One down, one to go

Yesterday, I went for my lumbar puncture / spinal tap experiment.  I showed up at the hospital an hour before the procedure and met with a physical therapist.  She administered a number of tests of my balance and gait, finding that I was a "severe" fall risk, at least by one of her measures.  After that, they drained 30ml of cerebrospinal fluid from the lumbar region of my spine to relieve pressure in my brain.  They repeated the tests one hour after the procedure and then two hours later.

When I arrived in the hospital gym to perform the second set of tests, I didn't feel better balanced and didn't notice improvement in my gait.  So I was initially disappointed.  But Amy did notice improvement, and the physical therapist's tests found distinct improvement.  She pointed out to me that, when I walked, the leading foot would now go out significantly farther than the other, and I moved more quickly.  This was whether I was walking normally or as fast as I could.  Her protocol found that I was now on the low end of "moderate" fall risk.

These results indicate that normal pressure hydrocephalus may be complicating my scenario. 

So, at the time I was being tested, I didn't perceive the improvement, but that evening I very much did.  It was exhilarating to recognize how well I could walk.

According to the surgeon, about 20% of procedures lead to headaches after the supply of cerebrospinal fluid (CSF) in the brain is depleted.  In this case, they would be removing 3X the volume of CSF that they normally drain, so the probability of headache was much higher.  My sister-in-law reported that she had an extremely severe headache after a lumbar puncture she once had.  I very definitely developed a headache, and I still feel it a day later.  And because of tomorrow's kidney stone surgery, I'm not allowed to take aspirin. acetaminophen, or any other anti-inflammatory medication.   

Of course, right after the lumbar puncture, my body went right to work replenishing the CSF, and my balance has returned to where it was before the procedure.  I will see my neurologist in a few weeks to consider the possibility of a shunt as a more durable solution.

My mother has a warning for me.  At 93, she was tested like I was and found not to be a fall risk.  She was so happy with the that result, that she went out to her garden to work, fell, and broke her wrist.  I believe that was this past spring.  (I saw her in mid-November, and she seemed to be doing OK with it.)

Tomorrow morning, we're to show up for surgery at 5:50 a.m.  That's for the kidney stone.  Hopefully, this will also go well.  I remain anxious about the effect of general anesthesia on the condition of my brain.