I spent last week in the hospital. It’s Fall, the weather is changing, mold counts are rising, ragweed season was rough, and farmers are out in the fields harvesting their crops. It’s always the perfect storm of things to induce inflammation in my airways.
It started off with an asthma attack. I was in the garage riding my spin bike one night when I hit a wall after 15 minutes. I backed off, slowed down, and figured things would soon get back to “normal.” Things did not get back to normal. I started myself on some standby prednisone and talked to my lung doctor when things didn’t completely improve. I restarted the prednisone, but it wasn’t enough. One the way to an urgent clinic I got a flat tire. Urgent clinic told me I had to go to the hospital, and the doctor in the ER admitted me after 125mg of solumedrol and some duoneb seemingly had no effect.
This is the first time I have been admitted not in the middle of an active attack where I felt like I was in distress. The ER doctor was going to admit me as soon as I got there, but I wanted to try some standard treatment first. After that it was three days of 240 mg solumedrol before tapering down to 60 mg of prednisone and getting out of there.
Right now I feel like I’m struggling. Doing everything for yourself is harder than it looks, and I’ve come down with bronchitis as well. Here’s hoping the medicine works and I can fully recover without relapsing.
If there’s one thing that can turn my day into a horrible, sweaty mess it’d be a breathing test. After I showed up at my lung doc’s office earlier this week to find their computer system in shambles and my appointment lost, they rescheduled me for today. I showed up 10 minutes before my appointment to find the computer problem even worse than before. Cardiology was turning all patients away and forcing them to reschedule, but fortunately pulmonology was seeing any patients who arrived. My appointments were still in the computer from a couple days ago as I was scheduled for spirometry and then a visit with the NP.
So a couple weeks ago I became extremely congested, which slowly moved from my sinuses to my throat to my chest. I did a measly five-day z-pack, which I was skeptical about, yet they tell me I only have expiratory wheezes now. I’ll take that over the constant accordion noises I was making at the beginning of the week. My visit did start out with spirometry which really isn’t a big deal. On a good day I just exhale as forcefully as possible into a tube and as long as I have three good attempts that aren’t statistically-significantly-different (did I just make that hyphen up?) from each other, I’m good to go. Not so much today. Any resemblance of a forceful exhale was sending me into coughing fits and I sounded like those old people who see my doctor. You know, the ones with SERIOUS breathing issues who are targeted by all the commercials for my medications. Even the nurse said, “GOOD GRIEF! Sounds like we’re breaking some junk up in there!” Eventually I had three that were similar enough to count and I actually felt much better after breaking up all that junk. Unfortunately that feeling last maybe an hour before I was back to where I was. This is why trying to stay active is important and why they’re always worried about people lying in hospital beds getting fluid in their lungs. There’s still no end in sight yet for my prednisone habit, but I’m hoping my exhales can start sounding less like the 70 yr old thankful Spiriva allows him to eat dinner at the table and more like…well, a normal person.
Yesterday I went on over to my lung doc’s office for my previously scheduled three-month follow-up. It was handy because we were needing to talk about my Pittsburgh visits, testing for VCD, my prednisone in-take, and this bronchitis thing I’ve been trying to kick. When the elevator doors opened there was a line of 8 or so people waiting to check in and a sign asking us to please excuse the extra wait as they try to figure out their new computer system.
Eighteen minutes later I’m next in line and I hear the people in front of me have my appointment time with my doctor….odd, right? They ask me for my birth date and name, which pulls up my “account” and I’m told, “Ok, so you have a 1:15 with Dr…., I mean, you have nothing in the system. Why are you here?” Sounds fishy, right? How else would they have known who I’m seeing and the time of my appointment if it hadn’t popped up on their screen? My appointment was originally for the previous day at the same time, but someone called me to move it to the next day. According to their computer I have an appointment in the middle of December, but I don’t want to wait six to seven weeks. I’ve seen similar situations happen to others before and you basically have two decisions: you can flip out and look like a jackass, or you can calmly work out a solution. I decided to not make an idiot of myself and see if my doc had any availability this week or if I could see the nurse practitioner. Turns out I can come back in a couple days to see the NP – problem solved. It’s hard to always know what to do, how hard to push, and what really is possible. Just be sure to stay calm and just ask. The worst that can happen is they say no, but never be afraid to advocate for yourself.
On my way out the thought popped into my head, “what if this bronchitis stuff clears up by Thursday and my lungs are clear and they want to know why I’m wasting their time?” Then I remembered I’ve been sick since May, I’m still hacking out hockey pucks and no, I will not be better by Thursday. My initial z-pack from the Urgent Care clinic is gone and the last thing I need is to let this linger and turn into the p-word. No one has time for the p-word.
It’s that time of year again. The temperatures are dropping and winter is coming. The plants that produce all those horrible allergens slowly go the way of the buffalo and my biggest fear turns to all the perpetually sick people who tend to surround me everywhere I go. It’s not like I have one or several people to blame, it’s really society in general, and working at a university doesn’t help me avoid germs. There’s only so much hand-washing, avoiding door knobs and staying away from crowded areas before I eventually come down with something. Last week my allergies went berserk on our way to Pittsburgh and I just stayed stuffed up/congested all weekend. Monday night I felt like I might be getting a cold/virus and then as the week progressed I watched as I started coughing blowing out multi-colored snot/mucous/phlegm and eventually went to an urgent care facility Saturday morning to be diagnosed with acute bronchitis.
I “love” trying to explain things to doctors who aren’t really paying attention. I realize I was at the urgent care and these aren’t my normal doctors and nurses, but when a guy walks in with obvious breathing issues, hands over a list of 15 medications and tells you “I have severe asthma” you’d think the next question wouldn’t be – “ok…do you use an inhaler for that?” My long list of medications, clearly separated into maintenance and rescue categories, has several inhalers listed. The doc didn’t really know what to do with me. She also wasn’t paying much attention until I said I’ve been to the ER/admitted seven times since June and have been on prednisone since May. Her eyes got really big and then she wanted to know if I’ve ever been intubated before, etc, etc. I eventually left with a 250mg z-pack for 5 days and was told, “you’re probably going to be very uncomfortable for a couple weeks.” I figured it wasn’t worth saying I’ve been very uncomfortable for months.
The weird part is noticing how this is affecting me differently than the other flares I’ve had these past months. I’m actually breathing much, much better than I was in August, but am still struggling. I’m just not bad in the sense that I need to be on supplemental oxygen and monitored constantly. At this point I’m still feeling the need to attempt work due to the ridiculous FMLA situation and I don’t really have any sick/vacation time to use up. Six months ago this would be a stay-home-no-brainer, but comparing how I am now to how I’ve been in the recent past…this isn’t that bad. I’ll really have to make a judgement call in the morning, but the good news is I happen to have a three month follow-up with lung doc #1 scheduled for Tuesday so we’ll see how my lungs sound and if I need upgraded to levaquin or something more heavy duty.