Myelograms Suck

Nerves are not highly visible on x-rays, CT scans and MRIs. Radio-opaque dye, however, is...well...opaque on x-rays, CT scans and MRIs. If one was to surround nerves with this dye, you may or may not see the nerve outlines depending on the location of the dye. That is the gist of a myelogram. Oh yeah - they inject the dye into your cerebral spinal fluid (CSF) and you have to lay on your back for about 24 hours.

The value of the myelogram is that the doctor can see the nerve outlines and determine if the nerves are receiving pressure from another object such as a disc, bone or scar tissue. This gives the doctor a map which can be used to evaluate surgical and non-surgical options.

I did not enjoy this procedure. The internet has a lot of descriptions of what is actually done. In all cases, your back is cleansed and numbed with a local anesthetic. Then, with fluoroscopic (x-ray) guidance, a needle is passed through the skin, fat, muscle, etc and into the fluid around your spinal cord. Once the needle location is verified by withdrawing a small amount of CSF, the dye is injected.

This is where the descriptions of the test on the internet vary. Some explain that the needle remains in your back for the remainder of the test. Others state that the needle is removed after injection of the dye. I was lucky in that mine was removed immediately after the dye injection. At this point, the x-rays begin. I was laying on a table with the ability to tilt. And it did, indeed, tilt. First, they rotated the table so that my feet were in the air and my head was down. This allows the dye to move towards the brain. Then, the table was tilted the opposite direction and I was practically standing up.

When the table first began to move, I started to feel hot. I felt the sweat building on my forehead, then on my back and legs. I told the nurse that the room felt really hot. She got a cool, wet towel and placed it on my neck and head. Suddenly my ears started to ring and I began to feel faint. I told them that I was going to pass out. They seemed unmoved by my complaint and continued the test for another minute or so. I complained that I was feeling faint again and was sure that I was going to be out. The neuroradiologist quickly leveled the table and told me to roll onto my back and pull my knees up. I did so and was no longer faint. I still am not sure if the dizziness was caused by the tilting of the table or panic and anxiety. I lean towards the anxiety theory, but don't know that I have a way to prove it.

After the x-ray portion of the test was completed, I was wheeled on my gurney into the hallway to wait for the CT scan. There was a line of several patients ahead of me, so the nurse brought my wife back to wait with me. We joked around a little. I was so glad the test was over. It was nice to have her with me again.

The CT scan couldn't have taken more than 2 minutes. The procedure was uneventful except for trying to move yourself, laying flat on your back, from the gurney to the CT table. When it was over, I slowly transferred myself from the CT table back to the gurney. I felt this horrible pinch/pain on the left lower side of my back. I gave a good loud grunt in an attempt to disperse the pain. I later learned that my gown had been taped to my back to keep it out of the lumbar puncture area. When moving from the CT table, my gown got hooked on the table and tore the tape away. I was presented the lovely gift of a bruise from this activity.

After all this was done, I was taken back to a recovery area where I was to rest for 2 hours before I could go home. This process is to give the spinal sac hole time to heal over and prevent CSF leakage. If too much fluid is lost, the patient can get a terrible headache lasting a couple of days.

I was starving since it was now 3:30 in the afternoon. Jane sat with me and helped me eat. The bed was supposed to be up to 30 degrees from horizontal. The nurses did not have a good ability to estimate 30 degrees so I was basically laying flat. If you've never tried it, you should try eating and drinking while flat on your back. Coke makes you choke with every drink and applesauce is almost impossible.