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I would like some information about the Spinal Leak

Question:
I Am taking my dad for a spinal tap and would like some information. 1. are 30cc's a lot fluid to take out? Does the amount of fluid taken out have an impact on the chances of a headache? 2. what are all the do's and don'ts around lying flat and drinking coffee to ofset getting a headache or, do you just drink the coffee once you get he headache? 3. I've heard something about a "blood patch" to stop a leak/wound from the procedure but, why not do a blood patch in the first place rather than have to go back if there are problems? 4 any information that would be useful would be appreciated.


Answer:
>Am taking my dad for a spinal tap and would like some information. > 1. are 30cc's a lot fluid to take out? Does the amount of fluid > taken out have an impact on the chances of a headache?

I have had four spinal taps and will answer what I can. I don't recall how many cc's were removed during my procedures but I am sure that the more taken does increase the chances for getting "the headache".

> 2. what are all the do's and don'ts around lying flat and drinking > coffee to ofset getting a headache or, do you just drink the > coffee once you get he headache?

This is the first I've ever heard of anyone being told to drink coffee after a spinal tap. After each of mine I laid very flat and very still for a few hours while drinking lots of water through a bent straw so as to minimize any movement. I never did get the headache so I endorse this method. I would double check that recommendation to drink coffee - maybe it's okay but I'd want to make sure.

> 3. I've heard something about a "blood patch" to stop a leak/wound > from the procedure but, why not do a blood patch in the first > place rather than have to go back if there are problems?

I never had the need for a blood patch and can only speculate on why they *do not* do them as a matter of course. Though possibly quite low, perhaps there is some attendant risk to the patient who receives a patch and if that's the case, the MD would understandably only use them when necessary. Again, this is pure speculation.

> 4 any information that would be useful would be appreciated.

I can only suggest that if there is any difficulty with the placement of the needle, consider having a nurse anesthesiologist available. They are quite adept at finding 'the space' since this is part of their regular routine. A fair amount of anesthetic procedures for surgeries involving the lower extremities rely upon their finding this same 'space'.

I will also post (seperately) a very interesting article that explains why these headaches occur and a method that can be used that claims 100% success (over 4400 procedures) in avoiding the post spinal tap headache. If you go to the URL you will be able to access a picture that shows how the angle of the needle when entering 'the space' can, if done properly, self-seal preventing the headache. The author is a retired MD anesthesiologist and his suggested method is compelling.



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