Wednesday, July 28, 2010

Paging Dr. House...

We had a medical mystery on our hands this past week and it was very unpleasant, to say the least.

At the zoo, I started developing a headache. It was hot and I wasn't drinking or eating much, so it wasn't that strange I had a headache. But after a few hours, it developed into a migraine. It quickly became the worst migraine of my life...not only did my head feel like it would explode at any minute, but my legs and arms were going numb. I had extreme photophobia (pain from light). I decided there was no way I could make a 2.5 hour drive home to Maryland so Evan took me to the ER in Chesterfield, Pennsylvania.

The ER gave me morphine and IV fluids which helped the migraine. They performed a CAT scan which looked normal, but insisted they needed to do a spinal tap to rule out a brain hemorrhage. I was TERRIFIED! I almost left AMA, but finally decided it was probably necessary. Thankfully, they gave me a second dose of morphine plus Ativan so I really don't even remember the spinal tap (or the next 8 hours). Unfortunately, the spinal tap revealed red blood cells, white blood cells and neutrophils, so they were concerned that I did, in fact, have a subarachnoid hemorrhage in my brain. They transferred me to another hospital with MRI capabilities (I really don't remember any of this).

I woke up the next day (Friday) and waited all day for a MRI which never happened. Evan came to visit me (and bring my Kindle) and convince the nurses to feed me (by 5pm I had not been given anything to eat or drink). My mother in law watched Marino so he didn't have to take the 2 hour trip again. As long as I laid down, I felt ok. The neurology team came to interview me about my migraine and medical history. I was really upset to have to stay another night and not see Marino. I definately had a breakdown about that when Evan was there. It's so difficult not to see him for a whole day, let alone 36 hours.

I had a roommate in the hospital which I always thought would be awful but it was fine. She was the same age as me and, considering we were on the stroke floor of the hospital, I guess that's why they put us together. But I felt lucky to have a nice, considerate, low maintenence roommate.

Saturday morning, I had the MRI. The nurses were kind enough to give me Ativan beforehand, so I slept through it. The neurologist came in to tell me the MRI did not show any hemorrhage, just some white spots which are indicative of migraines. Sonia and Sabrina came by with lots of great gluten-free snacks, magazines and sundries I was in desperate need was so wonderful of them to come visit me. Being hours from home and without my boys was very hard so I felt blessed to have a visit from some of my favorite people.

Saturday afternoon I was discharged but immediately my migraine came back on the car ride home. I wasn't sure if it was the sitting up or the sun, but I was in pain. By Saturday night, I needed to go to the ER again. My amazing friend Lauren brought me to our local ER so Evan could stay with Marino (this was midnight). They immediately gave me morphine, Benadryl and some anti nausea medicine that made my muscles lock out so I couldn't walk (won't be taking that again!). But my migraine was gone and I got a good night's sleep.

The ER doc gave me a prescription for Tylenol with Codeine and I needed to take that several times on Sunday, with minimal relief. Then we had a huge storm and lost power, so all of us went over to my mother in law's house for the night (she had power). I slept ok and got up and tried to get ready for work. My headache got worse and worse. Once I got in the car, I decided there was no way I could drive. The pain was just excruciating. I made an appointment with my regular doctor for 1:30pm.

By the time I got there, the pain was intolerable. I was vomiting in the bathroom at the doctor's office and I grabbed a nurse and begged her to help me. They had me lie down in a dark room, which immediately decreased the pain. After talking to the doctor, she was certain that the problem was not a migraine, but a spinal headache caused from the lumbar puncture. Apparently during the puncture, a leak of spinal fluid can occur, which causes the brain to drop and produces extreme pressure on the brain. The pain is positional - always worse when sitting or standing and better when laying down. This is, of course, very rare...generally only 2% of lumbar punctures result in spinal headaches. I have a history of being unlucky when it comes to medical odds! My doctor called the ER and prepared them for me coming in for a blood patch, a procedure in which they take some of your blood and inject it into the lumbar puncture site. This causes clotting and "plugs" the leak.

Unfortunately, due to the storm and the power outages, the ER was packed. I sent Evan and Marino home, knowing I would be there a long time (I got there at 2:30 and left at 8:30). I waited 2 hours before I even got a bed, so you can imagine how I felt having to sit up all that time. Then the nurses had trouble getting an IV in me. One even went so far as to tell me it was my fault she couldn't get it because I was too tense and thinking bad thoughts! Finally they called in an awesome phlebotomist who was incredibly kind and got the IV in no problem and without pain. They gave me morphine, fluids and ativan.

The anesthesiologist came in to explain the procedure to me. I was really scared but he was wonderful and very reassuring. While preparing for the procedure, he had asked me some questions about my favorite things and about Marino and at the scary parts of the blood patch, he would say things like "think about taking Marino to Tybee Island" (which is my favorite beach). I feel like many times doctors are sort of clueless about patient's fears, but he was awesome.

He numbed my back with a local anesthetic. He and the phlebotomist had a hard time getting enough blood from me (they needed 50 ccs for the patch) so they had a tag team effort trying to get the blood and passing it back to the needle for the patch. It was over quickly and my headache felt 75% better immediately.

After resting for an hour, I was allowed to go home, with orders to stay on bed rest for 2 days, no lifting more than 3 pounds, and to take Percocet for pain. I still have a small headache (not positional) and some pain in my back and one of my arms where they had trouble trying one of the IVs.

The whole thing was really scary and so painful. I am still kind of in shock about all that happened, but relieved to be on the other side of it now.


  1. Yikes! That sounds so scary. You DO have bad luck with medical odds! I hope you're feeling 100% better by now and hopefully they can keep the migraines under control with meds in the future!

  2. That is SO unbelievably scary! I hope that you are feeling better soon!

    Get some rest!!!

  3. Oh my gosh, Sara! I am so sorry that you had to endure all of this. I read this on pins and needles and feel a huge surge of relief now that you are on the other side. When I read the part about the doctor calming you with your own memories & thoughts, I got teary eyed! That was a rare find....that amazing doc! I know being in the hospital can be terrifying...especially when you are a momma! I had a huge mass that was thought to be ovarian cancer when Alex was three...I was in the hospital for 8 was not cancer...but terrifying nonetheless.
    So glad you are all ok....babycakes!

  4. Thanks, Jill! Luckily I was too out of it most of this time to even consider the awful possible outcomes. But there is nothing worse than being seperated from your child!

    I know, that doc is amazing. I have had terrible luck with (male) doctors generally not understanding fear when it comes to medical procedures, so I was pleasantly surprised. My friend who is a nurse at that hospital says he is the very best anesthesioligst (he is also incredibly handsome:)).

  5. How scary! I am glad they figured out what was causing the headaches. I hope you are feeling better now.