‘Dem bones’ are A-OK

Dexa scan reveals one less thing to worry about

I had a bone density (densitometry or “dexa”) scan yesterday (you just lie on a table while the machine passes overhead). At my age (73) I was probably way overdue for such a test. The only other one I’ve had was the one required when I signed up for Medicare, and as I recall then they only looked at my wrist.

Basically a dexa is an x-ray of your pelvis, lower back, and thighs, because nobody wants to see an old person break a hip (often the beginning of the end). It’s common in old age for bones to thin and weaken, especially in postmenopausal women. In addition, corticosteroids can cause it — I’ve had more than my share of them — and it’s also more common in taller women. I’m 5’8″ (or 5’7½” now if you want to believe the nurses at the cancer center).

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Medical guessing games

Three months’ worth of details exchanged in 30 minutes

I need a secretary (er, make that “administrative professional”) to keep track of all my medical stuff — the notes, the meds, the appointments, the instructions, etc. And I needed that secretary yesterday when I saw my oncologist for the first time since mid-January. So much had happened that he wanted to know about, and I had a bunch of questions saved up for him. It all amounted to a ton of details flying back and forth. Details I wanted to remember. Needed to remember. But I didn’t take notes because I wanted to give him my full attention. Besides, it’s routine to get a four-to-six-page printout after each appointment, detailing everything.

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Nothing if not thorough

Two months after the fact, bronchoscopy results are still coming in.

This morning I got yet another test result from that bronchoscopy I had waaaay back on December 29.

Not surprisingly, when one’s lungs are being examined for disease and/or damage, one of the things doctors look for is tuberculosis. This is done with an AFB (acid-fast bacilli) smear on a slide that is examined under a microscope for signs of mycobacteria. The smear provides presumptive results which can guide treatment decisions while culture results are pending.

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It’s called orthostatic hypotension

If it’s not one thing it’s another. This time: postural hypotension.

It’s another of those fun things that many senior citizens have to put up with, but it’s only become a notable problem for me in the last few weeks. The medical term for it is orthostatic hypotension. It’s that dizzy feeling you sometimes get when you stand up after sitting or lying down for a while.

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Bronchoscopy results mean more prednisone

My bronchoscopy was a nightmare but at least it produced new information leading to yet another change of treatment.

My bronchoscopy last Tuesday was even worse than I’d feared but having bitched at two different doctors since then, I’m finally done with it. Except to say I’ll do it again only at gunpoint.

Rather than repeat the whole story for at least the third time, I’ll just pull from my notes:

Wed Dec 30

Bronchoscopy yesterday. Awful experience (I woke up half way through it). The lavage part was like choking to death, coughing as hard as I could and unable to clear my lungs. Terrifying. I’ll never trust versed again. That or the personnel were incompetent. Hard to believe my experience was the typical one that I was told was “no big deal.”

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And for the holidays I’m getting … a bronchoscopy

Because the cough hasn’t gone away, a bronchoscopy has been scheduled. Now all I want for Christmas is for the cough to go away before then.

Oh joy. For my holiday surprise, I’m getting my very own bronchoscopy! On the 29th. One that will include a lavage and a biopsy. Now is a good time, the doctor said, because I’m completely weaned off the prednisone. And because the cough continues, not notably better or worse, but still definitely there. If it clears up before the 29th, I’m off the hook; I’m not counting on that.

I can’t begin to tell you how (not) thrilled I am by this. I may have mentioned before that I have a Class A Godawful gag reflex. I also have a deep distrust of the sedatives commonly used for the procedure, since I actually woke up from them during a colonoscopy about 15 years ago. All the assurances about how the drugs will ensure I don’t remember anything? Screw that. I don’t want to be aware of anything. And if I am aware, the well-being of anyone within reach will be in grave danger.

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The new doctor tries a new approach

CT scans suggest a different approach to treating a persistent cough.

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.” Continue reading “The new doctor tries a new approach”

In search of … answers

More CT scans today. Diagnosis and treatment still to come.

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. Continue reading “In search of … answers”

Cough finally getting specialist’s attention

The persistent cough that has been delaying my cancer treatment finally gets a specialist’s attention.

I saw the pulmonologist today for the first time. And as I suspected, nothing definitive came from it. The high res CT scan that she ordered isn’t scheduled until Wednesday, so I won’t know anything until sometime after that. She also ordered a sinus CT to be done at the same time, since sinus drainage may be a factor. She asked a lot of questions and provided some answers. I provided a lot of answers and asked a lot of questions. Additional answers from her await the new scans. And she mentioned a possible bronchoscopy, which gave me a chance to explain how very unhappy I’ll be if it comes to that. She explained the procedure, if it should become necessary, but I’m still not going to be happy. Continue reading “Cough finally getting specialist’s attention”