Had my pre-chemo doctor’s appointment yesterday morning and while at the pre-appointment bloodwork lab, discovered that I was scheduled for a procedure that afternoon which wasn’t on either my or Matthew’s calendar. The lab check-in people didn’t have the access to determine what the procedure was so we had to wait until we saw my doctor to find out it was for my first lumbar puncture chemo infusion.
The doctor was ready to postpone it, as he could tell I wasn’t mentally prepared for it–I’d been expecting to go back to work after my morning appointment with him–but Matthew and I talked it over and figured it made more sense for me to just get it over and done with.
The reason I need to have lumbar puncture chemotherapy is because blood cancers like lymphoma and leukemia can spread to the brain and cerebrospinal areas, with some–including ones that present in the nasopharyngeal area like mine–having a higher likelihood. However, most chemo drugs can’t penetrate the blood-brain barrier, and because of that, the cerebrospinal area is considered a “sanctuary” location for cancer cells. So even though my original lumbar puncture biopsy was clean, it’s possible the sample missed cancer cells if there aren’t very many. As such, it’s standard procedure to administer chemo drugs via lumbar puncture to cases like mine in addition to the regular cycles of chemo cocktail I’m on. I’m slated to have a total of four of these lumbar puncture chemo sessions.
One down, three to go.
The procedure itself was kinda ouchie at first, felt like the big nerve in my lower back and down my leg was being twanged and pinched repeatedly…which, I guess it was. But the nurse/doctor (I’m not actually sure if it was a nurse practitioner or a doctor doing the procedure) was extremely responsive, communicative, and kind, and she saw I was in pain–both from the change in my breathing and my yelp–and switched to the smaller (black v. yellow*) needle. That switch made all the difference. It went from unpleasantly uncomfortable to hardly more than a minor prick. She also made a note in my folder to use the black needle on my lumbar punctures from now on.
Also learned an interesting factoid. When administering chemo via lumbar puncture, they take out exactly as much spinal fluid as chemo drug that they plan to inject in order to maintain the fluid balance. The spinal fluid they took out they’re sending to check for cancer cells. Waste not and all, I guess.
Little sore still this morning, but at least no spinal headache. Went back to work today as this drug (methotrexate) isn’t expected to have the same level of side effects as the rest of my chemo cocktail, and I’ll be out of the office after tomorrow’s round three infusion blitz through the new year.