Vorticity Advection

The Valley Fever test was negative.  Thus the diagnosis of Hypersensitivity Pneumonitis is the only one left.

I’m down to half a pill (5 mg) of Prednisone now.  I’ve gained about 10 pounds.  I want to say it’s all water, but I know better.  I’m out of breath when I climb a flight of stairs, but nowhere near as much as before I saw the doctor.  Am I relapsing, or am I just flat out of shape?  Only one way to determine that:  Get in shape!

I get another CT scan on March 16 and go back to the doctor on March 24th.  My goal is to lose these 10 pounds by then. Five weeks, two pounds a week.  I think it can be done.

I used to work as a cashier at Kroger when I was in high school.  It was my first “real” job and taught me a lot about money management (namely how to get it honestly).  I also learned the value of education in that I could calculate change before I even entered the customer’s cash payment into the register.

Now, I like to mess with cashiers by giving them odd amounts that will result in desirable change.  Today, I ordered lunch at the Flying Cow Cafe here at the National Weather Center, and given a total of $5.64.   I didn’t have 64 cents, but I did have change for 14 cents, thus I gave the cashier $6.14.  The cashier took my money, stared at it, looked at me, then entered 6-1-4 into the register.  The till opened and $0.50 appeared on the screen.  She literally stared at the screen for a good 3 seconds before depositing my cash, then stared another two seconds at the till before getting two quarters and handing them to me.

A good cashier will just enter the money and get my change without hesitation.  A great cashier will see what I did and comment about my mathematical skills.  A run of the mill cashier will do what happened above.

Kids, learn math.  You will eventually find out that you will use it every day.

I’m down to 20mg of Prednisone a day (one pill) and I can say that it has made a huge difference.  I arrive at work breathing only slightly harder than when I left my car.  I can take three flights of stairs before I breathe hard, and I catch my breath much easier.  I have energy to work on the house, and other things (hoo-wah).

Next step is CT and a doctor’s visit in early December.  I still haven’t recieved any updates on the Valley Fever test.  I hate to say I want to have a fungal infection, but I want to have a fungal infection.  If I have Valley Fever, it means my birds can stay.

Again, sorry for the long time between updates.  Just hard finding time to sit down and type what could be a long story.

My wife kicked me out of the house the weekend after the last diagnosis and completely cleaned out the bird room with the help of our friends Richard, Eric, and Chris.  They took every cage and power-washed them, power-washed the blinds, re-painted the walls with a semi-gloss, sealed the floor, and put two filters in the room.  Richard was a true trooper and did most of the work.  I can’t thank him enough.

My son and my wife now do the changing of the papers in the cages.  Though they may not succeed in their goal of doing it daily, it is still getting done much more often than before, and not by me (which is the goal).

I went in for a bronchoscopy on Oct. 6th.  I couldn’t eat anything from Midnight on, so I arrived starving.  First they started an IV so they can administer the meds, then they come in 10 minutes later with a shot of Atropine that had to go in my butt.  Why?  It was supposed to calm my heart for the procedure, and if they gave it to me via IV, my heart would have stopped.  My wife laughed at me as I exposed my flank for the jab.

Then came the breathing treatment of Albuterol (to open my airways) and Lidocane (to numb my throat).  I had an oxygen mask with vapor coming out of it for 5 minutes, told to breathe deeply.  My wife laughed at me again and took pictures, saying “Luke, I am your father.”

They say the best way to deal with stress is with humor.  That explains my wife laughing at my misfortunes, and me acting like I was driving the bed as they wheeled me to the procedure room.  The orderlies laughed, and one visitor stared in confusion… which made me laugh.

I arrived to the room and noticed about four large (yes, LARGE) syringes, and four medium syringes, all full of saline.  I also see a small jar with a blue gel inside.   The doctor arrives as the assistants start filing in.  They get busy real fast.   In no time the doc is pouring the blue gel into a tiny cup, then dipping a two 10-inch swabs into it.  I notice the writing on the jar:  “Cocaine 4%.”  He sticks the swab into my left nostril slowly until it reaches the back of my throat.  He retracts it, re-coats it with the cocaine, then sticks both swabs in my left nostril and leaves it touching the back of my throat.  Now I know how those people who insert nails into their nose do it.

The doc takes the swabs out, then pulls up a tiny aerosol can full of Lidocane, and sprays it in my throat for 3 seconds.  Tastes like Chloraseptic times 10.  Next, the assistant attaches a syringe to my IV and in goes the Versed (conscious anasthesia, I’ll be awake but won’t remember anything), then the doc shoves a small syringe of clear goop up my nose (lube, whee), and I feel it start to go down my throat.  I then see the tip of the scope coming to my left nostril, then black out.

I wake up to a nurse wiping my nose.  It seems no time has passed and I’m a bit confused, but not groggy.  The whole procedure took 20 minutes.   Those large syringes of saline were squirted into my lungs then sucked back out for samples.  Glad wasn’t awake for that.  I’m wheeled back to the recovery room where my wife and mom are waiting.  I then notice something:  I came in starving, but now I’m not hungry, and I’m very alert.

“She don’t lie.  She don’t lie.  She don’t lie… cocaine.”

I’m told not to do anything for the next 24 hours as some of the drugs will still be in my system (whee).  Considering my weakened state, I head to my mothers so as not to be exposed to our supposedly contaminated house.  Soon as I get to my mom’s, I decide to collapse for a few hours.  My wife heads home to continue cleaning in my absence.  I wake up around 4pm and force myself to have some chicken soup, even though I’m still not hungry.  I head home that night after I get the all-clear from my wife that she’s done.

Two weeks later, I head back to the doctor’s for an update.  The summary is that he is 99% sure I have Hypersensitivity Pneumonitis, but my blood tests came up positive for “Valley Fever,” a fungus infection that is found mostly in California.  He puts me on Prednisone for the inflammation, and Fluconazole for the possibility of Valley Fever.

Since the checkup, I’ve been one week on 60mg of Prednisone a day.  While the pills taste awful (orange juice is best for washing them down), I cannot deny their effect.  I can now take one flight of stairs at work without gasping like a swimmer who stayed under too long.  I can walk without breathing hard, and I’m sleeping like a log again.  I went down to 40mg today, and go down to 20mg in two weeks.  I see the doctor again in early December for a checkup, and will have another CT scan to see how things are.

I still go in the bird room.  I go in the morning to feed them, and occasionally at night to get one out for some personal time.  I’ve been more observant about dust and have noticed a fine layer around the cockatiels (expected) and my african grey, Pepper (unexpected).  I’m figured I was going to have to say goodbye to the cockatiels, and I’m not worried about them too much as they are “happy-go-lucky” birds who are pretty easy to take care of.   Pepper is my bird, though.  I don’t know how I can say goodbye to him.

We have eight HEPA filters throughout the house, and mean to add more.  We keep working around cleaning where we can, with my wife doing most of the work.  I am extremely blessed to have someone who cares for me so much that she’ll put her own health at risk to keep me around.  My son is even doing work in the bird room without complaint.  It’s incredibly humbling, and I feel like I let them down at times.  But I realize it’s not my fault, it’s just my body.  Much like my wife’s arthritis is not her fault, it’s jsut something to deal with.   I guess it’s my turn to be looked after.

Sorry for the lack of update, but here’s the short version:

Hypersensitivity Pneumonitis.

Long version:

I get the x-ray.  Doc calls me up the next day and says he sees  “interstatial nodules” and he’d like to get a CT scan of my lungs before he makes a diagnosis.  He says he doesn’t see anything cancerous, so it’s not that (thank God).

I get the CT.  Doc calls me back and says he’s referring me to a pulmonary specialist.  That and I need to get some blood work done.   OK, I’m getting worried.

That same day, the office of the pulmonary specialist calls.  They have me scheduled for a breathing test that Friday.  Great, they are on the ball so maybe we can get some answers.

I go in early Friday to my primary doc’s office to get the blood drawn for the blood work.  The nurse was a very good vampire, and four vials and a bandage later I’m off to the breathing test.

I’m taken to a room with what I would call a plexiglass closet with tubes on one side.  The technician starts me off with a “blow” test:  I take a deep breath in, then blow as hard as I can through this tube that measures the volume of air I can exhale, then how fast I inhale afterwards.   I do this four times.

The next test is the “pant” test:  I’m enclosed in the room, then start breathing normal, then breath faster.  Sometime while I’m breathing fast, a valve shuts and I’m supposed to keep trying to breathe as I was before.  This measures the pressure that my diaphram exerts on the closed valve under “normal” breathing.

The third test measured my lung’s ability to absorb oxygen, though they used a partial mixture of carbon monoxide (0.2%) to do so.  I’m enclosed again, then I take a deep breath of the air mixture, then exhale it.  I do this four times.

Finally, we go back to the first test, only this time I’m given albuterol to open up my air ways (if there’s inflammation).  We wait 15 minutes for the albuterol to take effect, then do four runs again.  From what I could tell, my lung capacity didn’t change from the first runs.

Testing’s over, so I go home.  The following Monday, I come back to the pulmonologist’s office, this time with my mom in tow b/c my wife is out of town.  The doc comes in and promptly says “You’re in bad shape, man.”  He then tells me he believes it’s the birds (dust from cleaning cages) and I’ll probably have to get rid of them.  He says my lungs are at 40% capacity, and my pulse oxygen is only 88%, adding “You’re only 3 points away from me putting you on oxygen.”  I ask him various questions about what it could be, he gives various things it could be, but he keeps coming back to the birds.  Says it’s all over the house, and nothing short of getting either me or the birds out of the house will help me get better.  Otherwise, I could die from this.

I now wish I hadn’t brought my mother.  She’s hated those birds since we got the first one.

So, doc schedules a Bronchoscopy for the following Tuesday, then tells me to get some HEPA filters as a start.  However he still says “remove the exposure, or else.”

So I get a couple of HEPA filters at Wal-Mart, deal with a mother who is trying very hard not to say “I told you so,” and get home.

I unpack the HEPA filters, setting the big one up in the bird room, and the small one beside my bed.   Then I promptly get one of my birds, sit down in my recliner, and cry.

More later.

I recently went to the doctor under threat of “telling your mother” from my wife because I’ve had this cough for nearly six months.  I’ve also been short of breath from even minor exertion, and I have this rash….

Enough details.  The doc ordered a chest x-ray, and I should know the results tomorrow.  He said it might be asthma, but he wants to rule out anything else first.