Friday, August 30, 2013

3rd Second Chance - Chapter 1.4

I had my lung consultation this week with the Pulmonary MD. 

He reviewed my CT Scan and PFT (Pulmonary Function Tests) results.  

The CT Scan, compared to the last one I had in 2010, was mostly unchanged.  No evidence of blood clots, or cancer, or any other evilness lurking in my lungs.  All good!

The PFTs indicate that I do have moderate/severe Obstructive Pulmonary Disease.   He isn't quite sure why, or what specifically caused it.  My test for asthma was negative.  I was a smoker, for about 7 years, quitting in 1983.  He said that wouldn't be the cause.   He gave me an inhaler to try.  Although he indicated if it doesn't help within 2 weeks, then it won't be beneficial.  So far, it has made me cough more.  I am not seeing any improvement. 

Otherwise, he said that my lungs looked clear and were well enough to proceed with heart transplant evaluation.  He will send his written report to my Transplant Doc.  More good news!

This week I also had an appointment with my regular Cardiologist.  He told me that he received a lengthy report from my Transplant Doc, and that he agrees I am doing the right thing at this time of my heart disease.  Hhhmmmmmmmm.....  ✔ one for me!

My blood pressure has been running low... too low.  Recently, I've been having more "moments" of extreme light headedness, resulting in one black out incident.  A "moment" tends to occur whenever I've been sitting for 20-30 minutes and I stand up.   For example, when I get up from the sofa, I need to walk about 7 feet to the kitchen counter.  If I get up too fast, by the time I reach that counter, I'm hanging on for dear life.... And if I can't make it to the stool, just 2 more feet away, I will feel my knees begin to wobble.  I will either make it to that stool.... Or.... I will drop to the floor.  Totally unpleasant indeed.    If I get up and pause long enough, I can keep my "moments" more under control.   So, the Doc  reduced one of my meds that will bring my BP up a bit.

Once my Transplant Doc reviews the testing and written reports, he'll indicate what will be the next round of poking and prodding.

I often stop and think about this whole process, and the celebrated steps along the way.  I know its still early on in the process and my heart still functions on its own.  So it's hard to bring on the reality of replacing my heart.  I don't want to make it sound like its "so matter of fact".... It most definitely isn't.  I'm still not even sure how I feel about it yet.  There's way too many emotions that I can't quite sort out just yet.  

Stay tuned.... More to come!  

Thursday, August 15, 2013

3rd Second Chance - Chapter 1.3

As scheduled, I had my CT High Resolution Chest scan and PFTs on Monday. I was hoping to have radiologist and physician reports by now to possibly share.  But, not so.  Instead I'll describe the tests as I experienced them.

Both series of tests were non invasive!  No major pokes or prods.

It started with the CT Scan.  Very easy.  Essentially, I laid flat on my back, on a very thin table.  I had to raise my arms up over my head (which is rather difficult for me due to the RIBP).  The technician aligns the table with the 'donut' hole of the CT machine.  When the scanning was ready to begin, the table moved through the 'donut' hole, aligning my neck and chest.  At the same time the table moved back and forth, inside the CT 'donut' hole, I could see spinning of the scanner inside the machine.  This spinning device is what takes the 3D images and pictures of my chest from front to back.   Relatively high radiation is used for this test.  In all, I would say the entire scanning portion took 4 minutes.  No contrast dye to drink, and no contrast dye injected. :)

Next up was the Pulmonary Function Testing.  Also, somewhat easy.  These tests took much longer to complete.  I am guessing, that overall, they took about 45 minutes.  The tech had me sit in a small, glass room.  Sorta like a telephone booth.  Connected to the inside of the booth was a tubular breathing gadget, with a blue mouthpiece.  Most of the tests were performed with the booth door open.  For each test, I had to place a nose clamp over my nostrils to keep all breathing through my mouth into the mouthpiece.  Measurements were taken for exhaling and inhaling strengths.  Most tests were repeated 3 times. One of the tests was to check if i have asthma.  The tech had me do a series of breathing steps through the mouthpiece.  Then gave me too "shots" from an Albuterol inhaler.  Then, I repeated the series of breathing through the mouthpiece.  The tech did share with me that I do not have asthma.  I had all of the breathing tests as I previously indicated I would in the blog post of August 9.  The exception was I did not have the ABG (Arterial Blood Gas) test.  Yay!!

Here are a few pictures to show the booth I was in.  The breathing tubes were swung out and away in these pics.  But, when the testing begins, the breathing gadget is moved inside the booth.   There are also a couple of links to videos I took of the testing booth.

 You can see my cute little nose clips on the chair.

The breathing tubular gadget is swung out of the both on the left.  The blue portion on the end of it is the mouthpiece

PFT Booth 1  Click for video

PFT Booth 2   Click for video

I received a copy of the PFT results.  I did not receive a copy of the Radiologist report for the CT Scan, nor did I receive a copy of the Physician report for the PFT.  I will need to wait for my evaluation appointment with the Pulmonologist on Aug 26 to learn more.

Have I told y'all that I absolutely HATE to wait!

That's all I have for the moment.   More to come after Aug 26th!

Monday, August 5, 2013

3rd Second Chance - Chapter 1.2


My Right Side Catherization on Monday went well.  It was relatively painless.  Bee sting of lidocaine to the right side of my neck.   Followed by lots of pressure and a few more pinches.  No drugs to ease any anxiety or nervousness.  I was actually fine without them. I was totally conscious.  Once the IV sheath was inserted into my jugular vein, the Dr started feeding the catheter.  I could watch it on the monitor as it moved through the vein, and into the heart.  When it entered my heart, I could feel it.  An odd feeling.  Almost a tickle.  Although I did not laugh, I believe I may have coughed.  Then I could see it pass all the way through my heart, and out the other side.  Quite cool, indeed.  Several times during this process, the Dr drew small amounts of blood, handed them off to a tech, who placed them in a machine.  From that machine various measurements were taken.  There was also a tech watching a PC monitor, capturing various pressures.  All of these measurements and pressures roll up to an index.  My index was 2.84.   A normal cardiac index, according to Wikipedia, is 2.6 - 4.2.  If it was 2.0 or below, they would have started me on the Primacor IV drug (to aid with moving oxigen rich blood), and kept me in the hospital for all testing. 

Although the right side of my heart tested well, within a normal index, it is only a matter of time for it too, to fail due to the progression of the disease.  The left side of my heart is what is severely damaged.  Primarily a result of the Adriamycin in my chemo and radiation therapies.  So we are still moving forward with the transplant testing evaluation.  I will just need to do it as an outpatient.

Next up are a high resolution CT scan of chest, and  several Pulmonary Function tests.  

A high resolution CT (HRCT) scan takes many very thin sliced pictures of the chest.  Like cutting straight through my body, from front to back.  Each slice provides a lot of detail about the organs and other structures in the chest.  This will determine what damage the radiation has caused my lungs and chest.  Fibrosis, or scar tissue, causes breathing and lung restriction.  It will also help indicate how much of my shortness of breath is due to my heart damage.  All I'll need to do is lay flat on a table that will slowly feed through a large donut hole of the CT machine.

The Pulmonary Function tests consist of a DLCO, ABG, PFT and lung volumes.  

A DLCO is a lung diffusion measurement of how well the lungs exchange gases.  A major function of the lungs is to allow oxygen to pass into the blood from the lungs, and to allow carbon dioxide to pass from the blood into the lungs.  To do this test, requires breathing through a plastic tubed mouthpiece, and performing exhaling and inhaling steps as directed by a tech.

An ABG (Arterial Blood Gas) test measures how much oxygen and carbon dioxide is in my blood. It also determines the acidity (pH) of my blood.  This test checks how well my lungs are able to move oxygen into the blood and remove carbon dioxide from the blood.  Blood is taken from an artery in the wrist, a femoral artery in the groin, or the brachial artery in the arm.  OUCH!!  

A PFT (Pulmonary Function Test) Lung Volume measures the function of lung capacity and lung/chest wall mechanics to determine whether or not there may be a lung problem.  It will measure how much air I can exhale, and how much air I can inhale.  Specifically, how much air can I blow out of my lungs and how fast can I do it - strength of breathing muscles. This too, is a test that requires breathing in and out of a plastic tubed mouthpiece, and performing exhaling and inhaling steps as directed by a tech.

All of these tests are scheduled this coming Monday.  Followed by a consult and evaluation by a pulmonary MD, who works directly with my Transplant Team, at a later date.

Overall, I feel OK.  A bit more tired, more coughing, more light headed.  But still, I feel OK.  The heat here in TX has been in the 100's the past couple weeks.  That kind of heat makes breathing a bit more difficult.  

I'm still on target for overall evaluation - more to come!  :)

Saturday, August 3, 2013

3rd Second Chance - Chapter 1.1


I have been scheduled to do the Right Heart Catherization this coming Monday, 8/5.  Depending upon the outcome of the results, I may come home the same night, or next morning.... or, I may be able to stay for the week, and complete all transplant testing.  That, is preferred for me!  Otherwise, if I get sent home after the Cath, I'll have to do all the tests I listed on the previous post, as an outpatient.... Not fun.... Driving downtown, paying to park, very exhausting for me.  So, as those who know me best, for me to say I "want" to stay in the hospital, know it would be the better option overall!  

I may be 'out of touch' for a day or two at most.... :)