Wednesday, June 13, 2012

The Human Machine

I think I've suddenly figured out a way to prove the hypothesis about the ringing in my ears, and associated headache I used to have until I started taking meds to prevent the headache.

My problem was that I was trying to be a better neurologist than my neurologist.  I'm not.  I'm an engineer, and I'm a better engineer then he is a neurologist.

Initially, trying to be a neurologist was fruitful. I was able to use my google-fu to align my symptoms to the most likely cause. A slow leak of CSF fluid from somewhere in my head or spinal column. It was like sticking in a bunch of keywords and then sifting through all the results until finding one that matches very closely.  I did.. a study on "second-half-of-the-day-headache as a manifestation of spontaneous cerebral spinal fluid leak".

All the evidence was there.  I had a sudden onset period.. basically one day.  That indicates a physiological change in my nervous system, not a chemical change that would demonstrate gradual onset.  There were multiple symptoms, which slowly resolved to the two main symptoms, headache and tinnitus.  My body must have attempted to repair itself but couldn't complete the job.

There has been a question that I didn't know the answer to because it never matched up to any documentation I could find and it didn't make sense to me.   When thinking about the question as the engineer and not the neurologist, I think I've figured it out.

The question is;  why does my left ear ring louder than my right ear?

And what is the answer to that question?  Here.. I'll put a break in the page and you can ponder it for a moment before clicking on the link to see the rest... click the "read more" button.   See if you have figured out that my theory of a slow CSF leak is the right one.


I almost always.. probably 90+% of the time sleep on my right side.  I thought about fluid mechanics, and it's quite simple really.  Because I sleep on my right side, my right ear has more CSF pressure on it and I wake up and it is ringing less than my left ear.  By evening, it more or less evens out.

I sleep on a regular bed, but I typically have two pillows.. not completely stacked on top of each other, but one up against the head board and one I have my head on.  I have a third that I put under my left arm so it doesn't hang down but is more level with my chest.  That's comfortable for me.  That also means that my left ear is at about the highest point in my body - hence would have the least amount of CSF pressure on it for the entire time I'm sleeping.

Again, thinking like an engineer and not a neurologist, I need to change that fluid mechanic.  I'm going to shim the bed on my side (it's two twin mattresses side by side), and put it at enough of an angle that my head will be lower than my hips.  I'll have to do this and be able to sleep - and we've got enough sleeping pills here to put down a rhino, so that shouldn't be a problem.

I'll need to keep a chart.. time to bed, intensity level on a scale of 1-10 for each ear at bed time; time awake, intensity level in each ear, and do that until I'm consistently getting either no or greatly reduced intensity when I wake up.

If this theory proves correct, then I hand the neurologist the chart.. demand that he get me scheduled for a blood patch, and get it done.  From what I've read, blood patches are highly effective in plugging leaks. Some people with multiple leaks have less success and there is a potential that the patch eventually fails, necessitating that it be done again, or locate the leak site and fix it surgically.

If I'm wrong, and I don't think I'm wrong, then I'll have to give up on the CSF leak theory and try something else.  I don't have any alternate theories right now though, so this has got to be it or I'm basically fucked.

If it does work.. you cannot imagine how I will confront Dr. Turban on the follow-up visit.  The very first thing I told him on the very first visit was that I thought I have a CSF leak.  He has insisted not.

I would have dropped this theory entirely if the recent spinal tap had shown a normal opening CSF pressure level, but it didn't.  It was low.  Dr. Turban blew that off as being "low in the normal range".

I'm going to fucking solve this problem because it's fucking my shit up, and I'm tired of it.


There is one other possibility in play.  There is a shunt in your body that controls the amount of fluid pressure in your cerebral spinal area.  It's like a pop-off valve on a car.. get too much pressure, and it opens up to drain off the excess.  If it was popping open with too little pressure, a blood patch would not fix that.  If the blood patch does not work, I think there is about a zero percent chance that I could get Dr. Turban to consider a problem with the shunt.

1 comment:

Douglas V. Gibbs said...