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!  :)

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