August – September 2010 Issue

Way back before there were MRIs and CAT scans and lumbar punctures, doctors had an interesting way to diagnose multiple sclerosis: they would take the afflicted person and dump them into a bathtub full of hot water. If the person floated, they were declared a witch and put to work transforming toads into investment bankers. If, however, they merely flopped around on the floor when pulled from the tub and reported that they had lost all feeling in their limbs, they were diagnosed with MS and sent on a charity walk. (Seriously, am I being too cranky when I point out that all these MS walks are in dubious taste on some level? Probably.)

So now fast-forward to this past July, when the thermometer here in Central Aheya hit the mid-90s and pretty much stayed there for the next two months. Badda-bing, all my symptoms went to eleven. Muscle cramps, numbness, muscle cramps with numbness with a side of blinding headaches and blurred vision, topped with the kind of exhaustion normally experienced by people who work a lot harder than I do. The strangest (and most distressing) effect was a new one: my legs, after just a few minutes standing, would stop answering the phone. They might hurt at that moment and/or they might be numb, but eventually they would simply stop working and resist all my orders. It’s a very weird moment when you can see your leg, and sorta feel it, but it refuses to even twitch for you. This is, I can attest, very inconvenient when it happens, as it did one day, when you’re standing in the middle of a crowded bookstore and suddenly literally can’t walk, even with a cane.

Now that the temps have come down a bit things are better, but the weird disconnect in my legs after a few minutes standing seems to be a permanent feature. I also can’t really hold things in my left hand and, when I type, that hand makes scads of typos. It’s been exactly four years this month that they diagnosed me with primary-progressive ms, and I guess this is progress of the sort they meant. All I know is that it is enormously depressing and makes getting anything done a major chore. I would never have suspected how attached to walking across the room I was. Anyway, that’s where the August issue went.

See? Lame excuse. Is joke. You will laugh now.

Incidentally, speaking of lumbar punctures, one last thing. I mentioned a few months ago that I have taken to watching House in reruns. Certain people are apparently driven nuts by my willingness to watch the show out of sequence. I knew, for example, that a certain character’s paramour had died even before I knew said paramour existed. But since the show is supposedly modeled on the Sherlock Holmes mysteries, I like to derive an extra meta-thrill by deducing the backstory of each episode without the crutch of chronological order.

Anyway, lumbar puncture (aka spinal tap) seems to crop up as a diagnostic procedure fairly often on House (and they seem to initially suspect MS in almost every case), but, speaking as a onetime puncturee myself, I find the presentation of the procedure on House a bit deceptive.

In the show, they lay the victim on a table in a vaguely fetal position, swab his or her back with antiseptic, stick a long needle into the spinal column and suck out a bit of fluid. So far, so accurate. But the next scene is almost always a bit later, when they go into the patient’s room to deliver the test verdict. And here’s where reality diverges from House. In House, the room is quiet except for the snarking. In real life, however, the snark would be inaudible, drowned out by the howls of pain coming from the recently tapped patient.

When you have a lumbar puncture, the doctor will tell you that it is very important to lie completely still on the table for an hour or so after the procedure, lest you develop a headache from the test. What they don’t tell you is that the reason you may develop a headache is that they have just essentially drained your oil, lowered the pressure in the cerebrospinal fluid (CSF) surrounding your brain. But the reason they want you to lie there quietly for an hour is not to minimize the chances of you developing a headache. You are absolutely, positively going to develop a headache, the worst headache of your life, a week-long blinding weeping pleading bulletproof lie-on-the-couch-and-scream headache from hell, until the pokey little CSF factory in some remote province of your body tops off your tank again.

Lying very quietly on the table will not prevent this, so you might as well jump right up and go have a slice of pizza while you still can see, think and chew.

The real reason they tell you to lie there for an hour is to give the doctor a chance to get out of the building and halfway home before you start vowing to kill him and burn down his clinic.

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