Okay, I’m impressed. The new CT scans were just done yesterday and the pulmonologist called me today because she rightly assumed I wouldn’t want to wait until the 21st to make changes in my treatment. And there are definitely changes.
First, the scans confirmed the mosaic attenuation pattern she mentioned, which in turn confirms her preliminary diagnosis of bronchiolitis. They also showed a “ground glass opacity” in my left lung, the one that was catching some radiation. According to Wikipedia: “In radiology, ground glass opacity (GGO) is a nonspecific finding on computed tomography (CT) scans that indicates a partial filling of air spaces in the lungs by exudate or transudate, as well as interstitial thickening or partial collapse of lung alveoli.”
Also in the left lung she sees a small radiation fibrocyst. (I think that’s what she called it.) Not uncommon after radiotherapy, she said. It may or may not go away but is not causing the cough and, even if it doesn’t resolve, will not affect or limit my lung function.
The sinus CT, it turns out, revealed chronic sinusitis on the right side. It could have taken hold when my immune system was weakened during chemo and radiation. I’d noticed ongoing sinus drainage, but I always have a bit of that from allergies. However, she thinks it could definitely be contributing to if not actually causing the cough, particularly since my lungs are already inflamed and hypersensitive.
So, a number of changes in treatment. I’m to stop the oral prednisone by tapering over a 10-day period. A small taper from only 10 mg, but advisable because I’ve been using it since mid-October. I’m to continue the Advair inhaler which, although it’s also a corticosteroid, does not work systemically.
And to attack the sinusitis, Flonase, a steroid nasal spray (again, local not systemic) that I’ve used in the past with good results, and an antibiotic, augmentin, that I’ve used before for sinus infections. The augmentin is to continue for up to three weeks, quite a bit longer than the standard 10 days for a routine infection. But then, this is a chronic thing that needs to be completely knocked out.
Definitely a new approach. And I’m optimistic. Or at least hopeful. After all, what have I got to lose but this damn cough.
Note: Yes, she’s determined. I picked up the augmentin at the pharmacy and she has prescribed 850 mg twice a day for 21 days. That’s a lot of antibiotic!