Soon I am wheeled to an operating room, then rolled over from my back to my stomach onto a table. My head has a pillow placed beneath my chin, my left arm is extended and fitted with a blood pressure cuff, plastic tubing is draped below my nose, vents beneath my nostrils whispering oxygen into my face. My right arm is extended, and a team of gowned and masked medical people peer at the back of my hand, searching in vain for veins. My hand is massaged, squeezed, lightly tapped, lightly slapped, while cold lidocaine is applied low on my spine. “I’m one of those people who needs more lidocaine than normal,” I remind the anesthesiologist, and he assures me he’ll give me extra and wait a bit longer for it to settle in. “You might have better luck with my arm,” I tell the people clustered around my hand, who are now turning the lights low and searching for my veins with the vein finder, but they seem not to be listening to me. The pain management guy who’d promised me the fentanyl cocktail says they can’t do it until the IV is placed, and the hand IV is proving quite difficult. The group of doctors managing the IV keep massaging and slapping my hand, while the other half of the group of doctors hovers around my lower back, beginning the process of placing a catheter in my back and injecting me with contrast fluid. This will help them visualize the spinal epidural space as X-rays are continually passed through my body and broadcast to the fluoroscope, a TV-like monitor where they can see a real-time vision of what’s going on inside me.
An IV is finally jammed into a vein in my hand, but after several team members consult over it, the vein is deemed unproductive, and so the needle is withdrawn and painfully reinserted in a new spot in my hand. I’m grateful for the oxygen; otherwise I feel I might pass out from the stabbing in my hand, the twinge in my back. The second IV placement isn’t much more productive than the first, and two doctors massage and squeeze my hand to make the tapped vein offer up its blood. They need to inject 15 ccs of my own blood into the epidural space in my lower spine—but due to my dehydration and insufficient veins, they’re having trouble getting that much. The trick with an epidural blood patch is that the blood needs to be extracted and then injected more or less immediately, before it has a chance to clot. But all they can squeeze out of me is a few ccs at a time, and so they collect 5 ccs and inject it, then wait for 2 more ccs to accumulate and inject that, then wait for a few more ccs to be collected and inject that. This isn’t ideal, but they manage to collect and inject and collect and inject and collect and inject something like 11 or 12 ccs total. From my perspective on the table, inhaling oxygen and crying from the pain of my battered hand being milked for blood, it feels like a gradual filling up of my back until I can’t tolerate the pressure in my spine anymore, which means that it is over.
But as painful and uncomfortable as it is, lying there on the table, trying not to shiver in the cold dark room, my hand spiked with pain, my other arm squeezed in a cuff, a catheter in my back, and a needle in my spine, for just a moment I experience a revelation. I can actually pinpoint the instant the injection of fluid is enough to bolster my brain and make it float again, because as I lie on the table, I feel myself come back to myself. I find myself exclaiming, through my tears, “Oh my god, I can think again,” and there is this sudden rush, this undeniable sense of the me who is Me finally emerging from the shadows, fully inhabiting my brain, able to exist again. I hear the head anesthesiologist laugh and say, “Good, it’s working,” and the pain management guy apologizes for being unable to provide me with that fentanyl cocktail he’d promised and says he’ll bring me tramadol, and my back is wiped clean of contrast and medication and blood, and I—me, Me, the me who feels like myself, the me who can think—I am turned over onto my side and transferred to a rolling bed on my back and the fluorescent lights move above me and then the tramadol brings me some relief as I lie in the darkened, curtained waiting area, my back sore, my hand purpling from the assault, my brain allowing my mind to feel like myself again.
It takes two weeks for the bruises to fade, so by the time I have my follow-up with the anesthesiologist at the pain clinic, they are yellowish-greenish ghosts on the back of my hand. “How are you feeling?” he asks me, and I tell him I’m not sure. My back and leg didn’t feel as bad as they did after the last blood patch—maybe because they did the injection a little higher this time, and also got it in the right space without hitting a nerve—and my
