Friday, March 23, 2007

Bio Band-Aid

Recently a friend of mine was on the receiving end of a Diagnostic Lumbar Puncture (spinal tap). He had a horrible, migraine scale headache and the doctors wished to rule out some serious causes such as Meningitis or an aneurysm in the brain. Everything turned up clear so, they sent him home with the recommendation of bed rest and painkillers to get over both the migraine and the spinal tap. A couple days later, he seemed to be getting worse. He had developed a terrible hunch, and could not stand up straight. The only way he could be comfortable was to be lying down in a certain position. Needless to say, he had to go back to the hospital.

After much worry, it was discovered that this was not very serious at all. The puncture he had received from the spinal tap had not closed off and he was very slowly leaking spinal fluid into his body. The body just absorbs this fluid, but the normal spinal fluid pressure could not be achieved with this leak. This was the reason he was experiencing discomfort in his back. What is so interesting about all this is the course of treatment the doctors decided to take.

If left alone, this leak sometimes resolves within a few weeks. During this period the patient would endure night sweats, pain, and weakness while restricted to bed rest. Modern medicine has a much faster treatment: an Autologous Blood Patch. A blood patch is exactly what it sounds like; it is a patch made out of blood. The word autologous used here means that the blood used is taken from the patient. The doctor draws blood from the patient and basically squirts it from a needle into the spine near the internal leak site. I need to mention that spinal cord is actually made up of multiple layers of tissue, almost like sleeves. The blood used ends up in a certain one of these layers and forms a blood clot ball around the spinal cord at the leak site. During this procedure, the patient must stay very still and allow the blood to clot. Before all this takes place, a local anesthetic is provided. It's the perfect spray on band aid! As the blood patch is made out of your body's own product, the immune system recognizes it and does not attempt to attack. Your blood is also very clean, so there is no risk of infection unless the tools used are not sterile. As you are in a hospital, it's fairly safe to assume that they are. (Unless you are treated at the St. Joseph's Hospital in B.C. I suppose.)
Blood Platelets under an electron microscope. These cells allow the formation of clots.
The red pigment has been added by a computer as color does not exist at this level of magnification.

No one is quite sure why my friend got the headache in the first place. I think a migraine is the most probable answer, as I have them from time to time. There is some speculation that they can run in families.

Certainly beats using a fresh fish to "draw out the poison " (an old Scottish folk remedy.) I suppose they thought as the fish decayed, poison was absorbed causing the rot.

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