Health: Pulmonologist Visit

Morning All,

This one’s full of a lot of personal health information. If you’re here for the recipes and fitness updates, feel free to skip.

I don’t have any secrets. To my coworkers who are reading, this includes telling people at work. PLEASE DO tell them where I am and how I’m doing if they ask.

There’s bad news and good news today.

You all know by now I spent most of Friday night in the E.R. and have had some serious problems getting “asthma” under control for 3 weeks now. I saw a pulmonologist today. I saw Dr. Derel Finch at Minor & James. I have to tell you Dr. Finch is a WONDERFUL doctor. I truly lucked out in finding him. If you ever have any need for a pulmonologist in the Seattle area, I could not recommend him any more highly. He was personable and truly cared about the issue at hand, its treatment, and how all of the above would potentially effect my life. As you know, these qualities aren’t all that common in many specialists. Add to that his exceptional knowledge, and he’s a keeper for sure.

His first inclination was possibly viral bronchiolitis or pertussis (aka whooping cough). However, due to the treatments I’ve already had over the last 2-3 weeks, he fairly quickly eliminated both of those as they would have cleared with the medications I’ve been taking. He mentioned some possibilities at this point of severe bronchiolitis combined with asthma, or various autoimmune-related inflammatory lung diseases. He said my wheezing did sound a bit like asthma, but it hadn’t responded to treatment as he’d expect asthma to, and there’s still a low rumbly crackle in the lower left lung. For those who don’t know, O2 saturation is how much oxygen is in my blood compared to how much should be there. It’s a percentage, and goes up to 100. Mine is still hovering around 94-96, with occasional lower drops, so not great but not terrible either. In the ER it was down to 93, which is not good. He is pretty certain that there is some overlap with the Ankylosing Spondylitis and this lung thing, so he’s really looking into inflammatory issues. He mentioned Interstitial Lung Disease, which frankly scared the crap out of me.

He had me get a CT Scan as well as do bloodwork. He ordered a CBC, CRP (inflammation marker) and basic metabolic along with some standard other inflammation tests. He wants to eliminate the pertussis possibility, so is also checking for antibodies.

He called me himself this evening with the CT scan results and told me that “there’s nothing devastating” on the CT, and we’re narrowing it down, but it’s treatable. So that’s GREAT news. The film has not been read by the radiologist yet, but in looking at it himself, he saw some pretty major inflammation in my bronchioles. A disease called BOOP (even more here) is currently the most likely diagnosis. The only real downside of that is that fairly standard treatment is up to a year of high-dose prednisone. But at this point, whatever works!

I am to see him again on Monday afternoon. He doesn’t want me to even consider going back to work this week, and I am to lie low and watch tv or read, essentially. Anyone got any DVD’s I can borrow?

One piece of good news: despite all the puffiness in my face and extremities from the prednisone, I’m still down at 222 fully clothed in the doc’s office, and 221 this morning in PJ’s. So once the pred-puff goes down, I should be down around 210! I started at 232. I’m pretty proud of that. Sometimes, it’s the little things Honestly I cannot wait to be able to exercise again. After stopping coughing and starting breathing, re-ramping up the exercise is a HUGE goal. I will ask the doc on Monday if I can at least do the “chair workouts” that are made for folks with arthritis so I can try to keep up some strength.

Lastly, re medications, he had me do some “consolidating” – it’s still a LOT of medication, but as he said, we have to do whatever we have to do to get this under control.

This is what I am on now. Feel free to fill me in on any experiences you may have had with any of them:

MORNING:
Spironolactone 200mg
Armour Thyroid 65mcg
Zyrtec 10mg
Albuterol 2 puffs
Prednisone 60mg (until I see him next week and we will re-discuss)
Brovana 15mcg in nebulizer (new)
Pulmocort Respules .5mg in nebulizer (new)

PRN:
Albuterol inhaler – 2 puffs as needed
Hydromet (Hycodan) – 1 tsp every 4 hours to control cough

EVENING:
Trazadone 50-100mg as needed for sleep
Singulair
Benadryl 25-50mg as needed
Hydromet (Hycodan) – 1 tsp every 4 hours
Brovana 15mcg in nebulizer (new)
Pulmocort Respules .5mg in nebulizer (new)

I can haz a break now?

Amy