Those are heavy words to hear in a wrap up visit one hour before I have to rush to the airport. That's how it went though. Dr. Olson walked in saying those exact words. She was so relieved. She hugged me with tears in her eyes as she said it again with delight, "you don't have eosinophilic leukemia". She and Dr. Katial had been very concerned that it would be my diagnosis. It's not though!! (Let me tell ya though, even with the word NOT included, those words have a pretty hard impact when they're applied so close to home.) That's by far the biggest blessing of the week though! It's definitely something to celebrate. The preliminary results of the bone marrow biopsy are all they have so far, and all they know for certain is that it is NOT leukemia.
The next step is to wait. The rest of the results from the biopsy will be in by the middle of next week. Dr. Olson explained their expectations. It could be hypereosinophilic syndrome, Churg Strauss Syndrome, or terrible intrinsic asthma with high eosinophil counts. Regardless of the diagnosis, she said my treatment options have to change. Steroids do not work for my body anymore and have caused too much damage. There are chemo treatments or other therapies/antibodies they are going to try once a diagnosis is in place. Two of the possibilities are hydroxyurea or anti-interleukin-5 (IL5). She didn't go into details about prognosis or treatments for any of the possible outcomes. She said it would be best to discuss details when we know which one we are dealing with. As soon as the hospital calls with the results, all the doctors that treated or consulted on my case this week are going to have an interdisciplinary conference to create my treatment plan. She said she'll call as soon as she has any information.
That was the big news. On a smaller scale, she said tests confirmed I have an internal staph infection again. By Monday she will know which antibiotic she can prescribe for it and will call me with that information. We also discussed the dangerously low level of my current lung function and the fact that I'm heading back into a high risk environment Monday by going back to work. We were both concerned that I spiral downward too quickly before we will have time to get the new treatments started. She prescribed antibiotics and prednisone to get me back on track and stable.
She also increased my current asthma medications and added azithromycin, the antibiotic, three days per week. She said it would help to decrease lung inflammation. Many of the other tests from the week are still pending, so all of that information will also come later. For now, I'm thankful that I don't have leukemia and waiting hopefully to find out how to treat what I do have.
Saturday, July 30, 2011
Friday, July 29, 2011
the real me
What a week. Even though I am recounting these events daily, it's simply impossible for me to express what's really been going on inside me. I just won't allow myself time to process the gravity of what I've been through. I've adapted so strictly to the art of pushing through that I don't even know how to be truthful to myself about pain and weakness and even fear. I don't want to take the time to slow down and fall apart. I just want to believe that it's going to work out, and move forward with life. All in all that is a good plan and I truly believe that it is part of why I'm alive today. At the same time, I'm starting to recognize it's flaws. My illnesses, pain, weaknesses, and fears may not define me, but they are part of me and have definitely played a huge role in making me who I am today. Maybe instead of denying these parts of me, I need to start owning them.
The title of this blog is All for Good. That came from my belief that God can use everything for His Good. I have always known that in some way for some reason and somehow, all that I have experienced and lived through (no matter how yucky) would be worthwhile because in someway Good would come to someone because of it. I have been content even peace-filled about that. Maybe there's even more to it though...maybe it's time to become a little more accepting and own what I've been through. I've realized that by denying these parts of myself, I've been denying Good God has for me. I should be experiencing everything in my life~the good, the bad, and the ugly. It's all adding to the complicated mess of a project that I am.
I don't want to become a whiner, but I at least must learn to be real with myself. I can't continue to push past everything. This week was real and I need to be able to admit that it was unbelieveably tough. Each day was so packed with painful, exhausting tests and doctors relaying overwhelming news. Looking back, I know the only reason I made it through was because of prayers. This is the gift of my life...I am ready to own it. I am thankful beyond words for every test, doctor, nurse, and experience that I had this week. As hard as it was, I still loved being there because it was obvious that they ALL wanted to help me.
So I guess this means when I lay down tonight, I just might cry a little when I think about having to say yes to a third bone marrow biopsy. I also might chuckle when I think about my leg muscle cramping during the sleep study and I was afraid LaTasha, the tech would think I was thrashing about wildly on the video. Then I'll smile when I remember how Dr. Olson lit up and hugged me when she saw me in the hallway on Monday morning for the first time. And all of these emotions and more will be okay because they are part of me...christian, daughter, friend, asthmatic, dog lover, teacher, congenital heart disease, sister, undefined illness, althogether & more...the real me.
The title of this blog is All for Good. That came from my belief that God can use everything for His Good. I have always known that in some way for some reason and somehow, all that I have experienced and lived through (no matter how yucky) would be worthwhile because in someway Good would come to someone because of it. I have been content even peace-filled about that. Maybe there's even more to it though...maybe it's time to become a little more accepting and own what I've been through. I've realized that by denying these parts of myself, I've been denying Good God has for me. I should be experiencing everything in my life~the good, the bad, and the ugly. It's all adding to the complicated mess of a project that I am.
I don't want to become a whiner, but I at least must learn to be real with myself. I can't continue to push past everything. This week was real and I need to be able to admit that it was unbelieveably tough. Each day was so packed with painful, exhausting tests and doctors relaying overwhelming news. Looking back, I know the only reason I made it through was because of prayers. This is the gift of my life...I am ready to own it. I am thankful beyond words for every test, doctor, nurse, and experience that I had this week. As hard as it was, I still loved being there because it was obvious that they ALL wanted to help me.
So I guess this means when I lay down tonight, I just might cry a little when I think about having to say yes to a third bone marrow biopsy. I also might chuckle when I think about my leg muscle cramping during the sleep study and I was afraid LaTasha, the tech would think I was thrashing about wildly on the video. Then I'll smile when I remember how Dr. Olson lit up and hugged me when she saw me in the hallway on Monday morning for the first time. And all of these emotions and more will be okay because they are part of me...christian, daughter, friend, asthmatic, dog lover, teacher, congenital heart disease, sister, undefined illness, althogether & more...the real me.
Day Five~down to the wire
I woke up very early today...well, who am I kidding, I'm not sure if I really even slept??? This is it. As much as I want to stay here forever, as torn as I am about leaving with results pending~this is it. Our flight leaves Denver today at 6:10 and I'm pretty sure that I'll be on it. It's down to the wire and I don't only feel that sense of urgency within myself, but I feel it coming from Dr. Olson too. My schedule is jam packed today with everything else that she anticipates needing in order to diagnose me and develop a treatment plan. I approached the day filled with the clashing combination of anxiety and hope.
We completed the rental apartment check-out list, loaded the car, and headed around the corner to National Jewish. My first appointment was in radiology for a neck CT. It looks like the VCD is still cutting off my airway according to PFTs. The CT will make sure it is VCD and not damage from when I was intubated in the past. (The scan was normal - so it is the VCD I'm still fighting)
Next I had a Nutrition consult. Every doctor I've seen this week has been extremely concerned about my weight loss. My current weight is fine, but the problem is that the weight loss has been unintentional. Weight is something that I have never been one to talk about or point out (loss or gain) - on myself or anyone else. I'm just very uncomfortable with the subject. I've never been a huge eater, but gained weight like crazy anyway when I was put on such high doses of steroids long term. When I was finally off them in November, I suddenly started losing weight. I assumed that was the reason. Apparently there's more to it than that. They think it's a combination of natural loss and a possible adrenal insufficiency. The nutrionist and Dr. Olson talked to me about taking measures to not lose any more weight - how bizarre. They even connected it to impacting my illness. I trust Dr. Olson so much, but this one is definitely harder for me to grasp.
With nutrition concerns spinning in my head, I sprinted upstairs to the MIDC (minimally invasive diagnostic center) for my cosyntropin stimulation test which is the adrenal insufficiency test. It involved an IV and a lot of down time. Nurse Jennifer was administering the test but to my delight Deb (from Tuesday) was training her! They had to draw blood, inject cortisol, and draw blood again periodically. As time passed they would come in and out of the room to chat as they had time. Deb shared stories about crazy tunnels beneath National Jewish that led across Colorado Blvd and creepy chambers in the old TB wards. Seth, one of the nurses I had back in April & May even stopped in to catch up. I just adore these wonderful people. :)
I met with Dr. Musani next, an interventional pulmonologist. This meeting was informational more than anything. Dr. Olson wanted him to talk with me about the possibility of bronchial thermoplasty. It's a series of procedures over a six week time period where the doctor uses heat to reduce the smooth muscle in the airways of the lungs. This reduces their ability to constrict causing fewer asthmatic episodes. The problem in my case is that it is best suited only for patients with severe uncontrolled asthma, but are healthy in all other ways. My heart, sinuses, and high eosinophil count rule out the possibility of this treatment for now - but he said it could be an option in the near future.
On to rheumatology with Dr. Maleki ~ I really liked her a lot. This appointment was very long. She spent most of the time going step by step through symptoms of an autoimmune disease that she and Dr. Olson are looking at as a possible diagnosis for me. Churg Strauss Syndrome is so rare it only effects 10 in a million people. It presents as late onset asthma, heart defects, tingling or numbness in the extremities, and rashes. Dr. Maleki isn't certain that it fits me because I don't have the rashes. She's waiting for the bone marrow biopsy for more information. She ordered a few more labs and sent me on my way for the final wrap up with Dr. Olson.
We completed the rental apartment check-out list, loaded the car, and headed around the corner to National Jewish. My first appointment was in radiology for a neck CT. It looks like the VCD is still cutting off my airway according to PFTs. The CT will make sure it is VCD and not damage from when I was intubated in the past. (The scan was normal - so it is the VCD I'm still fighting)
Next I had a Nutrition consult. Every doctor I've seen this week has been extremely concerned about my weight loss. My current weight is fine, but the problem is that the weight loss has been unintentional. Weight is something that I have never been one to talk about or point out (loss or gain) - on myself or anyone else. I'm just very uncomfortable with the subject. I've never been a huge eater, but gained weight like crazy anyway when I was put on such high doses of steroids long term. When I was finally off them in November, I suddenly started losing weight. I assumed that was the reason. Apparently there's more to it than that. They think it's a combination of natural loss and a possible adrenal insufficiency. The nutrionist and Dr. Olson talked to me about taking measures to not lose any more weight - how bizarre. They even connected it to impacting my illness. I trust Dr. Olson so much, but this one is definitely harder for me to grasp.
With nutrition concerns spinning in my head, I sprinted upstairs to the MIDC (minimally invasive diagnostic center) for my cosyntropin stimulation test which is the adrenal insufficiency test. It involved an IV and a lot of down time. Nurse Jennifer was administering the test but to my delight Deb (from Tuesday) was training her! They had to draw blood, inject cortisol, and draw blood again periodically. As time passed they would come in and out of the room to chat as they had time. Deb shared stories about crazy tunnels beneath National Jewish that led across Colorado Blvd and creepy chambers in the old TB wards. Seth, one of the nurses I had back in April & May even stopped in to catch up. I just adore these wonderful people. :)
I met with Dr. Musani next, an interventional pulmonologist. This meeting was informational more than anything. Dr. Olson wanted him to talk with me about the possibility of bronchial thermoplasty. It's a series of procedures over a six week time period where the doctor uses heat to reduce the smooth muscle in the airways of the lungs. This reduces their ability to constrict causing fewer asthmatic episodes. The problem in my case is that it is best suited only for patients with severe uncontrolled asthma, but are healthy in all other ways. My heart, sinuses, and high eosinophil count rule out the possibility of this treatment for now - but he said it could be an option in the near future.
On to rheumatology with Dr. Maleki ~ I really liked her a lot. This appointment was very long. She spent most of the time going step by step through symptoms of an autoimmune disease that she and Dr. Olson are looking at as a possible diagnosis for me. Churg Strauss Syndrome is so rare it only effects 10 in a million people. It presents as late onset asthma, heart defects, tingling or numbness in the extremities, and rashes. Dr. Maleki isn't certain that it fits me because I don't have the rashes. She's waiting for the bone marrow biopsy for more information. She ordered a few more labs and sent me on my way for the final wrap up with Dr. Olson.
Thursday, July 28, 2011
Day Four ~ still amazed
Bike day - da dun da dun dadundadundadun! It's been such a traumatic and paralyzing thought to me that it's as if the Jaws music is playing in the background!! I don't know how I could have been more prepared. I dressed in my favorite Heart walk shirt :) and marched on to the third floor. My muscles tensed as I neared the check-in desk. Erin, the technician was ready and waiting for me (of course)! We went to the familiar room and she asked me to sit in the blood draw chair - eek.
Deep breath - I know this will be different I thought to myself...a man whose name I honestly blacked out came in and started working on my wrist for the arterial line. He had no luck. He tried three times. He became quite frustrated with my tense, trembling muscles and finally gave up. Brenda, the respiratory therapist jumped in to give it a whirl. She gave it good digging - gouging try with great effort, but no success. Throughout the process I was hinting and blatantly requesting that they get Tom to do it. He seems to be able to work with me like magic. Finally, they gave in. They returned to the room with Debbie (Bowdy- my friend) & Tom. I was instantly relieved! He smiled at me, asked for a hand warmer, and cleared the other therapists from the room. He placed in on my ice cold wrist and hand and waited patiently while he chatted with us (mostly Debbie - I wasn't so chatty at the time). He turned my wrist and calmly went to work. He took his time and successfully set up the IV in my artery. After drawing the first blood gas he called the others back into the room. We were finally able to move on with the test smoothly. Ten minutes later it was over. The nightmare had ended! Erin said my exercise tolerance was exceptional considering my lung function. I decided to mark that in the positive column and leave the third floor as quickly as possible. ;)
I had exactly ten minutes to change my clothes and check in on the first floor for my ENT appointment with Dr. Ramakrishna. I was shocked when he walked into the room because Dr. Olson was with him. She said she was concerned about the role my sinus disease was playing in my illness and wanted to be part of the appointment in person. (Wow) The consult revealed what he believed to be a staph infection in my sinuses and that I'll need another sinus surgery in the future. This time they strongly suggested that I have the surgery in Denver with Dr. Ramakrishna. They explained that I need a surgeon that specializes in complicated cases and treats them on a regular basis.
Cardiology was the focus for the afternoon. I had an ECG (which is the new acronym for EKG) first. At three o'clock I met with my cardiologist, Dr. Fenster. He explained the results from the bubble saline stress test I completed in February. (We didn't get to meet at that time). My heart was in great condition. The repair appeared to be a complete success. There was some evidence of bubble transfer between my lungs though. He said this was really nothing for me to worry about though, it was more diagnostic information for the doctors. It simply reveals that I have severe lung disease of some form-which we all know. :) Next, he discussed his and Dr. Olson's concern about my weight loss. He asked questions about my changes in taste since the heart surgery and let me know they are scheduling an adrenal insufficiency test. It will note any problems with my adrenal glands since the adrenal crisis which could be causing the unintentional weight loss.
At four o'clock I headed across the hall for an ECHO. Dr. Fenster explained that he ordered this ECHO to check for signs of eosinophils infiltrating the heart. He said he would review the test later this evening and consult with Dr. Olson tomorrow.
As we left, I had a call from my scheduler, Jennifer, so we stopped by to see her. She let me know that Dr. Olson had just called her and ordered more tests and consults for Friday. She still has one more test to fit in and at this point I only have one hour left open in the whole day! That doesn't allow much room for compromise! I know it will happen though - I have no worries. What I do have is awe. I am so blessed to be in this place. This is my fifth separate visit to National Jewish and I am still amazed at how wonderful it is. How often do you go to an appointment with two of your doctors collaborating in the same exam room because they want what's best for you?
Deep breath - I know this will be different I thought to myself...a man whose name I honestly blacked out came in and started working on my wrist for the arterial line. He had no luck. He tried three times. He became quite frustrated with my tense, trembling muscles and finally gave up. Brenda, the respiratory therapist jumped in to give it a whirl. She gave it good digging - gouging try with great effort, but no success. Throughout the process I was hinting and blatantly requesting that they get Tom to do it. He seems to be able to work with me like magic. Finally, they gave in. They returned to the room with Debbie (Bowdy- my friend) & Tom. I was instantly relieved! He smiled at me, asked for a hand warmer, and cleared the other therapists from the room. He placed in on my ice cold wrist and hand and waited patiently while he chatted with us (mostly Debbie - I wasn't so chatty at the time). He turned my wrist and calmly went to work. He took his time and successfully set up the IV in my artery. After drawing the first blood gas he called the others back into the room. We were finally able to move on with the test smoothly. Ten minutes later it was over. The nightmare had ended! Erin said my exercise tolerance was exceptional considering my lung function. I decided to mark that in the positive column and leave the third floor as quickly as possible. ;)
I had exactly ten minutes to change my clothes and check in on the first floor for my ENT appointment with Dr. Ramakrishna. I was shocked when he walked into the room because Dr. Olson was with him. She said she was concerned about the role my sinus disease was playing in my illness and wanted to be part of the appointment in person. (Wow) The consult revealed what he believed to be a staph infection in my sinuses and that I'll need another sinus surgery in the future. This time they strongly suggested that I have the surgery in Denver with Dr. Ramakrishna. They explained that I need a surgeon that specializes in complicated cases and treats them on a regular basis.
Cardiology was the focus for the afternoon. I had an ECG (which is the new acronym for EKG) first. At three o'clock I met with my cardiologist, Dr. Fenster. He explained the results from the bubble saline stress test I completed in February. (We didn't get to meet at that time). My heart was in great condition. The repair appeared to be a complete success. There was some evidence of bubble transfer between my lungs though. He said this was really nothing for me to worry about though, it was more diagnostic information for the doctors. It simply reveals that I have severe lung disease of some form-which we all know. :) Next, he discussed his and Dr. Olson's concern about my weight loss. He asked questions about my changes in taste since the heart surgery and let me know they are scheduling an adrenal insufficiency test. It will note any problems with my adrenal glands since the adrenal crisis which could be causing the unintentional weight loss.
At four o'clock I headed across the hall for an ECHO. Dr. Fenster explained that he ordered this ECHO to check for signs of eosinophils infiltrating the heart. He said he would review the test later this evening and consult with Dr. Olson tomorrow.
As we left, I had a call from my scheduler, Jennifer, so we stopped by to see her. She let me know that Dr. Olson had just called her and ordered more tests and consults for Friday. She still has one more test to fit in and at this point I only have one hour left open in the whole day! That doesn't allow much room for compromise! I know it will happen though - I have no worries. What I do have is awe. I am so blessed to be in this place. This is my fifth separate visit to National Jewish and I am still amazed at how wonderful it is. How often do you go to an appointment with two of your doctors collaborating in the same exam room because they want what's best for you?
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| Beautiful Downtown Denver |
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| Larimer Street |
Wednesday, July 27, 2011
Day Three ~ A Biopsy to Remember (times 3)
The big day was here. I've read about bone marrow biopsies and heard horror stories from people who've been through it. For some bizarre reason though, this morning, I was okay. I wasn't freaking out, I was surprisingly calm. I knew it needed to be done, and I knew I could handle it. I was ready.
We headed over to the University Hospital and checked in. Of course they needed to draw more blood right away - and chose to draw from the exact same over-abused spot. Next I was called to the back. They gave me ativan to help me relax. (honestly I didn't feel like I'd taken a thing). The nurse practitioner, Christy, asked me to lie on the table on my stomach. I was surprised to find out that I didn't even have to change into a hospital gown. :) (there's a positive). Hank, the friendly and calming nurse put on some music. They rolled down the waist of my jeans and started cleaning.
She started by putting pressure on the back of my left hip to find a spot on the bone that didn't seem to be hitting a nerve. She numbed the surface then went deeper to numb the bone. She drew out the aspirate first (the liquid marrow) from the bone. Next she began to drill or dig out the core (the hard bone) section. I'll admit this was a bit painful. Pain was shooting down my leg and up my back as she loosened the section of the core. Sadly, the first piece was too small. She had to go in at a second site on my left hip and try again for a larger core. I just pushed through knowing it was all for good and better health will come for me because of this.
When she finished, she asked me to roll over. I was all bandaged up and applying pressure to stop the bleeding. Hank and Christy were preparing the core and aspirate to send to the lab. There was a pause and an uncomfortable silence between the two of them. The needle tool the extracts the core had broken and would not release the piece of bone marrow from the tube. They couldn't get it out! They called for help from three other doctors. After thirty minutes of diligent effort they through in the towel. I told them I was willing to go through it again for a valid test sample. With shocked faces they praised my strength and prepared the surgical table to start again. This time she went in on my right hip. The extraction was successful and the tool released the core with ease (thank goodness)!
In the end today, I suppose you could say rather than one, I had three bone marrow biopsies ~ and I made it through just fine. I pray the information gleaned from this test will provide rich answers in Dr. Olson's quest to help me. What an experience to remember!
We headed over to the University Hospital and checked in. Of course they needed to draw more blood right away - and chose to draw from the exact same over-abused spot. Next I was called to the back. They gave me ativan to help me relax. (honestly I didn't feel like I'd taken a thing). The nurse practitioner, Christy, asked me to lie on the table on my stomach. I was surprised to find out that I didn't even have to change into a hospital gown. :) (there's a positive). Hank, the friendly and calming nurse put on some music. They rolled down the waist of my jeans and started cleaning.
She started by putting pressure on the back of my left hip to find a spot on the bone that didn't seem to be hitting a nerve. She numbed the surface then went deeper to numb the bone. She drew out the aspirate first (the liquid marrow) from the bone. Next she began to drill or dig out the core (the hard bone) section. I'll admit this was a bit painful. Pain was shooting down my leg and up my back as she loosened the section of the core. Sadly, the first piece was too small. She had to go in at a second site on my left hip and try again for a larger core. I just pushed through knowing it was all for good and better health will come for me because of this.
When she finished, she asked me to roll over. I was all bandaged up and applying pressure to stop the bleeding. Hank and Christy were preparing the core and aspirate to send to the lab. There was a pause and an uncomfortable silence between the two of them. The needle tool the extracts the core had broken and would not release the piece of bone marrow from the tube. They couldn't get it out! They called for help from three other doctors. After thirty minutes of diligent effort they through in the towel. I told them I was willing to go through it again for a valid test sample. With shocked faces they praised my strength and prepared the surgical table to start again. This time she went in on my right hip. The extraction was successful and the tool released the core with ease (thank goodness)!
In the end today, I suppose you could say rather than one, I had three bone marrow biopsies ~ and I made it through just fine. I pray the information gleaned from this test will provide rich answers in Dr. Olson's quest to help me. What an experience to remember!
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| Team of doctors attempting to save the core... |
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| still trying... |
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| one last idea...but no luck :( |
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| The core and the aspirate ready for the lab! |
Tuesday, July 26, 2011
Day Two ~ Spinning with Information
We woke to a beautiful Colorado morning! The skies were clear and bright and the air was crisp and calling us to enjoy it's wonder. What a place! I'm in love!
My first test was the ENO, which measures the amount of inflammation in my lungs. She called me back and reminded me that in February my score was 74. Dr. Olson wanted my score to be lower this time because the 74 meant I had a lot of inflammation in my airways in the winter.
No problem! I had this one covered! That was February when I was sick and now I've been quarentined from kids and people all summer. I was CERTAIN that the number would be super low! I took the test hopefully! Two minutes later a 234 popped up. I was certain that was a number that had to be converted. I asked if it was good - lower than 74??? She choked and said it showed massived amounts of inflammation. :( I took a breath and we tried again to see if the number remained consistent ~ 237. Wow - what a remarkable increase. Something is really going on with my body. I am so glad to be here in the capable hands of Dr. Olson.
After a short speech consult for vocal cord dysfunction, it was time for my appointment with Dr. Olson. I was filled with anxiety, impatience, hope, and confusion. I just want to give her everything she needs to help me to get on the right track. I went into the appointment alone because I tend to get so nervous with someone else in the room that I shut down and don't speak at all. I needed to speak.
Our time was priceless. She reviewed recent events to make sure she was up to date. She also asked a lot of questions about how I feel, how I'm dealing with things, what I do about problems. She was still waiting on most of the lab orders that Dr. Katial had sent, but a few were in. My eosinophils have gone from a high 1320 on July 7th to over 2200 now. They were also concerned about a few other results and wanted to discuss them together further to make a decision and a plan.
The sinus CT was a disaster. You couldn't even tell that I'd had sinus surgery four months ago. It it so frustrating. She immediatedly went to the other side of the building and found an ENT that she likes and made an appointment for me. She is insistent on getting to the bottom of my problems and helping me to have a wonderful life! She said she would be ordering more tests, talking with Dr. Katial, and getting back with me soon.
Soon must have meant very soon! She saw me in the hallway about an hour later and stopped me. She said they had spoken and she wanted me to go have a few more labs drawn and get a new schedule. She had added a few more appointments.
DanniLynn in the lab department laughed when she saw me again! It was my third blood draw today! They kept using the exact same site too because it is the only "good" vein in my arms. (ugh) After that, I headed to my GI appointment with Dr. Toribara. Surprise, surprise ~ he was simply wonderful. He was a delightful man. He acknowledged that his role was probably a small one in my complicated treatment plan. He explained how they were looking for possible silent reflux which has been documented to cause asthma symptoms. I don't have symptoms of reflux or any stomach symptoms at that, but I suppose it's better to go ahead and check everything.
To check for reflux, they use a terribly uncomfortable device called an impedence pH probe. It's a wire that is run from the nose to the top of the stomach and has to stay there for 24 (miserable) ;) hours! I know, I know! There are totally worse things in the world - but I will say that this thing stinks!! It totally makes you feel like you're gagging constantly - not cool. The end result is important though.
When Deb, the nurse called my back to insert the probe, she said Dr. Olson had called and wanted to talk with me before she started. I heard her fast footsteps coming around the corner. She peeked in and smiled that big smile, "Hey Toni! How are you?" She told me she and Dr. Katial had been talking about more of the results and were not finding a cause for the heightened eosinophils. They both believed it was very important and necessary that I have a bone marrow biopsy right away. She was scheduling it to be performed at the University of Colorado Hospital tomorrow morning. She insisted that they are the best and the information was key. "We're going to figure this out Toni, we are." I trusted her and believed it would be all for good in the end.
Deb inserted the probe and gave me my final instructions. I left National Jewish with a few more bruises and mind spinning with new information. That night I insisted we head down to the 16th Street Mall to walk around and escape the day. (or at least pretend to escape)
My first test was the ENO, which measures the amount of inflammation in my lungs. She called me back and reminded me that in February my score was 74. Dr. Olson wanted my score to be lower this time because the 74 meant I had a lot of inflammation in my airways in the winter.
No problem! I had this one covered! That was February when I was sick and now I've been quarentined from kids and people all summer. I was CERTAIN that the number would be super low! I took the test hopefully! Two minutes later a 234 popped up. I was certain that was a number that had to be converted. I asked if it was good - lower than 74??? She choked and said it showed massived amounts of inflammation. :( I took a breath and we tried again to see if the number remained consistent ~ 237. Wow - what a remarkable increase. Something is really going on with my body. I am so glad to be here in the capable hands of Dr. Olson.
After a short speech consult for vocal cord dysfunction, it was time for my appointment with Dr. Olson. I was filled with anxiety, impatience, hope, and confusion. I just want to give her everything she needs to help me to get on the right track. I went into the appointment alone because I tend to get so nervous with someone else in the room that I shut down and don't speak at all. I needed to speak.
Our time was priceless. She reviewed recent events to make sure she was up to date. She also asked a lot of questions about how I feel, how I'm dealing with things, what I do about problems. She was still waiting on most of the lab orders that Dr. Katial had sent, but a few were in. My eosinophils have gone from a high 1320 on July 7th to over 2200 now. They were also concerned about a few other results and wanted to discuss them together further to make a decision and a plan.
The sinus CT was a disaster. You couldn't even tell that I'd had sinus surgery four months ago. It it so frustrating. She immediatedly went to the other side of the building and found an ENT that she likes and made an appointment for me. She is insistent on getting to the bottom of my problems and helping me to have a wonderful life! She said she would be ordering more tests, talking with Dr. Katial, and getting back with me soon.
Soon must have meant very soon! She saw me in the hallway about an hour later and stopped me. She said they had spoken and she wanted me to go have a few more labs drawn and get a new schedule. She had added a few more appointments.
DanniLynn in the lab department laughed when she saw me again! It was my third blood draw today! They kept using the exact same site too because it is the only "good" vein in my arms. (ugh) After that, I headed to my GI appointment with Dr. Toribara. Surprise, surprise ~ he was simply wonderful. He was a delightful man. He acknowledged that his role was probably a small one in my complicated treatment plan. He explained how they were looking for possible silent reflux which has been documented to cause asthma symptoms. I don't have symptoms of reflux or any stomach symptoms at that, but I suppose it's better to go ahead and check everything.
To check for reflux, they use a terribly uncomfortable device called an impedence pH probe. It's a wire that is run from the nose to the top of the stomach and has to stay there for 24 (miserable) ;) hours! I know, I know! There are totally worse things in the world - but I will say that this thing stinks!! It totally makes you feel like you're gagging constantly - not cool. The end result is important though.
When Deb, the nurse called my back to insert the probe, she said Dr. Olson had called and wanted to talk with me before she started. I heard her fast footsteps coming around the corner. She peeked in and smiled that big smile, "Hey Toni! How are you?" She told me she and Dr. Katial had been talking about more of the results and were not finding a cause for the heightened eosinophils. They both believed it was very important and necessary that I have a bone marrow biopsy right away. She was scheduling it to be performed at the University of Colorado Hospital tomorrow morning. She insisted that they are the best and the information was key. "We're going to figure this out Toni, we are." I trusted her and believed it would be all for good in the end.
Deb inserted the probe and gave me my final instructions. I left National Jewish with a few more bruises and mind spinning with new information. That night I insisted we head down to the 16th Street Mall to walk around and escape the day. (or at least pretend to escape)
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| Who wouldn't want this piano? On 16th Street |
Monday, July 25, 2011
Day One ~ Familiar Faces/Familiar Failures
My first day back at National Jewish was filled with highs and lows. It was so good to be back in this comforting place where I know they "never say never"! I know my well being and improvement is their priority. Teamwork oozes throughout the building. In some ways, you feel like you're among celebrities when you're at National Jewish because of the level of excellence that is upheld.
My day began with an appointment with Dr. Katial, the Immunologist that performed my aspirin desensitization before my heart surgery. He asked for a summary of how my asthma/health has been since then. We had a pretty fun conversation because of my tendency to minimize the severity of my history. :) He caught on quickly and called me out! I guess I have been a bit "sicker" than I prefer to admit.
He ordered a truckload of labs and said he and Dr. Olson would review the results after they have more information and touch base with me.
From there, I moved on to radiology for CTs of my sinuses and my chest. In the hallway, I ran into Dr. Olson. She gave me a hug and asked what had happened so far. When I reported that I had already met with Katial, she turned to go talk with him about his plan.
My last test for this short day was the pulmonary function test in the box on that darn third floor. :( As the elevator rose higher I could feel my muscles tensing up. My peak flows have not been superb lately. Dr. Katial even gasped at the numbers from my morning spirometry. I knew all I could do was my best, I am here to get better. The technician couldn't get a consistant reading so she had me repeat the test time after time after time. It was terrible. I felt like such a huge failure, but what else could I do - I can't make my lungs work any better - I've tried - believe me - my will is quite powerful, but not that powerful...
Sadly, this was a familiar failure. It was nothing new, but still quite frustrating. To add salt to the wound, she said the tests were showing a lot of truncation. That means my VCD (vocal cord dysfunction) isn't under control like I thought it was. Ugh!! Sometimes I just want to scream with all this information. I must remind myself, that I am in the best place for failing though. I have the best team on MY side and they are beyond determined to help me have a better life.
I know this is all for good.
My day began with an appointment with Dr. Katial, the Immunologist that performed my aspirin desensitization before my heart surgery. He asked for a summary of how my asthma/health has been since then. We had a pretty fun conversation because of my tendency to minimize the severity of my history. :) He caught on quickly and called me out! I guess I have been a bit "sicker" than I prefer to admit.
He ordered a truckload of labs and said he and Dr. Olson would review the results after they have more information and touch base with me.
From there, I moved on to radiology for CTs of my sinuses and my chest. In the hallway, I ran into Dr. Olson. She gave me a hug and asked what had happened so far. When I reported that I had already met with Katial, she turned to go talk with him about his plan.
My last test for this short day was the pulmonary function test in the box on that darn third floor. :( As the elevator rose higher I could feel my muscles tensing up. My peak flows have not been superb lately. Dr. Katial even gasped at the numbers from my morning spirometry. I knew all I could do was my best, I am here to get better. The technician couldn't get a consistant reading so she had me repeat the test time after time after time. It was terrible. I felt like such a huge failure, but what else could I do - I can't make my lungs work any better - I've tried - believe me - my will is quite powerful, but not that powerful...
Sadly, this was a familiar failure. It was nothing new, but still quite frustrating. To add salt to the wound, she said the tests were showing a lot of truncation. That means my VCD (vocal cord dysfunction) isn't under control like I thought it was. Ugh!! Sometimes I just want to scream with all this information. I must remind myself, that I am in the best place for failing though. I have the best team on MY side and they are beyond determined to help me have a better life.
I know this is all for good.
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| A few pics from our VRBO Oh yes! That's a fancy chadelier over the bed! We were living it up! |
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| The cute little kitchen. |
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| Every rental needs a pretty pink bathroom :) |
Thursday, July 14, 2011
A Preliminary Schedule
Courtney decided to go ahead and send me a copy of my schedule "as is" so far. Dr. Olson is still working on squeezing in Dr. Katial and she said there may be some other tests yet to be added as well. This could give me an idea of what the week will look like though.
When it arrived, I anxiously opened the envelope to see what she had planned. At this point, the week is filled with mostly MD time and tests I've experienced before. I'm scheduled to see five specialists! I froze when I read over Day 4 though...she is planning to repeat the bike test. :( I could feel my muscles begin to tense and my heart start to race. I realized that this trip has become enough of a nightmare, I couldn't spend the next three weeks stressing about this test. I decided to call Johnna, my respiratory therapist, and figure out what I could do to prepare for it so I could be calmer on the big day.
Since then I've been building my resistance tolerance on the bike each day to get a feel for the actual test scenario. So on the day of the test, I won't have to worry about my performance on the bike, I can focus on staying calm for the dreaded A-line and dealing with the horrid mask (which will be plenty to worry about!).
When it arrived, I anxiously opened the envelope to see what she had planned. At this point, the week is filled with mostly MD time and tests I've experienced before. I'm scheduled to see five specialists! I froze when I read over Day 4 though...she is planning to repeat the bike test. :( I could feel my muscles begin to tense and my heart start to race. I realized that this trip has become enough of a nightmare, I couldn't spend the next three weeks stressing about this test. I decided to call Johnna, my respiratory therapist, and figure out what I could do to prepare for it so I could be calmer on the big day.
Since then I've been building my resistance tolerance on the bike each day to get a feel for the actual test scenario. So on the day of the test, I won't have to worry about my performance on the bike, I can focus on staying calm for the dreaded A-line and dealing with the horrid mask (which will be plenty to worry about!).
Thursday, July 7, 2011
Runaway
I have the image in my head of the child with a bag ready to runaway after hurting someone because she feels like the best way to make things better is to disappear...
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When Barb, the lung nurse called from National Jewish to set up my first visit over a year ago, she asked about my hopes or "dreams" concerning my health. One of the things I mentioned was that I would love for others to be able to forget that anything is wrong with me. It was a big one. It's not that I lack appreciation for what people do and feel for me or that I don't want to be loved...it's that for years now, too many years, I have been the source of heartache and worry for too many people that I love. I'm so tired of being a burden to my parents, my friends, and my co-workers. It seems like that childhood mentality makes sense - if I could just runaway I could stop the pain and worry I cause. If only it could be that simple...
Courtney called Tuesday morning with my official dates for this trip. She said I should plan to be at NJH for the full last week of July. Dr. Katial is the only one not on the schedule yet because he is booked, but she said Dr. Olson is convinced she can work him in somehow.
Even though I feel hopeful about this trip, it has already caused so much pain I'm wondering if it's worth it. Each decision I make to try to make things better seems to make them worse. Could I just runaway?
Courtney called Tuesday morning with my official dates for this trip. She said I should plan to be at NJH for the full last week of July. Dr. Katial is the only one not on the schedule yet because he is booked, but she said Dr. Olson is convinced she can work him in somehow.
Even though I feel hopeful about this trip, it has already caused so much pain I'm wondering if it's worth it. Each decision I make to try to make things better seems to make them worse. Could I just runaway?
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