Tag Archives: spinal injury

ARACHNOIDITIS RELAPSE AUGUST 2023 WITH ACUTE LOW PRESSURE HEADACHE FLARE – What is the connection?

“Perseverance is rooted in hope. We persevere when we believe that what awaits us is worth the fight.” – Sarah Walton

Sadly, following just over a year with much more ‘stable baseline’ arachnoiditis/ CSF leak symptoms…

I finally succumbed to a new flare.

Another relapse.

And it was again … BAD.

Bad enough that a 10 day course of 40mg prednisolone (oral steroid) hardly touched it….Took the edge off maybe… But certainly couldn’t stop it!

That is the power of my arachnoiditis flares. Once established – they seem untouchable to halt.

… Until we use the IV Methylprednisolone 1g a day x3.

Until we hit the inflammation HARD & FAST.

That’s the only thing that seems to stop it in its tracks and subsequently reverse the relapse process… back into recovery.

I have again documented this flare with a new YouTube video (see below) made post IV treatment. But it includes some footage from the flare itself.

I make these videos to raise awareness, to educate, to continue to tell my story, inform others of my progress and also to process my own trauma.

Because it’s always traumatic.

To feel that abhorrently unwell. To feel so vulnerable and out of control. To be brutally reminded of the nightmare of dozens of previous relapses … and especially the trauma of the memories of the ones from before…

… from before we knew about the central nervous system inflammation. About the Arachnoiditis that seems to have been there from the start.

Hiding in plain sight for many years.

Before we understood – about the arachnoiditis inflammation and the way these flares always seems to take me right back into my acute low pressure/ spinal CSF leak symptoms.

Before we understood ALL that … I just had to endure, hold on and attempt not to deeply despair at the horrendous symptoms in my whole brain, spine, nervous system and whole body. That take me over and force me back to bed. Pretty much all day every day. And back then we didn’t really know how best to treat it. So I would often be like that for months.

It is easier now.

You see I have a ‘plan’.

The support of two great neurologists at two NHS trusts who work together to ensure I get access to the best treatment as fast as we can.

Also the oral prednisolone 40mg DID help! They stopped terrible symptoms getting totally and utterly unbearable with ‘relapse lightening speed’. But it couldn’t stop it. And the day I did stop it to have the IV later on. My symptoms crashed in super quick time.

RELAPSE TRIGGERS

The relapse started after a mix of long car journeys to see family across the U.K. Then on top of that walking into a door frame, bashing my knee HARD and jolting my spine. Thankfully I happened to have a follow up telephone appointment with my CSF leak specialist neurologist the day things really took a turn for the worse – so that really was helpful and another undeniable moment of divine providence I am so grateful for. So he recommended we ask my local Neurologist to arrange the IV. As is the arrangement. As is my medical protocol already established over the past 3 years.

This is my 4th IV in 3 years since I was diagnosed with arachnoiditis. Although in reality it’s always been there since my fall from a ladder in January 2015. That’s what my MRI’s show from March 2015 and that’s the story my symptoms tell me.

It’s always been the same story. From day 1 until now. The same pattern of the initial illness to every relapse ever since. Although my lumbar/ sacral/ leg/ feet/ bladder symptoms have got worse over the years too.

I had the IVs Methylprednisolone 1g Thursday 24th – Saturday 26th August 2023 on GPAU (General Practice Assessment Unit) at my local hospital.

And I am thankful to report that I am now doing a lot better.

It normally takes a couple of weeks to truly get back to ‘my normal baseline’ symptoms. And today as I am writing this we are two weeks post start of the IV. Nearly 4 weeks since this all started. I have just finished the prednisolone taper from 30mg down to 5mg and have just returned to 5mg every other day. Today is my first steroid free day in about 3 1/2 weeks. Although I have taken 75mg diclofenac today to cover me as I try and phase out the steroids back to my normal 5mg every other day. I have also recently returned to my normal 4.5ml of LDN. (Low Dose Naltrexone). (Just to note I also have had to use Zopiclone (sleeping tablet) 7.5mg at night when on higher dose steroids. Although my sleep is now improving again too).

I am finally beginning to feel like ‘my normal’ is pretty much back – give or take a slightly more spacey head at times. But that is also improving each day.

I am back to walking over 10k steps a day and doing lots around the house to keep me moving about. I am also slowly introducing more going out a bit further and will start driving short distances again soon.

So it’s good news.

It came.

It took me down.

We fought back.

We conquered.

I am recovering.

“Endurance is not just the ability to bear a hard thing, but to turn it into glory” – Philip Yancey

For all this I am extremely thankful. To have diagnosis’. (Arachnoiditis & a Spinal CSF leak). To have neurology support at two hospitals. To have a treatment plan that works. To have GP’s who understand.

It all helps so much. The major battles are already fought and won. I have my treatment plan and supportive doctors in my corner. But in reality there are always many small battles along the way. Making lots of calls, sending lots of emails, following up and explaining things again and again. Reminding medical staff I have to lie down as it can’t sit comfortably and can’t be upright at all early on in a flare. Lying down in the car to get to hospital as I cannot tolerate sitting up. Lying down in waiting rooms – hoping for enough chairs together that are free. Otherwise we carry a yoga mat for me to lie on the floor without getting completely dirty. Then there is the chaos at home of me not being able to do things … although even that is easier now my girls are 16 & 18 and can help so much more.

For all the easier things about my story I know I am blessed. I am one of the fortunate ones. Because this level of openminded medical support can be unheard of in the lives of people with suspected or actual arachnoiditis or AA (adhesive arachnoiditis). Still my doctors are all learning with me. But as we learn together the support gets more solid, more understanding. Which really does help counteract the trauma of many years of ‘doctors not understanding’ (as I wrote about so vividly here after counselling.)

So that is why I continue to share my story. I don’t take my privilege for granted: I try to raise awareness. To educate doctors, patients and family and friends. To connect with you in your immense struggle, confusion & despair. To show you ways and treatments that ‘might’ help you too – if you can find the right doctors to help you. To implore you to just keep ‘holding on’ … for years if that’s what it takes (like in my case)… because things can still get better in the end. There is always hope.

Everything I discuss in my videos is based on personal experience, years of symptom observations, plus my own research and listening to others stories. My experiences are unique and thus uniquely managed by my two neurology teams and two different Midlands UK NHS hospitals. So I cannot comment or offer any medical explanations, advice or diagnosis to others. I only share my own story in the hope it may help others on their unique journeys to more answers. I can only answer your questions according to my own limited experiences and the research I have done.

But from what some of you do tell me – sharing my story can help right? Just to know that somebody – somewhere – sometimes across vast oceans ‘gets it’. That they understand your deepest struggle, your most excruciating pain. The daily overwhelming choice to try and keep on finding ways to live despite the constant trauma, questions, confusion, misunderstandings and the deepest of pains.

So today I write to remind you that I really do understand. But these days – more than ever – 8 1/2 years on. I am learning to find a way through it – dare I say – to even THRIVE.

For these reasons my videos and articles are all fully public and can be shared with anyone, by anyone, on any platform. I also write to make translation easier because I know many non-English speakers are keen to follow my story too which is harder with the videos.

So here it is – here is my new video, I have included a content summary below so that people can more easily skip through and find the parts they are interested in.

WHY DO MY LOW PRESSURE / SPINAL CSF LEAK SYMPTOMS GET SO MUCH WORSE DURING MY ARACHNOIDITIS FLARES?

The video documents my recent arachnoiditis flare in August 2023. During this video I also consider the question as to why my low pressure headache/ spinal csf leak symptoms get equally acute during the flare. How does the increase in the inflammation and the physiological mechanisms at play cause me to revert to such distinct Spinal csf leak symptoms? As has always been the case in my medical history over the past 8 1/2 years since a ladder fall in January 2015.

In it I present some theories of my own as to why this happens so radically including:

  • I leak more due to higher pressure from inflammation
  • I seep more from the adhesive area or via my compromised Dura in that area.
  • The inflammation blocks my spinal fluid flow causing radical changes in ICP.
  • Or the one I discuss most in this video: that the inflammation pulls at my spinal cord – especially if the more adhesive area is trying to adhere further. Subsequently, bringing an increased ‘tethering sensation’ to my spine. Pulling my brain stem to create that ‘brain sag’ affect – the feeling of ‘my skull being pulled into my neck’. But then also ‘my sacrum being pulled into my lumbar spine’. Could it be that this process then blocks flow too? Causing very real sensation of my spine being tightened and clamped at my neck and sacrum which further supports this theory. Also interestingly I had some people who had previously had surgery for ‘tethered cord syndrome’ comment on one of my ‘bizzare symptoms’ videos telling me that my symptoms sounded like I had a tethered spinal cord. To which I replied – that would make sense if I have AA. Which everything points to me having – at least mildly.

But they are all just ‘theory’ because not enough research has been done. Not enough patients have been studied to really know. Although the more years that go on … the more I realise there is a lot of ‘medicine’ that is about hypotheses and theory. Although then there is the force of science that wants that evidence and proof to back it up.

But I guess that there is a sense in which – I am the evidence. My medical history, scans, test data and response to treatment are all part of ‘the science of my story’. Even if I may be a bit of an anomaly.

Please do comment, reply & let me know if you have any similar experiences – especially if you have both arachnoiditis / AA as well as a spinal CSF leak. Do you find your low pressure / spinal CSF leak symptoms get increasingly more acute when your arachnoiditis is flaring? Do steroids or anti-inflammatories help you too with all your symptoms?

The more we talk and discuss – the stronger our theories can become. So it helps me to hear your stories – as much as your hearing mind hopefully helps you.

  • Content Summary so video can be skimmed through.
  • 0:12 Relapse Intro
  • 1:06 Post flare recap
  • 1:52 WHY DO MY SPINAL CSF LEAK/ LOW PRESSURE SYMPTOMS
  • GET SO MUCH WORSE DURING MY ARACHNOIDITIS RELAPSES?
  • 2:00 Low pressure/ spinal CSF leak symptoms
  • 3:48 Explaining my acute low pressure symptoms during relapse
  • 5:50 Taking 40mg oral prednisolone (steroid)
  • 6:03 My legs are not working properly
  • 6:50 Relapse cause/ triggers: car travel then jolting spine
  • 11:38 Follow up call with Neurologist
  • 13:40 IV Methylprednisolone 1g IV x3 days on GPAU
  • 14:40 Do high dose steroids increase ICP?
  • 16:40 2 week prednisolone taper from 30mg to 5mg every other day normal dose
  • 18:42 Can you relate? Do you get similar symptoms? Please do comment or reply.

Please remember that all videos and articles can be shared with anyone, by anyone, on any platform. As they are all in public realm.

So this is where I say ‘goodbye for now’. I am sorry I don’t update my blogs and videos as much as I used to. But to be honest I often just don’t have the time or energy. I like to do this. I like my story having a wider purpose. But it is also a challenge to achieve amidst even my mildest daily symptoms. So forgive me when I don’t write or make videos for a while. It’s normally because I am just ‘trying to find ways to embrace the life I have.’ And thrive as much as I can within all the restrictions, pain, limitations and debilitation.

But I do want to end by saying…

THANK YOU!

Thank you for listening. Thank you for taking the time to enter into my world for a moment. Thank you for your grace and kindness in bearing with my ponderings, wrestling’s and many questions.

You are appreciated. You are valued. And you are loved.

“When we know we are loved we find it easy to love other people” John Sentamu



Please do make comments or ask questions on YouTube, here, my social media pages or on Facebook group pages and I will try to reply when I can

For the full summary of my medical history including ladder fall in January 2015, spinal CSF leak diagnosis and footage of my January 2021 arachnoiditis flare see this 5 min video:

ARACHNOIDITIS RESOURCES

‘Arachnoiditis – Taming the Most Painful Pain’ Dr Forest Tennant video https://youtu.be/VGuS1iTuhLo and ‘Arachnoiditis No Longer A Rare Disease’ https://www.practicalpainmanagement.com/pain/spine/adhesive-arachnoiditis-no-longer-rare-disease

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

IV STEROID TREATMENT PAPERS: Dr J. Antonio Aldrete also co-authored a comprehensive medical book called ‘ARACHNOIDITIS THE EVIDENCE REVEALED’ with a whole chapter (51) dedicated to the study of using IV Methylprednisolone in the acute stages of Arachnoiditis/ Adhesive Arachnoiditis to prevent further progression and damage. Another medical paper supporting the use of steroids in treating early stage arachnoiditis: Immunotherapies in chronic adhesive arachnoiditis – A case series and literature review https://www.sciencedirect.com/science/article/pii/S2405650221000423?fbclid=IwAR0lAuYagMPknv0pATPQ1dvOt_b0VlIEn6yxJx-DJ9o22EDb45LHJYuH9mg And another case where IV methylprednisolone was successfully used: Idiopathic Arachnoiditis of the Cauda Equina: A Case Report from Tanzania https://www.karger.com/Article/FullText/518379?fbclid=IwAR32EN7tPQD3iKOO9I8bI05ylXvuy-yjLsDyVlmESVJsW63y_j1IqAuFxDo

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.

ARACHNOIDITIS FLARE & IV METHYLPREDNISOLONE TREATMENT – July 2022 Video Diaries

So my body decided this last week – perhaps seeing as it’s ARACHNOIDITIS AWARENESS MONTH 2022 – to completely relapse in typically explosive fashion! The full flare burst in on Tuesday following a slow deterioration after travelling a couple of hours by car to see my specialist Spinal CSF Leak neurologist (who also leads on my Arachnoiditis care) and having a neuro examination last Friday.

The neurological examination included straight leg raises, leg strength tests, reflexes, sensation tests etc.

I wonder if my body was slightly more vulnerable because I had slightly lowered my steroids and LDN over recent weeks. I often take 10mg of prednisolone if I am going on a long car journey – but didn’t this time. I only took 5mg. Then the travelling, neurological examination then the car journey the next day (as we stayed over in a hotel to break up the journey) was the final trigger to the almighty flare.

By the Saturday morning I was already feeling worse and the car journey home harder. And then things slowly deteriorated until the full symptom explosion on Tuesday.

It was so tough to be back there again – in a massive relapse – after a much better and more stable 18 months.

I am extremely grateful for the swift response of my local neurologist who supports me with the help of my CSF leak neurologist. They are the ones who treat me locally with IV methylprednisolone. She responded the same day we reported the relapse and set in motion the previous-agreed treatment plan (3 day course methylprednisolone (steroid) 1g bag a day).

Unfortunately though, the day ward at my local hospital didn’t have any beds until the next Wednesday so we tried A&E Friday after being redirected by them if I needed more urgent care. Thankfully it was unusually quiet at 10:30am and after speedy assessment I was quickly moved to a quiet dark room on GPAU (GP ASSESSMENT UNIT) and after lots of waiting, seeing a medical doctor and neurologist and after various examinations/ blood tests I was finally given the steroids at about 7:45pm that evening. I then went back on the Saturday and Sunday for the full course – which were much quicker. Those IV’s only took about 1 hour.

I am very thankful to both my consultants, and the doctors and medical staff I saw that day, who enabled access to this level of rapid care. It is my quickest treatment and acute symptom reversal to date. What used to take many weeks or months to slowly improve (& often not fully) is now is happening in a week.

Which really is a miracle to me.

I am so pleased to report that the results of the steroid treatment were again were radical, in completely reversing and turning around the flare.

Rapid treatment of flares is the key to stop further damage (nerve clumping and adhesions) and allows me to recover more quickly as I lose less conditioning – so it’s been good to find a new possible treatment pathway IF the day ward is not able to help so quickly.

To raise awareness I have made video and photo diaries from the past week of relapse symptom progression and the impact of the IV steroids (1 gram bag of methylprednisolone x3 over 3 days). My hope is that in time more people can be diagnosed far quicker than the 5 1/2 years it took me and get access to similar treatment whilst the condition is still more able to respond.

There are of course many risks to high dose and long term steroid use especially osteoporosis, adrenal gland issues and many other things. This does mean steroid treatment is not something to be taken lightly. But in my eyes – the risks to my body of further nerve clumping and adhesions in my lumbar spine that could leave me at least partially – if not fully paralysed and in constant intractable pain and thus bed bound – is a MUCH greater risk. To my body, mental health and even an osteoporosis risk in itself if I can’t walk. So the use of steroids must be carefully managed by an experienced medical team – but if they both radically improve the AA symptoms, neuro inflammation damage, quality of life, general health and mental health long term – to me it is worth the risk.

My hope is that in time as Arachnoiditis / Adhesive Arachnoiditis is more recognised, diagnosed and researched that more medications may become available that have less risks long term. This is what has happened with other neuro inflammatory conditions like MS or other inflammatory conditions such as rheumatoid arthritis or crohn’s / colitis. But that is partly because many more people suffer from these conditions and there is much more research and clinical trials done.

The new video is a 25min video in total because it includes video and photo diaries of my whole journey from relapse explosion to post IV recovery. But the information below the video in YouTube has chapter summary’s which allows you to skip through to different parts for ease and speed. And also enables people to go back to particular parts of interest.

https://youtu.be/UV8wHX26XgQ

These are the chapter summaries with timings:

  • 0:22 Day 1 of Arachnoiditis symptom explosion – back, neck, head pain, weak legs, burning feet, low pressure headache, cognitive issues
  • 2:08 Day 2 of symptom explosion – spoke to neurologist who will arrange IV methylprednisolone
  • 3:23 Key symptoms – Tingling, cold, burning feet. Walking getting worse, feet not working properly, trip hazard, neck burning/ stiffness
  • 5:25 Day 3 of relapse – Increasing photophobia, lumbar and neck pain horrendous, pins and needles everywhere, wee makes head worse.
  • 7:09 20mg prednisolone, 50mg diclofenac, 50mg pregabalin & 4.5ml LDN
  • 7:25 Video of me struggling to walk
  • 8:05 Twitching/ jolting/ electric shock sensation – take 2mg diazepam
  • 9:36 Struggling to walk up stairs
  • 10:06 Day 4 of flare – really struggling. Go to A&E and moved to GPAU.
  • 11:52 First dose of 1 gram bag of IV methylprednisolone on GPAU unit at local hospital
  • 12:23 Day 2 of IV steroid treatment including update on recovery morning after first lot
  • 16:20 Photos of receiving second dose of IV steroids
  • 16:39 Stairs walking much improved
  • 16:48 Day 3 of IV steroid treatment including update on recovery morning after 2nd dose
  • 18:58 Final 1 gram bag of methylprednisolone at GPAU unit
  • 19:05 Final update on recovery

My hope in making and sharing these videos is that awareness is raised. That patients, their families & friends, doctors, medical staff and the general public are educated and that more people with arachnoiditis can get diagnosed and treated. Especially before the condition often becomes more untreatable as it progresses.

It took me 5 1/2 years to get diagnosed with Arachnoiditis after my initial ladder fall and spinal CSF leak onset. Because of that I already have permanent damage to my spine/ nervous system. I battle constant pain, spinal fluid flow issues, I cannot comfortably sit down any more. My neurologist still believes I probably also have the small CSF leak shown on my last full protocol spinal CSF leak MRI’s in September 2019. Which probably complicates things further. My whole Intracranial Pressure System is completely dysregulated.

And yet the Arachnoiditis is still mild enough AA that I can still respond radically to steroid treatment of the acute flares. And we can hopefully now stop more rapid progression into more debilitating AA happening soon.

So I also make videos and share my story here to give others hope. Things can improve.

Please don’t give up!

It is such a hard, deeply painful, grief full, life altering journey to go on…

But an arachnoiditis/ AA diagnosis is not the end!

We are all learning together. And in time – maybe if we all can do our bit to raise awareness. To educate. To keep on fighting even when we just want to give up. Then things just might get easier for us and those patients coming behind us in the future.

So that together we can change the outcome for at least one desperate, struggling and broken soul with – or yet to be diagnosed – with arachnoiditis/ AA.

“Those who have a ‘why’ to live, can bear with almost any ‘how.’” 

Viktor E. Frankl, “Man’s Search for Meaning”

“Perseverance is rooted in hope. We persevere when we believe that what awaits us is worth the fight.”

– Sarah Walton

Please do make comments or ask questions on YouTube, here, my social media pages or on Facebook group pages and I will try to reply when I can


For the full summary of my medical history including ladder fall in January 2015, spinal CSF leak diagnosis and footage of my January 2021 arachnoiditis flare see this 5 min video.

ARACHNOIDITIS RESOURCES

‘Arachnoiditis – Taming the Most Painful Pain’ Dr Forest Tennant video https://youtu.be/VGuS1iTuhLo and ‘Arachnoiditis No Longer A Rare Disease’ https://www.practicalpainmanagement.com/pain/spine/adhesive-arachnoiditis-no-longer-rare-disease

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

IV STEROID TREATMENT PAPERS: Dr J. Antonio Aldrete also co-authored a comprehensive medical book called ‘ARACHNOIDITIS THE EVIDENCE REVEALED’ with a whole chapter (51) dedicated to the study of using IV Methylprednisolone in the acute stages of Arachnoiditis/ Adhesive Arachnoiditis to prevent further progression and damage. Another medical paper supporting the use of steroids in treating early stage arachnoiditis: Immunotherapies in chronic adhesive arachnoiditis – A case series and literature review https://www.sciencedirect.com/science/article/pii/S2405650221000423?fbclid=IwAR0lAuYagMPknv0pATPQ1dvOt_b0VlIEn6yxJx-DJ9o22EDb45LHJYuH9mg And another case where IV methylprednisolone was successfully used: Idiopathic Arachnoiditis of the Cauda Equina: A Case Report from Tanzania https://www.karger.com/Article/FullText/518379?fbclid=IwAR32EN7tPQD3iKOO9I8bI05ylXvuy-yjLsDyVlmESVJsW63y_j1IqAuFxDo

ARACHNOIDITIS UPDATE: ONE YEAR SINCE DIAGNOSIS

A few weeks ago I decided to do a new video update on my case to mark my progress a year after I was first diagnosed with arachnoiditis, and six months since my last flare, IV steroid treatment and the start of my making videos about my case. It’s taken me a few weeks to then add to this video with this additional expanded update in writing.

Sometimes I feel like it takes ‘an essay’ to give a more substantial picture of how things are. Videos help that as I can add quite detailed explanations. However, writing can also provide a different avenue which allows further explanation and summary of how things really are.

So to start off with I wanted to share my seven minute video update, then I will expand on what I have said in that with a few more details and explanations. https://youtu.be/Qa2RwmwYTDo

As you will see – it’s very good news for me on so many levels.

Compared to how things were last year and especially around the time of the admission that prompted the diagnosis… things are substantially better in so many ways. My symptoms ‘across the board – in my head, spine & legs’ are substantially better and more controlled. I can do between 9-12 hours upright in one go and then more again after that if I lie down for 1-2 hours to rest. I walk around 7-12km a day over 2-3 long walks. My head is clearer, I do not suffer with as much fatigue or so many debilitating headaches. I have been able to travel for holiday and to visit family in the UK (although this in reality remains very hard). I can do and achieve more ‘normal life activities’ than I probably have been able to do since my accident.

However…

When you are chronically ill there are often no simple answers to explain your current experience of life. Yes I usually ‘look well’ at the moment to most outsiders. But ‘looking well’ masks a hidden reality of constantly managing what I do and can’t do. What position/ posture I can stay in, to try and get the ‘best outcome’ of symptom stability.

My daily living is dictated by constant micro & macro self-management decisions & deliberate plans to help my body utilise its abilities rather than constantly be restricted by its disabilities.

I gave up on ‘normal’ a long time ago.

Since my accident (a ladder fall) in January 2015 I have not had one day I have felt ‘normal’ … like I used to before that day I fell. A time without any neurological issues in my head & spine. I cannot even remember what ‘normal’ feels like to be honest. I watch people sitting down comfortably or relaxing on a recliner chair with their head up and think ‘how do you do that?’ It’s just so uncomfortable for me to sit or recline (unless fully flat on my side). So it’s just not relaxing! I have become used to standing, moving around, walking, being quiet, lying down. I have got somewhat used to the unnerving constant pressure and subsequent ‘dreamy/ foggy’ feeling in my head. The constant stiffness, pain, tension and pulling in my spine.

This is my ‘normal’ which is far from normal… And yet I live A LOT closer to ‘normal’ than I probably ever have done in the past six years. I have found ways and means to bring balance, symptom management & utilise my broken body to the best of its capacity.

And that has been LIBERATING!!

I am doing well for me!

A New Way Of Living

I have found ways of living that generally work with and around my limitations, frustrations and restrictions. It’s often a quieter way of life … a long way from the busy, outgoing, energetic, packed full life I used to live… but full of many things I love and value all the same.

Through accepting my limitations – and not trying to constantly ‘push against them’ I can often find a ‘way to make it work’ … as long as I am realistic about what my body and brain can do.

Understanding Empowers

Understanding and treating the arachnoiditis more has been revolutionary to more physical and mental stability in my life. My body & its many issues are much less of an enigma to me … we have more answers and I have learnt to ‘flow with’ the illness more rather than do things that make things worse.

The Problem With Staying in One Position

For instance… today I am typing this in my iPhone notes… and because I am standing, mainly in one position, with my neck slightly bent & arms raised to hold my phone… the pressure is building in my head, upper neck & lower spine, the pain is increasing behind my eyes, neck & lumbar spine until I start to feel like my head wants to burst, my ears need to pop and sometimes a wave of nausea begins to come. The pins and needles & numbness are also increasing in my legs … so I am feeling that normal ‘arachnoiditis agitation & restlessness’ increasing.

But these days I know the answer to help alleviate these increasing symptoms … it is to walk, to move around. To allow my spinal fluid/ circulation or whatever is hindered to flow again more freely.

Then I can come back to this task later.

I have learnt to accept that my concentration can only remain consistent in one position for so long. But if I learn to do things in shorter bursts – 20mins here – 30 mins there… with breaks to move around and maybe do some simple housework in between…

…then I will get more done.

It works for me because I mix any church admin, preparation or other work or admin in with general housework, standing gardening, cooking, shopping or sorting things to help my body through moving about again at regular intervals.

To some people it might look like anxious or restless behaviour… and I think I could be ‘seen’ like that by others before. But in reality the constant moving about is mainly a biological manifestation to stop the aggravation of increased physical symptoms and pain from staying in one position too long.

Other Symptom Aggravators

I have to manage bending, straining, raising my voice, singing, what I carry, how fast I walk, how long I sit, using the loo, how far I drive or travel as a passenger, fast moving images (even scrolling on my phone or on the computer can make me feel nauseous), loud noise and bright lights etc… all things that exacerbate my symptoms. So need careful management.

Walking is really helpful for my lumbar spine, legs and general fitness but it can at times also flare my head pressure – especially if I walk too fast, try talk a lot when I walk or have to look down because of uneven ground. They can all cause a pressure surge in my head and neck & make the dreamy/ strange equilibrium feelings even more noticeable. However; the benefits of lots of walking greatly outweigh the drawbacks and it has been liberating to be able to do so much more that I could a year a go.

Managing Stress

I also have to carefully manage stressful situations or hurrying about. It takes extremely fine balancing to keep myself calm in difficult circumstances. This is because stress, anxiety, a lot of pressure on me or the need to rush are extremely detrimental to my symptom stability. I believe that this is probably a lot to do with the strain it puts on my intracranial pressure system. My normal biological reactions are very hypersensitive compared with your average person.

Things That Improve My Symptoms

Include: Moving around as much as possible, walking a lot – long distances every day – being quiet when needed, resting lying down in the evening, eating healthily at regular intervals, taking medication, planning my day to include all these things in good balance. Symptom management is all about good planning to provide correct breaks from sitting or staying in one position for too long. And good rest lying down later in the evening.

Often by the evening my lower lumbar/ upper sacral spine pain is pretty awful – especially if I have done a lot of standing, sitting or bending. It feels a bit like someone has ‘grated’ or deeply ‘grazed’ the inside of my spine. Like when your flesh is raw – but deep inside me. Although this does always improve after an hour or so lying down in bed or on the sofa.

Spinal CSF Leak Update

At the moment we do not know for sure whether my spinal CSF leak is there permanently, has fully sealed, comes and goes or possibly remains and acts as a stabiliser to my messed up intracranial pressure system. I say this because I do appear to struggle with higher intracranial pressure issues as well as low ones. Which is again typical of people with arachnoiditis & sacral Tarlov Cysts. So I have sometimes wondered whether – IF the leak is still there – whether it could possibly act like a ‘natural shunt’ that helps maintain my pressure surges. Equally, it could be that the leak isn’t permanent and it heals but can return. It really is hard to know. It was last seen on my September 2019 MRIs and I haven’t had a new full spinal MRIs at my CSF leak specialist hospital since then. However, it is clear that when my arachnoiditis symptoms do flare – when I relapse – that my ‘low pressure syndrome’ symptoms get a lot worse again.

We can only theorise as to why this is. I personally think that my CSF flow becomes impeded by the inflammation and nerve clumping because it improves so radically when I have the IV steroids… and, as my neurologist said, IV steroids will not seal a leak. So we know there has to be something else going on. It could also be that the inflammation causes an increase in intracranial pressure which causes me to leak more. But there are many unknowns. A spinal CSF leak has certainly been a big part of my story and probably the initial catalyst for my ongoing issues … but there is perhaps more to the way the whole CSF system is impeded by the arachnoiditis than we yet fully understand.

In my case, I have decided with my neurologist that it’s too risky to pursue any more investigations regarding the spinal CSF leak. Because these would include CT myelograms, epidural blood/ glue patches or surgeries which have the potential to make the arachnoiditis much worse and move it very quickly into much worse adhesive arachnoiditis. So in my case seeing that my typical low ICP symptoms have improved so radically through the use of IV steroids and my ongoing drugs protocol…. in my NHS neurologist’s words … it makes the issue as to whether I currently actually still have a CSF leak or not somewhat ‘academic’. In the end, when I had a CTM in September 2017 – I badly seizured & then after the subsequent high volume lumbar BEBP a week later I was seriously unwell for weeks to months after it. I wouldn’t want to risk that again without a critical reason.

So it is no longer a risk we are willing to take. In my own case it seems that the arachnoiditis is my bigger current problem. And thankfully when we treat the arachnoiditis EVERYTHING else improves.

Current Medication

My update video gives a summary of my current medication but here it is written down:

  • 5mg prednisolone every other day (after 20mg Omeprazole to protect my stomach)
  • 4.5ml LDN (Low dose Naltrexone via private prescription from Dickinson’s Chemist Glasgow) but with the awareness of my GPs and two NHS neurology teams
  • Iron tablets (Ferrous Sulfate) due to low ferritin levels found after blood tests following hair loss)

Medication sometimes used for symptom flares or for long car journeys/ travelling (as discussed in my video).

  • 50mg pregablin
  • 2/ 2.5mg diazepam

Supplements

Turmeric/ Curcumin, B-12 & B complex, Calcium, Magnesium & Vit D, Omega 3. (Disclaimer – I do not really know which help and which don’t. I simply chose them according to my own research and in relation to the meds I take). It’s my whole medication, supplement and walking protocol that helps. I also try and eat a low carb/ low sugar and high protein (inc some meat), dairy, vegetable & fruit diet.)

Halted medication & supplements due to possibly contribution to hair loss as discussed on my video. My hair loss has much improved since coming off these and taking iron tablets.

  • Diclofenac
  • Pregnenalone (non- prescription supplement)

Arachnoiditis: A relapsing / Remitting illness

As it is very clear if you have followed my story long-term, my illness has always followed a clear relapsing / remitting pattern. This means is that usually around every 4 to 12 months I have an acute relapse of symptoms. This is shown in my case summary video. However, I can then go through months of doing significantly better. This is a normal pattern for people with arachnoiditis and adhesive arachnoiditis.

Since we have learnt to treat these relapses with IV steroids I have found I have recovered from the relapses in comparatively super quick time. In previous years it would take many many very long weeks and months for me to ‘somewhat recover’ from them. My last one (before last summer) was in April 2019 and I never got back to pre-relapse levels until after the diagnosis and treatment in July 2020. Since then I have also been recovering to a much much better level of symptoms stability and a much higher peak in what I can do and achieve than I have probably at any time over the past six years since my accident.

However, this does not mean when the illness is in a season of more remission that I am not unwell.

I am always unwell in one way or another. As I said above … I never feel normal.

I have obvious permanent damage to my lumbar spine (nerve clumping) and to the way my nervous & intercranial pressure systems function. However, what I wanted to demonstrate through these videos is how much better I have been since my diagnosis last summer and new treatment plan.

So for that I remain extremely grateful for all the support I’ve had from both of my NHS neurology teams, other local consultants & my local GP practice. It’s not been easy for them to navigate my illnesses when there is not a lot of up-to-date information on them and they are very unusual (and under diagnosed).

It helps patients immensely when they find doctors who are willing to listen, learn, be open minded and consider new diagnoses regarding their case. Especially when there has been so many unknowns about their constant symptoms over the years.

It is very easy for doctors to start thinking that you have a mainly psychological problem rather than a predominantly physical one when your case is full of unknowns. So to be listened to and believed by doctors AND those around you is one the most healing things to a suffering persons holistic health. One of my greatest underlying fears throughout my journey was to ‘be abandoned by medical professionals’ whilst in my greatest time of distress, pain, symptom severity and need. Mainly due to a lack of knowledge and understanding about my conditions. So to know I am under two great NHS neurology teams is very helpful to me.

I know in some ways I am still at the start of such a very long journey. Despite being 6 1/2 years into it. But over the past year I have felt that new empowerment to face both the past, present and whatever the future may bring in a more holistically healthy & supported way.

None of us knows what tomorrow will bring. But it sure does help when you have an arsenal of ‘medical and holistic weapons’ at your disposal & and a great team of supporters around you – to help you face & navigate the battles the future will inevitably bring.

“… there was no need to be ashamed of tears, for tears bore witness that a man had the greatest of courage, the courage to suffer. Only very few realised that.”

– Viktor Frankl

I pray that I … and you… may continue to have the courage to suffer well & suffer strong. Whatever that may look like long term. The past 6 years have at times been a nightmare to navigate and at my darkest times I was ready to just ‘give up’ on life itself. BUT… I do not feel like that now. So I have said it before and will say again… please never give up because things can change and they really can get better again! And new answers to long term questions can come in very unexpected ways!!



Here is my 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 And another case where IV methlyprednisolone was successfully used: Idiopathic Arachnoiditis of the Cauda Equina: A Case Report from Tanzania

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.

NEW VIDEO DIARIES: ARACHNOIDITIS & SPINAL CSF LEAK RELAPSE/ FLARE

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

– Mother Teresa

At the end of January I had another horrendous relapse / flare of my arachnoiditis/ mild adhesive arachnoiditis & spinal CSF leak symptoms. Although I had experienced some pre-warnings in the weeks before, on Thursday 28th January my symptoms again exploded so acutely that I knew I needed to access another 5 day IV methylprednisolone ASAP, as previously agreed with my more local neurologist if that happened. It unfortunately still took a week to arrange for me to receive it at the local day case unit, especially as I really wanted to avoid going via the ED due to Covid and hospital pressures. It was also the first time of these arrangements being actioned which meant it took a little bit more time.

So as I waited at home as we and my wonderful GP team chased the hospital and my consultant to make arrangements for me ASAP, my husband and I made the decision to film what happens to me when I flare / relapse, and how I responded to treatment – as an open education and awareness project for other patients and their family and friends, as well as any doctors who may be open to listen and learn more about arachnoiditis and spinal CSF leaks.

We mainly decided to do this because when doctors, patients and the general public do not understand these conditions it causes us sufferers so many many problems in being ‘heard’ and accessing treatment. Also – as anyone can see from the videos when I am in a flare – things deteriorate dramatically in a week. Arachnoiditis/ AA flares should be treated as a MEDICAL EMERGENCY if doctors want to stop more permeant adhesions from forming – which could ultimately lead to paralysis, partial paralysis, incontinence and irretractable pain syndrome.

So I cannot stay silent!!

Without my IV steroid treatment, steroid taper and ongoing every other day 5mg prednisolone (steroid) and 75mg diclofenac (anti-inflammatory) & 4.5ml LDN (low dose Naltrexone via private prescription), I have no doubt the adhesive arachnoiditis would have moved into more severe categories over the last two flares.

It thus felt time to branch out into videos to complement my writing in this blog.

So I have a YouTube channel now packed full of educational videos showing my flare, talking about symptoms and how I have done in recovery since. I will keep updating my channel to talk about my progress or new things I am learning about that are relevant to the condition.

Here are some of the relevant videos and links:

This is my case summary video that was reviewed by a NHS Consultant friend before I posted it. I wanted to create a short summary of my whole medical journey that would also be of interest to doctors to and could be used as a presentation in their educational meetings and lectures if relevant.

Here are a few other videos from each section and a link to each ‘playlist’. All the individual videos can be found on my YouTube channel.

I will now add one or two key videos from each list here:

ARACHNOIDITIS FLARE DAY 2 SYMPTOM EXPLOSION
ARACHNOIDITIS FLARE DAY 6 WHOLE BODY HORRIFIC PAIN EXPLOSION
IV STEROIDS DAY 1 AT HOSPITAL DAY CASE UNIT
IV STEROIDS DAY 4 AT HOSPITAL DAY CASE UNIT
FINAL DAY (5) OF IV STEROIDS. IN THIS VIDEO I ALSO DISCUSS MY ISSUES WITH SITTING DOWN AND HOW I DO SIT. I ALSO TALK ABOUT HOW GOING FOR A WEE MAKES MY HEAD WORSE.
STEROID TAPER DAY 1 & STORY OF 2017 FLARE & SEIZURE FROM CT MYELOGRAM & FLARE FROM 40ML EBP
DAY 10 OF STEROID & ANTI-INFLAMMATORY TAPER PLUS INFO ABOUT RESIDUAL SYMPTOMS AND MILD SCOLIOSIS
DAY 12 OF STEROID & ANTI-INFLAMMATORY TAPER PLUS INFO ABOUT PAST RELEVANT RADIOLOGICAL FINDINGS OF TARLOV, SPINAL/ BRAIN CYSTS, BONE SPURS & OTHER GENETIC NEUROLOGICAL ABNORMALITIES INCLUDING POSSIBLE MARFAN SYNDROME.
DAY 3 OF NORMAL ALTERNATE DAY STEROID & ANTI-INFLAMMATORY PROTOCOL. (5mg Prednisolone & 75mg diclofenac). THIS VIDEO ALSO INCLUDES INFORMATION ABOUT MY APPROACH TO ANTI-INFLAMMATORY AND COLLEGEN BUILDING DIET & NUTRITION.
Year update added in July 2021

That should be enough videos to give someone more of an introduction to my new educational and awareness project. I have learnt a lot over the past six years about my two radiologically confirmed diagnoses, even though I only knew I had had arachnoiditis all along too since July 2020. (It can now be seen on my original 2015 MRI’s 3 months after my accident and before any of my spinal procedures. I also experienced symptoms of arachnoiditis as soon as my symptoms came on after my ladder fall in January 2015).

PLEASE NOTE: ALL MY VIDEOS & WRITING ARE FULLY IN THE PUBLIC REALM AND CAN BE SHARED IN ANY CONTEXT OR PLATFORM WITH MY FULL PERMISSION. MY ONLY DESIRE IS THAT PEOPLE LEARN FROM MY CASE SO THAT OTHERS DO NOT HAVE TO SUFFER SO VERY MUCH FOR 6 YEARS TO GET RADIOLOGICALLY CONFIRMED DIAGNOSIS. SO PLEASE DO SHARE THEM WIDELY!

Thank you to everyone for all your support in this new educational project. I had 1000 views of my main case summary video in one week and I know many doctor contacts saw and shared it. If any doctors do want to know more they should feel free to get in contact with me and I can share more about the hospitals, teams, GPs and consultants I am under – IF they want to find out more because this would help their patients to get treated more quickly.

I now have two written radiologically confirmed diagnosis of arachnoiditis from two senior NHS neurologists at two Midlands NHS hospitals. I continue my medical journey under both their care.

Email me at: beckyhillblog@outlook.com

If my journey changes the outcome for just ONE patient then it is worth it all. So if you are that patient today – I do this for you and pray that the information I share may make your journey a little easier than mine.

“Let me be filled with kindness, and compassion for the one
For humanity. Increase my love”

– ‘For the One’ Bethel Music

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 . And another case where IV methlyprednisolone was successfully used: Idiopathic Arachnoiditis of the Cauda Equina: A Case Report from Tanzania

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.

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

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

Desmond Tutu

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

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

Charles Dickens

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

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

Hope, hope to the last.

Six Years of struggle

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

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

Summary of My Ongoing Progress

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

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

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

Combination of Medications that Help

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

Intracranial Pressure Headache Improvement

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

Much Less Debilitated

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

Summary of Recent Improvements

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

The Freedom Found in a New Perspective

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

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

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

Radiological Evidence of Arachnoiditis

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

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

Clinical Rather than Radiological Diagnosis

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

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

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

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

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

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

ONGOING SYMPTOMS

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

CHRONIC NEURO PAIN IN MY SPINE & HEAD

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

PINS & NEEDLES

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

I HAVE TO KEEP MOVING: ‘RESTLESSNESS’

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

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

CSF FLOW & PRESSURE ISSUES

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

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

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

STRUGGLES WITH SITTING DOWN

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

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

ONGOING PHONOPHOBIA & PHOTOPHOBIA

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

TALKING WHILST WALKING

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

SINGING

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

GOING TO THE LOO

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

MOVING FORWARD INTO A DIFFERENT SEASON

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

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

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

Suffer Strong – Katherine & Jay Wolf

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


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

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

… to carry me through.

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

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

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

“Hope, hope to the last.”

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

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

– Martin Luther King, Jr
A long walk at Bradgate Park, Leicestershire over the Christmas holidays. It’s the first time in 5 years I have managed to travel over there and go for a long walk with my family. It marks another new achievement since being on the new treatment protocol.

Here is my new summary video of my whole medical journey as well as footage of my January/ February 2021 adhesive arachnoiditis relapse/ flare and treatment with IV Steroids. To see my daily video diaries from this time please see my YouTube channel: https://www.youtube.com/channel/UC9ZkCy9B_IpeaGrXd0CEgow

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

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

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

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

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

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.

Enduring the Pain of a Chronic Spinal CSF Leak

“Try to understand others. If you understand each other you will be kind to each other.”

John Steinbeck

Trying to understand others is a big motivating force in my life. I have learnt from experience over the years that the more we can TRY to understand others – and they TRY to understand us – the kinder we will be to one another. Ignorance about others’ lives and what they have had to deal with in the past, or what they currently face now, is often one of the reasons we misunderstand and judge others behaviour and words. Listening and more understanding, on the other hand, is often the key to treating people with more love, grace & compassion in every way.

This is one of the reasons I have tried to tell my own story over the past five years as honestly as I can. To help me to understand and process my own journey. To also help others to understand me. But probably most importantly to try and help others suffering to not feel so alone and misunderstood.

I want to use my writing abilities to be a public voice and advocate for the suffering and oppressed – to help them express and understand the inexpressible within themselves and to help those around them to also understand. Whilst also providing a window to those in the medical profession to help them understand spinal CSF leak patients better.

“Speak up for those who cannot speak for themselves; ensure justice for those being crushed.”‭‭

Proverbs‬ ‭31:8‬ ‭

Many doctors have no idea how much damage they can physically and mentally do to their spinal CSF leak patients due to their own misunderstandings and ignorance of the condition. As I wrote about in Dear Doctor, A Letter from your Naked Patient.

My Background Story

In January 2015 I fell off a small step ladder whilst painting and hit my head and spine hard. Although a little dazed and bruised at the time, I generally felt OK. But over the next 48 hours I started to feel more and more unwell until I was left predominately stuck in bed in a dark room (to read more about that see my original Living with a Spinal CSF Leak post or Surviving the Storm post). At first I was diagnosed with a concussion, then post-concussion syndrome. But finally after admission to hospital 8 weeks later with things not improving and in some ways worse (on my third trip to the ED) – I was diagnosed with a spinal CSF leak.

Although my cranial and spinal MRIs were deemed normal at the time, I was diagnosed after 2 weeks of observation on a NHS city hospital neurology ward where it was obvious I only ever felt well lying completely flat. I also had a diagnostic lumbar puncture which was low (7). (Although I would never recommend using LPs to diagnose because of the high risk of a new leak and the fact that about 60% of leak patients will not show low pressure anyway*). I also then had 5 much better months directly following a blind lumbar 30ml epidural blood patch before fully relapsing again that September.

I have now had 4 blind epidural blood patches – all gave me obvious consistent relief for weeks to months. Although never fully and always transient. I have also had countless MRIs, a cisternogram and a CT Myelogram. Although it is only recently that my UK CSF leak team have flagged seeing a suspected leak on my spinal MRIs.

High & Low Pressure Fluctuations

Over the past 5 years I have experienced months of being almost constantly flat in bed and months of being upright all day (following epidural blood patches). But never symptom free and always struggling with hypersensitive reactions to normal pressure changes in my skull. At times after blood patches my symptoms have also typically seemed to shift into a more high pressure pattern of getting worse lying down and better upright. Although those times were also very confusing – as they often are for many spinal CSF leak patients who experience hypersensitive pressure fluctuations. Which can be even more heightened after treatment/ healing.

I have discussed this with a number of people over the years. There is an online support group for patients experiencing symptoms consistent with Rebound High Pressure symptoms and treated for such symptoms.

My friend Lisa’s experience of pressure fluctuations and rebounding from low to high pressure following spinal CSF leak self healing is documented here. (Also found at Series 2 Episode 6 here: www.nationalmigrainecentre.org.uk/migraine-and-headaches/heads-up-podcast/)

Micro-Managing ICP Equilibrium

We were actually recently discussing over Twitter how spinal CSF leak patients both before and after treatment/ healing become experts in ‘micro-managing their ICP (skull pressure) equilibrium’. Bending, carrying, lifting, stretching, straining, going to the loo, shouting, singing, twisting, exertion, opening stiff jars, lifting a full kettle, travelling on bumpy roads, stress & anxiety etc etc all tend to send pressure bursts/ waves into our head. Which when we are leaking, just seem to also make us leak more until it builds and we can no longer maintain a manageable pressure equilibrium in our skulls.

So to manage the condition, I have to ‘micro-manage’ my ICP. For me this means avoiding many of the things I mention above as much as possible or plan them before I lie down to rest. I also ask my family to lift/ carry/ bend for me as much as possible. I use a ‘litter picker’ stick to pick things up off the ground. I often try to delay using the loo until before I know I can lie down where possible. I also stand up most of the time I am upright because sitting makes me worse far quicker for some reason. (Perhaps due to the location of the leak and the stretching of the dura from sitting down.) Keeping my spine completely straight is my key to more upright time. And reducing the ‘pressure busts/ waves’ in my skull which build up to make me progressively worse until I cannot tolerate the symptoms any more.

How it Feels To Have a Spinal CSF leak.

Please note these symptoms are there every day without fail. This pattern is consistent each and every day.

The best way to explain it, is like an ever-increasing overwhelming dull pressure/ intensity in the head. As it gets worse (over minutes to hours depending on how acute the leak is), you feel more and more detached from the world around you. That feels a bit like being drunk/ or using ‘gas and air’ – but accompanied by a heavy, pressure pain. The pressure is in the whole head but I feel it particularly in the occipital area, in my neck and behind my eyes. At its worst it is accompanied by a ‘pulling sensation’ which leaves you feeling like your head is being pulled into your neck. Or that your neck isn’t strong enough to hold your head up. Also many of the nerves around that area hurt more and more.

It just builds and builds until your brain starts shutting down. You can no longer think straight, process well, everything feels impossible, you become disoriented and confused and you can feel very very nauseous and I sometimes even want to gag. Although never actually vomit like some people do.

I also get pain in the bottom of my spine which gets increasingly worse. So I have described to others that it often feels like I have a metal rod going through my spine with a clamp at the bottom of my skull/ top of my neck. And one at the bottom of my spine. The sensation is then like someone is tightening the clamps either end so that my spine is being tightened, shortened and my skull is being pulled into my neck.

I imagine that it’s simply the sensation of your brain ‘sinking/ slumping’ into your skull because of the intracranial hypotension. Caused by the lack of spinal fluid to keep your brain in its cushioned, buoyant place. I think then this causes me to feel tension throughout my spine hence the clamp feeling.

The overriding feeling is…

‘I CANNOT COPE.’

I cannot cope…. with this intensity in my head.

I cannot cope …. with this level of pain & trauma.

I cannot cope …. with thinking and making decisions.

I cannot cope… with attempting to formulate words to explain what is happening.

I cannot cope …. with attempting to function whilst my body and brain feels like it is shutting down.

I cannot cope …. with this impossible illness.

My husband says I become vacant, distant and increasingly slow to respond as it becomes obvious that I am in a bad way.

Those feelings just increase until you feel like…

I CANNOT COPE WITH ANYTHING!!!
I MUST LIE DOWN & REST!!!!

You then think about the best quiet place that you can lie down flat in that moment….

Like a drug addict needing their fix….

…. Or a person in perpetual excruciating pain needing a morphine injection.

It’s obsessive.

My ‘morphine’ or ‘drug of choice’ is to lie down.

Morphine itself doesn’t work nor do any other pain killers. ONLY lying down/ resting works. Hence the debilitation.

The Impact of Lying down To Rest

As I lie down flat I feel a wave of relief as, almost instantly, things get easier. It can take anything from seconds to minutes to begin to feel the easing of symptoms. Although if things have got too bad because I have pushed myself too long, gone out for a longer walk or if I have just been on a longer car journey, it can take up to an hour-plus for my symptoms to fully calm to more manageable levels – where I feel more fully relaxed again from the extreme tension and trauma in my brain and body.

But as it does ease, it’s like your head slowly begins to clear. The intensity gradually eases. The ‘clamps’ loosen. The pain begins to dissipate. The brain fog and confusion gets better.

I can finally think and talk more clearly again.

I feel more normal again … although never fully normal. Never how my head used to feel before the accident.

At my worst times – when I was probably leaking most acutely – after being upright too long (sometimes a matter of minutes) I would not even be able to walk or talk properly. My speech would become slurred and incomprehensible. My legs would turn to jelly and I would struggle to walk without holding onto things to pull myself back to bed. And everything would feel like a dream.

My brain would just begin to completely shut down.

Until I would HAVE to lie down, as if being saved from drowning in pain, trauma & confusion… and after 5-10 minutes of lying flat I could think and talk more normally again.

Countless doctors and nurses in hospital over my various stays observed this which helped confirm the diagnosis at that time.

Those were more my classic spinal CSF leak symptoms. My problems with doctors came when those times were extended to hours or even most of the day of being upright. Especially after epidural blood patches. That is when many spinal CSF leak patients fall through the ‘text book diagnosis’ cracks. Into the ‘chronic migraines’ or ‘NDPH’ (New daily persistent headache) or chronic fatigue boxes.

And yet I know hundreds of patients in the UK/ world wide who can be upright most, or even all of the day, with spinal CSF leaks still evidenced on their scans or found in exploratory surgery – proving that it is possible, and actually more common than once thought (as any up-to-date research on the subject will tell you). Some patients with all the symptoms but no scan evidence turn out in exploratory surgery to have a thin membrane covering the leak which stops them fully healing but provides enough covering to not show on scans and give them more upright time. Some of these patients started off leaking through a simple lumbar puncture, but were previously told by doctors that they definitely could not be leaking still, and suggestions made that they ‘spend too much time on Google’ or it is simply ‘all in their head.’ Which regularly pushes very unwell patients into deep despair.

This is part of what makes this condition very difficult to endure.

The fact is that lying down not only helps much of the intense, traumatic pain. But it also helps my focus and ability to concentrate so much. This means that I often opt to lie down to write messages or emails to people, or talk on the phone for extended periods – simply because I can ‘think straight’ lying down – much better than I can upright. Especially if I have been upright for a while.

I normally write most of these blog posts lying down too.

Current Symptoms

I currently find I have about 1-4 hours upright AT A TIME. Generally more first thing in the morning and if I am well rested. Before things get too unmanageable and I have to lie down again for 1-2 hours to recover. I am then up for a while then down again throughout the day. I have also learnt to generally try and pre-empt when I really need to ‘get flat again’ so it doesn’t get too bad. Otherwise I can’t cope and it takes me longer to recover. Some days – like today – I am more up and down like a yo-yo for shorter time’s to try and avoid longer periods flat and do more writing or things on my phone lying down.

This has actually all been much easier for me in COVID-19 ‘lockdown’ because being at home all day means I can plan my lying down breaks much more easily. It’s extended periods upright outside of the house which are hardest for me.

However, as much as lying down is my ‘painkiller’ of choice. I must tell you that it doesn’t always ‘make all the pain go away’.

We Do Get Pain Lying Down Too

I live with a constant underlying dull head pressure and pain to varying degrees. Since my accident I have never had a fully clear head without any pressure, fogginess or pain at all.

Not one day, not even for one hour.

I imagine that everything is so messed up, inflamed and damaged in my head and spine these days and with my ICP equilibrium. That the pain and feelings of pressure (to differing levels) never really fully leaves. And often if I ‘over do it’ either upright or trying to do too much lying down. (A lot of typing, reading or talking). I can get a different type of headache on top of my normal one. A very painful more frontal headache, combined with a feeling of pressure and nausea. That can really stop me in my tracks for a bit. I actually feel it a bit now as I write this on my iphone whilst lying flat. I imagine it’s partly the exertion of holding my phone, and typing a lot on it. Whilst also concentrating to write. Sometimes normal painkillers can help this additional headache a bit but not always.

That kind of headache makes me feel very sleepy and I yawn a lot to try and release the pressure. If I then get up I often feel my ears popping as if my pressure is trying to equalise again. I still obviously have a lot of problems regulating my skull pressure.

I must also add here that I can also get those ‘pressure bursts’ I mention about being upright – lying down too. If I stretch, move or turn over too quickly, speak too loudly or even ‘pass wind’ (funnily enough – that’s how sensitive my head is!!!) I get a tangible wave of dull pressure and pain into my head. That can also make me feel rather light headed for a few minutes. But it normally eases again lying down if I am still and quiet for a bit – but not always.

The Vicious Cycle of Stress and ICP Regulation

Stress is also a MAJOR problem for spinal CSF leak patients. Due to the natural increases in ICP stress and anxiety brings – it is one of our worst enemies. Which is a major problem when our symptoms and the resulting debilitation are SO stressful, and at times traumatic, to deal with. I fully believe that the 2-3 major mental health crisis’ I have experienced were in seasons of major stress caused by the trauma and exhaustion of dealing with the illness and trying to get medical help long term. As well as experiencing relapses and pressure swings post treatment.

That is when I go from manageable head pain (if I have consistent lying flat breaks). To unmanageable, perpetual, excruciating, persistent head pain.

Upright AND lying down.

It is the EXTRA PAIN (on top of the normal more positional spinal CSF leak symptoms) that pushes me ‘over the edge’. And that level of pain feels impossible to deal with. That is what happened when I fully relapsed last year and later wrote this article as a window into the torturous suicidal mind.

At that point I had relapsed again and was desperately unwell physically AND mentally. I saw my neurologist in May 2019 and we were rather confused as to whether my symptoms could be high or low pressure related. Due to some features that looked more like high pressure linked to terrible symptoms on a recent flight to Italy on holiday and previously head pressure and pain lying down and in the night/ early morning. Although after an ‘acetazolomide trial’ (a drug used to reduce ICP) made my symptoms doubly worse until I could hardly move, walk or talk upright at all. It became clearer that it was probably another low pressure relapse. And after a few weeks following the full relapse my symptoms fell into a clearer low pressure pattern anyway of symptoms being greatly reduced lying down. (Especially once my sleep was restored & extra Neuro pain helped by medication from the GP – Mirtazapine, Zopiclone & Nortriptiline which was approved my my neurologist.)

These confusions about pressure are very very common as there are so many symptom overlaps between high and low pressure and their differences are often not clear cut. ** They can also have paradoxical symptoms which can confuse many. I know people with low pressure sounding symptoms that turned out to have IIH. It is also possible to have high ICP/ OP readings from intracranial monitoring or LP AND a spinal CSF leak. (I know of many people who have had normal or high pressure readings (one with an OP of 45 and I have heard with someone with over 50) WITH an evidenced spinal CSF leak. So it’s never a simple process to know what is going on.)

Also Rebound Intracranial Hypertension symptoms following treatment – although increasingly documented are often sneered at or laughed at by most neurologists. I was onced asked by a neurology consultant secretary after none of the neurologists in the office had heard of it… “did you see it on google Mrs Hill?” in a sarcastic tone. It’s this kind of experience that just leaves you feeling stupid about the complexity and debilitation of your symptoms. I replied, “Yes you can find it on google – can I send all the links so someone can actually consider it.”

Holistic Calmness to Manage Symptoms

So, regarding all this, and as I have previously written about – holistic calmness is often the key to managing a chronic spinal CSF leak. But calmness is not easy to come by when you deal with the stress of everything I have described above. Calmness for me has to go so much deeper than for the average person to try to maintain enough balance to keep my symptoms under control.

I tried to explain this once to a friend of mine who is also a doctor. My ‘normal ups and downs’ are so exaggerated by this condition that I imagine what to ‘normal people’s’ body and mind might feel like small changes in equilibrium – to me is felt so much more acutely. Hence some doctors will perhaps purely attach such issues to a patients lack of mental and emotional stability, rather than recognising the underlying physical medical problem creating these ‘mental and emotional’ swings and issues.

Mental Health & CSF Leaks

As I have explained again and again to both patients and doctors – You cannot separate the physical and psychological in any medical condition… But especially in this condition. I like to call the combination of the physical and mental in spinal CSF leak patients and during recovery as ‘a big ball of mess!!’ Where it is impossible to know where the physical ends and psychological begins.

You just cannot separate them.

Especially due to the way this condition effects our ICP (head/ skull pressure) and how that then both responds to stress & triggers stress.

When I say: ‘I CAN’T COPE!’ It’s not normally because I cannot cope in my mental health – per se. It’s mainly that I cannot function physically in that moment so then cannot cope any more mentally with the physical trauma of those symptoms either.

Once I lie down for a bit “I CAN COPE” much more.

But anyone will tell you when you are in a lot of pain or feel really really ill physically – you also struggle to cope mentally too. So the more I try and push my body to do what it struggles to do physically, the more pressure that puts on me mentally and emotionally. Causing this vicious circle where the physical and mental simply feed off one another and you can end up in dangerous places psychologically too. This is why many spinal CSF leak patients can have both underlying depression & anxiety AND be prone to major mental heath crisis’ when their body and mind pack in after trying to ‘push through’ for too long. I believe we are massively more at risk of complete physical and mental breakdowns than the normal population.

I never had any mental health issues at all before my accident. All my problems have always been directly linked to my medical condition – as confirmed by both psychiatrists and the counsellor I have seen since.

Why I Share My Story Publicly

So there is more of my current story of battling a spinal fluid leak (and at times more recovery) for 5 1/2 years. This condition is still so often so unrecognised, under-diagnosed and so misunderstood that it causes many patients untold amounts of extra pain and distress.

This is seen again and again and again when you hear the hundreds of stories in the private Facebook UK and International Spinal CSF leaks and recovery support groups. Most patients have a MAJOR battle to be heard and it causes them untold trauma physically & mentally that can effect them well into the future. Even if they can and do more fully recover in the end.

That is one of the reasons I continue to share my story. To be a voice for others struggling – as much as for myself. To try to reach some who are suffering so deeply and feeling so alone and misunderstood. And to help their family, friends and maybe even their doctors understand this condition better.

Case Update

In my own case – I am still working with my UK NHS specialist neurologist and his intracranial pressure team to try and find a way forward to help me. At the moment this includes considering Digital Subtraction or Dynamic CT Myelograms to try and locate the actual leak site (which is often very complex and hindered by the fact that my last CTM caused me to seizure) or trying a fifth blind epidural blood patch as these have helped a lot in the past.

Although the current pandemic had delayed all that somewhat. And our NHS – although wonderfully free at point of access – is also often very very slow. Particularly for patients needing multiple scans and procedures to help them with long term conditions such and this.

So mostly I have had to learn how to live with this awful condition and find the best life I can within all of the pain and restrictions. And this is where I am immensely thankful that with the help of my amazing husband, family, church family, many friends and the spiritual support from my faith. As well as some wonderfully supportive doctors I have discovered on my journey. I have found a way to live and enjoy life – amidst all of its pain. With God’s help I have found purpose, meaning and hope even amidst so much personal destruction.

So I want to encourage all those reading this today. That even if your life will never return to what it once was. There is still more beauty, joy and meaning to be discovered here and now. It will take a lot of grieving, support and wrestling through the journey. But to find more meaning within it perhaps you could reach out to support someone else, help educate others about CSF leaks, volunteer for one of the CSF Leak charities or find new creative ways to use your skills & expertise to make a difference in our world.

Your Life May Never Look Like How You Once Imagined It

But maybe rather than giving up hope we need to re-imagine a life that IS worth living. Through grieving the losses deeply – accepting our new reality – but then by finding a new way of living. Here and now. As many others have had to do before us.

My story is a testimony that it is possible to rediscover a new way of living even when you are not yet well. A spinal CSF leak is not the end of everything.

It may be the death of the life you were living, or imagined you would be living.

But sometimes it is also the beginning of some new things discovered that can be even more beautiful than what you knew before.

“Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.”

Dale Carnegie


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

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.

This post is a continuation of my Living With a Spinal CSF Leak post that I wrote 3 years ago. To read more about my spinal csf leak journey then please see the Spinal CSF leak tab in the top menu.

*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 over 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 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. 

Finding Peace in the COVID-19 Storm

It feels stormy out there right?

Everything is so strange. In one moment our whole world has changed. A surreal season which we are struggling to understand. To catch up with or comprehend.

And as time goes on…

We all know people deeply affected by this world-wide tragedy. Those who got sick and recovered. Those who never did recover and so sadly lost their lives. NHS & care staff working on the frontlines dealing with new levels of stress, pressure and anxiety that those of us stuck at home can hardly fathom. Our day to day lives so completely transformed.

Will we ever return to the normality which was once known?

Can we truly find peace in this uncontrollable storm?

Our chaotic unpredictable universe is reminding us of how out of control our lives often seem. We have again recently all had to face our own mortality and brutally realise how fragile we truly are.

Is anything certain any more? What does the future hold for any of us?

It feels stormy out there for so many. But it also often feels stormy in here too – right? Within us, in our chaotic minds. In our homes, families, relationships and lives.

Chaos is not at its worst outside of us. It’s actually most dangerous when it takes over within us.

How can we find stillness in chaos? Is it even possible without escaping from, or numbing away, our anxious thoughts? Or in trying to escape or distract ourselves from the reality of the current major struggle in our world?

These are important questions. Ones that I have had to dig so much deeper into and wrestle with a lot over the past five years since I fell off a ladder in January 2015 and sustained a debilitating brain/ spinal injury that I still have today.

In that one moment my life suddenly rocketed out of my control. One day I shifted onto a new life path I was never meant to take. A place I had not planned for or envisioned to live or endure.

These current restrictions due to the Coronavirus lockdown are actually not so strange for me, because the past five years have kept me predominately at home anyway. And for many hours a day lying down to control debilitating brain and spinal pain and other symptoms which means I still spend an awful lot of time in bed or on the sofa.

So many times my life felt devastated, as the restrictions and debilitation overwhelmed me. I watched so many around me continue on with their ‘normal’ lives whilst mine remained somewhat ‘on hold’ and out of control.

…. until ‘one day’ I would hopefully get fully well.

Then things could return to ‘normal’ I could again shift back onto the path I should be on.

But I never did get well…
I never got to take back control…
My old ‘normality’ never came…

So I have had to learn how to live here. To find a haven of peace even when the storm rages. To let go of my need to try and take control of my, or others, destinies. To climb out of the box of ‘normal living’ to embrace new spaces found in the ‘abnormal’ reality here.

It’s not an easy journey.

I know that so well.

It’s painful! It’s full of grief.

But it’s full of wonder and profound new discoveries too.

The letting go of control.
Of embracing a new way of living.
Allowing old dreams to fade.
So that new ones can arise.

I have had to adapt, I have had to change so much so as to find a new way of life that can be lived in this place. To discover new hopes and dreams within all of the restrictions. Rather than constantly grieving the life I hoped to be living right now.

I have had to dig deeper. To find peace and stillness – even when life doesn’t look like how I imagined it before.

Through all of my wrestlings I have discovered a deeper peace that I know is always there to be found. If I will continue to ‘let go of the old’ and ‘embrace the new’. Settling in my heart that change must come and that life can still be lived in the midst of all the restrictions and pain.

I must look for the firm foundation amidst all of this shifting sand.

Where is this unchanging peace found?

In my experience there is only ONE true and reliable avenue to discovering lasting peace. A peace that is described and experienced as ‘passing all understanding’. It’s unfathomable because it is not based on your circumstances going well. It’s not reliant on a peaceful place being found. It’s not even discovered only when everything is quiet & still.

Because for me… true peace is not the ABSENCE of something. It’s not a place where there is no longer struggle, pain or discomfort. Instead my experience of peace is the PRESENCE of something far more beautiful.

To be exact – my peace is the PRESENCE of SOMEONE!

A person who is always there and will never leave me, because He forever lives with me. He constantly dwells within me. He is all around me and will never forsake me.

My peace is a person… yet He is also a supernatural force.

My peace is so gentle … and yet He is also known to roar.

My peace is abundantly loving… and yet He challenges me each day.

My peace upholds me… even when I can no longer feel Him there.

My peace is Jesus Christ.

The tangible stillness that guides my life’s ship through the storm.

A place where He is fully in control even when everything within me feels like a storm.

An indescribable presence, so still, so restful, so easy. Where the heavy burdens I have been carrying are lifted. And His gentle yoke of unconditional love and undeserved grace is left in its place.

He is the ONE who has won my heart with the beauty of His unending Love.

He is my ultimate calm.

So many people misunderstand my Saviour. But it doesn’t mean that He is not there. He is always standing patiently, glimmering in the shadows of our lives. Knocking at the door of our hearts. Willing us to let Him in. Desiring us to allow His Light to radiate into our dark places and shine through our broken pieces into our hurting world.

So that we can experience the supernatural power of His peaceful presence. An unimaginable Love that takes you over as He enters in. Awakening you by the grace that He plants within.

In His peaceful presence there is a realignment of His Spirit and your soul. You find that you become restored back to who you were always meant to be. You discover the purpose for which you were created. You finally discover what it really means to truly be ‘me’.

In His presence the striving will cease as His supernatural rest takes over as He does His own work in you. His peace descends as you cease resisting who He made you and who you were designed to be.

I wonder – do you know that peace yet? Have you experienced its stillness?

Do you feel it now?

I feel that peace. The deep calm of knowing Him and Him fully knowing me. It emanates through and from His Spirit who came to live within me the moment I fully surrendered. The time that I was born again into His family. The occasion that I was made fully new.

He is my peace.
My love, my life, my all.

Do you desire to feel deep peace today? Has anxiety taken you over and you long for even just a taste of peace again? For normality to be restored? To discover the joys of how life used to be. To go away somewhere, to retreat back to your favourite places of beauty & joy. To return to a life that was more ordered and controlled, when your plans were not put on indefinite hold.

Well He is here for you – if you will call out His name.

His name is Jesus.

Call to Him today.

He is always waiting, always willing and always longing for your call.

Jesus said, “”I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.””

– John‬ ‭16:33‬ The Bible ‭‬

We will have trouble in this life. Our broken world is full of it. If we can avoid it today – it will somehow reach us tomorrow. But Jesus transcends the trouble in our world. And with your permission that presence of peace can enter into your own personal chaos.

You simply have to…
Let go.
Surrender,
And dare to let Him in.

You cannot earn peace. You cannot muster up enough positivity to win it as your reward. You can only surrender to Him and allow Him to do His deep work within you. Until peace begins to take control of all that you say and do.

I assure you – once you start to taste and experience the glorious fruit of His peaceful presence, you will be ruined for anything else.

Because peace is not a place. It is not an absence. It is not even an escape.

Peace is a person.

Peace is a presence.

His name is Jesus.

And you can experience Him now.

IF you will surrender and let Him in!

“Deep peace of the running wave to you.
Deep peace of the flowing air to you.
Deep peace of the quiet earth to you.
Deep peace of the shining stars to you.
Deep peace of the gentle night to you.
Moon and stars pour their healing light on you.
Deep peace of Christ,
of Christ the Light of the world to you.
Deep peace of Christ to you.”

– A Gaelic Blessing

Five Years Ago: A Poetic Reflection of my Spinal CSF Leak Journey

Five Years ago this week…

I fell from a small step ladder.
Five years ago this week – my life took a dramatically different turn.
Five years ago this week – I got sick and have never fully recovered.

Five whole years…

Of enduring
Of fighting
Of grieving
Of accepting

But also five whole years…

Of learning
Of growing
Of loving
Of living

One fall. One injury.

Changed so much.

My girls were just 7 & 10 the day I fell.
They were there watching me paint.
They saw it all happen.

The fall.

The getting up again.
The dusting myself down.
The continuing to paint.

The next 48 hours where their mum got more and more ill.
The constant medical, GP, A&E visits, followed by multiple hospital stays.
Seasons of me being stuck lying down flat for months on end.
Followed by the seasons (post epidural blood patches) of being upright all, or most of, the day.

They have seen it all!

The turmoil and struggle.
The wrestlings and pain.
Their mum so different.
Our lives forever changed.


Never to return to who she once was.

Lives dictated by multiple restrictions.
The never ending storm of tragic depictions.
We have had to learn how to ‘live here’ to ‘find life’ amidst all the challenges.
To find a way to live in, and through, the never-ending seasons of chaotic pain.

Sometimes life doesn’t look like we imagined it to…

We always believed I would get well!

In days…then weeks…then months…then years…

Surely I would get well again?
Surely I wasn’t such a bad case?
Surely ‘normality’ could and would be restored?
Surely the longed-for redemption would come?
Surely this, or that, treatment would work?
Surely time would bring the full healing that I need?

But ‘normality’ never came.
It remained elusive.
At times tantalisingly near.
But always on shifting horizons.
Never to fully appear.

The start of last year was another journey towards that goal.
Following a year of healing with a good trajectory. Feeling better, things improving.

Until that haunting plateau returned.

I again stubbornly kicked and pushed against it.
Determined – this time – to fully overcome.
As I tried to win the never ending bid for freedom…
I brutally whacked right into that figurative brick wall.
Running at full speed.
Determined to this time to make it fall.

It didn’t fall.

I did.


Shocked and dazed I crumpled into the mud – yet again…

Completely spent
Totally wrecked
Utterly broken

I dramatically relapsed in the Spring – physically and mentally.
I shouted and screamed internally – again.
I fell into the pitch blackness of total despair.
And I grieved like never before.

‘How am I supposed to keep living like this?
I cannot do this any more!’

Four and a half years of pain and struggle had taken their toll.
Four and a half years of fighting to be heard, and get well, had left its open wounds.

I had nothing left to fight with.

It was tough to come back from that figurative fall.

But we did find a way again.
In God we discovered a resilience that can only be found in Him.
His Words provided a way forward – an indescribable peace within.

There is always a way forward if we don’t give in.
There is always beauty to be found – even amongst the mess.
Always a light shining somewhere – even in dark places.
Always a deeper love to be discovered – even amidst intense pain.

IF we can keep following the light.
IF we can keep focusing on its radiating beauty.
IF we can allow ourselves to be guided into new horizons.

New mindsets.
Hidden joys.
Intense loves.


IF we choose to never give up…

Only then…

Can we find a new life.
Can we find a new depth of love.
Can we find new purpose.
Can we find pathways to new adventures.

If we will simply stay the course.

Who knows what tomorrow might bring?

Five years ago this week…

I fell off a small step ladder whilst painting.
Five years ago this week I tasted of the devastating debilitation of a spinal CSF leak.

I wouldn’t want to relive these past five years.
I wouldn’t want anyone else to experience those depths of struggle.
So I will fight and keep speaking out until our stories are heard.

Until change comes.

But I also know…

That I wouldn’t want to go back to who I was before that week either.
I am changed forever.
But the change is not all bad.


There has been something deeply beautiful about this impossible journey.

A profound way where excruciating pain teaches you what ‘living’ truly means.
A hard and winding path that brought many wonderful and inspiring people – whom I never would have known.
A wandering that has at times felt aimless – but has also led to glorious discoveries.
A stormy voyage that has shown me stunning new spiritual landscapes and revelations previously uncovered.

Five years ago this week I fell from a ladder.
Five years ago this week I got a life-destroying spinal fluid leak.
Five years have passed of leaking (& at times somewhat recovering).

But never getting fully well.

But regardless of the pain, the suffering, the seeming wrecking of so many many dreams.

I have lived.
I have loved.
I have learnt.
I have grown.
I have spoken out.
I have used my writing.


In the hope that one day things will be different.
Perhaps other families will be saved our pain.
Maybe one day someone’s similar journey will be easier.

Simply because,

I ran the relentless marathon first.
Refused to give up.
And told my never-ending story – despite all of it’s indescribable pain.

“I abandon my addiction to the certainty of life
And my need to know everything
This illusion cannot speak, it cannot walk with me at night
As I taste life’s fragility…
I can’t pretend to know
The beginning from the end
But there’s beauty in the life that’s given
We may bless or we may curse
Every twist and every turn
Will we learn to know the joy of living?”

(Looking For a Saviour – United Pursuits)

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  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 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.

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.