LUMBAR PUNCTURE

The following Tuesday, September 25, found us back at the hospital once again. The doctors had called us and said they wanted to go ahead and do a lumbar puncture ("spinal tap") in order to check the pressure in Ashley's spinal cord. A build-up of pressure in the spinal fluid can cause problems. When they had initially talked about doing a lumbar puncture to check for the presence of cancer cells in the spinal fluid, Ashley had expressed a very strong desire to be sedated for the procedure. Therefore, we told them that she would want to be sedated this time as well.

When we arrived at the clinic and were preparing for the lumbar puncture, they asked if Ashley had eaten anything that morning. She had a couple of bites of a donut hole on the way to the hospital. The doctor got a funny look on his face, so I asked him what the problem was. As it turns out, Ashley wasn't supposed to eat anything after midnight if she was going to be sedated. Problem was, nobody told us that.

So now we had two choices: 1) sit around the hospital for several hours waiting until enough time had passed since her two bites of donut hole to make it safe to do the sedation, or 2) go ahead and do the procedure without sedation. Ashley wasn't wild about either option, but we finally convinced her to go ahead and do it without sedation. I think the final selling point came from one of the nurses who told Ashley that, without sedation, there was no need to do an IV. We ended up doing the lumbar puncture without sedation (Ashley HATES IV's).

Nurse Heidi had already applied Emla cream to Ashley's back when we arrived in clinic. Emla is a topical anesthetic that is used to "deaden" the skin at the site of a "puncture" in order to lessen the pain. Another anesthetic was injected into Ashley's back at the site of the lumbar puncture. That in itself was quite painful.

Once the anesthetic had taken effect, Doctor Bowers pulled out a needle about 3 or 4 inches long with a small plastic connector on the end of it. Fortunately, Ashley was lying on her side facing away from Doctor Bowers and could not see the needle. I think she would have "freaked" if she had seen it. Doctor Bowers then proceeded to insert the needle very carefully into Ashley's back until it had punctured through the spine at just the right spot.

A very long calibrated tube was attached perpendicular to the needle via the small plastic connector. Spinal fluid began flowing through the needle and into the calibrated tube. The level at which the fluid stopped rising indicated the amount of pressure inside the spine. I was watching Doctor Bowers' face closely as he watched the fluid rising. I had no idea how high the spinal fluid was supposed to rise. When it leveled off, Heidi said, "13, that's good." We were relieved. At least that was one problem we did not have to worry about. Ashley was a real trooper through the entire procedure (which only lasted a few minutes).