Wordless Wednesday: The Impatient Outpatient

Asthma sucks

Sorry for the recent lack of blog posts, I’m busy being a professional patient. Air quality is bad, and my lungs are totally out of whack. And I’m sick of being sick.

Who on Earth is Tarlov, and How Did I Get His Cysts?

Yesterday I went back to the imaging center for my second MRI of my lumbar spine. This time it was done with contrast dye, which I had a mild adverse reaction to (burning sensation, nausea, etc). Once my body calmed down after the dye was injected, the MRI was pretty simple.

This afternoon the results made it in to my primary care doctor, and his nurse called me with the results. She said that there is no visible spinal disc compression, but I do have Tarlov Cysts in the sacral region of my spine. She said that I should come in next week to discuss my treatment plan with Dr. J. Because I am impatient and curious, I did a little Google sleuthing to find out more info on Tarlov and his cysts.

Tarlov Cyst (Perineural Cyst; Sacral Nerve Root Cyst)

Definition

Tarlov cysts are abnormal sacs of spinal fluid that usually form at the lower end of the spine (sacrum), or tailbone area. In most cases, they do not cause symptoms. But, if a nerve area is affected, you may experience pain.

Causes

The cause of a Tarlov cyst may be related to:

  • Trauma to the spinal cord
  • Increase in the cerebrospinal fluid pressure
  • Blockage of cerebrospinal fluid

Often times, the cause is unknown.

Once you have a Tarlov cyst, the following may cause it to become painful:

  • Traumatic injury such as a fall, automobile accident
  • Heavy lifting
  • Childbirth
  • Epidural anesthesia

Symptoms

Most Tarlov cysts do not cause symptoms. If you have any of these symptoms, do not assume it is due to Tarlov cysts. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Nerve pain
  • Pain in the lower back, buttocks, legs and feet, vagina, rectum, or abdomen
  • Pain when coughing or sneezing
  • Weakness, cramping, or numbness in the buttocks, legs, and feet
  • Swelling, soreness, or tenderness around the lower end of the spine (sacral area)
  • Abnormal sensations in the legs and feet
  • Sciatica symptoms, such as pain when sitting or standing
  • Headaches
  • The feeling of “sitting on a hard surface”
  • Pulling and burning feeling in the tailbone

Treatment

Most of the time, Tarlov cysts do not require treatment. Treatment options include:

  • Corticosteroid injections or other medication injections—to relieve pain
  • Prescription medications—such as pain medications, antiseizure medications or antidepressants (both of these may be used to treat pain)
  • Lidoderm patches—applied to the sacral area to provide temporary relief of pain and discomfort
  • Aspiration of the cyst—a needle is used to drain the cyst to relieve symptoms
  • Transcutaneous electrical nerve stimulation (TENS)—electrical impulses are delivered through the skin to help control pain

In rare cases, surgery may be done if symptoms are severe and the cyst has caused changes in the bones of the sacrum. Surgery involves removal of a thin layer of bone and the cyst.

I’m not sure what all of this means for me at this point. I’m not informed of the details, and will iron out a treatment plan with my doctor next week. I’m going to do my best to keep a good balance between rest and activity, and hopefully this condition will dissipate on its own. I REALLY hope it’s temporary. My mother has been dealing with chronic pain issues for well over a decade, and I don’t want to have a life where pain chains me to the bedroom. On one of the info sites, in interesting letter was written by a nurse who deals with Tarlov Cysts. I don’t see myself sending it out to friends and family, but it scares me a little that I might have to live life like this.

Didgeridoo for Sleep Apnea???


Ever heard of a didgeridoo? I read a very crazy news article from Reuters this weekend that talked about how regular didgeridoo playing can help with sleep apnea:

Reuters
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Regular didgeridoo playing reduces snoring and daytime sleepiness, finds a study published by the British Medical Journal. Snoring and obstructive sleep apnea syndrome are common sleep disorders caused by the collapse of the upper airways.

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Reports of didgeridoo players experiencing reduced daytime sleepiness and snoring after practicing, led experts in Switzerland to test the theory that training of the upper airways by didgeridoo playing can improve these disorders. They identified 25 patients with moderate obstructive sleep apnea syndrome and who complained about snoring. Patients were randomly allocated to an intervention group (didgeridoo lessons and daily practice at home for four months) or a control group (remained on a waiting list for lessons). Compared with the control group, daytime sleepiness and apnea scores improved significantly in the didgeridoo group. Partners of patients in the didgeridoo group also reported much less sleep disturbance.
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The authors conclude that regular training of the upper airways by didgeridoo playing reduces daytime sleepiness and snoring in people with moderate obstructive sleep apnea syndrome and also improves the sleep quality of partners.

I’m sure some of you are sick of reading about the sleep problems that I’ve had for so many years, but how could I not share this bizarre nugget of medical research? I’ve been using the CPAP machine for the last 5 nights, and so far haven’t had much relief for my daytime sleepiness. According to my sleep tech friend Lori, it’ll be at least two weeks before I have a real marked difference in my sleep/wake cycle. I am dedicated to finding a way to finally have restful sleep, and I wonder if I’d have any luck with the didge. Course, I’m not sure I’d want to invest in the very strange instrument without renting one first, and I have no idea where I’d rent a didgeridoo. Maybe I could join an Australian Club, or hang out at the Australian Consulate’s office. What do you think, does this seem like craziness, or do you thing there’s something to it? One thing’s for sure, I could totally pull off the Aboriginal hair…after a night of the CPAP headgear, my hair look like a banchee!

Sleepin’ Sexxxy


I met with Dr. I today to discuss the results of my last sleep study. He said my daytime sleepiness is caused by sleep apnea, pure and simple. No narcolepsy, just obstructive sleep apnea. When I had the nose mask on a low airflow (6) I had about 10 disturbances per hour with snoring. When I had a full face mask on medium airflow (9) I had only 2 disturbances over several hours with no snoring. He said if I stick with this mask with a chinstrap, I should have marked improvement in a few weeks. So now I get to put on this lovely mask along with my bedtime attire. Sexy, eh?

What the doctor said

All hooked up last week

Yesterday afternoon I had the quickest doctor appointment of my life. I arrived at the office about 4:10, and I was back to my car by 4:25. Seriously??? When does that ever happen. I only had to pay $1 for parking instead of the usual $5 (which by the way is really lame to be forced to pay for parking when you’re already paying your doctors. The joys of living in an urban metro area)

The bad news is that there wasn’t a lot for the sleep doctor to report about my polysomnography test from last week. He had ordered the CPAP version; but even after a clearly marked written order (and a lot of arguing on my part), the sleep tech only gave me an NPSG test (for new patients). Dr. I said that he hadn’t yet dictated my whole report, but that my sleep structure was almost identical to my last test in 2007. Approximately 10 disruptions per hour, similar oxygenation, similar REM sleep time, mild-to-moderate snoring (which Taylor doesn’t agree with. haha) Dr. I was really upset that I basically had the test for nothing, and he promptly got on the phone with the director of the Sleep Disorders Center at Piedmont Hospital to make sure that I don’t get billed for the erroneous study. Dr. I apologized to me profusely, he waived my copay, and set me up for the CPAP study in his VIP suite at Georgia Lung Center in Austell in March (longer drive, but nicer facility and it includes breakfast)

I wonder if I had refused the study the night of, which I was tempted to do, if I wouldn’t have gotten in my car accident last week.