Today was (another) CT scan day — for the high res scans I mentioned earlier. This time they did inspiratory (“Take a deep breath and hold it”) and expiratory (“Take a breath, exhale completely, and hold”) scans. For one of those, I forget which, I was lying on my stomach instead of my back. So now they have all sorts of scans to examine and compare. Oh, and they got a sinus scan too, since the pulmonologist thinks sinus drainage might be a factor. If so, I’m in trouble, because that’s just a year round fact of life for me. Lots of low grade allergies, and there’s always some allergen floating around even if it’s only the dog, the cat, or my outstanding collection of house dust.
It’s my understanding that the pulmonologist will study all this and call me to discuss it on the 21st. She was already booked solid with appointments that day, but I’m content with a phone call. Don’t need to spend an hour driving down there just for a discussion that could be conducted on the phone. I want to see the scans, of course, but I’ll be down there again sooner or later and can see them then.
I’m just hoping she studies everything carefully, has an “aha!” moment, and prescribes something that will quickly, magically banish this cough. Sooner rather than later, please.
The fly in the ointment that I haven’t mentioned before: She’s a fellow. Still studying, with her fellowship having come after her residency. Not exactly a greenhorn, but not a grizzled old pulmonologist who’s been diagnosing tricky lung problems for thirty or forty years. She does consult with another doctor, older I assume. I’m trying to be open-minded about the medical education system and her abilities and knowledge in particular. She might be brilliant. But I can’t help wishing I was seeing the head of the department or an associate professor or someone more experienced than a fellow. I could have seen one of the established doctors if I’d waited till February for an appointment, but I didn’t want to cough that long.
So now I wait. And cough. Some more..
Note: If you’re into medicalese, here’s an abstract I found that sort of explains what’s going on. Remember, the pulmonologist saw a mosaic attenuation pattern on my first CT:
Areas of variable lung attenuation forming a “mosaic pattern” are occasionally seen on computed tomography (CT) or high-resolution CT (HRCT) images of the lungs. This CT mosaic pattern of lung attenuation is a nonspecific finding that can reflect the presence of vascular disease, airway abnormalities, or ground-glass interstitial or air-space infiltrates. However, it is often possible to distinguish among these categories. In small airways disease and pulmonary vascular disease, the pulmonary vessels within the lucent regions of lung are small relative to the vessels in the more opaque lung. In infiltrative diseases, the vessels are more uniform in size throughout the different regions of lung attenuation. The distinction of small airways disease from primary vascular disease requires the use of paired inspiratory/expiratory CT scans. The terms “mosaic perfusion” or “mosaic oligemia” have also been used to describe this heterogeneous pattern of lung attenuation. We believe that the term “mosaic pattern of lung attenuation” is preferable when describing areas of variable lung attenuation because the term “mosaic perfusion” implies pulmonary vascular pathology.