Expert: Ronald Levy, M.D. - 5/29/2008

Question
I had a myelogram done to diagnose a degenerative disc.  It seemed to go well.  However, that night I had a headache which became extremely severe by the next day and was accompanied by nausea.  I stayed flat while drinking large quantities of liquid and caffeine, but my headache was so severe that on the 3rd day, upon my doctor's recommendation, I went to the ER and received a blood patch.  My headache went away almost immediately, and was gone for one day.  However, the following day it returned.  

It has now been 10 days and I still cannot get out of bed due to the pain and nausea (except to use the restroom).  I have read that even though most of the time headaches go away in a few days, this can continue for up to 2 weeks (with the average being about 8 days?).  At what point would you recommend that I go get another blood patch done? (I have been extremely leary to do so up until this point, as with the risks involved of another needle in my already sore area of my back, I want to wait it out if I can.)  

Also, I seem to be slightly better today than I have been over the past 9 days.  Is this a sign that my symptoms will begin improving?  Do these symptoms go away gradually over time or is it something that happens fairly quickly?  With today being the 10th day with slightly decreased symptoms, is it reasonable to expect this will be completely gone by 2 weeks?

THANK YOU for your time and expertise!

Mindi


Answer
Normally I would say to go back already, but since you say it's getting better and would prefer to stick it out, go ahead. It will go away slowly. If it doesn't keep getting better or it gets worse, you should go back for the repeat blood patch.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston