Ron Smith

So I began my second round of chemo with a lot of confidence in my ability to endure chemotherapy and not suffer the stereotypical ill effects.  Maybe its my age and otherwise good health, or maybe TV just dramatizes chemotherapy for the sake of good entertainment, but my nausea was mild and only caused me to lose my lunch a couple times.  Obviously depending on your flavor of cancer, your chemo regimen may be different.  I personally am going through the Hyper-CVAD regimen, that is spread across many days (up to 14) depending on the cycle.

The one aspect of my treatment that I was most anxious about where the Lumbar Punctures (LP).  My experiences in the first round caused me to have a continuous migraines for 9 days after the LP was performed.  Moreover, the procedure itself was a very uncomfortable, though not painful experience.  This round I figured I would be more prepared.  I had the nurses administer Phenergan, an antiemitic that has sedative qualities to it.  This allowed me to be a lot more relaxed during the procedure, and it went off without a hitch.  This LP was performed in concert with a 24-hour infusion of Methotrexate through my IV.  The combination of the two caused me to sleep for about 18 hours.  Upon waking I was greeted with a pounding migraine that was reminiscent of my first round.

Over the next 9 days I slept roughly 14-18 hours a day due to the headaches.  Throughout the week the doctors tried numerous pain medications: MS Contin, Oxycodone, Dilaudid, Vicodin, Fioricet, IV’s of Caffeine.  All of them had little to no lasting effect on my headaches.  It was not uncommon for me to wake up at 7 AM and by 9 AM I would be asking the nurse for my cocktail of Flexiril and Ativan so that I could go back to sleep to escape the pain associated with the headaches.

After I while I found ways to mitigate the headache.  By laying flat on my back, putting on my sleep mask and beanie (due to light sensitivity and temperature sensitivity), I was able to stay awake all day.  But not able to sit up or stand for more than 20 minutes without the headache returning.

Then on Tuesday, day 11 post-LP, with my headaches not as strong but still present, a nurse, whom had not been assigned to me for a while made a suggestion.  He had worked for a neurologist, and when the patient was not a candidate for a blood patch, he would suggest they wear a back brace.

It was a, “why didn’t I think of that moment.”  The reason a blood patch is performed is so that it can increase pressure around the LP site, and hopefully the clotting agents in  the blood would stop the leak.  Well here was a simple, non-narcotic, non-invasive way of applying pressure directly to the area.  I was eager to try anything that might provide relief at this point, so he went and grabbed a back brace and I put it on.

Within an hour, I was thanking him profusely.  For the first time in over a week, I was able to go for a walk, sit down and chat with friends, or even sit behind the computer for more than an hour without a migraine laying me flat on back, literally.  I wore the brace throughout the day and evening, and only felt the need to lay flat one time.  It was the difference between night and day for me.  I was able to return to doing the things that I enjoy, and wasn’t forced to lay like a lump watching 4 channels of crappy TV.

So for those that may have come across this post, and are suffering from post-LP headaches, and for some reason a blood patch is not an option.  Please consult your doctor first, and if they find it acceptable.  TRY A BACK BRACE

Anecdotally it helped me and stopped me from having migraines.  Hopefully it helps you as well.

Acute Lymphoblastic Leukemia, cancer, Chemotherapy, headache, Leukemia Information, Lumbar Puncture, Migraine, Personal Ramblings, spinal tap