PDA

View Full Version : guess I'll join in and add all my fun


brain drain
01-22-2008, 05:40 PM
I am so happy I found this board and all of you. This has been a wealth of information. I have just recently been diagnosed with a spontaneous CSF leak. I am a 47 y.o. female who was in good health and very active previously to my leak. I started leaking in August of 2007. I spent 2 months trying every allergy medicine out there to relieve the symptoms before I called my doctor. Everyone told me that after we got a frost that the allergies would let up and I would be fine..well..didn’t happen. I made a dr. appointment mainly because I was concerned because only the right side of my nose leaked. I was suspicious about that although “Blues On Call” wasn’t. They said maybe my sinuses were just made that way. Then one day my son said to me – “Mom, you lay down an awful lot lately – why are you so tired?” I thought if a teenager notices something, there must be something wrong with me.

My dr. gave me more medicine and nasal sprays to try so there went another month or so of nothing working. He did sinus xrays, which were normal. He gave up and suggested I try an allergist. I had already given up and made an appointment with an ENT who also specialized in allergy testing…the smartest thing I could’ve done. He examined me in early November and the first thing he said to me was he suspected a CSF leak. He questioned me if I had head injuries or sinus surgery, both of which I hadn’t. My leak was clear but tasted salty – it leaks so much that you can’t help getting it in your mouth occasionally. Besides, when it isn’t leaking out my nose, it runs down the back of my throat. He asked if I had been having bad headaches to which I answered no because I am on migraine meds since I have had migraines for about 10 years now. I believe that medicine has now been a Godsend. I was so opposed to taking that years ago and wanted to quit taking it recently. I had migraines constantly when they first started and my dr. suggested taking Nortriptyline, an anti-depressant but also a chronic painkiller. It took a couple of months to work but taking it daily did help my headaches. From what I have read on here, I would suggest any of you suffering from the chronic pain to suggest the medicine to your doctor. I know that it has helped and is helping me. The ENT scheduled me for a CT scan and also allergy testing. My CT scan came back normal. I went ahead with the allergy testing that showed (after 60 punctures..ouch) that I was barely allergic to dust and molds. The dr. said there is no way that was causing my problems and he even called the dr. who read the CT scan to make sure nothing showed up. The dr. was more frustrated than me at that point. He asked me if I looked up anything about the CSF leak and I just shook my head yes. He could tell by the look on my face that what I learned had scared me. He told me he would rather rest on the side of caution and send me to a specialist in a bigger hospital and gave me a choice of which direction to go – both about an hour away from home.

I chose the teaching hospital/university only because I am familiar with the neurosurgeon on board there. I prefer him over anyone if things go that way after reading all that I did. I have since seen the specialists and had 2 more CT scans and 2 radionuclide cisternograms. The CT scan my local hospital did was useless to them. These doctors are very thorough – they did 2 days back to back of intense screenings. They examined me and I have nice straight sinuses so hopefully they find the leak and can reach it from there. They told me the migraines may be related to this and that as long as I am leaking so good that the risk of infection is lower. They wanted me to take a small cup home over the weekend to try and get them a sample of fluid to test….lol…I said, give me your cup now and give me ten minutes and you will have what you need. I think they were a little shocked. All I need to do is tilt my head and out it comes. They had more than enough to test within 15 minutes. They said they needed 1 ml. about 10 –20 drops; I gave them more than double that. It did test positive as spinal fluid. They only see about one case of a spontaneous leak per year but at least they see it. They do see the leaks from sinus surgeries and head injuries more often though. I was so silly trying to figure out what I could be allergic to..trying to figure out what my office at work had in common with my kitchen and bathroom at home….it was the activity and how I held my head. I notice lifting anything makes it much worse. I hate getting groceries. lifting the bags just aggravates it. I used to be very active and lifted weights (not heavy but just to keep in shape). I started feeling extremely tired this past spring/summer. I gave up lifting the weights in August when it just made my nose run too much and I got too tired. Walking does not bother me other than I do get more tired than I used to. Thank God I can still do that. It is my stress relief and the only exercise I ever seemed to be able to stay dedicated to. I don’t know how any of you that do physical labor for a living can function. I know I couldn’t do it. I am thankful I have a desk job.

I know I have written way too much here. I apologize but I did want to mention the few things like the pain medicine in case it would help someone else. I feel really bad for everyone that can’t seem to get enough drops for testing. Keep trying ..you know your body better than anyone. I have learned to trust my instincts…if your instincts tell you that it’s a leak, then it is more than likely a leak. . Btw – something I never read in all these posts – about these pledglets. Just an fyi – I had to keep mine in overnight to get the follow-up cisternogram. No one mentioned what they looked like. They are flat little squares about ½ the size of your little fingernail and they have these long strings attached. They put them in my sinuses and taped them to my face and left the strings hanging with little tags on them (about 6 in. of string).I looked like I had whiskers or dangling earrings hanging from my cheeks. They put 3 in each side. Wasn’t a fun adventure except the ENT that did the installation was really good looking – had to find something good in all of this. Then the radiologist that took them out was a sweetheart too…I wasn’t expecting nose junk (tryin’ to use a word that isn’t gross) to come out with them. I kinda wish I would’ve had a heads up on that. I don’t know what the future is holding in store for me…guess I will find out a little more next week but at least I don’t feel so alone now. Thank you all. I have been reading this board since November and I’m sure there are others like me who read but simply don’t post. I will keep in touch on here and will continue to read.

a real drip
01-22-2008, 06:57 PM
Hi Brain Drain!

Congrats on getting diagnosed so quickly! My heart breaks for my friends here who have gone months or years without a diagnosis.

You didn't mention, have they pinpointed the leak location? Because our symptoms are so similar I'm curious what the experts will propose. If you've read any of my posts you won't be surprised to hear me say GET A SECOND OPINION!--especially if the neuros want to drill into your skull. :eek:

I want to thank you so much for validating my fatigue. I've gained quit a bit of weight this past few months (not related to CSF leak at all) and keep wondering if my fatigue is mostly related to that rather than the leak. I mean, there are days when walking my dog three times a day is a major chore--although it doesn't help when it's only 10 degrees outside. ;)

I'm so glad you posted and I look forward to hearing more of your story as it unfolds. As I'm sure you've already noticed, folks here are very friendly, supportive, and knowledgeable. I have learned a lot here.

*bunchBest wishes for a speedy recovery,
a real drip ;)

sadlisa
01-22-2008, 08:05 PM
Brain Drain,

So happy your doctors were on top of things. I hope you have a speedy recovery. My instincts have said this may be my problem for 4 years. I have a physical job and each year it gets harder and harder to do. When I told my doctor that work makes my symptoms worse, he asked if I like my job. When I responded yes, he asked if I like the people I work with. I work by myself and I like me so I guess so I responded. That was the end of that. I am now scheduled to have a CT myelogram and cisternogram at the same time. I hope they find it! So happy for you, Thia

brain drain
01-22-2008, 08:32 PM
a real drip: I have just finished with all the testing (hopefully all of it)...2 days of it in fact. This was to pinpoint my leak. I don't go back to the ENT until Jan. 29th and will know the results then. He didn't even want to discuss our options until the leak is pinpointed. I found it quite amusing the way he kept looking at me. I asked all the right questions..he knew I did my homework. And he did have the right answers. From everything I have learned from everyone on here....I knew what I was talking about when I went to see him & I knew what to quiz him on..I think he rather enjoyed that. I also feel really bad for anyone hard to diagnose...honestly, I leak so much...it was easy to get enough fluid to test. And I am not sure at this point where I heard this but I was told that I am getting so tired because my body is working overtime trying to keep up making the spinal fluid I'm losing. So maybe this is the case with you too. Sometimes I wonder if I can ever make it fast enough. One of the ENTs doing my tests yesterday asked how much I thought I leaked a day...I estimate about 1 cup or so...well that's what comes out my nose..don't have a clue how much is going down my throat. What I like so much about the hospital I chose is that there are groups of specialists working together...its kinda like "House"...they all pull their information together and are really eager to listen to one another. Most of the doctors would ask me questions about the spontanaeous leak..they wanted to know what more I learned. I can just picture them all studying up this week ..lol..they are just so interested. I was like this 'prize' patient. I had to hear how rare this was at least 20 times. I don't know what my options will be but I can't continue on like this. I know stress bothers me and makes it seem to leak more and although I have a desk job..I have a stressful one. I know I can't do anything physically demanding either so I have no choice but to try and get this fixed. I'm scared I'm going to be in worse shape not getting anything done. Hopefully we can go up the nose and do it..guess I have to wait and see.

sadlisa: good luck with your tests..I hope they find your leak too.

take care all

a real drip
01-22-2008, 10:03 PM
Yep, Brain Drain, we are the lucky 5% (spontaneous cranial leakers). None of the specialists have been able to tell me what caused my leak.

Sounds like you have a good team in place. But why so long in getting the test results? My ENT called me on my cell phone with the test results while I was lying down somewhere on the amb-surg ward recovering from the tests! I guess every hospital has its own protocols. Also, I didn't get the radionuclide or pledgets. After the lumbar puncture, they just tilted me upside-down on the table to get the dye to run up into my head. (It still cracks me up to think of it. I believe the radiologist would have been pleased if the tilt table were able to shake me up and down a little to make the dye move faster! :p)

nancydrewbr
01-23-2008, 01:13 AM
Dear Brain Drain,

Welcome to the board, you are in good company! And thank you for sharing your story. It's so helpful to know that others are going through this and we are not alone and can help each other. You are so lucky to have gotten diagnosed quickly. It only took me 6.5 years and 40+ docs, but like u said u know when something is wrong!!! I was exhausted too and very thirsty.

My doctor would have called you a "gusher" as he had never seen someone with a low volume leak, like mine. You may have read it took me a whole weekend to get droplets out for testing. It's the low volume leakers that seem to drag on for years and then the laundry list of symptoms appear ("chronic inflammation" seems to play a big part) and the docs just seem to shake their heads and give up. Luckily some of us persist.

My leak had gotten to the degree that a CT scan showed I had a "slight thinning of the sella." It was this info that I was able to do detective work with and finally diagnose myself. I could have written the csf leak (rhinnorhea/nose) symptom list!!I was so postive, that my primary doc called the Neurosurgeon and I was diagnosed very quickly thanks to a great Neurosurgeon who listened and could feel my pain. The lumbar punture/cisternogram confirmed my 2 leaks and a CT with 1mm thin cuts confirmed the defect/fracture sites.

I had only wished I had found this site sooner, but not one doc from some of the best hospitals mentioned csf leak to me. The teaching hospitals are great, there are lots of good docs with deep depts., who love to see unsual things and therefore like to run the tests and write papers. Hopefully your case can further our efforts along in the medical community. My doc proclaimed my case was "difficult and unusual", just like yours!

On this board tonight, we have one here diagnosed and ready for surgery( we've all been praying for her!)), one in the process of being diagnosed and one that has already had two csf surgeries, so we are all on call if you need us!

I've been through two surgeries on the criibriform plate(a common site, fixable via the nose) and am also at a good teaching hospital. I am 8 weeks post surgery but slipped and fell on the ice 5 days after surgery, thus complicating my healing process. I am not sure but have a gut feeling that the graft shifted/dislocated as I am still leaking my usual low volume drip and have that horrid inflammed feeling and the symptoms persist. An engineer friend had to explain the principle of hydraulics to me and how force can shift a piece of glued tissue easily. It makes total sense. Slipping and falling on ice was not on the post op recovery list. Ouch!

An email was sent in to the doc today, so will hopefully be seeing him soon to be evaluted once again. At least I got diagnosed (July, 2007)and that is a very promising start. It's helped me get through the last several months, knowing that this is the real problem and that I did not need a tonsillectomy. So all of you awaiting surgeries, etc. After 9 surgeries, nothing but nothing can compare with a tonsillectomy at age 47!

Once again welcome, thank your for your story and will try to answer honestly any thoughts/concerns, etc. It's been quite a journey.

Best of luck,
Nancy Drew and the Secret of the Drip :-)

brain drain
01-23-2008, 10:17 PM
that's funny..I was on the tilt table too..the radiologist said "try to wiggle yourself back & forth" to get the dye up in there..yeah right...all the pressure on your shoulders and your head and he wants you to wiggle...he said well at least shake your head ..ha ha..I'm worried about ending up on the floor on my head and he wants me to shake around....wonder what we looked like from their view on those tables?? what a visual... I wasn't a happy camper..had to have the spinal twice because he didn't put that dye in along with the other stuff the first time..guess he didn't think they wanted me to have both or it wasn't marked clearly..he did manage to go back in the same puncture and it wasn't so bad the second time. I told him I would rather have 2 in one day than have to come back another day to do that...he didn't have much of a sense of humor at first and was very apologetic...we did tease each other when I was done though and said we hoped we never had to see each other again. You know..you have to keep your sense of humor in all this or we would all go crazy..I could've been really mean about having to go back in there but what's the sense of that...would just have made everything tenser and hurt more...I think he was expecting to be cussed out or something...us spontaneous leakers are 'nice' people though..look what we gotta go through..may as well grin and bear it cause we're at their mercy anyway

hey nancy drew (and the secret of the drip)...that's too cute..very creative you are

nancydrewbr
01-24-2008, 01:32 AM
Looks like I missed something by not going on the tilt table for diagnosis. :-( I was however on the tilt table during my surgery, they called this the Trendelenburg position, where they tilted me down and could actually see the leak during surgery. (always get post op notes)They somehow can make you valsalva during surgery, so this intracranial pressure must have forced the fluid out. Let's just hope they remembered to put my seat belt on!!!

My guess is my docs had never seen two leak sites...not to mention a low volume leaker. And it's just more amazing that a Neurologist even when I asked about the possiblity of a csf leak, said "No, you would be really miserable." One ENT sent me for a botox injection in my left cheek where the facial numbness( a very well known symptom of a csf leak) was and another very well respected ENT sent me to a dental school, where I attended pain camp for weeks. The "pain" psychologist there had me trying to do bio-feedback to relax.....oh the stories are worthy of a book!

But, yes, you are right Brain Drain, keeping a sense of humor is key. The last thing my doc told me is well you look good. I had to laugh and tell him that has been part of the problem. They equate looking good with feeling well....au contraire!

No news back from the doc yet and oh yes, still leaking!

sadlisa
01-24-2008, 08:11 AM
I can agree with you on the looking good part! It has been a big part of the doctors taking me serious. Maybe we should go to our appt. with out brushing our hair and in our pajamas. I get the feeling many on this forum were real movers and shakers before this happened. I know I have a hard time with the taking it easy part. The best to all, Thia

brain drain
01-24-2008, 10:00 PM
boy the "looking good" thing...makes me laugh..my ex's family was upset to hear about my problem and asked me to come visit them which I did..that's the first thing they said to me "you look really good"...then at the hospital everyone that wanted to take a peak at me - I could see them staring at me with the same intense look like they were expecting to see something strange about me & when I just laughed and talked normal, it kinda broke the ice and they just said - so you leak huh. Even the ENT that put the pledglets in me took the time to make them look neat on my face cause he wanted me to still 'look good' lol - one of the radiologist told me that he did a nice job and I 'looked really good' even with those on...maybe we try to 'look good' to camoflauge our feeling crappy...yeah I agree, we should go to the drs. looking like cruds..boy am I glad I leak so good..guess they wouldn't have believed me either if I didn't....hey at least we are "lookin' good":)

nancydrewbr
01-25-2008, 12:39 AM
To all of those "looking good leakers", your posts were the only things that made me laugh today... I forgot to tell you, I decided not to wear lipstick, that really made me look exhausted, but I still got the well u look good and I always love the, "well how are you?" If I was good I wouldn't be here, that's for sure.

I have had different reactions that when you are strong and not moaning on the floor, they think oh she is not in any distress, read those office notes! Once after waiting three months to see an ENT specialist, I burst into tears, I felt so bad.....his reaction, "What's with the tears?" I nearly died, where's the compassion??

Well after reporting my continued leak,(8.5 weeks post surgery now) fall on the ice 5 days after surgery and persisting symptoms to the doc's office late Tues. I got a call that I am to be scheduled for a "special nuclear scan for csf leak study". The secty. did not know which scan I was to have. My guess, is another lumbar puncture/cisternogram, but I could be wrong. It's almost impossible to do the betta II transferrin test on us low volume leakers, because you cannot get enough to test, but we are still leaking and as mentioned have a really terrible time convincing the medical community something is radically wrong. Persist! I am a good example of how this problem has been overlooked.

Just curious but besides being totally exhausted, what are your symptoms?

Mine are: headaches, tinnitus, change in hearing, facial numbness, neck pain ,a weird tingling in my arms/legs and a horrible inflammed/burning feeling + being very tired and deteriorating during the day. Whoops, I forgot the running left nostril only and fluid going down the left side of my throat.



Best wishes to all and very determined to get this csf leak solved, SO, I can look really good and put that smile back on my face and help others! On to that tilt table!

Nancy D. :-)

okleaker
01-25-2008, 12:29 PM
Oh my gosh if I had a nickel for every time someone said to me "you look good" or "you don't look sick" I could pay all my medical bills at once!!!! Maybe I'm being overly sensitive but I'm starting to get really annoyed that people keep asking how I'm feeling....like something has just miraculously changed overnight. I just say "the same" and go on. I think I need a therapist!!!!

I feel cheated that I didn't get to use the tilt table. I think I might have enjoyed that!!!

sadlisa
01-25-2008, 01:31 PM
"How are you feeling?" Yes it is a stupid question and we sound like we complain when we tell them. But who are we to complain to? They are the only ones who can help us move things along in our investigation of ourselves. Because I had meningitis and they all want to pass it off as after effects, they say I need to learn how to live with this. In other words. You need to take your lumps. What do they think we are doing? That still doesn't mean we don't want the answers as to what it is causing our symptoms. I laugh all the time at the comments my doctors give me. Thia

LauraL840
01-25-2008, 02:22 PM
they say I need to learn how to live with this.

You know, it's this mentality that REALLY pisses me off! We've been told by several doctors that perhaps DH needs to learn to live with this, or accept that he may have to live with this. It's just crap. He's got a FIXABLE problem .... it needs to be fixed, not lived with!

If someone hit you over the back of your head with a ball bat every time you stood up, would you live with them? I understand that some medical conditions cause people to be in chronic pain and that sucks. But to just accept the pain of a leak as chronic, and something to live with, without ardently pursuing treatment is ridiculous!