Pulmonary Function Test

I went for the lung function test at the hospital this morning. To my surprise, the pulmonologist called to discuss the results soon after I got back home. Lighting quick communication is one of the advantages of the digital age.

Her notes from the patient portal online state: “The lung study shows you have moderate COPD, Obstructive Lung disease.”

She asked if I had ever smoked, or been around people who smoked, because the obstruction is pretty significant for someone my age. (I’ve never smoked, but my parents smoked around me when I was young.) She said I was around 64% capacity at the beginning of the test which is comparable to someone in the second (moderate-severe) stage of COPD. After some inhalations of albuterol, the function climbed to 80%. She said the fact that my lungs opened up to the medication was a good sign, meaning whatever is clogging them can probably be reversed. Apparently someone with typical COPD won’t respond to the meds. I go to see her and discuss next steps on Friday.

I talked with HR at work and found out short-term-disability lasts up to 26 weeks, but they will post my job after I have been out of work for 12 weeks. I have missed work since 11/30/15, so I am in my sixth week. If I lose my sales route, I will have to apply for whatever is available if and when I return to work.

Sikki is hoping I don’t go back, that I wind up getting a job elsewhere. She doesn’t seem concerned about the finances, which isn’t her historical reaction to things like this. If it gets to the 11th week and I’m not better, I still might try to return to work just to keep my route.

But if I am to be out of work for an extended period of time, I need to get focused on something useful. Perhaps I’ll start writing something more substantial: I’ve got a book or two inside that I’ve never brought to light.

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Long Shot Xolair (Psalm 118:17)

It is Monday night, pushing 9:30 PM. The allergist did some skin tests today and confirmed allergies (no surprises there). Then he took a bunch of notes on my history. He wants to get records from my old pulmonologist in Wilmington and from the new pulmonologist in Shallotte and from my primary care physician. Three doctors, three specialties working in tandem and what do they know?

Not too much.

After I told the allergist all the meds I’m on and how my symptoms have not abated for several years, he concluded I have “moderate to severe persistent uncontrolled asthma” and prescribed weapons-grade doses of my personal favorite medication, Predisone. (Ye Olde Pred-ator makes me hungry and unable to sleep and gives me a roaring case of the flaming holy grumps.)

He didn’t sound too hopeful that more inhaled steroids were going to do me any good since I haven’t improved on them for 4-5 years, though I’ve changed medications several times to try and find one that works. Instead he recommended a shot therapy that is more “aggressive” than typical allergy shots: something called Xolair. Costs about $12,000-$14,000 a year, two of every thousand people go into anaphylactic shock as a result of getting a dose, it increases risk of certain cancers and might increase risk of heart disease. And it doesn’t take effect for about three months after you begin treatment. To about a third of the people who take it, it’s a miracle drug. To another third, it helps. For the rest it does squat.

When I asked if he thought I could exercise (since my job is pretty physical), he said my lungs sounded too “junky” and inflamed right now.

Boy oh boy. I was pretty depressed when Sikki and I left the place because today was the first time a doctor said he doesn’t think I’m going to get better right away. Sikki was starving and drove to Taco Bell, and I was in the passenger seat wondering whether I should just try to push through the trouble somehow and attempt to go back to work next week. I’m still mulling that over, because there might not be a job to go back to if I’m not better three or four months from now. I don’t want to be stupid but I functioned for a long time at my job while I was sick. So I know working wouldn’t improve my lung function but it would burn some calories and — of course — make money. This time is different, though; my breathing has gotten progressively worse.

It’s hard to know what to do. I’m an old and tired 40 years, but I don’t want to sit at home on disability or something. I want to go out and work to provide for my family. I wouldn’t have expected I’d be dealing with a long, drawn-out illness at this point in my life.

Tomorrow morning I go for a pulmonary function test at the hospital, then I return to the pulmonologist on Friday morning. If I can’t exercise I am going to have to start being more mindful of my caloric intake or I will weigh 300 pounds by the time this thing blows over.

I’m sure it will blow over. It’s temporary, a season.

The pastor called last night. He said the Lord brought me to this area to minister to the people here, and to find life. Not to die. Amen.