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Spinal tap testing question
duchessmom posted:
Hi. I'm frustrated and concerned, and wondered if anyone might know some technical answers. I had a spinal tap (for diagnostic purposes) and have been anxiously awaiting the results. Then I just got a call -- one week after the spinal tap -- to say that they had forgotten to take my blood at the same time, and they need it, because their testing will compare the blood serum with the CSF. (Why did it take them a week to figure this out -- shouldn't they have already started the test?) As I understand it, this is for the crucial MS test.

So, I just had to go back to the hospital (a long drive into the city, it's a big teaching hospital) to give the blood. My concern is that the CSF has been waiting around for a week -- is it still "fresh" enough for the test? And is there a concern that the blood was taken a week later, not at the same time, since it's supposed to be compared? I asked the technicians and they said it was all right, just barely; I asked for someone higher-up, and she (I don't know her position) assured me (on the phone) that there wasn't a problem, but I get the feeling that they're protecting themselves. I feel like I've fallen through the cracks. Do you know if the test will still be viable/accurate? (And now I have to start waiting all over again for the results!) Thanks.
Neil S Lava, MD responded:
To understand immunological activity in the central nervous system, it must be compared with the immunological activity in the serum. The testing looks for oligoclonal bands in both the serum and spinal fluid. In multiple sclerosis one sees oligoclonal bands that are not seen in the serum.

Once in a while we forget to send the patient for blood tests at the time of their spinal tap. Therefore we have the blood drawn at another time. Usually a few weeks between the 2 tests is not significant. Sometimes I have already drawn this serum test for other reasons a few weeks before I do the spinal tap.

It doesn't sound to me as if you need to worry about this. They probably have already performed the spinal fluid part of this test they just can't report the test without the serum comparison for it would not be meaningful.
lepman replied to Neil S Lava, MD's response:
Dr. Lava, If I have done this right One of my M.R.I. pics is going to show up in my profile pic. I have some speculations about them and need to know if this is a normal pic or not. If I over stepped my bounds then I guess this would be an insult. Sorry if I stepped on some toes.
An_204923 replied to lepman's response:
Hi Lepman ...

It might be worth trying again on Friday - One of the Drs may spot this anyway, but, Dr Lava does tend to pop in on a v. regular basis on a Friday. (Dr Rumbaugh does pop in too, but on a less regular basis.)

Good luck.
lepman replied to An_204923's response:
Thanks, I'll keep that in mind.
lepman replied to lepman's response:
Dr. Lava , I sure hope you have the time too look even though it's only one pic.
Neil S Lava, MD replied to lepman's response:
I am sorry, I don't feel comfortable commenting on one picture from your MRI. If you are concerned about the reading, you should review it with your physician.

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