Tuesday, January 19, 2010

Remember...

this, this, this, this, and this? (There are more instances too. Only I didn't want to seem like a complainer!) In November, I went back and got refills of all this and my doctor finally said that I needed a pulmonary function test (PFT) to see what is going on with me. Well, because he gave me a refill of the steroids and scheduled the PFT for the day after they concluded, I passed with flying colors. "There's nothing we can see, ma'am."

Well, a couple weeks go by and then I have my yearly December physical appointment for my health insurance discount. I let the doctor know that the coughing is still hanging around and asked if I could just see a pulmonologist anyway. He said OK and scheduled my appointment for a little more than a week later.

December 16th was D-day for me. My appointment was at 10:00am. My symptoms were steadily getting worse since my last appointment with my regular doctor. So I did what every other sane person would have done, right? I skipped my breathing treatment the morning of my appointment with the doctor I had been waiting to see for 5 months.

I arrived at that doctor's office with one of the worst coughing fits I had had in almost a month despite all the requests by my husband to "please, take a breathing treatment." I told my husband he was nuts and that this coughing disease was going to get eradicated if I didn't die in the process, which would help get me to see my daughter that much faster - thank you very much!

The nurse took my vitals and went away for a while - and I hacked and hacked and hacked away in that room. A little while later the nurse came back in and said we're going to give you a PFT again, then a breathing treatment, and another post-treatment PFT. She led me to the pulmonary function testing room. She instructed me to take a deep breath when she says "start" and then blow into this machine as hard as I can for as long as I possibly can. Usually, they like to get three valid tests to be able to get the best information. Because I was in the midst of a HUGE coughing attack, I think it took like 25 tries to get 1 valid test. The nurse finally said, "I'm not going to torture you anymore."

I went back to the exam room and they gave me four puffs of an inhaler, waited 10 minutes, and then took me to repeat the test. It only took me 5 tries to get the 3 valid tests they needed this time.

The doctor came into the exam room a few minutes later and said, "You have asthma!" Then she told me that according to the medical definition of asthma, there should be a 12% change for the better between the two PFT's after the administration of albuterol. According to the charts my tests provided, my change for the better after the medication administration was (drumroll please)....25%. Yes, that's DOUBLE the definition! (It finally is my turn to get good news!)

So, she gave me another 10 days of oral steroids, for while the inhaled steroids kicked in, and also an albuterol inhaler for those times when I need extra help so that I could quit carrying the portable nebulizer everywhere I go. She gave me a written plan on how to take the medications and how much to take when they symptoms are out of control. She told me that my symptoms were "really bad." Then, she gave me another breathing treatment with the nebulizer before sending me home to "finish off" my coughing fit.

I have been going by this plan since December 16th. Today was my one-month follow-up appointment. I have taken all my medications like I was supposed to every day. I have only had to use the inhaler only about 3-4 times per week in the last week, which I thought was massive improvement from 3-4 times per day prior to my visit with her.

The doctor repeated the pulmonary function test today and said it was even better than the second test at the last visit, which she likes to see. But, she only wants me to have to use the inhaler 2 times per week or less. So, we are going to see in the next month if all the medications are going to do that trick or if she is going to put me on another medication. She said I have "severe and persistent asthma" today.

She told me that after I asked if I will be taking this medication every day for the rest of my life. After all, I am still in my early (-mid) 30's. She said after 6 months of being on all this and am within the 2 times or less range of needing extra help to breathe, we can talk about weaning some of the medications to see if my condition regresses or not. So, there is hope that I am not totally dependent on daily maintenance medication for the rest of my life. What do you think my chances are of being weaned off this medication with a "severe and persistent" diagnosis?

8 comments:

  1. Oh Lori, how good to finally have an answer!

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  2. First of all Lori, Ken and Monica wouldn't know what to do without you. You will see our Angel when it is your time. My bet is you will be weaned off some of the meds soon. Love, Mom Boes

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  3. Oh wow Lori, I guess it is great to finally know what the problem has been. And you should get it under control real soon. My hubby has asthma (since birth) and one of my boys. Hubby had it pretty bad for many many years of his life. The both take a preventative med daily and the reg inhaler hardly ever. Hope you are all better soon.

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  4. I think even with severe and persistent asthma that you will see yourself weaned off some. I was told in my early 20s that my asthma was going to kill me. Here I am 10 years later and the only time I see any issues is when I have big hormonal fluctuations.

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  5. I have faith, Bug. You will be able to be weaned off the meds sometime this year. Things are looking up for you, Girlie. I love you.
    Mom

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  6. Hi!
    I just read your post and wow... I have the same issues. It gets especially worse in the winter months for me. Have you seen an allergist? That is who manages my severe asthma. We have found that sometimes in the spring and summer (when it usually is the best) that sometimes when it flares up it is because of my mold allergies (which flares when it is very wet out) Because like I said my symptoms are worse in the winter months. So if it is a wet spring or summer my asthma get worse.
    I take Advair and singulair and also the provental(rescue inhaler). sometimes I use my son's nebulizer treatments when its bad. If they gave you singulair it really does work, but I find it makes me sleepy so I suggest take it at night.

    I hope you get to feeling better soon!

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  7. I think you'll probably be able to cut back on all the meds at some point. My mom had to do multiple breathing treatments a day for a while. Now she doesn't have to use the nebulizer at all and only has the inhaler.

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  8. Lori,

    Back in high school I was diagnosed with asthma, had the nebulizer at home, used the inhalers, etc. They did allergy testing and all came out negative. It was determined that I had stress induced asthma (my home life was less than ideal at the time).

    I would think it is plausible that yours could have generated for the same reason. Given time, I'd like to believe that you could be free of all meds as I am today.

    Praying that things stabilize for you and you can gradually wean from any assistance.

    Misty

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