Like a lot of people, I've found myself directed back toward the "rougher" side of medicine as a result of the onset of medical problems in later life -- in my own case, hydrocephalus, or what used to be called "water on the brain".
So I wasn't too happy a couple of weeks ago when an overly-cheerful, bouncy young call-center worker contacted me "to schedule our LP"; I knew enough to discern that "LP" meant "lumbar puncture" -- what used to be called a "spinal tap". I had never undergone this procedure, but one of my roommates while hospitalized and confined to a body cast as a ten-year old had -- and it had not been pleasant.
But that was waaaaay back in the winter of 1959-60, and my team, despite my protests and insecurities, tried to reassure me that the process had become somewhat easier, I remained unconvinced, and it was only the hard fact that my insurance wouldn't cover general anesthesia that "persuaded" me -- kinda like the "Farris persuader" in Ayn Rand's "Atlas Shrugged" (or so I thought).
So it was with considerable reluctance that I arrived for my procedure last week, and an hour wait after "gowning up" didn't help to ease my concerns; but after that, things began to move in the right direction, and quickly,
I was advised that the procedure would be carried out while prone on the table-type fluoroscope upon which I was already seated to avoid any possible misdirected approaches (I underwent a "heavy duty" spinal fusion during the '59-'60 hospitalization) and that a local anesthetic, albeit via the spine, would also be used. So it was onto my stomach for a few minutes while the "tactics" were drawn on my lower back in some "surgical ink", and onward to the main.]event.
I had been previously sedated by 1 mg of Lorzepam immediately after the final signing of formal authorization, but I was fully aware of my surroundings at all times; the local anesthesia was no more discomforting than an injection of Novocain or Lidocaine, and I felt virtually nothing when the extraction needle was inserted, Collection of about 30 ccs of cerebrospinal fluid (CSF) probably took a few more minutes -- during which I was able to hold a fully-coherent conversation (the subject was music -- "trad" jazz to be exact) with the man in charge.
And once a small band-aid was slapped on the puncture site, I was ready to go home (though, unlike my two previous non-sedated colonoscopies. not ready to drive.
I HAVE ONLY ONE MEASURE OF SERIOUS, BUT POSITIVE CRITICISM TO OFFER TO THE MEDICAL PROFESSION IN GENERAL: Please, when discussing procedures that might be viewed as unpleasant by a patient who's been "out of the loop" for a long time; try to call attention to any improvements in the process that make it less threatening. It's not so much the prospect of pain, as the fear of the unknown, especially when combined with previous negative experiences, that can make us very nervous.