Boy, the year 2011 has been a struggle for me health wise. I don’t know if it was self-inflicted or not, but I have not been the same after that 39.3 mile weekend in January.
On Monday two weeks ago I woke up to pain under my left shoulder-blade when I breathe in deeply. Plus, my lungs did not seem to be happy either. PF (peak flow) were a tad low but that is not uncommon in the morning. The biggest thing that was concerning me, I was getting winded easily. Unfortunately, the whole day I was feeling pretty crappy and taking short breaths to keep the pain at a minimum.
Tuesday wasn’t much better, blowing a PF of 380 (69% of personal best) did not thrill me.
Allow me to digress a moment, after the January down turn, my PFs on a good day ranged about 450 – 480 (82% – 87%) consistently. In December of last year I was consistently in the 510 – 540 (93% – 98%) on my good days. Yeah, I could see the down turn even in my PFs also. Anytime my lungs get below the 400 range, I can really feel it.
Anyway, Tuesday by mid-morning I was still blowing a 380 even after taking my control meds and quite a bit of relief meds. Oh, the lovely pain under my shoulder-blade was still there also. Well, this is the part of the story were I over react to my condition. To kind of defend myself, this was my first experience with my lungs acting this way. Hey, I have only been an asthmatic for a year now. I am sort of a newbie to this disease. Most of my exacerbations have been severe dyspnea, which made standing for 5 minutes like sprinting 400 meters (that’s even with nebing ever two hours). I was not anywhere close to that.
So, I decided that the pain and my cranky lungs need a professional opinion (basically I thought I needed help). I called my pulmonologist and the nurse suggested that if I feel that I need to be seen quickly I should either see my GP (general practitioner) or go to urgent care. I was really scared that the pain was not a good thing that I ventured over to urgent care in the hopes that they would give me some relief. After listening to my lungs…not much air moving and x-rays…lungs looked good, the doctor on duty told me that I should continue what I am doing and that was it. Boy was I frustrated, I was a few bucks lighter due to copays and no relief. Although, I did have some peace mind because my x-rays showed no infections. Oh well, I had a three-month check-up appointment for my pulmonologist in two days so I would see if I could get relief then.
Wednesday rolled around with little change.
Thursday was my pulmo doctor visit and spirometry test. I try to stay off relief meds the morning of the test so I can get an accurate test of my lungs, but I couldn’t do it this time around. I need to take a drag off the inhaler first thing when I got out of bed and then nebed at 10am, two hours prier to the test. I was getting winded a lot and didn’t feel like pushing it any longer. After the drive across town and a lengthy walk to the building, I was totally out of breath. Being that I made it in the nick of time, the respiratory therapist (RT) arrived in sort order and took me to the room with the glass box (dreaded Pulmonary Function Test equipment, called PFT for short). I don’t know about other offices but my pulmonologist office has two of these PFTs and my doctor can have results in his hand in minutes after I am done. I sure beats going to the hospital to get it done.
Before starting the test I told the RT that I had taken relief meds today and that I am not doing very well. She told me that it was good that I disclosed that because they need to take this in consideration as my test results are reviewed. I also told her that I just might pass out this time around as I do the spirometry test (thank goodness that was the only test my doctor had ordered for the visit). For some reason I get very light-headed doing this test. She told me that this is common and pointed to the rubber mat just outside the glass booth. Gosh, I guess I wouldn’t be the first person to fall out of the booth and land on the mat. Luckily, I managed to not pass out but boy was I light-headed. I also went on a coughing spell, which was unpleasant, after completing the last of three tries. Hmm…this was the first time for that to happen to me.
After the PFT, I was off to do some waiting in the examining room. The doctor finally arrived and had this look on his face. Yeah, the look of “Should I ask him how his three months have been”. He could tell by the test that my FEV1 (gauge of lung obstruction) was not what it should be. Sadly, after downing all the pulmicort to fix my January exacerbation, my FEV1 was 71%. This was the same as last visit.
He looked at my chart and told me that I am taking quite a bit of steroid. Huh, you are telling me? Yes, I find (by a combination of symbicort and pulmicort) 1000mcg of budesonide daily to be a frightening amount. After a little discussion, we came to the conclusion that I can drop one puff off the pulmicort since it made little difference since last visit. I was pretty happy to hear him say that. I have wanted to wean off the stuff for a while now. It is hard on the waist line, you know!
For some reason, lately, he hasn’t been telling me my test results. When I was climbing to a near normal lung function he always told me where I was at. Now, he doesn’t tell me and I really would like to know. I made him show me my test results this visit. Yeah, sadly, I have dropped a few percentages and have stayed there for three months. Brightside, I have not gone any farther down. My FEV1 was 71%, which was not too bad, but it was showing obstruction. Ouch, I hate hearing that.
We also had a discussion about my looming blood work and why it has not been done yet. I told him, yet again, that I need help because I am scared to death of it. Finally, he got the picture and gave me a prescription of a “don’t give a hoot about anything” kind of pill. I hope the darn thing works (yeah, still working on getting my blood work done. I can’t drive while under the influence of this drug. So, somebody has to drive me there. Weekends have been really busy lately, the only time we have to get it done.)
As for the crappy week, he didn’t have anything for me either. He said my lungs are rubbing like sandpaper against something (not sure what he said) and causing pain during inhalation. I was a little shocked that there was no relief to be found by this doctors visit either. Rats!!! I guess I was meant to suffer this time around.
Good news, the crappy week started to dissipate the next day and I steadily started feeling better over the weekend. I was glad to see this because all I wanted is to get better and get back to my 10K training schedule.
Wow, this has gotten to be a long-winded post. I learned quite a bit from the week.
1) I really need to write an asthma action plan and quit waiting for a doctor to do it for me. (Basically monitor how much relief meds I am taking and seeing when enough is actually enough before seeking help. Plenty of info from the CDC to assist me in making it. I think it will be much more helpful to have this written down instead of in my head.)
2) Do not panic
3) Quit going to urgent care and just go to my primary doctor (I can wait a day to see him. If I am that bad, maybe I should go to the ER instead).
4) Listen to my inner-self a bit more (Yeah, I actually do feel it coming on the majority of the time. I should go by my action plan and when I can do no more with my relief protocol, seek out help).