Tag Archives: Mild Traumatic Brain Injury

BUTTERFLIES IN THE DIRT AND A NEW DIAGNOSIS: ARACHNOIDITIS AND A SPINAL CSF LEAK

“When you look another human in the eyes (or read their stories) and see how they’ve found strength in the face of their suffering, it makes you sit up with a little more hope.” – ‘Suffer Stronger’

Katherine & Jay Wolf (my addition in brackets)

Butterflies In The Dirt

I walk a lot at the moment. And if you know my recent story you will know the profound beauty in me just saying that. But walking still isn’t always easy for me because it can both help some symptoms and exacerbate other ones, especially my head pressure issues as well as my back and legs. But I am so grateful to say that it’s been getting easier again recently – since my recent new diagnosis and treatment plan. I can now walk much further and far more than I have been able to since before my last relapse in Spring 2019.

We are so blessed to have beautiful countryside five minutes from our house. And this seems to be butterfly season. Lots of white and colourful butterflies are flying around.

But often I see them like in this photo. Resting in the dirt. Being still for a moment on the dry, cracked and broken path. And through them God always reminds me….

You can always find great beauty in the broken dirt of life. If you choose to truly SEE it.

 

‘Could I have Chronic Arachnoiditis?’

Where do I start on the whirlwind of the past month or so? A couple of months ago I had only ever vaguely heard of something called arachnoiditis. And to be honest I was at a stage where I was far too weary for much new medical research. But that word ‘arachnoiditis’ kept coming back up, it kept being thrust back into my view – however much I tried to avoid and run away from it.

I believe now it was Divine providence – sweetly nudging me to pay attention. Because I would soon need that information in a critical way.

So I began to read and research yet again – another conditionanother lead… and as I did my mindset went from a ‘no that can’t be me’ to it becoming quickly apparent how well the diagnosis fitted with my whole medical journey since my ladder fall in January 2015. It was actually a very timely speedy journey of revelation – that only by God’s mysterious grace – soon coincided with my most horrendous relapse/ flare ups in the whole 5 years I have been ill – that soon had me hospitalised for two weeks.

I am actually still in a state of both partial shock and partial wonder that following so many clear acts of Divine providence (key things and key people coming together at the right time) – I finally got the correct treatment I needed that perhaps reversed a more severe or even catastrophic injury to my spine.

A Unique Story

Here is my ongoing holistic medical story in its ongoing messy glory. It’s messy – because I am a typically messy human. I don’t fit well in others ‘boxes’ because I am unique. So although I share my story in the hope it might help others, assist their loved ones in understanding and to help any members of the medical profession to understand these conditions and their long term impact on their patients; I also want you to know that my story is my own unique story.

Of a unique body with a unique biological makeup, a unique accident and a unique resulting neurological injury.

That has caused me untold suffering for 5 1/2 years.

However, one reason I write is that perhaps my unique case can help shed more light on others unique cases too. Our stories are simply that – the truth of what is happening in our life as a WHOLE person. The truth of a complicated and rare medical journey in a complicated and unique human being.

I am not sure where to begin this next chapter in my story apart from to describe the events leading up to my hospital admission and the revelation that we may well be dealing with chronic spinal canal nerve inflammation as well as a spinal CSF leak.

Spinal CSF Leak

I do not have time in this blog article to explain my medical history since I fell off that ladder in January 2015. And how I fell onto my head, neck and spine very hard. How I was diagnosed with post concussion syndrome, then finally 2 months later a spinal CSF leak. (See this original article). I do not have much room here to explain that my current NHS ‘intracranial pressure MDT’ have seen evidence on my MRI of a small CSF leak in my neck (cervical ventral spine). To read more about that please see this blog article.

PLEASE NOTE: Many of my ‘arachnoiditis symptoms’ started after that fall alongside the ‘spinal csf leak symptoms’.

They have always been very interconnected. Apart from the severe lower back/ sacrum pain. (That got worse over the latter months to years after that original fall). However, many of these key symptoms were there from that first week after I fell – it’s just the more severe pain was more in my neck rather than lower spine the first few months (Query – maybe it could have started as ‘cervical arachnoiditis’ around the potential leak site following the trauma & spread as arachnoiditis can?). My neck certainly took much impact in a funny position with my head hitting a raised ledge. All the main bruising was all down my right arm and pain into my middle fingers. I have always had major nerve issues and acute stiffness in my neck (although that is also typical of SIH neck pain). Although I also developed the severe leg weakness & gait issues and whole body tingling/ spasms & jerking etc from that first week – so I am not sure how it all works together.

And just to state here: I have not had a medical procedure in or near my spine since September 2017.

 

This Relapse/ Flare Story

This relapse actually followed my typical pattern of relapse (last one Spring 2019). There was no clear trigger this time – although in hindsight Covid lockdown brought changes to my routine that might have added to things. For about 2 weeks before it fully hit me I began to feel more unwell than usual. My forever troublesome back/ sacrum area was getting worse again and that was causing me to often lay down more than my head. I felt like I had 100 tiny pins stuck in my sacrum and down my legs. My legs started getting markedly weaker especially towards the end of short walks. I had more pins & needles in my legs, feet, saddle area, arms and hands. My head and ‘normal leak symptoms’ were also clearly worse.

So we typically asked those questions – ‘Am I doing too much?’ ‘Perhaps I need more rest?’ ‘Perhaps I have a virus or even coronavirus ‘(I even ordered a test). But this time there was something else. I felt like a had a UTI – and my bladder didn’t feel right. I just felt like I constantly needed the loo and there was a constant burning around those nerves too. And that’s bad for me because for years going for a wee makes my head much worse. So it was all just so painful for me. So I did a urine sample for the GP nothing came back as abnormal. Everything was getting increasingly painful & exhausting.

Then my symptoms do what they always do when I relapse or flare – like my last one in Spring 2019…

Everything suddenly EXPLODED!

Symptom Explosion

A day came – a Friday – when I got up as normal. But it was tough. It was really very tough. And within half an hour my body was flooded with that overwhelmingly debilitating draining feeling from my head down. A feeling I have known so many times. The feeling that came when I first got ill around 48 hours after my ladder fall in January 2015.

A Sense of Being Unbelievably Unwell

At that point my worst symptoms all very quickly returned: the inability to speak, the slurring, the slowness to respond. Then came the weak legs giving up and the having to pull myself back to bed. Then as I lay down back came the twitching, the jerking and the spasms. And the feeling that I may just pass out any moment – but never really do.

I cannot explain how awful it is to experience that. But it is not uncommon for me. That has been my normal since the start from after my fall – when things are bad.

But this time some things were worse. Mainly my back. The nerve pain exploded, I could no longer lie on my back at all, it was all down my legs. It all burnt, stabbed and tingled. The pain was just getting worse. I could hardly stand or walk at all.

I just felt weird, my whole body was full of pins and needles, both inside the whole of me and all over my body. A bubbling, strange sensation in my whole body – feeling stuck in another world. Mind can’t think – I struggled to process & respond.

I then started struggling to be touched by anyone. Everything was hypersensitive. Everything hurt so bad and people touching me would often just make me twitch, jolt & spasm.

Two Wonderful Doctors

By this time our (including two key doctors) minds had been opened to consider a new diagnosis of chronic arachnoiditis. As I said before – as I began feeling more ill the past two weeks I again had read more. And as I read about its symptoms, triggers, biological predispositions, links to spinal fluid flow, leakage & seepage, multiple spinal procedures and the presence of spinal cysts. It rang too many bells to ignore. So I had sent information to the two main doctors (from two different hospitals) who know my case well. My current neurologist and a doctor who has generously followed my case and CSF leak updates for years even after me moving on from their hospital. They had both already agreed that it was something that needed considering. I ticked so many boxes already … as shown in this list I made into an image.

In the end after updating our more local hospital doctor contact about my worsening symptoms that Friday, he called on the Saturday & spoke to mainly my husband – as by then I was struggling to talk and respond at all. After listening carefully about what was happening and asking various questions – he advised us to call an ambulance and then kindly in advance explained my case to the consultant neurologist on call. I am so deeply grateful for this doctor who has had so much patience and humility over the years to listen and understand my whole medical journey, in a way that he became the advocate I needed. He was my voice when I had no voice. Especially as my husband could not be with me at all due to Covid lockdown and seeing as I often feel so intimidated, scared & anxious around new doctors due to my case being so complex – especially when my speech and thought processes are so impaired.

Admission via Ambulance

The ambulance crew came and by then I was in such a whole body nerve pain flare I was very hypersensitive to touch, examination and even having my blood pressure (BP) done. It was all excruciating and would just make me jolt and spasm. I could only slur and half speak with very delayed responses. They thought I had either a stroke or meningitis. Although the stroke team at the ED soon ruled that out and the medical doctor who saw me was baffled but knew I needed to be admitted. And although struggling to speak – I managed to direct them to my medical files to read my history (as I lacked the ability to explain it myself). And after a couple of days on a medical admissions ward – I finally made it to Neurology.

At this time I had ALL the red flag symptoms for arachnoiditis/ lower spinal canal nerve inflammation/ and things were only getting worse.

Brain and Lumbar Spine MRI

I had to be very deeply sedated for my brain & lumbar spine MRI as I could not lie on my back for more than seconds to minutes without spasming/ twitching or jolting. Which really would not work in an MRI machine.

However the MRI was read as clear for both low CSF pressure/ SIH (which is normal for me) and adhesive arachnoiditis/ cauda equina inflammation or compression/ epidural fibrosis and anything else considered etc. Although interestingly at first they also missed reporting a possibly key piece of the puzzle due to seeing it as an ‘incidental’ finding.

Tarlov Cysts

I have at least 1 or 2 Tarlov cysts in my sacrum. Which I now know can both potentially cause cauda equina inflammatory disorders (CEID) but can also be the result of that inflammation. They keep not being reported from my multiple scans (I had to view my own scans and ask in 2017 for the confirmation I had a Tarlov cyst/s – but were told they are ‘incidental’.) Which I already knew is not necessarily true because Tarlov cysts can actually also become symptomatic after a fall. You can actually leak or seep spinal fluid from Tarlov cysts and they can effect normal spinal fluid flow to cause intracranial hypertension (high pressure headaches). They can also cause issues with sitting down and effect your lower extremities & bladder & bowel function. This video from a German Neurosurgeon who is a ‘arachnoiditis and Tarlov cyst specialist’ even describes Tarlov cysts as a form of arachnoiditis as well as often an additional feature. He later discussed it further here and shared his experience in surgery is that everyone with Tarlov cysts has evidence of a form of arachnoiditis. So they are VERY relevant to my condition. (See here for Dr Tennant’s bulletin on this or other medical articles below).

Other Spinal Cysts & Potential Connective Tissue Disorder

I also have an arachnoid cyst in my brain. Multiple prominent meningeal diverticula cysts in my thoractic & cervical spine. And a small pituitary cyst (I am under Endocrinology for but has remained unchanged). Could any other of these also be more than just incidental findings to my wider case – could any of them be part of a bigger picture of spinal canal inflammation/ collagen weakness/ biological predisposition – which can all be connected with arachnoiditis and spinal CSF leaks and seepage? (My NHS CSF leak team were already very mindful that about 30% of ‘leakers’ leak from meningeal diverticula.)

My Dad also has some undiagnosed key features of Marfans syndrome (including pectus excavatum & more recent heart problems) and he is tall with long thin limbs like me – which could mean I am more pre-disposed to all these things genetically (50% chance if he does have some Marfans). There are also some hypermobility features in other close family members. Although I have never been hypermobile AT ALL and was very healthy until my fall. But perhaps any such genetic predispositions could be hiding in my spine. I do have a mild scoliosis of the spine. My Mum also died six years ago following complications after surgery to remove a massive benign brain tumour. So there is a family history of neurological abnormalities there too.

Lack of Knowledge or Expertise to View scans

The first issue with scans is that arachnoditis can be very hard to see on scans until it becomes adhesive and even then many neuroradiologists miss it due to lack of experience with the condition.

The other main problem I have is that I am most doctors’ and neuroradiologists’ first known or one of their first known recent cases of arachnoiditis. Many of them do not know much about spinal CSF leaks either. So they lack experience of the conditions. I have also been informed by more expert neuro-radiologists/ doctors that you really need head to toe axial MRI images with IV contrast and/ with both T1 & T2 weighting and VERY experienced eyes to diagnose features of arachnoiditis or spinal nerve inflammation or even actual AA. (Although I am hopefully due more scans soon more like this soon and have been seeking out more experienced eyes to view them). One of the articles below also suggests that the use of ‘stir cycle’ images on MRI might help to spot the neuro-inflammation.

Pls note: I went on to get radiological support for the diagnosis.

Medications

Whilst waiting for the MRI and deciding what to do, Neurology put me on pregabalin for the excruciating nerve pain, pins & needles & hypersensitive reactions etc. Diazepam for the spasms, jolting and jerking, paracetamol, laxatives. And I was already prescribed zopiclone by the GP that I tend to mainly only use during ‘flare ups’ because I always develop severe insomnia. (Another typical arachnoiditis symptom).

The combination of these medications did help me and eased some of the symptoms and allowed me to sleep more. I finally got my voice and mental clarity back so could begin to self advocate again and help the doctors to better understand my case and journey. But I was still stuck lying on my side with legs that hardly worked, bladder & bowel issues and pulling myself to the bathroom whilst walking on tip toes because my feet burnt & legs hurt too much to have my feet flat on the ground.

Dual Hospital Team

By then my more local hospital neurologist got in touch with my specialist low pressure/ spinal CSF leak neurologist (from another UK NHS hospital) who at that time happened to also be treating a friend of mine (from the online leak support groups) for early onset arachnoiditis following various spinal procedures at another separate hospital. So he was learning fast about the condition.

That friend has also been the absolute star who first provoked me to start looking into arachnoiditis due to her sharing her own very courageous, but deeply devastating recent journey of getting a spinal CSF leak following a lumbar puncture (multiple attempts) from another different hospital that went very wrong.

Then in embarking on the journey of getting that fixed she developed acute arachnoiditis. (If it is diagnosed and treated with (IV) steroids in the first 60-90 days you can completely reverse it and prevent it becoming adhesive) (Read this medical article for further details)

So she and my normal neurologist (whom she had approached for help) had already been learning so much – which was one of the timely things that helped me so much in my own time of desperation and need. For that special friend – I am forever grateful.

IV Steriods

It was finally agreed by my hospital Neuro team, my normal specialist neurologist (from the other hospital) and the hospital anaesthetist who had done two of my epidural blood patches in 2015/16 who was also involved – to trial me on the emergency treatment for arachnoiditis. Mainly as the risks and side effects of the treatment were lower than the risks of leaving me with a potentially severe arachnoiditis flare up which could be causing me more permanent damage & adhesions.

So they trialed me on 500mg of IV steroid methylprednisolone – the first dose carefully observed but I responded very well and straight away felt a boost of more clarity, energy, eased symptoms and stronger legs. So I then I had a total 5 days of 500ml IV steroids methylprednisolone.

Results of Steroid Treatment

The results of the 5 day treatment were actually quite dramatic in reversing this flare up.

The main change was probably to my legs. I could finally walk more normally and started walking up and down the ward, then out in the wider hospital, then I ventured for 30 mins to 1 hour walks around the grounds. This often included walking up 6 flights of stairs to the Neuro ward. This was a million miles away from willing & pulling my unimaginably painful, burning and tingly legs to the nearest bathroom.

My mental clarity returned so that I went from hardly being able to speak, to speaking with more clarity on the other medications, to finally being able to have hour long conversations and speak to the staff and other patients more easily.

The back pain, pins & needles and burning reduced considerably. I could lie on my back more (although still very tender – but that has been normal for years). I had a lot less leg pain. My photophobia radically improved and I could remove my sunglasses and stop covering my head. The meds had dealt with a lot of the jolting and twitching – but that now completely disappeared. I still had positional head pressure that got worse the longer I was upright – but I could be up for so much longer than when first admitted. My bladder and bowel also began to function more normally (although going to the loo still makes my head worse).

I did so well that I was finally discharged 2 weeks after my admission. Having not been able to see my husband, kids or any other visitors due to Covid lockdown restrictions.

Diagnosis from my Normal Neurologist

The next day I travelled to see my wonderful normal spinal CSF leak specialist Consultant Neurologist who was given the task of continuing my follow up. He had been kept informed about what had been happening during my stay at the other hospital and had been consulted. But obviously again still took down all the history of recent weeks and did his own neuro examination which actually showed after two days off the IV steroids some things were getting worse again and I found the examination more distressing again especially in my back and legs.

So he made a clinical diagnosis of arachnoiditis (we cannot know if it’s become adhesive at all over the years without scan evidence – so that needs to be investigated) as well as a spinal CSF leak.

He put me on an oral prednisolone taper as well as diclofenac (for neuro-inflammation), pregablin, omeprazole (to protect stomach) and very occasional use diazepam if needed (only used so far for travelling as sitting in the car for long journeys can still be torture). Restoring the (oral) steroids helped to again reverse things getting a bit worse again after the IV treatment ended.

Improvements Continue

It’s still early days but I can report that my legs continue to get stronger and I am now walking at least three times a day from 20 mins to 1 hour at a time. (I have not been able to do that since before my last relapse in April 2019). I am keeping this routine because walking and gentle stretching is thought vital to help stop the disease progression and nerve adhesions developing. And walking and gentle stretching exercises can potentially help any scarring and adhesions that might already have been there. My 5 year journey has also shown my best times came from more walking (but within balance) when I was able to. So that gives me confidence that it is of key importance.

So I am thankfully doing much better than I was.

A key feature being I can be upright a lot more than I have been able to for over a year and my head is much clearer than it has been for a long time. I still have many issues – so fatigue or the sacrum nerve pain is often the main thing still causing me to lie down to rest currently – although my head issues are always present too.

But I am so happy that we have perhaps reversed me moving more permanently into a more severe category of disease progression at this time and for that I am so very very grateful and thank all my doctors who worked as a team to help me.

The Tennant Foundation

I have to also say here that I am immensely grateful for all the expertise, medical articles, research and even direct emails from the founder of ‘The Tennant Foundation Arachnoiditis Research & Education Project’. Although in his late 70s and retired from clinical practice Dr Forest Tennant continues to offer so much advice, support, research and help to patients with arachnoiditis, AA or chronic cauda equina inflammatory disorders (CEID). It is his hard work and ongoing research (amidst others) that has helped myself, my dear friend who helped me & my specialist Neuro and many other doctors learn so much through his work.

Useful Links from Arachnoiditis Experts including Dr Tennant….

‘Arachnoiditis – Taming the Most Painful Pain’ video
https://youtu.be/VGuS1iTuhLo

Arachnoiditis: A Clinical Update https://www.practicalpainmanagement.com/pain/spine/adhesive-arachnoiditis-no-longer-rare-disease

Patient & Family Handbook for Adhesive Arachnoditis http://arachnoiditishope.com/pages/wp-content/uploads/2019/02/Arachnoiditis-Handbook-5th-Edition-2019.pdf

Then this was also helpful to myself & my doctors… Dr Sarah Smith: The Arachnoiditis Syndrome http://www.arachnoiditis.co.uk/index.php/information/medical-papers-2/124-the-arachnoiditis-syndrome-dr-sarah-smith

And this other article of hers is interesting and highlights that a normal MRI does not rule out the diagnosis of arachnoiditis. https://www.practicalpainmanagement.com/pain/spine/adhesive-arachnoiditisa-continuing-challenge

And this: Suspecting & Diagnosing Arachnoiditis (J. Antonio Aldrete) https://www.practicalpainmanagement.com/pain/spine/suspecting-diagnosing-arachnoiditis

Ongoing Journey

So I am at the start of a new medical journey… As well as 5 1/2 years into it. I am still not well or normal by any means. But I have made massive improvements since this recent flare & in many ways on how I have been for about the past year since my last relapse. I still have intracranial pressure issues. I still have major sacrum nerve pain problems – but less than I did. It’s also very hard to know what could be directly related to the arachnoiditis/ possible AA/ chronic cauda equina inflammatory disorder because these can all effect spinal fluid flow and can cause leakage, seepage and can cause spinal cysts to form/ grow which can then add to inflammation issues. My head seems better than it has been in a long time – but still has many issues.

What is simply the spinal CSF leak? What is connected to the new things were are learning about now? It’s hard to know.

Multiple Spinal Procedures

I still believe this all started as a direct result of that fall and my biological predisposition. I had so many of these symptoms for the two months before my first ever spinal procedure (a lumbar puncture to check pressure which was a 7 at the time). However, my multiple spinal medical procedures (1 diagnostic LP (OP 7), 4 BEBP, 2 LP’s for Cisternogram (OP 10) & CT Myelogram (OP 11) and 1 LP accident instead of an EBP), may well have added to my spinal nerve inflammation issues in different ways. I often found EBP could clearly help some things but as time went on they could also could cause flare ups of intense pain in the following weeks/ months too. We often wondered if this was due to Rebound High Pressure issues, but perhaps it was also (or perhaps more of) an inflammation flare.

My CT Myelogram in September 2017 also caused a seizure within a couple of hours of the procedure (perhaps that was partly due to both the horrific pain, contrast irritation or me staying lying flat afterwards). My already acute symptoms then became even worse – including my weak legs, restricted gait and ‘drunk head’ sensation. So they admitted me – then requested an EBP (although the first attempt became another LP unfortunately). I then had a massive spinal and non-positional head pain flare for at least two months after that (although interestingly I could also be upright more than before the EBP). But the constant pain and often nausea around that time again- at times- left me feeling suicidal as it was so unrelenting. Until I instinctively started walking rather obsessively – which again may have been my saving grace back then as walking can help prevent adhesions forming.

I am NOT Angry with Doctors who Tried to Help me

I feel no resentment at all towards the doctors who requested those procedures or did them. They were trying to help me with ongoing debilitating low pressure headaches as best they could and didn’t always understand these other complications well. Many of those doctors also fought their own battles to try and help my case at the time – so how can I be angry with them doing their best for me according to what they knew then? Also some of those same doctors have been wonderful at listening – and absolutely instrumental – in helping me now which helps the sense of learning together. And learning together means learning through both the good and the bad – especially in rarer/ misunderstood conditions. So as long as they will now also learn lessons from my case in being much more aware of complications such as arachnoiditis and spinal nerve inflammation, then I remain grateful for all their help on my journey.

I DON’T expect doctors to know what they just don’t know. But I DO expect them to listen, learn and consider with humility when new possible complications and complexities emerge they may have little current understanding of.

Other Previous Flare Triggers

Also I have equally had flares/ relapses due to a second bad trip and fall in May 2017 or over-exercising perhaps without also reducing neuro-inflammation (esp a few weeks following my second EBP in November 2015 from which I had actually seen much low pressure symptom improvement). However, I tried some heavier exercise due to all the residual neck, spine stiffness, pain and ongoing head issues – but this ultimately lead to a serious pain and awful symptom flare including severe insomnia 6 weeks after the patch & my first serious mental health crisis.

I have had other flare ups perhaps triggered by long car journeys, or even plane or bus rides, like in April 2019 after a holiday to Italy which again also caused a very serious mental health crisis too due to severe insomnia and constant unrelenting awful pain. See my A Window into a Suicidal Mind blog post. (‘Bucket seats’ like in many planes & cars are reported as really bad for arachnoiditis/ AA patients). And perhaps this time the Covid lockdown added to the flare because I was doing a lot less walking and natural physio (shopping & driving locally) than before which I now understand is so important to stop disease progression. We must keep walking and moving to stop nerves sticking and clumping together.

The Next Step

The next step is hopefully to continue with a low dose anti-inflammatory/ steroid treatment and gentle exercise protocol. But that is all to be discussed further with my GP & Consultant Neurologist. I also need more appropriate scans and to get them read by someone with more expertise. (I am currently waiting for a further outpatient MRI at the hospital I was admitted to.)

I know from experience that having the ‘evidence’ many doctors like to see isn’t always possible. But not having it doesn’t mean you do not have these conditions. (It took 4 years and multiple scans for a neuroradiologist and neurologist to spot a suspected spinal CSF leak in my neck.) I know people whose scans have been read for years by top neuroradiologists, neurologists and neurosurgeons who have all missed CSF leaks, arachnoiditis or AA that has only been picked up by a specialist on those same scans some years later.

Sometimes we unique patients do not ‘tick all the boxes’ or give the desired evidence – especially with rare / misunderstood conditions – as I wrote about in my widely shared post ‘Dear Doctor, A Letter from Your Naked Patient.’ But it doesn’t mean we are not exceedingly unwell.

Sometimes the truth is there – but it’s hiding – and can’t be seen by most doctors until someone more knowledgeable gets involved or those same doctors spend a lot of time researching these conditions to make the necessary connections. Also arachnoiditis will often not show on scans unless it becomes adhesive.

Which is why a clinical diagnosis and emergency treatment – without scan evidence – can be vital in preventing potentially catastrophic adhesions and nerve clumping which may only show on scans once that patient is significantly permanently disabled by the condition.

Gratitude for Doctors

I will keep on pressing forward. Seeking more answers. Looking for the correct treatments and working with some of the wonderful doctors I have supporting me on this journey – both old & new.

Without an open minded and open hearted multi-disciplinary team of doctors across two hospitals coming together to help me in recent weeks. – including the two key doctors who have followed/ dealt with my case for years my current prognosis could no doubt be even more bleak. I have never been THAT bad and so many red flags were being raised that I was perhaps moving into realms of more permanent spinal damage if left like that. Especially if things could have been becoming more adhesive.

Some people with severe adhesive arachnoiditis can end up paralysed, partially paralysed and incontinent and possibly with intractable pain syndrome IF they do not receive the right treatment and ongoing treatment protocols at the right time. So if someone is in a seriously debilitating ‘red flags’ flare, like I was, then it should be considered a medical emergency.

The Joy of Gratitude

I am so deeply deeply thankful for all the support I have had from my ever faithful, constantly sacrificially loving and understanding husband and very resilient teenage daughters. As well as many wonderful doctors, other fantastic medical staff, our family, special friends (already battling these conditions), our church family who have cooked and prayed hard for my family and looked after us and many many more supportive professionals and friends. And that gratitude and wonder is something I will allow my mind to keep pondering, to keep meditating upon – even whilst I continue on my journey of enduring what is often the burden of unimaginable daily struggle & pain.

… Although at this moment in time that is a bit easier than it has been for a long time.

Because to remain grateful in suffering – to keep remembering all the abundant love, support, care, kindness and compassion you have been shown by God and others – is a big part of always seeing that beauty in the brokenness.

As I keep being reminded of every time I see, yet another, stunningly designed, beautiful butterfly resting in the broken and cracked dust & dirt.

There is always beauty to be found – even in the dirt. IF we will keep our eyes & heart open to SEEing it.

“When we are grateful, we are most fully alive. Gratitude allows us to absorb every possible pleasure from a moment…. When your heart is full of gratitude, life paints itself in far brighter and more vivid colours…Life becomes an endless celebration… There is always something that fills you with joy & unleashes hope and inspiration.”

From ‘Uprising’ by Erwin McManus

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.

Dear Doctor, From Your Naked Patient

Dear Doctor,

Perhaps we once met, perhaps we never will.

Regardless of which it is – today I just want us to try and understand one another better. Because if we can TRY to understand one another more, then perhaps we can work together to help your patients find more holistic healing and hopefully make your job a little easier too.

I decided to try and connect with your heart today, because I know that under all those important professional masks, doctor degrees, awards, uniforms, stethoscopes, fancy clothes and endless medical guidelines….

You are simply human like me.

Today, you might be my doctor and I might be your patient.

But perhaps yesterday, today or tomorrow we will equally face the same or similar challenges in our lives. The kind of personal difficulties and traumas every human faces at times. The types of trials and wrestlings that are simply common to our humanity, and a normal part of our broken world.

Maybe tomorrow you may even face the horrible illness I am facing today. Or perhaps one day you will find that one of your loved ones is in my ‘patient shoes’ – and someone else is in your own ‘doctor shoes’.

So please could we connect as equals – as human to human.

Rather than my inferior condition to your superior position. Or my entitled demanding to your service providing.

Please would you take a moment to humbly listen, as I attempt to open my heart to you today?

First, I need you to know some of my own story for you to understand me better. To know that I have been very unwell for nearly five years now. In January 2015 I fell off a small step ladder and that one moment changed my whole life. And from that moment I was catapulted into a life of constantly being someone’s patient.

Maybe being your patient.

During that time I have met some wonderful doctors who were able to connect with me, listen, and who tried to help me as much as they could. I appreciate them more than they will ever know.

They were bright lights in immensely dark places.

But most of the time I have met doctors who didn’t really understand. And some who didn’t seem to even want to try. I met many doctors who treated me as another inconvenience in their very busy day. Another form to fill and box to tick. The nameless, faceless puzzle to try and solve that day.

You see dear doctor…

I have a condition that you may not know much about. And even if you think you do know a lot about it, if you spent a couple of hours in my home listening to me and my family you would probably find that you don’t know as much as you think you do about my complex case. Even many ‘top neurology specialists’ don’t truly understand my condition – even though many of them think they do.

And because of that, some of you have unknowingly added to my pain, giving me wound after wound that I am still healing from today.

You see, for the past five years I have been battling a spinal CSF leak. Perhaps you have heard a bit about them. Patients can get them after lumbar punctures, epidural anaesthetic injections or spinal surgery. Recently more doctors are realising that spinal fluid leaks resulting from these procedures are probably more common than previously recognised. The truth about their devastation seems, in the past, to have been hidden – mainly because many doctors only knew of the classic acute PDPH (post dural puncture headache) symptoms; they didn’t know that you can be leaking spinal fluid and not be stuck flat 24/7. It’s possible that you can be upright a lot of the day, but still be very, very ill. Experiencing all sorts of other horrible, debilitating, distressing, rarely recognised and widely misunderstood neurological symptoms.

I acquired my leak from that step ladder fall in January 2015. More of that original story is here if you want to learn. All my scans – until recently – failed to show IH (intracranial hypotension) or evidence of a leak in my spine.

And yet….

Every single day since that ladder fall I have felt exceedingly unwell. I have not had one fully pain free day. I have not experienced a single day when my mind was clear and my brain worked like it used to.

I need you to know – dear doctor – that every day is a struggle for me. I have fluctuated between being bed ridden for months on end, to months of being upright all day.

And everything in between that as well.

But never well. Never normal. Never knowing the health I used to know.

I could never fully explain to you how impossible it has sometimes felt to live like this.

Recently – after more than four years – my UK NHS specialist team think they have located my CSF Leak in my cervical spine, a ventral leak, hidden at the back my dura on new MRIs. We are currently waiting for new scans to be read and reported to confirm and categorise the leak and work out a better way forward.

I was diagnosed with a suspected spinal CSF leak two months after my original fall. For a while they thought it was post-concussion syndrome – until I was finally admitted to hospital after my third trip to A&E. An understanding neurologist finally picked up on the fact my symptoms only went away lying down. Since then I have had 8 separate MRIs, a radionuclide cisternogram and a CT myelogram of my brain and spine. Until recently, they ALL failed to show any evidence of a spinal CSF leak at all.

Can you imagine how hard it is to be so very, very ill, but lack the vital evidence that definitively PROVES to you – dear doctor – that I am leaking CSF from my spine?

I know I am as ill, and sometimes even much worse, than some of those who have the scan evidence you want to see. And yet I know that some of you still doubt me, and I know that some of you still don’t think it’s all quite true.

Even though…

  • Research shows that at least 25% of spinal CSF leak patients don’t show classic signs on their brain MRI. *
  • Medical papers show that around 50% of patients don’t show the leak on spinal MRIs.*

And yet I still often feel that I have to ‘prove’ to you how ill I really am.

That my lack of evidence is my own curse.

My own fault maybe?

I have been there with you. Lying flat in a hospital bed as you have towered over me, asking question after question, requiring me to prove myself to you. Like I am a criminal standing in your ‘doctors court’.

With you as the ‘self appointed judge’ over my medical destiny.

Do you know how deeply you have wounded me?

To be unbelievably and traumatically ill with a ‘apparently rare’ brain condition, and then find I also have to summon up energy (I don’t have) to ‘fight my case’ in your ‘doctors court’.

Challenging me to PROVE how ill I really am.

Do you know what damage that has done to me?

You probably have no idea how much it has affected me these past five years. How much it wears me down. How much it has infected my mental and emotional stability. How much shame I have had to carry.

Simply because in your busy, overwhelming, important – and often under-valued – job, some of you seem to have forgotten that your patients are simply human.

Just like you!

We share a fragile humanity.

I know that to some of you we are simply different diagnoses that come and go. Some more complex than others. Some that don’t quite fit the ‘diagnosis box’ you are trying to force us into. Simply ‘medical cases’ – charts, scans and notes – that walk into your busy world one day…

… never to be seen again.

Do you realise how much it messes with our heads?

The reason I am writing to you today is in the hope that somehow, I can re-connect with your human heart. Maybe – just maybe – we could get better at understanding one another again. So that we don’t have to end up with all of these painful misunderstandings and confrontations, which can sap your energy just as much as mine.

I know as patients we also need to realise that you are only human too.

That you are not ‘miraculous supernatural healers’ that can defy the laws of medicine, physics and nature. You are simply humans, trying your best to help other sick humans heal up and get well. Many of you wish you could do more for us – not less. You are bound up by the ‘system’ that controls you, by ‘modern medicine’ with all its exhausting bureaucracy, targets and restrictions. We know that there are those of you with equally broken hearts who wish you could offer us more than you do.

I am sorry that we sometimes forget that you are human as well. When we get lost in our own vulnerability, shame, pain and confusion and lash out at, and blame, you unfairly. I am sorry when we also fail to treat you with the kindness, compassion and gratitude that you deserve, as you work with systems that often overwhelm you and bring you crashing to your own exhausted knees.


But today, I can only speak from what I know. I can only try and share from the heart of a very broken patient, who knows that things really do need to change.


You are all overworked and overwhelmed in many ways. And yet some of you seem to be more connected to your own humanity than others. Some of you seem to know how to connect with your patients heart to heart. Some of you achieve this despite all the many challenges of your role.

So I want to say thank you. I know that you are the ones listening to me more openly today.

Recently I have been thinking more deeply about what ‘being a patient’ can feel like for us and how to try and help you understand more – dear doctor. Especially for those of us stuck lying completely flat in a hospital bed due to a spinal CSF leak.

But also as A VOICE for your many other patients as I try to explain what it feels like for us to enter your normal vocational world.

You see, for you, the hospital is your workplace. For us, it’s often an immensely distressing place.

We are not normally there by choice, but because we know that there is no other way to get well than to come to you. So when we enter your ‘hospital work place’, we often feel so vulnerable, so confused, so distressed, so exposed, and often in so much pain.

One way to describe it to you is that we feel like we are metaphorically simply naked and exposed for you all to see.

You may not have ever been a deeply vulnerable and distressed patient yourself – so we know it’s hard for you to fully empathise and understand – but if you want to try and understand us better when you come to see us…


Can you take a moment to imagine and picture what it would feel like if it were you lying on that hospital bed, fully naked – so exposed, vulnerable and ashamed – with absolutely nothing to cover you up?


Our own masks, worldly titles, fancy clothes, make up, hairstyles and badges of honour have ALL been snatched or stolen away. So we are subsequently feeling so cold, so messy, so vulnerable, so distressed, so confused and so naked – whilst you are simply getting on with your daily grind in your normal place of work.

Please be kind to us. Please be patient with us. Please listen carefully to us. Please TRY to understand us.


Don’t stand at the foot of the bed and tower over your patient – she feels small already – take a minute, sit down, listen…Try to understand. Realise you will never understand. Try anyway.”

– C. Sebastian*

Dear doctor, we feel small already… please don’t make us feel even smaller.

In our smallness you can often appear so big, so important and so intimidating. You are covered in all your doctor masks, fancy doctor clothes, doctors badges and medals of honour, and talk with your important-sounding ‘doctor speak’.

Sometimes we don’t even understand what you are saying.

Because you are not talking to other doctors; you are talking to your naked patient who already feels so very small and so very stupid lying down in that hospital bed.

Please listen carefully to us before you attack and accuse us of not feeling as ill as we say. Please open your minds to the fact that just because we don’t fit your boxes, it doesn’t mean we are not truly very, very sick.

You are meant to be our healers – not our accusers.

Dear doctor, you should know that after leaving your hospital or doctors office and perhaps never seeing you again, over the past five years I have experienced two intensely excruciating complete mental health collapses. I have also found myself close to those places again and again.

And in those places – normally when I completely relapse physically, I stop sleeping and have no energy to fight anymore – in those places, all of my traumatic memories of encounters with intimidating and insensitive doctors return to me. I picture you as scary ‘doctor-judges in the medical court’, and I don’t have the energy to try and ‘prove myself’ to you again, and face getting my case thrown out with the lack of suitable evidence.

So I want to just give up.

Dear doctor, did you know that in those dark and distressing places my broken and exhausted mind decides that death might be my only way out. The only escape from the constant battles. The only way to end the never-ending fight. The only way to stop having to defend and prove myself again and again to another intimidating ‘doctor-judge.’

Did you know that your insensitive words and actions one day could indirectly contribute to my death?

Do you realise how serious that is?

You see, when my impossible medical journey pushes me to places beyond what I can endure, when my mind packs in and my body breaks down due to the immense stress and strain of daily battling a debilitating and distressing misunderstood neurological illness year after year…

I end up feeling more broken, more vulnerable, more distressed, more naked and smaller and smaller than ever before.

I feel like a worthless and insignificant judged ‘chronically-ill’ nobody. Who just cannot get well. However hard I try.

Dear doctor, I then need you to know that I need you to see me as…
Just another naked and vulnerable human patient…

…. looking for someone to help cover me up. Someone who can put a blanket of compassion, kindness and hope over me so that I won’t feel so very very cold, ashamed and completely overwhelmed from the fight.

You see…

I am your naked patient.

So please understand that in my nakedness, all I can see is all your importance, all your knowledge, all your intimidation, all your doubts about me and my case, all your intelligence and words I don’t always understand.

So you scare me!!!

I can no longer see your equal humanity; I can only see my naked inferiority beside your beautifully adorned superiority.

So dear doctor, please be gentle with me. I am not as strong as you think. My heart has been broken and wounded again and again. Some days I just think I will sink.

All I see is my broken humanity. All I see is my naked vulnerability.

So dear doctor, today I wanted to connect with your heart. I wanted to try and reach you, human to human.

As your equal.

To please ask you…

When I feel that naked, the best way to help me is to remember that underneath all of your adorned and celebrated doctor-robes, you are just a naked human too. You may not feel it so much today… or even tomorrow. You may not really ever understand what I am actually trying to say.

But please try and imagine yourself as that naked patient, lying in that hospital bed. And think about how you can move a little closer to our inflicted lowered level and status; to sit down, to listen, to try and understand…

Whilst realising you can never fully understand.

But please do TRY anyway.

Because one day…

That naked patient…

Might be you!

And then you will want to meet a kind and gentle doctor, who can also relate and connect to your vulnerable and exposed naked humanity.

And I hope that they will try to bring you more holistic healing….
Rather than inflicting wound after wound after wound... that can sometimes be even harder to heal from than the original condition over which you met.

Sent, with heartfelt tears, gratitude and deep respect for your willingness to listen and learn,

From,

Your naked patient


“Don’t stand at the foot of the bed and tower over your patient – she feels small already – take a minute, sit down, listen…Try to understand. Realise you will never understand. Try anyway.” – C. Sebastian

*Quote from this beautifully insightful TED talk on encouraging ‘Narrative Humility’ in the medical profession.
Narrative Humility: Sayantani DasGupta at TEDxSLC youtu.be/gZ3ucjmcZwY

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.

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 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.

*Please see this 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.

*Please also see this other in depth 2018 medical paper 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.

Living With a Spinal CSF Leak.

“There is no greater agony than bearing an untold story inside of you.” – Maya Angelou

I started this blog at the start of January 2015. For a while I had wanted to write. But in all honesty I was scared.

“What if I write and nobody wants to read it?”

I soon learnt that writing isn’t just dependent on others reading it. It’s a great form of self expression in its own right. It’s the attempt the find the right words to tell our own stories about our lives.

One of the first momentous, yet deeply personal stories that I shared was the first anniversary of my Mums death in a post called ‘A Journey Through Grief and What I Have Learnt.’ I had felt that in telling my own unique story, people might just connect and maybe they could relate as they struggled through their own story of grief.

Little did I know that the same week I started this blog and wrote the above piece, would be another life altering week for me.

That was the week that I sustained a brain/ spinal injury I am still battling now –

21 months later.

That day I was painting and needed to reach high up near the ceiling. So I used a relatively small step ladder to stand on, but it was resting in a place that wasn’t completely stable. I had already used it that way for hours and felt confident it was ‘stable enough.’

But my confidence was misplaced.

I took a seemingly small risk, the type that we all take everyday. But on this particular day my risk taking didn’t pay off. It was that day I had an accident. It was that moment where it felt like so much went wrong.

I have been living with the consequences of that decision ever since.

In one horrible moment the whole ladder had toppled over and took my feet from under me with it. I fell onto my back and hit the back of my head….

But,
It’s OK!
I am fine!
A bit dazed!
A bit bruised!
No real damage done!

Or so I thought!!

So I finished that painting. Exhausted & aching all over, but obviously to be expected after painting all day and having a few bruises from the fall. But within 48 hours it became obvious,

I WAS DEFINITELY NOT OK!!!

Two days later I was diagnosed with a concussion.

“You should be better by next week.” they told me.  But I wasn’t….It got WORSE!!
So we went down to A&E.

“I am sorry Mrs Hill you have Post Concussion Syndrome. You are looking at about an 8 week recovery time.” they said.

No surely, not me.
Give it four weeks.
It can’t be that bad.
That is such a long time!!! (I confidently, yet naively thought!)
I’m sure I can bounce back like any other time I have been ill for a few days.

Eight weeks later of being pretty much bed bound, in a dark and quiet room, and things still getting worse.

We head down to A&E for the third time since my fall.

I was finally admitted that time because I was so unwell, in severe pain and vomiting after being given morphine which didn’t touch the pain, only made me feel even more ill. I was finally seen by a Neurologist the next day and she moved me to their ward to look for evidence to support their initial diagnosis of low pressure headaches caused by a spinal CSF leak.

I am not going to list all my symptoms because I have done that all before. But what I will say here is that I am so very, very grateful to a handful of people who in the midst of their own pain and struggles decided to help others like me.

I have to tell you about the wonderful team at www.csfleak.info who helped me to understand more about my injury and helped me to realise that the fact I ONLY ever felt remotely well LYING FLAT IN BED for those two months, was not due to post-concussion syndrome after all,

It was probably due to a  SPINAL CSF (Cerebrospinal Fluid) LEAK!

This meant that somehow the accident had caused a small tear in the membrane in the centre of my spine (the dura) that holds in your spinal fluid. This means that my spinal fluid leaks out and is absorbed my body.

So when I am upright sitting or standing, due to gravity, my brain drops in my skull, because it lacks enough fluid to hold it in place.

Twenty One months after my fall.

I am still not better!

I have had some ups and downs along the way. Bad months in 2015 of being almost fully bed-bound. And other months after epidural blood patches (I have had 3) of being mostly upright.

But since that fall I have never had one single day of being…

Fully
Symptom
Free.

Such is the journey to full healing with this unusual and often under-diagnosed condition. Many people do get diagnosed, receive treatment, get well quickly, and never look back.

But many others face constant battles, discouragements, set backs and difficulties throughout their journey of being diagnosed and treated. Often a lack of knowledge by the medical profession makes getting fully better hard for many.

stone wallRecently, I have become so acutely aware how little many doctors, and the general public, know about spinal CSF leaks. I have heard so many stories of people struggling to get a diagnosis and, even when they do, facing many barriers to treatment.

There are many hospitals that really don’t know what to do with ‘these rare patients’ and this often makes delays in treatment an unfortunate reality for many.

I am so grateful for an amazingly supportive and well informed group of CSF leak sufferers who form an online community through the ingenious invention of Facebook groups. Many of us cannot imagine how we would have faced this journey without one another and I honestly think that some people in those UK and US based groups would not be alive today without that wonderful resource. Despair and suicidal thoughts are very prevalent within this group of patients.

Having someone tell you “I get it” whilst you both spend yet another day staring at the ceiling, flat in bed, can mean everything to someone really struggling. Even when that other person is half way across the country or even the world.

We face the daily struggles together!

It can be a lonely and difficult road battling a chronic illness. That road sometimes feels impossible when you slowly begin to realise how little knowledge a lot of doctors have about your condition.

I recently watched a very moving video, that is on the wonderful US spinal CSF leaks charity website. www.spinalcsfleak.org/resources/patient-stories/ About a lady who got a spinal fluid leak from a very badly placed epidural for the birth of her second child. She got two dural tears from the needle which caused spinal fluid to leak from her spine.

It took her 2 1/2 years to recover (she had a new born and 4 year old at that time) and she had to have 11 epidural blood patches (where they inject your own blood into the epidural space in your spine) and two surgeries to get better.

But what struck me the most was that even though everyone knew the area of her spine the leak would have been in (which is half the battle with traumatic (or spontaneous) leaks like mine) time and time again doctors refused to listen and often implied that there is no way she could be leaking CSF, and perhaps it was instead, ‘all in her head’ or something she would ‘just have to live with’.

I cried so much watching it because myself and many other leakers have faced similar battles to hers.

I find it heart breaking when people are suffering and needing help and support. And yet due to a lack of knowledge and understanding by the medical profession AND the general public, people are often told things like;

‘We have got nothing left to offer you,’
‘Try your best to get on with your life’
‘Perhaps you should try and get out more.’

Which is just a slap in the face when you are literally stuck lying flat in bed!

And yet, it doesn’t need to be that way!

There has been so much research done about spinal CSF leaks already. There IS knowledge out there. There are specialists who are leading the way, publishing medical papers and providing hope that many people CAN fully recover and perhaps don’t have to just learn to live with it after all.

Peoples minds need to be opened.

Medical professionals need to know that there is more information out there than they might realise. That there are a whole range of diverse symptoms. That people can still be leaking and debilitated, yet still function (well sort of) upright most of day. That there are many different kinds of treatments available and things that can be done to help.

  • Recently I have been thinking; how I can spread awareness?
  • How can I do my bit to help make the way clearer for those patients coming after me?
  • What skills can I offer the cause that might make a difference for both me and others?

One thing I have chosen to do is write. I can use my words to draw attention to this condition. I can tell my story in the hope it eventually reaches the people who need to hear it.

“Well, everybody’s got a story to tell and everybody’s got a wound to be healed.” Plumb

So today that’s what I want to do. I want to welcome you in to my world. I want to share with you a snap shot of what it is like living with a chronic CSF leak. So that you might have some more understanding yourself.

These days I am so very thankful that I get more hours upright than I used to. It really does make it that much easier to deal with. It helps me to feel more a part of the world around me and connect better with my kids. But it is still very very hard and debilitating to live like this.

stone wallHere is a typical start to my day….

I got up about 7:30am this morning. Lying in bed in the mornings I can actually feel pretty normal. But that feeling never lasts for long!

I get up, shower, get dressed and have breakfast, including a cup of tea and 2 pro plus caffeine tablets (because I can’t stand coffee!!)  – which can help to give me a bit more up time (although I often find it can be an artificial type boost feeling). During this time I already feel the neck stiffness and occipital (bottom back of the head) pain beginning to build up, but it’s manageable and relatively mild.

I drive part way and then walk my youngest to school. Chat to the other parents/ carers, go back to the car. Then this morning I decided I would pop to the shops.

My head is getting worse bit by bit, the pressure is building, the pain in my neck/ occipital region is increasing and my head is beginning to feel more full and a little cloudy.

I go into the supermarket – only to get a few things so it’s not too heavy. I don’t use trolleys, I don’t use a basket. I don’t take a handbag – only my purse – so that I can get as many things as possible and carry them without making my symptoms much worse.

So depending on what I have that might be 4-8 lightish items that I can hold in my hands/ arms without dropping them. If I do drop one of them (like the other day), I have to leave it or ask a shop keeper to pick it up for me. (Because bending down might make my leak, and will certainly make my symptoms, worse. At home I use a grabbing stick like the one below).

FullSizeRender

The nausea is setting in.

I pay for them on the self service check-out which is at an awkward angle so you have to bend a little to put them on the counter once scanned.

This increases my symptoms.

I bag them up and pay and by this point – just carrying the weight of those few things is making the nausea worse, so I start gagging in the lift to the car park, feeling like I want to vomit (although I don’t think I am ever fully sick).

Thankfully there is no one else in the lift with me!

I drive the short distance home – put the things away. Talk to my husband while he’s making a cup of tea (he is working from home today). During our conversation my head and neck is getting worse (I feel like someone has whacked me round the back of my head with a baseball bat!!) and I start gagging again uncontrollably – but thankfully I don’t actually vomit.

So my husband says, “you’d better go and lie down.”

I walk up the stairs and can feel my legs beginning to get very weak, I have to think about the steps I am taking, willing my legs to keep moving. The cloud in my head thickens. That feeling of not being able to cope with the intensity in my head floods over me! 

It’s 9:30am – I have been up two hours and can no longer function upright!!

I am now lying down flat in bed – feeling a lot better and writing this. I will stay here for probably an hour or two before getting up again to do some more jobs at home for maybe half an hour to an hour before the same thing happens and I have to lie down flat again.

That’s how it goes throughout the day every day although later on in the day the up times are often less and the down times can get longer.

If you saw me at the school at 8:30am, even though I had symptoms, you would think I looked fine, chatting to people (which is great because some days I don’t get to see many people).

So this is me on a good day – last year during my worst times the above would all happen with my symptoms within about 10mins of being upright.

I couldn’t even have a shower.

I would have a shallow bath once a week which I would have to lie completely flat in. As soon as I got out I would have lie on the bed with a towel round me, with my wet hair on a towel. It would take at least 1/2 hour to 1 hour before I might manage to be upright enough to put some clothes on and dry my hair a bit with the hairdryer. Or often my husband would help try and dry it whilst I lay flat.

When I was in hospital, a year ago, waiting and battling for more treatment (a second epidural blood patch) – I was in a bad way. I would spend all day lying in a head tilted down bed to alleviate symptoms and keep my brain in the place it should be. I could only manage about 5-10 mins upright at a time which makes things very hard.

We were facing lots of barriers and delays at that time (which I write about here), because the anaesthetists didn’t want to blood patch me a second time (after 5 much better months following the first) they instead wanted me to try an occipital nerve block done by the pain management team. (I did have the nerve block, it didn’t work at all, but it did leave my head, neck and hair covered in the sterile cleaning stuff.) Following that it took me two whole days to find the strength to get my husband to take me into the shower in the hospital bathroom so that he could help me wash all the chemicals from my hair and neck and help me get changed. He then dried it with a hair dryer whilst I lay flat again. (That would pretty much do me in for the whole day!!)

It’s an utterly debilitating condition. It’s not good for anyone’s physical and mental health to have to lie flat in bed all day. And yet some people are left that way, long term, because doctors don’t know what to do with them. They don’t understand how to treat them.

They do not seem to realise how impossible it is to live like that!

People are just not aware that many spinal CSF leak patients end up feeling suicidal (as I did at Christmas and write about here) because of the physical and psychological toll of the condition. Which is often exacerbated by the battles to find doctors who understand the condition, show compassion and actually do their best to help you.

There can still be an ‘old school’ mentality at large in the medical profession, even following correct diagnosis, of trying one epidural blood patch (and sometimes not even one) but if it fails to fully get you well, then they recommend that they should just try to help you manage the pain.

‘Manage the pain?’

I don’t have a sore leg, or a mild headache that goes away with some pills or a even a worse headache and stiff neck that is solved through a nerve block.

My brain drops in my skull when I am upright, wreaking all sorts of havoc in my head and body until I literally can’t physically or mentally cope. You can’t just ‘manage’ that kind of pain. And actually I wouldn’t always describe it as ‘pain’ it doesn’t do it justice. It is an intensity that can actually only be described as a sensation that is ‘beyond pain.’

(And just to add here that no painkiller I have had (Including IV morphine) has ever touched it)!

IT’S REAL!
IT’S HORRIBLE!
IT’S DEBILITATING!
BUT – IT IS TREATABLE!

Things ARE changing, patients are speaking out and coming together as a force to challenge conventional thinking about CSF leaks. And thankfully, little by little there are more wonderful doctors who are meeting enough well informed leak patients to see how great their suffering is and are slowly beginning to offer them new opportunities for diagnosis and treatment.

When someone with a leak meets a doctor who understands, or at least tries to understand, it’s truly a beautiful thing. It honestly means so very much to us.

Those doctors will never be forgotten.

We don’t expect miracle workers. We know we may not be easily fixable. But to meet someone with a willingness to try, an ear to listen, a humility to learn and a compassionate heart can make all the difference to someone on such a difficult road.

stone wall

In February this year (2016) a video was posted on You Tube that is doing so much to help change people’s minds and hearts about spinal CSF leaks. In the video Professor Ian Carroll from Stanford University Hospital in the U.S. gives a passionate lecture in which he is trying to enlist the help of doctors and medical professionals to help find and treat those suffering from spinal CSF leaks.

Through this video Dr Carroll has become our spokesperson, bravely, boldly & passionately challenging conventional thinking in the medical profession at large. And joining others in the quest to change current practice and stop people suffering unnecessarily from a mainly treatable condition.

I know for me, and many other longer term suffers, Dr Carroll’s video on YouTube is a breath of fresh air that reminds us that we are not going completely mad. So many patients have taken great hope through the impact it, and other recent information, is slowly having on awareness, diagnosis & treatment of spinal CSF leaks.

I am so very grateful for this wonderful resource from a doctor who is wanting to reach both doctors AND patients. I have gratefully been able to share this resource with some of the many doctors who have cared for me over the last 21 months. Some who have gone to great lengths to understand the condition more and do their best to support and treat me.

It is always a special moment when you meet a doctor who does watch the video or reads though the websites. People’s hearts and minds CAN be changed and it is wonderful when you see that happening.

Change does not often happen instantly. We are not all going to wake up tomorrow in a world where every person with a spinal fluid leak is going to get properly diagnosed, treated and fully recover. These conditions are complex and it takes time for understanding, research and practice to filter through.

But we can all play our part!

So today I want to ask sufferers and their families to think about;

  • How could you speak up and tell your story?
  • How can you be part of raising awareness too?

We might not all be able to write blogs, create websites, volunteer for the charities, fund raise or spread the word on the street. But perhaps we could post on social media, share a link, wear a t-shirt, or tell something of our own story.

Or perhaps you could respectfully share with a medical professional a medical paper on leaks, tell them about the UK and US CSF leak charity websites, or send them a link to Dr Carroll’s video.

You never know, they might just take a look especially if you approach it well.

“I alone cannot change the world, but I can cast a stone across the waters to create many ripples.”  – Mother Teresa

Change will only come;
little by little,
step by step,
patient by patient,
doctor by doctor,
hospital by hospital.

By individuals and groups choosing to raise awareness and helping to challenge and transform conventional perspectives and opinions.

Perhaps we can all work together to enable patient and doctor to compassionately help one another to understand this debilitating yet treatable condition. So that even if we have had a tough and difficult journey ourselves, we can seek to build bridges with others that can open lines of communication. That might just change people’s hearts and minds for the future.

That way, we are building a legacy for the future. We are making the road that bit clearer for those following behind.

Mindful of the fact that they may never fully know the difficulty, struggles, sacrifices and battles of those who went before.

“Do not go where the path may lead, go instead where there is no path and leave a trail.” -Ralph Waldo Emerson


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.

To watch my recent YOUTUBE video summary of my whole medical journey on my new YouTube channel please click here.

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.

Please see this 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 3 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.

Here is the link again to Dr Carroll’s video.

Please also see this other in depth 2018 medical paper 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 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. 

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

“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.

Learning Patience

Patience is not the ability to wait but the ability to keep a good attitude whilst waiting. – Joyce Meyer

There is nothing like hospitals to teach you the virtues of being patient.

I am writing this, in hospital, after a relapse. Neurologists think I have a recurring CSF leak which perhaps exacerbates post traumatic migrane symptoms from my original concussion.

When better to write a post on patience! 

Hospitals require patience.
Patients need hospitals
Learning to be a patient patient is hard.

Being unwell makes being patient so much harder. You go to hospital because you are unwell. Being unwell is unpleasant. Your ability to function normally is challenged. You just want to get fixed, get better and go home.

But often instead you have to: 
Wait
Wait
Wait
Then wait a bit more! 

For everything!

The wonderful medical staff are so busy with all the patients trying to be patient whilst ill. Which can’t be easy.

So everything takes a while. 

When my husband brought me to A&E, a couple of days ago, I was having one of my ‘drunk like’ episodes. Basically amidst all the head pressure, dizziness and general head & neck pain, my head also goes a bit funny and I act rather tipsy. (A symptom that has appeared occasionally when things have got bad. Which wasn’t helped by waiting sitting upright for so long – which is not helpful if you are leaking Cerebral Spinal Fluid).

All this meant I waited in the A&E assessment waiting room a bit like a small unwell child.

Speaking loudly,
Reading all the signs out loud,
And asking my husband every five mins:

When is it my go?”. 

I kid you not – that is literally how it was!

It’s both half amusing and half troubling for Matt and I (and probably exceedingly annoying for everyone who probably assumed I had vodka in the water bottle I constantly swigged).  

Why is waiting so hard? 

  • We are not used to it. 
  • It feels like a waste of time. 
  • It can make us feel anxious or frustrated. 
  • We want quick fixes and quick answers. 
  • We are too used to our fast paced world. 

However, 

Perhaps, if we realised there are lessons to be learned from waiting, we would embrace times of waiting more easily. Maybe then we would not allow ourselves to get so frazzled.

I am speaking to myself as much as anyone else as I write this. There is nothing like a lesson learned in real time, as I wrote in my last post Breaking Free! From Self Pity. And there is nothing like being ‘stuck’ in hospital to refine your waiting skills.

It’s a challenge to say the least. 

But we must try to find positives in hard times or we will become consumed by the difficulties. Being frustrated, annoyed and impatient usually does nothing to help the process and certainly doesn’t help get you better.

I do know how hard this is though, especially when you feel desperately ill. 

My first night after being admitted was tough. I wasn’t in the best way (although not ‘as bad’ once I actually got to lie down flat of course). I was on a medical ward because they firstly wanted to rule out a brain infection, such as meningitis, so I had lots of doctors coming to check me out.

During the night I somehow laid on the cannula they had put in my arm and pulled it out. Once I realised, and had called the nurse, I looked down and saw the bed and me covered in a pool of blood, from it leaking.

The nurse came, sorted out the cannula and started changing my bed and I got myself to the loo to try and change. (which was a challenge in itself because my walking and balance were affected by my general CSF leak/ post concussion heady symptoms). But in true Becky Hill style I was intent on doing it myself and thought I felt OK enough to manage.

How wrong I was! 

I started to try and clean myself up and during the process pretty much fainted, but seeing as I was by then half undressed and smeared in blood, whilst trying to wash the blood out of my clothes, I thought I would try again, not wanting the nurses to have to rescue me.

Unfortunately, that was wishful thinking and in almost passing out again, I managed to unlock the door and ring the emergency buzzer.

I was lying on that hospital toilet floor, feeling extreamly weak, desperately vulnerable and overwhelmingly nauseous. I then had to wait for someone to hear the buzzer and come.

I could hardly move, hardly talk and certainly couldn’t look after myself in that moment. 

But I still had to wait. 

It probably wasn’t even that long before the nurse came. But it felt like forever. Listening to that buzzer, hoping someone would come.

Trust me I know how hard it is to wait when you are desperate. 

It turned out my blood pressure was very low and the wonderful nurses put a lovely hospital gown round me and wheeled me back to bed, the doctors came and they had to give me IV fluids to help sort me out.

Waiting can be so hard, especially when we are feeling weak, vulnerable and desperate. 

It’s also hard to get waiting right in those moments. (Hopefully others can then empathise more with our impatience in those moments). 

In general though, we can all learn to wait more patiently in both easy and harder times. Here are some of the ways the process of waiting can help us.

1. Waiting teaches us how to be patient. 

Well that’s obvious, isn’t it? 

But it’s not always the case. Waiting is often enforced upon us and hence it is something we ALL complain and get frustrated about.

Who likes enforced waiting? It’s just down right annoying isn’t it? 

Yes it is! However, being patient brings peace and a lot less stress during difficult times. Stress just produces tension in our bodies and minds and usually just makes the whole ‘waiting’ experience more traumatic than it needs to be.

We may still need to challenge the process and find out if all the waiting is really necessary. But we can do that from a place of peace and understanding rather than anger and frustration.


2. Waiting can help our empathy of others’ difficulties. 

When I have to wait, especially in a hospital, it’s easy to start to look around and try to work out how important my case is compared to others.

If we are not careful the selfish tendency we all have kicks in and we are blinded by our own problems and cannot even begin to see the difficulties others face.

‘Me, me, what about me!’

Patience instead allows us to show more empathy to others around us and see the difficulties they face as well.

3. Waiting can be an opportunity to rest.

We are often not very good at resting when it also involves waiting. I know that I am certainly not! We complain about our busyness and then can’t cope with resting either.

This is because enforced rest is often neither convenient or welcomed – because we can’t choose it or use it how we want.

It feels like a colossal inconvenience and a waste of our precious time. Which may well be the case.

However, rest is a good thing when used correctly. Sometimes it is only thorough rest that complete healing comes. But only if we let go of our anxiety in the process and attempt to fill our thoughts with better things.

4. Waiting increase our endurance. 

“We can rejoice, too, when we run into problems and trials, for we know that they help us develop endurance. And endurance develops strength of character…” (Romans 5:3-4 The Bible)

Endurance is a great virtue. Without endurance we won’t get very far in life. It is endurance that spurs us to keep on keeping on, even when the going gets really tough.

It enables us to push through difficulties and come out stronger the other side. Without endurance we become floored by every trial, however small. We give up trying, aiming or working towards better things.

  
Learning how to ‘wait’ better can do a deep work in us that enables us to face the challenges life brings and overcome them as best we can.

Patience brings us peace amidst the storm because we stop allowing the storm to control our feelings and actions.

In this way, we not only ‘survive the storm’ but we can ‘thrive in the storm,’ because ultimately that which came and brought chaos in our lives, actually produces more peace, contentment and thankfulness.

Maybe if we see things differently we will no longer fight ‘waiting’ so much. Maybe we will instead find a way to embrace it, with wisdom, allowing it to do the work in us it can do;

If we will just let it. 

“Without patience, we will learn less in life. We will see less. We will feel less. We will hear less.” – Mother Teresa

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Next time you have to wait. Have a look around you and perhaps ask yourself:

What can I learn, see, hear and feel from this process?  

How can I contribute to a peaceful atmosphere amidst the wait and even in challenging it? 


To read more about my journey since my concussion and CSF Leak please see my first post here.

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.