Tag Archives: Hope

Arachnoiditis, Spinal CSF Leak

ARACHNOIDITIS AND A SPINAL CSF LEAK: FINDING HOPE ON THE JOURNEY

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“Hope is being able to see that there is light despite all of the darkness.”

Desmond Tutu

Today I want to write about HOPE, because hope is one of the strongest forces that can guide us through immensely dark seasons. Love is always the power that truly drives all I do. But hope brings energy to keep on going even when its presence is only the flicker of a flame in the darkest of nights.

”It’s always something, to know you’ve done the most you could. But, don’t leave off hoping, or it’s of no use doing anything. Hope, hope to the last.”

Charles Dickens

Today I am writing to remind you & myself that hope always lives & always remains even when everything appears hopeless. At those times we can often only see unending disaster & pain. Which can feel completely overwhelming to endure. But when we find hope we discover little rays of light that begin to glimmer & shine in the midst of the darkness.

So today I hope you will join with me and choose to HOPE again. In whatever area of life feels hopeless to you at the moment – I pray that you will find the energy to...

Hope, hope to the last.

Six Years of struggle

It’s six years ago this week that I fell from a small step ladder whilst painting & my life took what seemed like a major detour into a long term neurological nightmare. In early 2015 I was diagnosed with a concussion, then post-concussion syndrome, then a spinal CSF leak/ low pressure headaches. However, it wasn’t until the summer of 2020 that I was also diagnosed with arachnoiditis during one of my worst flares/ relapses I have ever had – as I wrote about in ‘Butterflies in the Dirt & A New Diagnosis.‘

This is my ongoing story since that time. My real life story that reminds us that sometimes hope surprises us when we chose to stay the course. Sometimes it turns things around in ways we never imagined or expected. If we will just hold on hope can bring better days again.

Summary of My Ongoing Progress

In general, it’s been mainly good news regarding ongoing progress in my recovery since the new (but old) diagnosis of chronic arachnoiditis. There have been some great results over time from my new ongoing treatment protocol to reduce spinal canal nerve/ arachnoid inflammation & help to ease the pain of the damage already done. This includes various medications and a personal physio plan of continuing to walk a few miles a day over 2-4 separate walks and gently stretching my spine regularly.

Successful treatment has meant that I am now managing to be upright and do things for stretches of on average 10-12 hours at a time before I need to lie down to rest. I can then get up and do even more after 1-2 hours rest.

Which is massive progress because during the year following April 2019 (my last bad relapse/ flare) and my hospital admission after actuely relapsing in July 2020 – I could only manage a maximum of 4 hours upright in one go – normally only 2-3 hours max. I then needed at least 2 hours lying down flat before getting up for maybe 2 hours again, and that was how my whole day went! So all the very high levels pain and debilitating head pressure issues are much improved since I had the IV steroids (methlyprednisolone) in hospital and then continued under an arachnoiditis treatment protocol. My walking is also much stronger and generally good and my mental clarity much improved so I can do a lot more in the day at home & for our church as well as maintain a helpful walking routine. 

Combination of Medications that Help

I continue to take 5mg prednisolone (steroid) every other day and 75mg diclofenac (anti-inflammatory that crosses the blood-brain barrier into the spinal canal) the day in between. I also take 4.5ml a day of LDN (Low Dose Naltrexone) as recommended by a US specialist & other arachnoiditis suffers. (This is not available on the NHS for arachnoiditis but prescribed & purchased privately from a registered LDN trust clinic. Although my GP & Neurologist have been informed I am taking it). I also take Omeprozole 20mg to protect my stomach and some other supplements including Pregnenalone to help nerve regeneration, Turmeric capsules for inflammation, Omega 3, calcium to protect my bones, vitamin B complex, magnesium & vitamin D. 

Intracranial Pressure Headache Improvement

Interestingly, what we previously assumed were classic low pressure/ spinal CSF leak positional symptoms have greatly improved too with the treatment. Which suggests the arachnoiditis inflammation was probably more of a problem on that level than we all previously realised. Which is perhaps good news for other patients that might improve on medication and with more walking and gentle stretching too. IF they could have an arachnoiditis/ spinal canal inflammation element to their ongoing symptoms.

Much Less Debilitated

The main positive thing that has changed since the new diagnosis and treatment is that I am currently much less debilitated and do not need to lie down much at all. I can also manage a lot of the pain & symptoms better – by keeping moving, regular long walks, lying down when the pain and head pressure gets too much, being quiet for a bit… and in the meantime I can do & achieve a lot more as I said above, especially as my mental clarity is much better than it was.

Summary of Recent Improvements

So the never-ending battle continues but 2020 brought new gains that I never imagined could come without more invasive procedures. That experience this year has been something of a miracle in our lives. My husband feels that I am currently the best I have been in the whole nearly 6 years… and I would probably agree with him in many ways. Although there are elements of the lower spinal pain and stiffness that are perhaps worse than other times on my journey.

The Freedom Found in a New Perspective

I think understanding the new diagnosis helps a lot too with management and mentally/ psychologically dealing with it all. It really has been very liberating to understand some more of my strange symptoms & behaviour over the past six years better in hindsight. This is why seeking out more answers can be so helpful to patients like me. Especially those with rare conditions – because it helps you to understand yourself better & gives more explanations for why you sometimes act and respond in the ways that you do. Which is so helpful for your holistic health.

I really do believe in cases of rare illnesses that there needs to be more doctor & patient partnership in understanding new diagnosis. Doctors often do not have the time to fully research and understand more unusual conditions. But if patients and doctors can choose to more humbly learn together then that can help everyone. This is especially true in our newer age of the internet and online support groups. Patients often have the time to research, learn & explore things doctors just don’t have the time for when they meet very few patients with those conditions. This subsequently means that listening doctors can then help a patient understand it all better too, because patients often lack the wider knowledge of medical complexities that doctors are much better placed to help them understand.

In my own story I am still immensely grateful for every doctor who has had the humility to patiently listen carefully and to think outside of ‘normal boxes’ to help very unique patients like me hopefully discover more answers to unique questions about their medical conditions. Those doctors are very precious to us, especially when they help us over the long term so get to know you a bit more personally too.

Radiological Evidence of Arachnoiditis

We have at least made some progress on this level since my last blog article too. My scans have been looked at by a few different doctors now including neuroradiologists, neurologists, a neurosurgeon & an arachnoiditis specialist. The conclusions coming from all avenues is that there are various ‘suggestive features’ of arachnoiditis as well as some possible mildly Adhesive Arachnoiditis (AA) elements on my MRIs. This includes my lumbar spinal nerves being situated more towards the side and back of my spinal canal (first seen in retrospect on my first March 2015 MRIs which would support my theory that a biological predisposition as well as the fall and leak were the trigger – because those scans were done before I had had any spinal procedures). As well as some possible areas of mild clumping & nerve adhesions forming & some inflammation of the cauda equina nerve roots.

This is all actually all very in line with a diagnosis of chronic arachnoiditis. It is usually a clinical diagnosis based mainly on symptoms, but over time people will often display suggestive features of spinal nerve/ nerve root inflammation, swelling and positional shifting, which may also cause spinal cysts forming (incl. tarlov, arachnoid or similar cysts – as I have). Patients may also begin to show some suggestive, possible or probable mild nerve root clumping and adhesions evident on their MRIs etc.

Clinical Rather than Radiological Diagnosis

It has been reported to me that I have enough suggestive features of all of these elements to help support the clinical diagnosis of arachnoiditis. Although not enough to support a radiological diagnosis of adhesive arachnoiditis or cauda equina inflammatory disorder.

These findings are also in line with my own experiences of treatment. I had previously read that the steroid & anti-inflammatory meds will only really work on those in earlier stages of illness progression. So my radical response to both the IV steroids given in hospital in July/ August 2020 (500mg IV methlypredisolone a day over 5 days), the subsequent steroid taper and taking anti-inflammatories, in addition to lots of walking & some gentle stretching would support the theory that the arachnoiditis is present and potentially dangerous to me, but it has thankfully not yet advanced to a more severe permanent type of adhesive arachnoiditis.

This supports my theory that we may well have thankfully stopped a more ‘adhesive episode’ taking hold this summer. I really was extremely unwell and in unimaginable levels of pain in my lumbar & sacral spine and legs. Which without treatment could have well done more permanent damage to my spinal nerves – had we not halted its progression through aggressive treatment.

Arachnoiditis and especially AA can progress very quickly when it severely flares. This is why it’s of paramount importance that people are diagnosed & treated via a clinical diagnosis before it is so serious that it is more evident on MRIs.

Treatment will always work best BEFORE the damage has become permanent & radical enough to clearly show on scans. Specialists also tell us that scan evidence does not always correspond with symptom severity anyway. As with a lot of other conditions like spinal CSF leaks.

So the earlier it is treated the better. Ongoing treatment can also help to halt progression through flares. Which is of great value to me and other sufferers of this awful misunderstood condition. Knowing how to treat it can potentially stop devastating, irreversible damage to people’s spines and whole nervous systems.

ONGOING SYMPTOMS

Despite all the improvements – for which I am incredibly thankful – the reality is also that I believe I still have permanent damage to my spine from the arachnoiditis/ leak – because chronic pain is a normal significant daily part of my life. It is just much more contained than it used to be. This again would align with what is being seen on my MRIs.

CHRONIC NEURO PAIN IN MY SPINE & HEAD

It often feels like a ‘carpet burn’ sensation – like when the top layer of skin has been gashed off – but deep in my lumbar/ sacral spine and upper neck in particular. Or definite nerve pain and pressure flares in my spine & head. Sometimes that builds to more pin’s sticking into me/ stabbing pain. It also means my spine is very stiff which also leads to a lot of leg stiffness & leg pain too. Although lots of walking helps this. Also various movements such as bending, lifting, twisting, straining make all this worse.

PINS & NEEDLES

I also get regular intermittent pins and needles/ buzzing in & all over my legs and feet & sometimes in my hands and other places. I understand what people mean by saying it feels like ‘bugs crawling on you or under your skin’ (paraesthesia) but to me it’s distinctly pins & needles – but it’s like a buzzing that pulsates and moves about on the inside of my legs and all over the surface of my skin. Thankfully it has improved a lot on how it was during my last ‘flare’. These days it’s more annoying than debilitating and thankfully my feet no longer ‘burn’ like they did in the summer.

I HAVE TO KEEP MOVING: ‘RESTLESSNESS’

A key ongoing symptom feature for me (that I have heard is very typical of arachnoiditis) is that remaining sitting and standing in one position for too long exacerbates my all my symptoms, including spinal & head pain, leg stiffness, pins & needles and the feeling of pressure in the back of my head, whole head and upper neck which leads to more fogginess and sometimes even very bad nausea or hot flushes. I have often recently wondered if this is partly a CSF flow issue – as once I start moving around again or walking – it improves. The sensation is that my intracranial pressure builds in my upper neck & whole head – but it improves through gentle movement. Even lying down for a while can cause this to happen. The minute I get up my legs are all stiff and weak and my ears pop from the pressure changes.

What this means is that I can begin to feel very agitated and distracted if I have to stay in one position for a long time. This could be read by others to be an anxiety issue or simply a deep restlessness. But I now know it’s mainly simply a typical symptom of arachnoiditis, due to build up of pain and discomfort to high levels and the body’s natural reactions to that pain and discomfort in my spine, legs & head. As the video explains well.

CSF FLOW & PRESSURE ISSUES

This would tie in with various arachnoiditis specialist’s theories about CSF flow issues and high intracranial pressure problems related to arachnoiditis. On that level I have wondered if it’s possible that the small leak that has been identified in my ventral cervical (in my neck) spine by my NHS Intracranial Pressure MDT could possibly help regulate my pressure rather than distinctly making things worse and causing typical low pressure symptoms. Which I guess could tie into my cranial scans never actually showing low pressure/ SIH.

It may also explain some of my confusing symptoms that at times over the past 6 years have completely baffled neurologists as to whether it was low pressure, high pressure or another headache type or combination. I do often wake up with a headache or at least a ‘pressure filled head’- in the night or early in the morning and I especially struggle with very weak & stiff legs and a ‘full head’ if I have to get up in the night or early morning for the loo.

Although the CSF flow and pressure theories are mainly based on my own observations of my symptoms – I don’t really know the truth of it all of course. I have come to believe it’s all FAR more complex than my doctors & I perhaps previously realised regarding CSF / ICP / arachnoiditis links. Which again would make much more sense of my own medical journey over the past six years. Arachnoiditis is known to both sometimes increase intracranial pressure, but is also known to cause you to leak or seep spinal fluid too. So that again explains more about why my intracranial pressure dynamics are often all over the place & may well continue to be pretty messed up long term. Which would also tie into my general hypersensitivity to any pressure changes. Although again all these things have currently improved to less debilitating levels since treating the arachnoiditis which shows how interlinked it all is with the inflammation as well.

STRUGGLES WITH SITTING DOWN

Thankfully I can sit for much longer than I could – but only either with a very straight spine or leaning slightly forward. Although it is never a comfortable position for me and will make my head and spine pain & pins & needles worse especially after a 30mins to one hour or so. I can also feel very sleepy and nauseous after a while sitting which can makes me yawn obsessively (I again think it’s an ICP increase thing). So I again often have regular ‘getting up breaks’ when sitting alot. I will also be extremely stiff when I get up and have to get my legs moving quickly to get them working properly again.

Travelling sitting in a car is particularly bad for me too. If I travel in the car or drive I sit in a very strange position with the seat really far forward and very straight or slightly leaning forward. I have also invested in a ‘wedge cushion’ to use if a passenger – to help align my spine better in the ‘bucket’ type seats, which seems to help. Bucket seats are known to be very bad for arachnoiditis/ AA sufferers.

ONGOING PHONOPHOBIA & PHOTOPHOBIA

My head is still very sensitive bright and flashing lights, fast moving images & to the layering of sounds. I still struggle with lots of noise at the same time. Like music with a beat, or music in the background with talking, or a combination of other general noises. The music I listen to these days tends to be quiet & acoustic and I usually listen with headphones in my ears to block out some of the other sounds. But all this is much better than it has been for a long time and this Christmas I have been able to tolerate flashing lights much better than in previous years.

TALKING WHILST WALKING

Talking & walking is much better for me now which has been helpful when it’s one of the only ways to see people during the pandemic restrictions. But sometimes it’s still a bit of challenge especially if my head is already a bit flared. One of my worst movements whilst walking is attempting to turn my head to look at things or to talk to someone. That will immediately fill my head with pressure, make it cloudy and cause a lot of pain and pressure in my upper neck. The same thing happens moving my neck to look up or down. So my key is to walk with my head facing forward and my spine very straight.

SINGING

I love to sing, especially with my husband, but singing has often been a key test of how bad my symptoms are since my accident. At their worst I cannot sing (or hardly speak) at all. Even during the first half of 2020 (pre-arachnoiditis diagnosis) my husband and I would often sing for our online church since the pandemic closed church buildings. But I would have to practice lying down then would only get up to record or live stream. But since my new treatment plan I can also sing more. A good example being our recording of Oh Holy Night for our Online Carol Service. I have not been able to properly sing this carol for the past five years especially because of how high it goes at the end. Normally singing that high would cause my head to full with pressure, make me feel drunk & cause me to need to lie down. But to our joy this year I managed to record this at home & this was actually done after a number of practices & a couple of takes – so that has been some encouraging progress.

GOING TO THE LOO

Going to the loo still a problem for my head & bladder. It still feels like either my pressure is increasing or I am quickly losing spinal fluid as I wee – as my head almost immediately feels very strange, full of pressure & my ears will often pop more showing a quick clear pressure change (like happens on a flight). It is also still often uncomfortable on my urinary tract which will still feel a bit irritated for a while before and after I have been. But it’s all much better than it has been in a while & especially in the summer. Previously I could often only go for a wee directly before lying down. Emptying my bowels also makes my head worse especially if there is any straining at all – which I avoid at all costs. Straining is not at all good for leaks or arachnoiditis.

MOVING FORWARD INTO A DIFFERENT SEASON

So it’s a mixed picture of massive gains made in the second half of this year, combined with a reality of continuing to manage many ongoing symptoms.

However, for the first time in a long time I have made much more progress & found many ways to stay busy & occupied within all my limitations. This has included helping the shift to more online church through video creating, editing and social media & website development. These are all things I can do, as and when I can, standing, sitting or lying down, either on my smart phone or for shorter bursts on the laptop. I also continue to help provide pastoral support – alongside my husband – for people in our church & connected to us. Although even a lot of this has had to shift online or over the phone this past pandemic year.

“The real work, the hardest work, is to pick up the pieces and decide how to put them back together again. The new thing that emerges may not work the way it used to, but it can bend and stretch and change us in ways we come to treasure even more.”

Suffer Strong – Katherine & Jay Wolf

That quote is precious to me because it describes my journey well. The past six years have been a marathon journey of learning to accept, adapt, stretch, bend & change according to my current abilities & limitations. My life journey since my accident has in no way been linear. Sometimes it’s been as changeable as shifting sands. Just when you get used to being able to do even more – you again simply crash, burn & relapse.


In those times of disappointment, in those moments I wasn’t sure I had the energy to start another recovery journey again, I found that I had to find ways to acknowledge the grief & pain but then allow myself to bend, change & be moulded anew. In those places I had to let go of finite disappointments & focus on…

A bigger Picture. A bigger Person. A bigger Presence.

… to carry me through.

Until, yet again I have found myself in the more peaceful place of slightly calmer waters. Having let go of who I once was and embracing the life I have been given now. Whilst choosing to allow it to be used to be a blessing & make a difference in others lives.

So that is the infinite hope that I cling fast to. A hope that is not based on the life I imagined, but is based on something far more significant. The the life I was given to live. So I must embrace all that it is – and attempt to use it for good. To make the difference in our world that only I can make. Reaching the people that I was uniquely called to love. And trying to offer hope to others overwhelmed by hopelessness.

Part of that process is continuing the task of simply telling my complicated never ending story – in the hope that it may become a ray of hope in someone else’s darkness. So today I want to tell you again to never give up. Instead choose to…

“Hope, hope to the last.”

Remembering that good can come again in our lives… IF we will only keep holding on and enduring for another day, another difficult season. However impossible that sometimes may feel.

“We must accept finite disappointment, but never lose infinite hope.”

– Martin Luther King, Jr
A long walk at Bradgate Park, Leicestershire over the Christmas holidays. It’s the first time in 5 years I have managed to travel over there and go for a long walk with my family. It marks another new achievement since being on the new treatment protocol.
Here is my new summary video of my whole medical journey as well as footage of my January/ February 2021 adhesive arachnoiditis relapse/ flare and treatment with IV Steroids. To see my daily video diaries from this time please see my YouTube channel: https://www.youtube.com/channel/UC9ZkCy9B_IpeaGrXd0CEgow

For more posts of my arachnoiditis diagnosis please see the arachnoiditis menu above.

ARACHNOIDITIS INFO: ‘Arachnoiditis – Taming the Most Painful Pain’ Dr Forest Tennant video and Suspecting & Diagnosing Arachnoiditis (J. Antonio Aldrete) and The Arachnoiditis Syndrome (Dr Sarah Smith)

A medical paper supporting the use of steroids in treating early stage arachnoiditis and in the prevention of further adhesive arachnoiditis: Immunotherapies in chronic adhesive arachnoiditis – A case series and literature review

For more previous posts about my story of living with a spinal CSF Leak (from before we understood the arachnoiditis element) please look at the subject heading on the menu bar above.

SPINAL CSF LEAK INFO: Here is a brilliant 2 min animation about Spinal CSF leaks. For more information about spinal CSF leaks please see the UK charity website at www.csfleak.info or the US charity website at www.spinalcsfleak.org. Please see this May 2018 medical paper about the 10 most common myths and misperceptions about spinal CSF leaks. It is by some of the top world experts in treating this condition.

Mental Health, Perspective

A Window into a Suicidal Mind

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“I remember the wild agony of no way out and how the stars looked, endless and forever, and your mind can feel like it’s burning up at all the edges and there’s never going to be any way to stop the flame.”

Ann Voskamp

Only those who have experienced the trauma of a suicidal mind can truly understand how agonisingly dangerous it is.

We usually do the upmost in our lives to avoid things that might kill or harm us. But when it is your mind trying to kill and harm itself – it can feel impossible to get away from. It takes you hostage, binding you up with all its lies and accusations, torturing you inside your own head, home and life.

Refusing to let you go.

If only I could explain to you what it feels like…

I recently read the beautiful article on suicide that the above quote is from. And straight away I connected with the author whom I instantly knew understood.

You see I never used to understand.

I used to assume that I would never think that way. That life couldn’t get that bad for me. That I couldn’t be that selfish. I assumed that my ‘superior’ coping mechanisms could surely carry me through any storm that came my way.

Until life took me through seasons when I truly felt …. “the wild agony of no way out…”

At the end of April this year I dramatically relapsed in my spinal CSF leak and arachnoiditis symptoms…AGAIN!! After eighteen months of clear improvement since my last epidural blood patch. Everything came crashing down again physically and mentally.

And I found I had absolutely NOTHING left to fight with.

I had completely burnt myself out physically, mentally, emotionally and spiritually from fighting this horrible condition and all the misunderstanding’s surrounding it – for so long.

I ended up stuck in bed nearly all – day and night – in almost perpetual intense, agonising pain. Everything simply exploded symptom wise and it felt like I was getting every type of headache and nerve pain in my spine you can get on top of the ‘low pressure’ issues. It was non-stop, non-positional pain, and made worse by the fact I was hardly sleeping at all.

I am only now beginning to feel more ready to talk about what happened back then more openly. Rather than just wanting to hide from the world and not speak up.

It’s only crippling shame that tries to keep me silent.

But as I get increasingly well, I know that part of my healing and restoration comes in being able to talk more openly about how bad things were. I know that the only way to deal with shame is to speak it out. So as to process my own journey and also to connect with others’ suffering and struggling, as well as to help others to understand more.

So here’s some more of the brutal and raw truth about the traumatic wrestlings of a suicidal mind. At the time, I wrote some poetry in my iPhone notes. I guess to try and process my thoughts and explain to others how it felt. I did show these to my husband at the time which he appreciated – even though they were often painful for him to read.

This Pain in My Head

I am going mad
This pain in my head
Persists and won’t go away
It’s killing me slowly
Polluting my life
Stealing everything away

What do you do When you are Drowning?

I am drowning – can you see?
My head keeps sinking below the surface.
My legs furiously attempting to keep my head above the waves.
I have no strength left to fight.
My legs are growing so tired.
My mind just won’t stop whirring.
The pain won’t let me go.

I am suffocating – can’t you see?
Where life is being squeezed out of me.
My energy leaving me, my endurance gone.
My life just a shadow of what it once was.

I am in inner & outer torment – can you see?
The pain and debilitation slowly taking over all I am.
Like gangrene it eats away at me.
Stealing my life, my strength, my hope

I love you all so much – can you see?
I am devastated by just what may be.
To think of your tears, your cries, your heartbreak and pain.
To think of destruction eating away at your hearts.
To think of the backlash and the battle.
To think of all the awful desolation left behind.

How could I?
How can I?

What am I supposed to do?
Do I keep existing or allow the waves to take me where they will.

So the battle rages and I sink yet deeper still into the darkness.
The pit of despair – a place that won’t let you go.
Destruction all around me.
Devastation following.
Despair keeps on calling my name.

I am stuck in the pain and anguish of living here.
Trying to love here…
Trying to suffer well…
Trying to hold on…
Trying to clutch on to life…
Trying to not let go…

But losing…
I am losing…
I am losing…

I don’t want to be lost
But devastation is calling my name.

The Torment of Pain

Pain torments you it pulls, pushes & wrestles with your mind
Persistent pain consumes you until nothing else is left
It eats you alive leaving your flesh exposed
Infection after infection ravages your thinking
Mind constantly infected
Tormented
Trying to hold on
Trying
Trying
Trying to hold on
Gasping
Reaching
Clutching
By my finger nails
Trying to hold on

How Long am I Supposed to Endure?

How long am I supposed to endure?
She asked, writhing around in pain
How long do I need to exist in this for
She asked, living as if death was life

They tried to understand
but still couldn’t see
the pain
that never went away.
The torture of not knowing how long to endure
Was stealing her whole life away

The problem was
she could no longer see
a future any better than this
She tried and she tried to hold on for love
But the pain was pulling her to defeat

Many would question the size of her love
The fact she could not endure or remain
But that is because they never lived in her body
And never kept on feeling her pain

Somehow reading them as separate poems doesn’t quite do justice to the intensity of the trauma that takes over your mind when you are backed into the ‘corner of dark shadows’ that is suicidal ideation.

Your mind is completely out of control.

You can no longer think rationally. It’s just a massive ball of dark, oppressive and negative thoughts crippling your perspective and adding to your intense internal and external agony.

I still felt so much love and love was actually my only anchor and light. But love was often even painful to feel, because you think that if you really loved others – that much – you should be able to endure and remain.

Right?

But you don’t have any energy to remain anymore.

It’s relentless.

Completely overwhelming.

All consuming.

Utterly unbearable.

And as dark as dark can be.

….And I was hardly sleeping at all. So there was no relief.

That’s why it’s called ‘mental illness’ – because you are extremely unwell.

And you just can’t ‘snap out of it’. Or just ‘think positive thoughts’. Or ‘reign in your thoughts’. Or simply ‘change your perspective’.

You no longer have that ability.

Your mind is no longer your own.

Without the love, compassion, support and care of my amazing husband, family, church family, friends and doctors, I am not sure I would have made it through.

It still scares me to know first hand what a vulnerable and dangerously over stretched mind can end up like.

But I do know talking openly about it shows how far I have come since then. To know that I was simply very very sick – both physically and mentally. It breaks my heart to know that others are facing this same battle – in similar and very different ways – each and every day.

Unless we can try to listen and understand more what goes on the the mind of someone feeling suicidal, we won’t be able to help them overcome the immense stigma, shame, misunderstandings and trauma of that experience. We need to know how to best try and help ourselves when we find ourselves there. As well as helping those stuck in the oppressive prison of a mind on the edge of suicide.

So that’s why I am opening up my own immensely humbling experience again. To let another struggling soul know today that you are not alone. I have been there and I want you to know…

It can get better again.

I know you can’t see it – yet.

I couldn’t either.

I only felt the ‘agony of no way out.’

But one day the sun did again begin to break through the clouds.
And I began to walk out.

Albeit bruised, battered, burned, startled and scared from the fight. But I made it through again. So please just keep putting one foot in front of the other.

Just hold on a little bit longer.

Allow someone else to walk through it with you.

And then get strong enough to share your story. Because it might help to reach and save another struggling soul too.

“I wanted the brave to speak up, to speak the Truth and Love:
Shame is a bully and Grace is a shield.  You are safe here.
To write it on walls and on arms and right across wounds:
“No Shame.
No Fear.
No Hiding.
Always safe for the suffering here...”
If we only knew what fire every person is facing — there isn’t one person we wouldn’t help fight their fire with the heat of a greater love.”

Ann Voskamp

To read more about my first mental health crisis please try this post; ‘Breaking Through the Darkness .’ To read more about my beginning to understand how crippling shame had become in my life please see; ‘The Shame of Chronic Illness and Pain.’

UPDATE: Please note that in August 2020 I was also diagnosed with arachnoiditis as well as a spinal CSF Leak – I now have radiological evidence to support both those diagnosis. To read more about the new diagnosis please see this link.

For more posts about my story of living with a spinal CSF Leak please look at the subject heading on the menu bar above.

Here is a brilliant 2 min animation about Spinal CSF leaks.

For more information about spinal CSF leaks please see the UK charity website at www.csfleak.info or the US charity website at www.spinalcsfleak.org.

God & Spirituality, Spinal CSF Leak

Finding A Way Through: My Spinal CSF Leak Recovery 

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UPDATE: Please note that in August 2020 I was also diagnosed with arachnoiditis as well as a spinal CSF Leak – I now have radiological evidence to support both those diagnosis. To read more about the new diagnosis please see this link.

Our greatest glory is not in never falling, but in rising every time we fall.– Confucius

It’s been a while since I have written here. The last six months have been a season of deep trial and anguish, whilst simultaneously becoming a season of great joy. My ongoing health battles have been truly exhausting and yet…

I am currently seeing some light at the end of the tunnel.

And today, I have rediscovered my voice to share my story. 

Following just about holding on through the immense challenges of the the last three years – since I fell off that ladder in January 2015 – I can now pretty confidently say that it seems that I am currently in recovery from my CSF leak. We are hoping that this time – following epidural blood patch number four last September – that I can make a full recovery.

At the moment it looks like we are heading that way. And yet my three year journey has been full of a cycle of injury, treatment, recovery and relapse. So it has been intensely difficult to definitely say to the world – “this is IT!”

Although that is of course the hope and dream.

Following my long summer of 2017 spent almost totally flat in bed (or on my beautiful garden bed outside) I had a CT Myelogram scan mid September to try and locate my spinal CSF leak. Traumatically, the scan caused me to have an epileptic seizure and yet failed to evidence my leak. Such is the challenge of looking for these elusive leaks – 50% of which are never actually found. I was subsequently then left even worse off than I had been – hardly able to walk or be upright for more than a few minutes at a time. So I stayed in hospital and a week later I had a 40ml lumbar epidural blood patch (after the first one was aborted due to the needle going too far). Two days later it appeared that my headaches had shifted from low to intense rebound high-pressure headaches and I was finally discharged with the diuretic acetazolomide to help these new headaches.

High pressure headaches point to the fact the blood patch has probably worked – however the journey of trying to discern what is high or low pressure is not for the faint of heart.

In fact – over the next few weeks – it again almost completely floored me.

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Over the following couple of months I was extremely unwell, even though I could be upright much more. This took its toll on my mental health as I struggled to work out what on earth was going on in my crazy body. One day I was sure it was rebound high pressure symptoms and the blood patch had worked – the next I was convinced it was still low pressure and that the treatment hadn’t worked. Day by day, week by week, the confusion and debilitation of severe neurological symptoms and pain – both upright and lying flat – and an inability to rest and sleep properly – took its toll on my mental health. Until I realised – if nothing changed quickly – that I was heading towards a second complete mental breakdown.  (Like the one I had had a couple of months after my second epidural blood patch in November 2015).

When suicidal thoughts began to again abound – as I again convinced myself that I was probably still leaking and would maybe never get well – I knew I had to take radical steps to calm my terrifyingly restless and anxious thoughts and again find a way through the anxiety and confusion.

“A person who worries still thinks in some way that he can solve his own problem. Worry is the mind racing around trying to find a solution to its situation” – Joyce Meyer

The darkness of hopelessness and despair began to wash over me like a flood – mixed with the sheer exhaustion of three years of fighting and partially recovering and then relapsing again and again – and I was slowly beginning to feel like I was drowning again mentally and emotionally.

My legs were madly trying to tread water to keep my head above the waters – but some moments of some days I felt far too worn out to keep battling to stay afloat.

But what choice did I really have – right?!

There is no choice – because the only other choice is the unthinkable… and yet in the darkness you DO think the unthinkable. In the silence of pain and debilitation – your mind can end up in a scary place.

You just need it all to go away…you just need the pain and struggle to end…

You even sometimes naively wish what you had was terminal – because at least then there would be an end.

There needs to be an end.
There has to be an end.

How do you keep going, when you don’t know how long you have to endure? It’s the not knowing that feeds the anxiety, it’s the fears of getting worse that drain your depleted energy… and yet there is no escape.

You just need an escape…

But then you become consumed with guilt and shame for being so selfish to not only think – but at times dwell on such horrible things. Because if I love my family then I have to endure – because love never gives up! Right!? Unconditional love endures till the end.

…And yet how do you keep on going when you are utterly exhausted and at the end of yourself.

It’s a vicious cycle.

I even shouted at God on a few occasions to make it all stop because I couldn’t take any more of it. I told Him I wasn’t strong enough to keep on fighting. I was utterly worn out in every way – I pleaded with Him for no more pain, no more medical battles, no more clear scans, no more chaos in our life, no more crazy debilitating symptoms!

Shame was pulling me back down into its dark clutches. In my mind shame taunted me with the fact I was too weak, the fact I couldn’t cope, the fact I was chronically ill and couldn’t get well, the fact I had seizured after the CT Myelogram – so thought no one would do any more scans like that now to try and find the leak. The fact that I thought soon enough Doctors would give up on my difficult case.

I heard a voice within me screaming; ‘You can’t do this! You might as well give up! You will never get well – your worthless life will be full of this kind of pain for good. It won’t get better. It will only again get worse. Relapse is inevitable – and you will only go and muck up any healing again anyway!!

I HAD to still those relentless voices.
I HAD to rediscover the voice of hope.
I HAD to somehow find a way to discipline my restless mind.
I HAD to trust God for the strength to somehow make it through.

“If you hear a voice within you say, ‘you cannot paint,’ then by all means paint and that voice will be silenced.” – Vincent Van Gogh

I had to find the voice of faith, unconditional love and abundant grace.

That still small voice that is always whispering to my heart telling me: You CAN do this and I AM is here helping you through.

I couldn’t do it alone. I needed Him to walk me through. I needed Him to talk me through.

I needed His voice.
I needed to draw closer to His heart to hear His whispers.
His words became my breath of life.
His truths lit up the path ahead.

Moment by moment
Day by day
I somehow made it through…

Even when it seemed impossible.

“You will keep in perfect peace all who trust in you, all whose thoughts are fixed on you! Trust in the Lord always, for the Lord GOD is the eternal Rock.” -‭‭Isaiah‬ ‭26:3-4‬ ‬. The Bible.

Things began to settle down a bit a couple of months or so after my fourth blood patch and I began to discover that I could be upright more and walk further – little by little, week by week.

But I knew I had to protect any progress.
I needed to focus my mind and fix it on more hopeful things.
I knew I must use my thoughts to meditate on more calming concepts.

I had to shut down the multitude of voices that surrounded me and work on listening to the one I most needed. The voice that whispered, ‘be still’ in the midst of the raging storm. The only voice that had the power to break through the deep darkness that enveloped me, with the light of true abundant life. The voice singing songs of love over me – as He navigated my broken vessel through the raging seas.

And,
…step by step…
…hour by hour…
….day by day…
…week by week…

I am finding my way into more and more peaceful waters.

Physically, mentally, emotionally and spiritually – calmer times have come.

branches de petales

I am not yet ‘back to normal’ – back to where I was before I fell that day in January 2015. And yet, I can be upright ALL day long without needing to lie down. Week by week I am growing in confidence in what I can do. Month by month my strength is building and my body is in less pain and is more fully relaxing.

I still have issues in my head. My Neurology Consultant and I agree that it seems to be a ‘hypersensitivity to higher pressure’ – so I still need a lot of calm and quiet in my days. I cannot rush about like I used to. Stress, raising my voice, singing, talking too much, bending, lifting, going to the loo – and similar things – all increase the pressure in my head.

But it is improving … slowly … and it is gradually heading in the right direction.

So that I can hope, believe and dream again – that one day I will be fully free from this horrendously debilitating condition. Free from the monster that has plagued the last three years of my life and attempted to rob far too much from our family. I still have to fight the fears of relapse – because that has been my very real experience so very many times.

But I HAVE learnt so much on this crazy recovery story – and those around me have learnt so much too.

Doctors are learning how better to treat this condition – because I chose to open up my life and to keep them informed. Patients are learning how to find a way through – because I chose to speak up, challenge misguided opinions about the condition and reach out amidst my pain. Christians are finding a way to endure seasons of great suffering – because by His grace I have somehow managed to wrestle through.

And one day – one fine and beautiful day to come – I hope that I can fully enjoy and embrace the wonder of hindsight. That in a time hopefully coming soon – I can stand on the mountain top and tell the world that I managed to just about endure and somehow made it through the pain. I have always known that that will be a glorious season – where I will shout, sing and share the tales of complete restoration and stunning redemption from the intense struggle. Where I can testify to how God brought our family all the way through.

But in the meantime…

….whilst things are still a little hazy and complete recovery is a dream not yet fully attained… I want to tell you of my gratitude. For life, love and breath in my lungs. For my amazing husband, my enduring children, my loving family, dear friends and wonderfully supportive church. I want to tell you about all the wonderful doctors and nurses that have helped me through – even when their understanding was so limited. I want to speak of my gratitude that I can currently be upright ALL day, that I can walk for miles whilst listening to music or inspiring words. That I can drive locally, go to the shops, visit friends, eat in a cafe and sit up in church.

I need to tell you that when you have tasted of utter debilitation, that being able to DO things again is a wonder to behold.

However, most of all I need to tell you about the fundamental thing that has brought me through.

He is known as Jehovah – the stunning three in one God – who so very many people don’t yet know. He is my light in the darkness. He is unconditional love in the midst of trial and sorrow. He is my undeserved grace when I completely fall apart and shout at Him in anger and despair. He is my comforter when I am distressed. He is the still small voice that sustains me. He is peace to my anxious thoughts. My fountain of life. My inner calm.

He is the way, the truth and the life.

branches de petales

But most of all I need to tell you that in and through His stunning grace – He carried me – on the days I never thought I would make it through. Sometimes through my husband, children, family and friends. Sometimes through a song or inspiring words that someone chose to share. Sometimes through the prayer offered up by someone who saw our pain. Sometimes through a whisper on the wind picked up when my heart and mind were finally still.

So I will ALWAYS hold fast to Him and listen to His songs of love – until that day comes when this beautiful scripture becomes my physical – as well as – my spiritual reality.

“My beloved spoke and said to me, “Arise, my darling, my beautiful one, come with me. See! The winter is past; the rains are over and gone. Flowers appear on the earth; the season of singing has come…”  – Song of Songs 2:10-12. The Bible.

My dream is that one day I will sing again – with all the breath in my lungs – without it hurting my head.

And on that day I will sing a new song of never ending love from my soul, to the ONE who carries us through our deepest, darkest pain.

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To read more about my story of living with a chronic spinal CSF Leak click here.

Here is a brilliant 2 min animation about Spinal CSF leaks.

For more information about spinal CSF leaks please see the UK charity website at www.csfleak.info or the US charity website at www.spinalcsfleak.org.

Here is a medical journal publication about rebound intracranial hypertension (rebound high pressure) as a complication of epidural blood patching. 

This is a wonderful new May 2018 medical paper about the 10 most common myths and misperceptions about spinal CSF leaks. It is by some of the top world experts in treating this condition. I was told so many of these myths by various neurologists, anaesthetists, radiologists and many other doctors during my lengthy and traumatic nearly 5 year battle with a spinal CSF leak. This kind of misinformation caused many delays, misunderstanding and great distress on my already immensely long winded and difficult medical journey.

This other in depth 2018 medical paper is about both low and high intracranial pressure syndromes and their similar and different symptoms. It also mentions cross overs with other headache types. When a patient suffers with a spinal CSF leak long term it can cause massive fluctuations in their whole pressure system both whilst suffering from a spinal CSF leak and following treatment. This is why lumbar puncture pressure readings and ICP pressure monitoring can prove an inaccurate diagnostic tool for SIH (low pressure)  and RIH (rebound high pressure) as this paper refers to as does the 10 myths paper. My initial LP in February 2015 reading was a 7 which was considered ‘evidence’ of low pressure by some doctors and normal by others.

Spinal CSF Leak, Suffering & Grief

Facing Disappointment After Disappointment But Pressing On Regardless…

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“True hope is honest. It allows a person to believe that even when she falls down and the worst has happened, still she has not reached the end of the road. She can stand up and continue.” – Philip Yancey

I’ve now been on the roller coaster of chronic illness and pain (with a spinal CSF Leak) for nearly 2 1/2 years. During that time I have been almost fully bed bound for months at a time, then for many other months I have been able to live a part normal life where I can be upright enough hours to get the basics done at least.

I have not had one day feeling fully well for those 2 1/2 years.

It’s been tough!

I can hardly remember what it feels like to feel healthy or live normally. To be able to make plans trusting I can go through with them. To not be on this daily treadmill of dealing with the multitude of restrictions and limitations. Whilst simultaneously having to be extremely patient, letting go of what I can’t change and trying my best to stay thankful for all the good parts of life too.

Following about a year of slightly more manageable symptoms. Last week I tripped and fell flat onto the pavement, and within 24 hours of that fall it became obvious that the very minor accident had caused a complete relapse of my CSF Leak symptoms, leaving me again stuck in bed/ lying fully flat for over 22 hours a day.

And it’s honestly so disappointing.
Going backwards again instead of forwards.
To again be struck by the full force of this cruel condition.

The roller coaster is exhausting. It can take months and months to see any improvement in this condition then in one moment, in one misplaced step….

BOOM!

I am back to where I started.

And it is honestly wearing me out!

These are the words I wrote a day after the new fall, as it became clear that I was facing another big symptom relapse….

Every time I face a setback my heart sinks.
Every time I get worse again, I remember how good I had it last week when I was slightly better.
Every time I want to give up, I know I can’t, I have no choice but to keep on going.
Every time I want to sob and sob, to let it all out, but soon realise I shouldn’t because it will only make my symptoms worse.
Every time I picture the life I can’t live and have to let it go again.
Every time I hope for better days but worse days come instead.
Every time it tortures my motherhood that I can’t be the Mum I want to be.
Every time I can’t help my husband look after our home or do everything I want to for and with my children.
Every time my body rebels and forces me to have get flat again before it completely shuts down.

Every day I have to pick myself up, dust myself down and choose to keep on fighting another day.

Sometimes I get weary.
Sometimes it feels like I have nothing left to give.
Sometimes I wonder if I am really strong enough.

But what else can I do but get up and keep on going? Hoping and believing that one day things will again be better than they are now. And that I will one day be able to access the medical care I need to help me get better.

That is what I wrote last weekend as I faced the consequences and hard reality of that fall. They were the feelings and thoughts that bombarded me last week. They were the things I had to face but then let go of.

It’s really not easy to be back here again!

“Pain is no evil, unless it conquers us.” – Charles Kingsley

And yet something is different this time. Those thoughts and feelings didn’t plague me for as long. I have realised that within me I have reached a place of deeper freedom. The journey I have been on for over 2 years has taught me so much and made me so much stronger, whilst simultaneously being more aware of my weakness.

As the condition has beaten me down yet again, I have felt a deeper resilience rise up from the inside – despite it all. A deeper peace to keep on letting go.

I almost feel a shout within me of ‘come on then, bring it on!’
A battle cry that I will not give in, I will still keep living here.
An act of throwing off the burdens and obstacles coming against me.
A determination to make the best of things that I can.

So that is what I am choosing to do. However long this cruel condition keeps knocking me flat. However much it tries to mould my life around its limited perspective. However much it tries to feed me with despair and taunt me with the life I could be living.
However much it tries to bind me up in it’s web of disability, restrictions and chronic pain.

I have to decide that I will not let it rob me of who I really am and who I am really meant to be.

If being Becky Hill means working with this rather than wearing myself out trying to constantly fight it, then I must work with it for as long as I have to. Looking for the opportunities, rather than focusing on the limitations, seeing the beauty still around me, even in those moments it feels unbelievably hard. Because….

  • if I cannot live here, then how can I ever ask anyone else to live through their own very challenging season either?
  • if I cannot find a life amidst all the restrictions, then how can I teach my children to do the same?
  • if I give up the fight then how can I encourage and draw out resilience in others?
  • if I cannot find joy in the midst of suffering then does my spirituality mean anything to me?
  • if I cannot love deeply and see outside of my self, even where there is pain, have I even found true love at all?

So seeing as I have relapsed again as we head into summer, we made our own declaration to this debilitating condition. We brought a garden sun bed that goes completely flat so that if I have to spend my days lying flat, I can do that outside as well. Amidst the garden, the sun, the natural world, the cool breeze and the birds singing their wonderful distinctive songs.

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So I will play card games with my family outside whilst lying flat, I will keep sharing my heart with my husband, I will ask my kids all about their days. I will continue to write, I will read books that inspire me, I will try to connect with and encourage others with my words. I will listen, learn, grow and change. I will enjoy the presence of God and allow Him to touch and change me from deep in my soul.

This condition has and will change me, that is inevitable. But I am determined for it to be only for the better. Because I will not let my spinal CSF leak completely devastate mine and my families life. I will not let negativity overshadow our love for one another. I will not let it steal my peace, love and joy. I will not let it take me down and pull me into the never ending pit of despair.

Instead I will rise up from deep within and find a way to live with all the restrictions, to enjoy the simplicity of life, to appreciate everything I do have and can do, and love everyone I can with all my heart.

“Pain is inevitable, but misery is optional!” – Andre Olivier

So it’s true: last week I tripped, fell and relapsed yet again. But last week I also chose a better way forward. I cried, I faced the pain and loss, I recognised the challenges ahead. I am not in denial, I am more aware than ever about how difficult this will be. There is never a simple way forward in this relentless CSF Leak game.

But after falling I had to get up again. I had to choose to live my life with even more determination and resolve. I had to make a decision…. to not give this condition permission to destroy my life.

Instead I must use it to build more resilience, increase my compassion and help me feel another’s pain. Use it to embrace time to write, read, learn and inspire. To declare that we can still have a life even when so much is stolen. We can still have purpose even when we are mainly stuck in bed.

So let me learn to endure this trial for as long as I have to. Let me find a way to tell another …. ‘yes this really is so so tough – but it can be done, we can find ways to live life like this.’ So let me choose to let go of the life I thought I should live and embrace the life I am currently living and give all I’ve got to truly living here.

Let my heart be moved and my mind be transformed until – rather than complaining – I can sing a new song of thankfulness and joy. Rather than focusing on all that’s lost, I will see all that can be gained. Rather than pulling others into my despair with me, I can choose to love and encourage others even in the midst of my and their pain.

It’s then that purpose can still be found in suffering. It might not be the purpose we envisioned for our life, or the path we would have chosen for ourselves or our family. But this is the life we currently have. So with a deeper resolve and a new patient resilience I will declare that I am finding a way to do this. We, as a family are finding a way to do this.

For as long as this journey takes.

I may not be able to do much. But I still have my work-in-progress story that is being written. It’s taken me on a tangent I never envisioned or imagined. But it’s still my story. Although I cannot control every part of my story I am the greatest contributor to the style in which it is being written, formed and shared.

So let me write the best story I can. The real story. A story of strength in weakness and love conquering all. So I can keep encouraging you to keep writing your best story too.

“Our story is what we have to offer the world…. I wish I had a different story than the one I just lived through, but I am so grateful for the story that has made me who I am today. Even the pain. Even the wounds. The sadness was real. The brokenness deep. The scars mine. It’s my story. It’s who I am. It’s how I’m becoming.” – Erwin McManus (The Artisan Soul).

This is my story!

It’s my story of who I am. It’s my story of who I am becoming. But it’s definitely a work-in-progress. I wonder how the book of my life will unfold? I wonder what it will all become in the end?

To read more about my story of living with a chronic spinal CSF Leak click here.

Here is a brilliant 2 min animation about Spinal CSF leaks.

For more information about spinal CSF leaks please see the UK charity website at www.csfleak.info or the US charity website at www.spinalcsfleak.org.

Spinal CSF Leak

Nine Months On: My Ongoing Journey Of Overcoming A Spinal CSF Leak. 

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“Courage isn’t having strength to go on, it’s going on when you don’t have strength.” – Napoleon Bonaparte

Each of us has a story. Our life stories are unique to us. Lives, circumstances and even illness and injury are not often ‘text book’. 

We are all individuals and our lives and bodies are complex. 

I want to continue to share my own story, in the hope it might help you on your journey and also hopefully educate people about some of the complexities of these conditions.

I have chosen to write the post specifically with CSF leak and post concussion sufferers in mind. Which is why it is longer than my normal posts.

Over the months I have read about other peoples stories.

Some of them tie into my own experiences. 

Some don’t. 

So I wanted to add my own story to those out there. Maybe you will relate to it. Maybe not. But I hope that it helps you regardless.

“Facing pain may require more courage than we’ve ever had in our lives.” – Samuel Chand

We all have days and times in our lives when we don’t want to get up in the morning. When life is busy, stressful and hard work. Times that you crave to be able to stay in bed all day read a book, watch TV or listen to music.

Then you get ill or injured and, for a time, staying in bed all day becomes your reality.

And it is far from easy. 

If you have seen any of my previous blog posts you will know I fell off a ladder 9 months ago and sustained a concussion (mild traumatic brain injury) and was later diagnosed with post-concussion then 8/9 weeks later, a CSF Leak (Cerebral Spinal Fluid Leak). Which we assume is somewhere in my spine.

At the moment I am lying flat in bed writing this. I have spoken about lying flat in many of my blog posts, but what does this actually mean? 

I mean my upper body and particularly my head has to be flat on the bed or sofa. Sometimes I can use a very thin pillow to support my head. Often even that lifts my head too high, so I tend to spend most of the day, and sleep, without a pillow. I can be on my back, side or even front.

But my head must be as flat as possible

When I was in hospital, both times, It would intrigue me that so many very ill people are propped up in bed with pillows and their beds raised up.

That concept is unthinkable for me at the moment. In fact the reality is that would just be a form of torture. It seems alien to me to be unwell and sitting propped up. 


I have a routine now where I drink lying flat (even cups of tea) using straws. I eat all my meals and snacks (apart from dinner) lying flat. (I just eat dinner extra fast so I can lie down again quickly). 

My first time in hospital the pain had got so unbearable that my husband would feed me dinner, so I could lie flat, because that is the only way I could manage the symptoms and the pain.

Nine months later, following a relapse, I have learnt to manage it a lot better. The main way to do this is just to avoid being upright for more time than absolutely necessary. Five or ten minutes is normally manageable. Beyond that is often unbearable.

You have no choice but to lie down because it reaches the point you literally just can’t function upright. 

So I currently try to only get up when absolutely necessary.

When I lie flat I am almost symptom free. I say almost, because I still can feel weak and dizzy and get some aches and pains. 

But lying flat I generally feel more like me: 
I can write,
I can talk,
I can think.
I feel more normal! 

Sitting or standing at the moment is a whole other issue. You would not believe how you can go from feeling mainly symptom free to feeling really very ill in a matter of minutes or even sometimes seconds of being upright.

Since I was diagnosed with a CSF Leak, I have caused the doctors and Neurologists a lot of confusion because my full set of symptoms are not fully in line with their normal experience of a CSF leak. 

Most doctors experience of CSF leaks are mainly from epidurals that have gone wrong or lumbar punctures (LP’s/ Spinal Taps) where the hole in the spinal dura won’t close. Also people can obviously get cranial/ skull leaks from trauma, which can be seen through spinal fluid dripping out your ear or nose. These can be (but not always) easier to diagnose and often easier to treat.

Spinal leaks, whether spontaneous or through trauma (as in my case), often cannot be easily seen or proven. Which makes diagnosis and treatment problematic.

Mine also seems to be connected to the original post-concussion diagnosis. Which tends to confuse doctors because I often present at A&E with symptoms that are more in line with post-concussion syndrome/ post traumatic migraine.

The telling sign that there is probably a CSF leak, in the mix, is that I have the postural element of the injury. I am generally symptom free lying flat, but symptoms build when upright. If I am upright for too long the symptoms will also extend to lying down for a while after, but they always dramatically improve. 

This has lead the Neurologists to conclude that they think I probably have a CSF leak that exacerbates post-concussion migraine symptoms. I will try and explain this to you further in the hope that it might help other people with similar issues.

A couple of weeks ago I was admitted to hospital following an almost total relapse of symptoms. There are a few things that were slightly better than last time I was admitted 6 months ago, but generally it’s the same thing. I think perhaps part of the difference now is that I know how to manage the injury better than I did before. 

Here were my symptoms I was admitted with (in no particular order). 

Dizziness,
Balance issues,
Walking difficulties,
Speaking difficulties, including slurring of words and inability to fully express myself.
Drunk like behaviour.
Pressure in the head.
Neck stiffness & pain.
Pain at the lower back of my head.
Photophobia (light sensitivity)
Shaking and spasms.

These are actually almost the same symptoms I had every time I visited A&E since my injury (4 in all). The third visit I was in such acute pain in my head/ neck that they tried to give me morphine, which rather than take the pain away, made it worse and made me very sick so they decided to admit me for a brain MRI scan.

It was only through this first admission that I finally got to see a Neurologist who raised the possibility of a CSF leak due to the postural nature of my symptoms.

The consultant looked into two possible diagnoses: Post traumatic migraine from the concussion or a CSF leak.

Neurology then set about to investigate the CSF diagnosis which proved more problematic than we would have hoped.

If you read up on CSF leaks you will soon discover that diagnosis can be immensely difficult.

Unless you have recently had a lumbar puncture/ spinal tap, an epidural or spinal surgery and then present with postural headaches. Proving you have a leak and finding it can be a bit like looking for a needle in a haystack.

They firstly did an MRI brain with contrast which came back clear of Intracranial Hypotension or ‘brain sag/slump’. This is the condition that low CSF causes. Basically, because there is less fluid round your brain, your brain then falls in your skull, due to gravity, when you are upright. The pain and symptoms are due to the pressure this puts on this area of your head and the stretching/ squashing that occurs.

It is not unheard of for these scans to come back clear. And from what I have read, severity of symptoms do not necessarily correspond to these scan results.

So they attempted to find a leak site in my neck via MRI. This also came back normal. Which is again not unusual.

The leaks are often minute. Most imaging, even MRI, is not powerful enough to locate them. 

They then did a lumbar puncture/spinal tap to look at opening pressure. Mine was a 7. They said they would consider it to be low if it was 8 or lower. Worse cases of CSF leak are often a 3 or below. (Normal is about 10-20).

So that supported the diagnosis but it was not a definitive diagnosis. 

When they did the LP I knew it was the same sensation I felt. However, following the LP I had an additional headache which was even worse, again postural, and all my other symptoms increased too:

Head pressure,
Neck pain,
Dizziness,
Instability walking etc.
My back also hurt a lot at the site of the LP. 

These restored back to what they were before the LP a couple of days later.

I then had an MRI of my spine which came back clear. 

The neurologists then decided to try a high volume blind epidural blood patch. Which is used to treat spinal CSF leaks when they can’t locate the leak site.

Usually if you have had an LP or an Epidural they know where the leak is so they can inject the blood patch into the same location in the lower epidural space in the spine. This is supposed to help seal the leak through the blood clotting and generally increase the spinal fluid pressure. These procedures have a high success rate. 

It wasn’t easy for them to agree to get an anaesthetist to do a blind patch at first, because of the higher risks involved and lack of evidence to back up the diagnosis. Blind blood patches are a lot less effective than ones directed at the actual leak location. 

The problem is we think, it is possible, that my leak might be in the upper or even cervical (neck) spine. To do a blood patch higher up the spine is very high risk because of the lack of space between the vertebra to reach the epidural space and because of the proximity to the brain.  

Eventually a team of anaesthetists agreed to do a blind blood patch and they took me down to surgery to do it. I think they managed to inject 30ml of my blood, taken from my arm, into the epidural space in my lower spine. 

The consultant anaesthetist then advised not to do a second blood patch, even if symptoms did not improve. When people have blood patches following an LP or epidural CSF leak, relief can often be quite instant. They will also often do a second or even third blood patch if the first one fails. In my case they were concerned about doing another high volume patch without further investigation. 

I laid flat on my back for about 15 hours after mine, without moving, to help it to ‘take’.

When I was able to get up some things had improved, some things hadn’t. 

I had the choice whether to be discharged or stay at hospital to pursue more investigations and treatment (which was not a simple route). I chose to go home (having been there 18 days) and work on my recovery and hope and trust that things would improve.

And things did improve, a lot.    Within a few days I was back on my feet. I could walk on my own again outside, I could drive short distances. I didn’t have as much problem with head pressure and pain.

But it was still there. 

I always put this down to the fact I had had a brain injury (concussion) prior to this and had been in bed for 3 months.

Surely things would just take time. 

Symptoms improved gradually and I thankfully pretty much got back to normality.

But I still suffered with head pressure, head pain, spaced out symptoms, dizziness, back pain (from the blood patch) and neck pain.

I still found I could not get through a whole day without lying down flat. Life became about pacing myself. Staying positive and believing that things would keep improving. 

Then I relapsed. 

Perhaps I did too much.
Perhaps I took too many risks.
Perhaps it happened regardless of what I did.  

Over the period of about 2/3 weeks things got progressively worse. I had to lie down flat more and more during the day to cope and compensate.

I went back to the GP, got a referral back to Neurology (which I would have to wait for an appointment for). Tried lying down for most of two days to see if that helped.

Then symptoms got overwhelming and we headed back to A&E for the fourth time this year. As I talk about in ‘Learning Patience’. 

The thing that again confused the Neurologists was why did I always present with symptoms more in line with post-concussion syndrome/ post -traumatic migraine BUT the symptoms are obviously very postural.

Why did I not just present with an unbearable postural headache, as in ‘normal cases’?

I understood this dilemma myself because when I read about symptoms. Most people would talk about unbearable headaches, and even though I experienced headaches, they were not always fully in line with others descriptions.

In fact, other people’s descriptions were probably more in line with the additional headache I experienced during the couple of days after the LP. That headache was more distinctly a headache as well as increasing all my other current symptoms.

What I tend to experience is nothing like I had ever felt before. 

I will try and explain the sensation I experience at its worst. 

I sit up, almost instantly my head begins to cloud over and the pressure builds, that makes me feel dizzy and unstable on my feet. Each minute of standing this increases. It feels a bit like you have been whacked round the back of your head by a heavy object.

What feels like a stiffness in the upper neck then increases followed by what moves from an ache to an increasing pain at the bottom back of my skull.

After a bit it can feel almost like I am being strangled, from the back of my head. I can also feel a pressure behind my sinuses, it can make me cough and gag, the front of my neck gets tense. I struggle to think, can struggle with my words, increasingly struggle to walk without support and then if I am up too long I can end up twitching/ shaking and having small spasms.

You become consumed by doing what has to be done as quickly as possible and getting back to lying flat. I feel very irritable and shaky because I just physically and mentally cannot cope with being upright.

The longer you are upright, the worse it gets and the longer it takes to recover lying down. Once back lying flat it often can take a few minutes to recover from what can only be described as the trauma of being upright. (Occasionally it takes longer to recover). 

The doctors always ask me ‘do you have a headache’? or ‘how is the headache’? But to me it’s not simply a headache.

It’s not just about a crazy ‘pain in my head’ it is more than that. It’s an intensity that is unrelenting and sets off various other symptoms. Pain is one of those but not necessarily the over riding symptom. 

The overriding unbearable symptom is intense unrelenting and increasing pressure in my head that makes doing anything immensely difficult. Until I reach a point my body and mental processing cannot cope with it anymore and it begins to react accordingly by shutting down.
I just cannot function properly sitting or standing. 

It is a headache, I guess, but nothing like headaches I ever had before my injury. I often feel the pain more in my upper neck than head.  Previously, the very occasional headaches I had were always at the top front of my head and were completely different. There is no comparison. I think it’s perhaps more migrane like but I never had a migrane so I don’t really know.

Headaches are unpleasant. You lie down and they are still there. You take painkillers to get rid of them. (I have occasionally had a normal headache in addition since my injury – they don’t go away lying down). 

These so called ‘headaches’ feel like you are being tortured. My body literally cannot handle being upright. Which is why when I have to sit up to travel to and wait in A&E waiting rooms, my symptoms always increase and I act like a drunk person. I cannot physically or cognitively cope with the strain put on my brain.

When eventually I get to lie down (usually before I see an A&E consultant) I am suddenly not quite as bad. Which is probably one of the reasons the first two times I was discharged as just having post-concussion syndrome.

We didn’t understand the relevance of posture at that time. 

When I finally was admitted. I still didn’t fully understand the need to be fully flat. My bed was often at first a little raised. I used large pillows. I sat up to drink drinks, eat, get changed, use the bathroom, speak to people.

I now realise that is why the pain built up to be unbearable. I have learnt not to do that any more. Which means I have generally learnt to manage the pain, without medication.

As long as I lie flat pretty much for 24 hours a day. 

It’s a part positive of the condition – I get relief from the torture. 

But you obviously can’t live a normal life like that. 

“When we face life challenges, we must find a way not only to survive them, but in time, to actually grow from them. We must find a way to keep on keeping on, no matter how hard or painful life becomes. As a result, we can avoid getting “stuck” and live life in spite of our circumstances.” – Kelli Horn

After a few days in hospital, after my relapse, they agreed to try another blind blood patch. Which was again the subject of great debate between the Neurologists themselves and the Anaesthetists (especially because they had initially advised only doing one). 

So that is what I am currently waiting for. They said I could have it as an ‘outpatient’ so I get to wait at home rather than hospital. (One blood patch was already cancelled though because of lack of theatre time available and then a subsequent recovery bed). 

Blind Epidural blood patches usually have a 50% success rate. Being a person of faith in God and optimism I am choosing to believe it will work and again get me back on my feet.

It did last time. We are trusting it will again. But this time we are praying that it fully heals and will never come back.

You don’t realise how precious a normal life is till it is snatched away from you. 

“All the world is full of suffering. It is also full of overcoming.” – Helen Keller

I have and am learning a lot and developed more compassion towards others with long term health issues. Compassion means ‘to suffer together’. There is a beautiful thing that can happen if we allow our own suffering to develop our compassion towards others.

Humanity becomes more unified, gracious and loving as I wrote in ‘We Are All Messed Up’.

If you suffer with post-concussion or a CSF leak I hope that you find a way through, discover the strength you will need and that you will find doctors who understand and can help you.

Having a unusual injury or illness is hard, but let’s choose to keep holding on to hope for the future. Encouraging one another and hoping that doctors become more knowledgable and understanding of this debilitating condition.

There is always hope, there is always progress being made. Life may be hard but there is always something we can do and achieve.  

Even amidst the pain. 

“Your past mistakes, hurts & pain can help give someone else a future. Whatever we have gone through enables us to help others.” – Christine Cain

UPDATE: Please note that in August 2020 I was also diagnosed with arachnoiditis as well as a spinal CSF Leak – I now have radiological evidence to support both those diagnosis. To read more about the new diagnosis please see this link.

I would love to hear about your stories and experiences with concussion, post-concussion and CSF Leaks? Please do comment below. You never know you might help someone else in the process.

For more of my posts on this subject please see my first post here. You can see my ongoing series of posts by clicking on the CSF Leak and Concussion menu at the top of the page. 

To read more about my ongoing story of living with a chronic spinal CSF Leak click here.

Here is a brilliant 2 min animation about Spinal CSF leaks.

For more information about spinal CSF leaks please see the UK charity website at www.csfleak.info or the US charity website at www.spinalcsfleak.org.

A fantastic informative video that you can refer to about spinal CSF Leaks, their symptoms and treatments is The Mystery Headache: Migraine, Positional Headache, Spinal Fluid Leak? by Professor Ian Carroll at Stamford University Hospitals.

This is a wonderful new May 2018 medical paper about the 10 most common myths and misperceptions about spinal CSF leaks. It is by some of the top world experts in treating this condition. I was told so many of these myths by various neurologists, anaesthetists, radiologists and many other doctors during my lengthy and traumatic nearly 5 year battle with a spinal CSF leak. This kind of misinformation caused many delays, misunderstanding and great distress on my already immensely long winded and difficult medical journey.

This other in depth 2018 medical paper is about both low and high intracranial pressure syndromes and their similar and different symptoms. It also mentions cross overs with other headache types. When a patient suffers with a spinal CSF leak long term it can cause massive fluctuations in their whole pressure system both whilst suffering from a spinal CSF leak and following treatment. This is why lumbar puncture pressure readings and ICP pressure monitoring can prove an inaccurate disgnostic tool for SIH as this paper refers to as does the 10 myths paper. My initial LP reading was a 7 which was considered ‘evidence’ of low pressure by some doctors and normal by others.