My daughter, Kayla is being treated for Acute Lymphoblastic Leukemia, also known as ALL. Treatment length for girls is for two and a half years. For boys the treatment is three and a half years. A major component of Leukemia treatment is to have chemo infused into the central nervous system through the spine. This action prevents the leukemia cells from hiding in the spine or brain while trying to proliferate.

This procedure for leukemia treatment is called Intrathecal Methotrexate. Intrathecal is the space in the spine where the spinal fluid is accessed, located in the lower back. Methotrexate is the name of the chemo used.

Many other patients have sailed through their treatment with no problems from this procedure. This has not been the case with Kayla. After each treatment she would get a migraine. These migraines originally lasted one day. Later they increased to two days, then three and finally a week. It is a known fact that the headaches from this can be very severe.

I questioned the medical staff about this problem and was told that the meninges (special covering of the brain and spine) can get very irritated for certain people. The procedure removes spinal fluid in the same exact amount that fluid chemo will be replaced with. In other words, remove a tablespoon of spinal fluid and replace this with exactly one tablespoon of liquid chemo.

Some patients are much more sensitive than others because the cells or lining becomes irritated.

The doctors tried smaller needles, an infusion of caffeine, after to relax the veins. We tried keeping Kayla very still for a minimum of 45 minutes after the procedure. Although all of this was tried, nothing worked. Kayla’s headaches now lasted a week after every spinal and they were terrible. Morphine did not kill the pain.

I remembered during my own illness 25 years earlier, (non-cancer) discovering that large, intramuscular shots, hurt far less if I could get the nurse to sit down, allowing the liquid to go into the body very slowly. I wondered if this same idea would work for the spinals.

On the next appointment for the spinal, I convinced the doctor (very nicely) if he would inject the chemo very slowly into her spine. He told me that he does inject slowly but he would be willing to try going even slower because of my request.

The spinal was done on the 29th of September 2008. The doctor used a #22 (very small size) needle for this procedure. An infusion of 125 milligrams of coffee was infused post procedure. Much to my surprise, no headache all day! This continued, no headache on the 30th, or the rest of the week! What a victory.

A doctor friend told me that some people have reactions that can last months because their meninges get irritated and the reaction does not go away. Grrr!

Spinal Headache Tips

* Spinal headaches can show up five days after the procedure. Here are things you can do to alleviate these.

* A number 22 needle has made a difference for Kayla. Funny enough that the one time they did not have the 22 needle, Kayla ended up with a headache for four days.

* Ask for an IV infusion of caffeine.

* No movement of patient for a minimum of forty minutes after procedure. (Per our oncologist.) The patient is to remain lying down.

* Request that the doctor remove the fluid very slowly and replace fluid very slowly.

* Drink beverages high in caffeine. [1]

* Drink plenty of water. It is advised in several different articles to get strict bed rest for 24 to 48 hours after procedure if you are prone to spinal headaches.

* “The spinal headache often is described as “a headache like no other.” Spinal headaches are much more severe when the person is in an upright position; they improve when the person lies down.” [1]

* Take an approved pain medication for the headache.

* If the pain persists talk to your doctor about other options.

I sincerely hope that this information helps those people who get the excruciating headaches after spinals that Kayla got. It was such a relief for all of us when we finally found these various things that worked.

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References:

1. www.medicinenet.com/spinal_headaches/article.htm