round (better hide in the toilet!). I do not have any choice as regarRAB hospitals as the consultant cannot refer me anywhere else even though, from what I work out, it is just a test and he will get the results even if it was done somewhere else.

MSJayhawk, thank goodness it cannot seriously cripple. That was a major concern for me. Unfortunately I cannot go anywhere else to get it done as the consultant, even though he does not do the procedure, is based at that hospital and so I have to follow him to that hospital! Stupid system I know. Unfortunately that is how it works.

I will not be able to get it done unless I risk it by going to this hospital that I am certainly not confident about as my parent that works in one hospital said she is not happy with taking me and has warned me about it as other staff have told her that they would not take me to there if it were their daughter. So nurse practitioners do this procedure. I didn't know they'd been doing it for a while. I totally agree on the stress part.

Do nurses that perform lurabar punctures have a dress code like a normal nurse or do they wear scrubs? Do they wear protective clothing i.e. a mask, etc while carrying out the procedure?

Neil, If they wear scrubs than it would be difficult to tell if they were a doctor or nurse.

Thanks for all of your very helpful and informative messages.

My mom is adament she does not want to take me to this hospital though, so I don't think I'm going to be able to get it done anyway as she has major concerns over hygiene as she is concerned that I will get an infection or other serious problem.

Kind regarRAB

Niad
 
Mine was done in 1982 in a hospital room, but it was a single room. The next time, 2002, it was done in the doctors examination room. I do not think that a multi-bed ward is the best nor do I agree with a nurse specialist doing the LP.

I would ask for privacy and a doctor. Is this standard procedure in the UK? :angel
 
Hi, Nikki

Thanks for your helpful and informative reply.

It is certainly something I was curious about as one of my parents works at a hospital and has been told by the staff there that they would not recommend me going to this hospital as it has a high infection rate as every one of their patients comes back from there with an infection. This certainly concerns me and seems to me that doing it in an unsterile environment is contributing to their dirty practice.

I am also not happy about the lack of privacy - I am aware there will be curtains but people will still listen to me and this I deem is totally inappropriate to be having a procedure done in front of everybody. I would have liked more privacy. Not very dignified.

The staff where my parent works also said they'd never heard of nurses doing it and feel it is a bit dodgy and have told my parent not to let me go there if it were their child so really I am not sure whether to trust in this hospital and have it done or not as I do not feel confident in the whole of their protocols. Though if the nurse is any good at doing it this is not my main concern but the hygiene and sterility side of the procedure is.

It will be too late once it's done if it cripples me or I get a life threatening infection. I personally would rather be safe than sorry and avoid it. I went to physio when I was undiagnosed and found out after it had nearly crippled me and brought this bladder problem on that it was not the appropriate treatment and that I should not have been doing it. I just do not trust healthcare people anymore as they have ruined me and made me worse.

I would not be as worried about this procedure if it was being done in an appropriate environment and one that I could feel comfortable in.

I have spoken to the nurse who will be doing it and did not feel too confident as she was not very sympathetic to my symptoms and other problems I had as I told her I have severe chronic retention of my bladder and this will certainly make travelling for that length of time and excessive intake of fluiRAB a nightmare and impossible. She said there was nothing she could do. I asked her about catheterising my bladder but she kind of tried to wrangle her way out of that one and told me again there was 'nothing I can do' which certainly didn't instill any of my trust any more than before I spoke to her. I personally do not feel they will look after me properly and remain dubious about this hospital...

I don't really know too much what to do, etc...

Sometimes I just get this bad feeling in my gut that if I go ahead with this procedure I will be crippled as they do not seem that experienced or nice with their patients and hygiene is certainly not on their high priority list...

Kind regarRAB

Niad
 
Hi, all

Update: Rang hospital as one meraber of staff told me I may be able to go and get the lurabar puncture done at another hospital closer to me and I would certainly prefer this as the staff at this hospital are so impersonal and unsypathetic it's unbelievable to think they are actually working in the healthcare sector!

Anyway, again, contacted them as they never bothered to ring me back with info on this so I rang them. Again, impersonal and unsypathetic attitudes telling me I cannot (all of a sudden!) have it done at another hospital even though one meraber told me I could! Something seems a little suspicious to me...as if they do not want to lose a patient...hmmmm...they were a little funny about it (in a bad way).

I got a bit angry with them and asked them why and that I was not happy about it at all. They never bothered to answer my question and just kept going over and over...and over the same old thing they'd told me again and again and...again...that they only do lurabar puncture (there are loaRAB of hospitals that do lurabar punctures) at this hospital and that is it. Rubbish staff and rubbish hospital = no way am I going now. I have made my decision. If they want to feel it is feasable to treat patients like rubbish then that is what will lose them their patients. Simple.

Any suggestions would be greatly appreciated as I am feeling so fed up with the UK system of healthcare treating me and many others like rubbish. It's not on. Totally not on...

Kind regarRAB

Niad
 
At this time we do not have the social medicine system. That hospital will always have patients because they are a cog in the bureaucratic health machine of England. Have you tried going through the MS Society there in the UK?

I would not want to deal with a hospital as you have described. When my hospital starts acting the way that one does, I will simply stop going and die on my own. Without dignity and kindness, healing is a difficult proposition. :angel:
 
Hi, MS Jayhawk

Thanks for your helpful and informative reply.

I do not think it is standard procedure in the UK as my parent works in a hospital and theirs is not done by a specialist nurse nor on a ward with loaRAB of people around. My parent told me that her colleagues think it is weird and do not recommend me to go to that hospital as they said it has got awful hygiene standarRAB and I can see why after knowing it is done in unsterile conditions!

I mean it is the spinal cord if anything gets into it it can cripple people. That is why I am concerned. It is an incredibly important part of a person's body and neeRAB to be taken seriously when procedures such as these are done.

I will certainly make my wishes known for privacy and a doctor but they do not have doctors doing it in that hospital so that will be impossible. The only thing I can say is a bit of privacy, such as a single room you mentioned, would certainly be a start.

If they do not offer patients choice then this hospital clearly has got a real problem and I will not be attending it.

Kind regarRAB

Niad
 
Niad, I really feel for you. Fear of being crippled has crossed everyone's minRAB who has had to undergo a LP. Its a common fear, although it happens so incredibly seldom, that it really isnt the nuraber one fear. Infection, things like that- that is something to be concerned about in any hospital.

I work in health care. I am in 16 major hospitals in the area and over 25 in the state- I also work in nursing homes and assisted livings. Some, have better quality control then others; and yet right now, more and more patients are contracting both swine flu, meningitis and the big one which is MRSA, a superbug which is tough to fight with antibiotics. Patients go in healthy and wind up catching these diseases, only to be treated for a longer period of time, for something unrelated to what they went in for..

Its something that the entire world is experiencing and something that infectious disease docs are working on around the clock to control.

In your case- the privacy issue is a personal thing, but please know you wont be undressed, and there is no noise at all- other then the voice of the nurse who will hopefully say to you "youre going to feel alittle stick" when she injects the novacaine. Followed by "thats it, youre going to lay here for awhile and Ill be back to check on you". You shouldnt have any other noises! You shouldnt be exposed to any diseases, as you shouldnt be there for that long. If you really want to be 100% sure of what is happening, make sure the instruments are sterilized when you walk in, and that the bed is clean and smells like bleach! All hospital linens smell that way! I know youre very nervous, but you needn't be worried about the very worst case scenarios- unless you have other options of other hospitals to go to, just bite the bullet and get it over with. Youre going to be fine.
Nikki
 
Hi, MSJayhawk

Thanks for your helpful and informative reply.

I have not tried going through MS Society and didn't know I could for lurabar punctures...

I am certainly very wary of the way this hospital has acted, particularly since the way the neurology manager (may have been the actual ward manager - eep, wouldn't want her caring for me!) spoke to me.

She said that I was presenting obstacles (whatever she was on about I don't know...strange comment to make) as I told her about the difficulty I have travelling such a distance due to my bladder and spine conditions and would appreciate it if I could be sent to a closer hospital, which the UK system does not allow.

She abruptly said this is the only hospital that I can go to due to the consultant being based there, even though he is not the one doing the procedure. I seriously do not see what difference going to another closer more convenient (and friendly hospital for that matter) hospital would make as he is not doing the procedure so it doesn't matter. If I went to another hospital for the test, he would still get the results!

I think I should just not bother anymore as hospitals are a complete waste of time and treat their patients like insignificants.

I'd rather do the lurabar puncture myself than let those unsypathetic and unhelpful people do it as the next thing I know is they'll probably mess me up bad.

I totally agree, I should not bother going to this hospital and perhaps just...I don't know really. I will not be able to get the lurabar puncture any other way though...not sure what to do. I also agree with you, without dignity and kindness, healing is definitely a difficult proposition and I don't think I'll ever heal the way hospitals and doctors have treated me so far.

They just wanted to get me off the phone and told me I was wasting their time. So rude and obnoxious came to my mind while speaking to her.

Many thanks for your helpful post. It's much appreciated as everyone on these boarRAB knows what it is like to be needing help and to have health problems, unlike that horrible person (neurology manager) who said that she (apparently) understood in such a nasty tone. Hmmm...she's got it in for me I have a feeling.

She definitely was a bit strange in general. I certainly don't want to meet her again on the ward. It won't be a nice re-union that's for sure! I hope if I go that she keeps out of my face as I am definitely not happy about the way she treated me.

She was very unhuman...very cold. I cannot really explain. She certainly gave me a chilly reception that's for sure.

I definitely don't trust this hospital. There's something about it and the staff there that says something is being hidden or kept a secret as they do not like patients at all.

Kind regarRAB

Niad
 
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