Praise then darkness, and creation unfinished

I saw the pulmonologist today, with adrian_turtle there for emotional support and to help me remember things) and what the doctor said was reassuring. She showed us the CT scan images, described what they showed, and told me that I have what looks like mild bronchiectasis, and the treatment is to do things to clear my airways.

To clear my airways, I'm supposed to take guaifenisin, then two puffs of the inhaler, then "10 huff breaths" into the flutter valveacapella device. When we went to order that device online, as Dr. Koster recommended, Adrian noticed that the contraindications include ruptured eardrum. So I just sent the doctor a message asking whether having had a ruptured eardrum several years ago, which healed as well as they ever do, is relevant here. That happened before I moved to Massachusetts, and isn't in my records at Mt. Auburn.

Next week (or maybe the week after, given holidays) I will go to the hospital three times, on consecutive days, so they can take sputum samples, which will be sent off to be cultured, with results in 8-12 weeks. (It's not the lab, the "mycobacterium avian complex" are inherently slow-growing.) I have a follow-up visit in three months, with a pulmonary function test before I talk to the doctor. If it's positive, we will discuss whether I should take multiple antibiotics every day for a few months, or just wait and keep an eye on things.

To clear my airways, I'm supposed to take guaifenisin, then two puffs of the inhaler, then "10 huff breaths" into the flutter valve. When we went to order the flutter valve online, as Dr. Koster recommended, Adrian noticed that the contraindications include ruptured eardrum. So I just sent the doctor a message asking whether having had a ruptured eardrum several years ago, which healed as well as they ever do, is relevant here. That happened before I moved to Massachusetts, and it's not in my records at Mt. Auburn.

ETA 12/18: Dr. Koster said I should order and start using the device, and let her know if I experience any sensitivity in my ears when I start using it. So I have done so, for delivery 12/22, that being the earlier of the two options on Amazon. (The guaifenisin should be here on the 20th.)

Dr. Koster also said I should stop using the steroid inhaler (because it can increase the risk of infection), and just use the albuterol. I'd be using that twice a day, every day, as part of clearing my lungs, and I'm thinking as needed and once at bedtime until I hear back from her about the flutter valve.

After reading the instructions carefully a couple of times, and getting cattitude to read them carefully, I have used the first dose of the inhaler, and rinsed my mouth afterwards as instructed.

It's a good thing the instructions note that I might not notice the powder entering my mouth or lungs, because I didn't. I think I followed the instructions properly, but I should reread them again before the next dose (in the morning).

It's also a good thing Cattitude was here to help me get the thing open the first time, because removing the cap for the first time needed a stronger grip than I have.

I am supposed to use this twice a day, whether or not I've been coughing, and can use the albuterol as a rescue inhaler if I'm coughing despite the Pulmicort.

I have a 30-day supply, and Carmen wrote the prescription with one refill. I have an in-person follow-up with her on December 14th, which will be long enough for me to get an idea of whether it's working. The follow-up is in person so she can measure things about my breathing, something that wouldn't work by telemedicine.

I've mostly spent the past week being sick, and/or getting over being sick, depending on how one looks at it. I took two sick days (Monday and Tuesday of last week), then worked from home on Wednesday. Thursday and Friday I went to work, and grumbled about some of the details of that (it's not my boss's fault, but we are on another annoying project that will mess up deadlines).

cattitude got back from California Friday evening, and has been taking care of me over this long weekend. This helped, both on a variety of emotional levels, and on the practicalities of not needing to go out if the milk supply was running low. (I pushed things a little on Tuesday, to get stuff like milk, juice, and toilet paper before the snowstorm. Going back to work on Thursday may also have counted as pushing myself.)

For chunks of this, I haven't even been focused enough to do any interesting reading, instead doing a lot of sudoku puzzles and rereading some Will Cuppy. I haven't been to the gym in a bit, which isn't good for my mood, but given the way my chest was feeling as recently as yesterday I'm going to wait until Thursday and my next appointment with Emilie. (I'm breathing reasonably deeply, but by evening there was some soreness, as of overexertion, near my sternum. Lots of hot liquids.)

I had meant to try to see people while Cattitude was away on business, but first I put off making plans while I saw how much time I needed alone, and then it was clear that I was sick, so I didn't arrange to see anyone. julian_tiger and adrian_turtle were both helpful in different ways, but both encouraged me to rest.

I have been to the cardiologist and had a stress test. The conclusion is that my heart is just fine. He thinks the breathing difficulties are "a touch" of cold or stress-induced asthma, and he doesn't think I need to pursue this any further, in part because I "exercised well," by which it turned out he meant without shortness of breath.

I asked his office to send today's results to my G.P., in case I do want to pursue it further, or she does. What I am not feeling at this point is any sense of urgency; it has now landed in the queue somewhere behind a dental appointment and seeing the eye doctor (both of which would ideally happen in February, but I suspect at most one will).

The stress test itself was rather less stressful than I was expecting: ultrasound, then walk on a treadmill until I got my heart rate up to 150, then another ultrasound. I don't usually get to 150 on the gym's cardio bikes, but it's not that unusual for me either.

After seeing the cardiologist, I walked a little in Carl Schurz Park (East End Avenue in the mid-Eighties, an area I don't remember ever visiting before), then rode the bus (since it was about to arrive) a few blocks to a branch of my gym. I did some weight training (this branch lacks some of the hardware I like, enough so that I may stop at the usual place after work tomorrow). I grabbed a not-very-good lunch at a random place nearby afterwards, then back across Central Park, and up to Washington Heights. I walked a few hilly blocks in the sunshine, and now have a loaf of seeded rye bread (some of which is in the freezer for later), and took the subway the rest of the way. Now, tea.

( gym details, for my records )

Well, I have the results of the pulmonary function test.

I called my GP's office yesterday afternoon, and told them that I needed a prescription to have it redone, and if they couldn't send it (and the receptionist seemed to think that this was impossible, and that the hospital that had lost track of the first one would happily call them to get another) someone would call me.

This morning, I found voicemail from my doctor's office from later that day, saying that they didn't want to write me a prescription to have the test redone because they had the results. Yes, phrased about that way. However, I am told that the test results were normal.

I am also told (or my voicemail is) that the hospital mailed the doctor the results. I am left to guess whether they would ever have notified me, if I hadn't kept calling to ask for a replacement prescription. The timing is a little too coincidental otherwise, and there was no suggestion of "the hospital that said it couldn't find the tests when we asked for them has sent them to us," as I would expect if they had turned up in that day's mail, rather than having been sitting, ignored for some days after I had called repeatedly asking for them. I realize that doctors wait to be called for test results. But this doctor's office had made it fairly clear that they had my messages, and knew I wanted these results: it's just not clear whether that applies when it means they have to actually give me them, rather than just convince me not to call daily.

I am contemplating changing doctors, but the questions include whether another would be better at this sort of thing, and whether near my office is actually a good idea: handy for routine things, not so good if I'm sick enough to stay home from work and want to see a doctor.

And I need to call a cardiologist, that being the next stage here given that the lungs have tested normal, as expected.

ETA: I just called my health insurance company's robot system, and found that they processed two claims for 12/15, one processed weeks ago (that'll be the X-ray) and one processed yesterday, so it seems pretty clear that the hospital dropped the ball here, not the GP. Nonetheless, my current doctor's office is also not exactly convenient for me; the question is, in part, whether it is less inconvenient than East 19th Street (or some other midtown or even Washington Heights location) would be. But the question feels somewhat less urgent.

I saw a pulmonologist yesterday morning. He and his nurse ran assorted tests, including breathing into their equipment, a nebulizer, breathing in specific ways while he listened to different parts of my chest with a stethoscope, and X-rays, and asked a bunch of questions. The conclusion is that I don't have asthma--which I had rather thought, but it's well worth it to be sure.

He did say that if I have another episode like last Thanksgiving, of the serious breathing problem which turned out to be a lung infection, he'd like to see me during it.