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Archive for the tag “bronchoscopy”

Woman cannot live on chicken and watermelon alone {or can she?}

Breakfast, lunch, and dinner.  I'm not kidding.

Breakfast, lunch, and dinner. I’m not even kidding.

I’ve been calling it my roast chicken fetish, and I’ve roasted and eaten a LOT of birds in the past six weeks. For a while there, over the winter, I wasn’t eating much of anything because nothing sounded good.  Lack of appetite was just one of the grab bag of auxiliary symptoms I had, the primary one being not being able to breathe.  The weight loss was okay; I’ve worked harder to lose less, but sometimes I’d get hungry and would go to the grocery only to come home with things (comfort food) that didn’t taste nearly as good as they sounded. Root beer floats worked for a bit, but after a while I was down to cereal and milk, and even then didn’t finish the bowl (unheard of for me). If one of my animals went off their food to the same degree I’d be in a minor panic but for myself it was just “huh.”

20150508_161708

Hanging out on a sunny spring day with my best guy.

About a week before my bronchoscopy I was at the grocery and got some roast chicken at the deli counter. It was actually pretty good and satisfying. The day of my bronchoscopy I had some lemonade and watermelon at Whole Foods.  That was good too. The day after my bronchoscopy I was in pretty rough shape, with deep, um, productive coughing, with said production laced with fresh blood (normal after the biopsy procedure, but still disconcerting). I sounded like a 3-pack-a-day smoker, and felt like I’d been pummeled, weak and tired. There was nothing to eat in the house – I’d stopped buying food because most of it would go bad – and I was hungry. Lemonade and watermelon sounded good. So did protein and fat. I got dressed and made myself presentable (barely), and went to the nearby grocery for a rotisserie chicken. And some watermelon. And some lemonade.

Yum.

Yum.

That was six weeks ago and I’ve eaten a LOT of chicken in the meantime. Instead of buying the hot, rotisserie birds at the grocery, I started roasting my own. I fill the cavity with chopped garlic cloves and a couple teaspoons of Celtic sea salt, rub the skin with butter or olive oil, sprinkle another couple teaspoons of salt, plus some thyme and paprika, and pop it into a hot oven (400 degrees) for an hour or so.  When it comes out I’m salivating and barely able to wait for it to cool. I’ve found that wings are my favorite part. They have just the right combo of skin/fat/meat. Because the skin and the fat? Well, the embarrassing truth of it is that’s the part I think I crave the most. I’ve learned that the skin is best when hot and crispy from the oven, so I eat most of it then. It’s kind of gross when I think about it too much. Prior to this, I don’t think I’d purchased chicken in a year or more, other than a breast or two (bone-in) to make soup stock. But now? I’ve eaten a good sized flock, with no end in sight. We’re getting the first watermelons up out of Mexico now, so they’re a little easier to find (I was buying the plastic packs of cut up watermelon and trying to rationalize the price by the fact that I wasn’t eating much else). And copious numbers of Cuties have been eaten (and I’m not a citrus person in general). I’m sad that it’s the end of Cutie season. Gallons of lemonade have been guzzled; I buy Santa Cruz organic lemon juice, add a little water and a squirt or two of stevia and bam!  {this sounded so good now I just made a glass of it}

Today's prescription: a day of PTO/work from home, where this was the view from the office.  Hashtag healing.

Today’s prescription: a day of PTO/work from home, where this was the view from the office. Hashtag healing.

This all has been weird and wild and I figure just part of the healing process. I’m glad to be eating normally (well, not normally, but normal quantities) and while I hesitate to talk about my sarcoidosis from a woowoo standpoint – I don’t want to give it more power or “become” my diagnosis—I also know I have to acknowledge it and not tra-la-la it away. I’m all about magical thinking, but denial does no one any good. I know this whole sequence of events and diagnosis (and the more I read, the more I realize it didn’t just appear out of the blue; it required the exact sequence of events to occur) has to be addressed. This is something I have to look in the eye and understand before I can bid adieu. Scram. Get lost. You’re not welcome here. I’m feeling better physically than I was a mere two months ago (but not as good as I was feeling one month ago, dammit) and being able to walk and breathe at the same time has been an eye opener to how ill I was for a while there. Somehow as you go through it you just cope and don’t really examine it too much.

For now I’m still under the influence of prednisone, a steroid of course, that, while it’s helped me to achieve that walking and breathing thing that’s not to be taken lightly, kind of messes with me otherwise, and I’m not liking it much. Scatterbrained, irritable, and a general feeling of discontent. Other things like appetite changes and sleeping changes are less noticeable. I get really hungry when I get hungry, and I feel like I’m not sleeping as well – this one is hard to describe – but mostly doable. The feeling of overall frustration or dissatisfaction, tinged with a dollop of hopelessness is making for a sour stew, though, and I’m having a hard time getting beyond it. I can distract myself out of it, a good thing I guess, but the concentration needed to turn it around is in short supply. Concentration on anything is absent, it seems. A TV program, a book, a task, it’s hard to stay with anything for very long. I find this supremely frustrating, because I need to work on getting rid of the sarcoidosis once and for all, and not just rely on the palliative effects if the prednisone. So far the benefits have outweighed the side effects, though I don’t anticipate this will be for much longer. I need to heal, and find my bootstraps to do so.

The clean up crew after some heavy duty pruning with my pole pruner.

The clean up crew after some heavy duty pruning with my pole pruner.

I also know part of all of this discontent is the annual spring/summer thing I go through, where I see all the things that need to be done, or that I want to do, and wonder when I’m ever going to make the leap to what I really want to be doing. Right now giving my property a haircut is first and foremost. In the five years I’ve been here, the trees have continued to grow, and grow well. They would happily take over the property if left to their own devices. Take it back, I guess, since it’s obvious they once ruled supreme. Someone carved out some space for sky years ago, and left enough trees in place that the sky is once again receding under the canopy. It’s almost claustrophobic at this time of year, when the jungle-growth is rampant. I’ve been letting the sheep out regularly and they’ve managed to gobble up almost all of the normal undergrowth like a herd of wooly locusts. The grass around the house looks like a putting green and still the pasture languishes. I purchased a pole pruner – cordless, because I don’t do gas engines – which is basically a baby chainsaw on a stick. After taking a chainsaw introduction class a couple of years ago I realized very quickly I wouldn’t be buying a chainsaw (too dangerous for me). This is a way to have the tool but safer to use (it would be really hard to chop your hand or leg off by accident) and I’ve been having fun trimming and pruning. The only problem now being I really, really need a chipper.

Gratuitous cuteness: A cluster of baby orb weavers, newly hatched. So adorable!

Gratuitous cuteness: A cluster of baby orb weaver spiders (garden spiders), newly hatched. So adorable!

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And the winner is… {part 3 of 2}

Taking flightThis horse race call has been going through my head for the past week.  I hear Chic Anderson calling it.  “And they’re off! Asthma breaks with an early lead, with Flonase in the saddle. Then it’s Hypersensitivity Pneumoitis, with Farmer’s Lung aboard. Two lengths behind is Interstitial Pneumonia and trailing way behind are the longshots in the field, Sjogren’s Syndrome and Lupus. As they round the first turn Asthma has fallen to the back of the pack and pulled up. He is not a contender. In the backstretch now, Hyerpsensitivity Pneumonitis is pulling ahead; Farmer’s Lung letting him have his head.  And from out of nowhere here comes Autoimmune Disease with Sarcoidosis on board! He’s running like a freight train! As they come around the final turn, it’s Autoimmune and Sarcoidosis nosing ahead! Farmer’s Lung is giving Sarcoidosis a run for his money! Down the stretch they come!”

It doesn’t look like it will be a photo finish, but I’ll find out in two days who wins the race, according to the medical community, when I get see my pulmonologist to get the results from my bronchoscopy last week.

For weeks, now months, I’ve been dealing with this “lung thing.” And aside from the debilitating effects on my daily routine, and outright crappy days with pleurisy, fever, zero appetite, and skull-cracking headaches, it’s been mostly invisible to others. I’m good with that. And while I pride myself with not making this my story from the get-go (public blog posting aside – ha! – my co-workers and others mostly were unaware until after my bronchoscopy last week, where I had to take a couple days off and came back to work with a deep, hacking cough from the biopsy and lavage procedures), I also sought medical help within 3 weeks of my first symptoms and didn’t wait around for it to get better on its own. I have an overall aversion to doctors and the need for medical care, but I knew there was something more serious going on and waiting was not prudent. A lot of farmer’s lung sufferers believe it’s just a bad cold they’ll get over, and delay treatment (which can then cause permanent scarring to the lungs), but when you can’t catch your breath it gets acute quickly, so I didn’t screw around.

My good eater girl: Daisy's getting so positively chubby that I feel like I should get a curly tail for her.

My good eater girl: Daisy’s getting so positively chubby that I feel like I should get a curly tail for her.

As someone who lives with animals, I totally get and agree with the typical animal response to illness or pain: don’t let anyone know and don’t call attention to yourself (I know, the blogging publicly aside is ironic here) you’ll be targeted/more vulnerable. Of course with the prey animals (birds, sheep) this mindset is more acute, but even my carnivores are stoic in the face of these weaknesses. It’s not very helpful to me as their caretaker to not have an obvious sign to go with, and can make for some “back from the brink” saves when they don’t let you know until they’re so ill they’re no longer able to hide it. So it takes observance, and a daily familiarity with their habits and behaviors, to know if something’s not quite right. A little testiness with others, or a quieter than usual demeanor, or the holy grail for the dogs: off their feed (red alert!) and the sheep: separating themselves from the herd (don’t panic yet, but hovering rightthere).

Lorna and her babies; these two lambs were probably the only reason she pulled through after a very difficult assisted birth.

Lorna and her babies; these two lambs were probably the only reason she pulled through after a very difficult assisted birth.

For me, I’ve found I’ve had all of these symptoms: less patience, less social and more isolation from others, off my feed (sure I have reserves, but for a Finn–we’re good eaters–to go off their feed is major stuff!). Less patience with the prima donna project managers at the office; the ones who think you’re sitting at your desk drying your nails, just waiting for them to unload their project with the impossible deadline on your desk. No, actually, I have six other project deliverables I’m working on, thanks though. This is always great when it’s followed by some version of adult business-civil temper tantrum. Drop everything and make my Most Important Project your priority. Yay. Normally I can shrug these off, and even laugh at them. Lately I’ve found myself snapping at them and their ridiculous expectations. Oops.

Yeah, you maybe should back off.

Yeah, you maybe should back off.

But it’s winding down to the diagnosis now; and the autoimmune factor is coming to the forefront, which is okay. Sarcoidosis is something I can work with, and have good hope that with some mitigation I’ll be as good as new by the end of the summer. I also believe, though I doubt I could get anyone in the medical community to agree, that this wasn’t just a long-time-coming diagnosis, but a progression of several of the horses in this race, including the starting gun: the tetanus-diphtheria-pertussis vaccine I got two weeks before my symptoms started. I’m still kicking myself for agreeing to that (my cat had accidentally (not aggression-related) scratched my ear open to the cartilage). My last booster was less than 10 years ago, but the doctor felt this was a risk (and was my cat vaccinated? – what do feline vaccines have to do with a scratch?).

And because I do believe that Farmer's Lung is still a concern, I purchased this attractive accessory for feeding the sheep and chickens.  It's hugely helpful and protects my lungs from dust and mold. Yaasss.

And because I do believe that Farmer’s Lung is still a concern, I purchased this attractive accessory for feeding the sheep and chickens. It’s hugely helpful and protects my lungs from dust and mold. Yaasss.

With this depression of my immune system, a the constant puff of fine hay dust and mold spores while feeding the sheep had just the opening they needed, and Farmer’s Lung strolled in the door and settled in for a stay. Then, as I gasped through January and February, feeding and caring for the beasts as I struggled to get a breath, my body working hard to keep up with the demands of my daily chores, the autoimmune factor opened up (I already have one autoimmune disease – Hashimoto’s thyroiditis – and they say once you have one…) and Sarcoidosis came in the door I left open in my negligence. I know this is probably irrational hooey and makes no sense scientifically to anyone with a medical degree, but a weakened immune system is huge. It’s like putting out the welcome mat for all kinds of detritus. Being basically healthy and from good sturdy stock, my only fault being not getting enough sleep (and the incredible restorative powers therein), I’ve learned a valuable lesson to take me through the next half.

Love this dog to bits!

Love this dog to bits!

Farmer’s Lung and the power of good health {part 1 of 2}

Got home from work in time to see this the other day - days are growing longer! Weee!

Got home from work in time to see this the other day – days are growing longer! Weee!

I’ve always been a person blessed with good health. Other than the usual occasional cold or flu, or the rare intestinal disturbance (food poisoning), I’ve been relatively trouble-free for my whole life (aside from some chronic ear infection stuff as a toddler). I’m a both feet on the ground, steady as she goes type. I mainly go for hiking and walking, and plenty of work around the farmstead—lifting, pushing, carrying heavy objects, raking, digging, hoeing, and the infrequent wrestle with a recalcitrant sheep. I’ve had my share of bumps and bruises, muscle aches and strains, and then there’s the old ski injury that crops up (bad sprain of my right ankle in my mid-teens), and knee joints that gripe a bit. And all the stuff that comes with time and, perhaps, not enough regular activity and maintenance of muscles. Like a lot of people, I tend to be a weekend warrior type, especially during the winter when daylight hours are scarce and the weather is unwelcoming. And a few stiff muscles after a busy weekend is usually my only payment. I’ve always been thankful for my sturdy stock genetics, feeling lucky more than once at how tough and trouble free my body has been. No allergies, no gut issues or skin issues, just all around good health, for lo these many years. And of course, even as I’m thankful, I’ve also taken my good health for granted, not nurturing my body as I should. While I eat well (whole, real foods, mostly organic, low carb and not a lot of junk or sugar), I tend towards overeating and also sleep deprivation (by choice and probably my biggest abuse). I’ve not worked at keeping consciously toned as I travel my middle years and the rebound after a weekend of overuse isn’t as quick.

So I find myself with not one but two health issues right now that have been turning my crank for the past few months, and really realizing, like for real, just how good I’ve had it all these years. One is less concerning, especially as this other has reared its head, and while it seemed debilitating when I first noticed it back in September or so—a sharp pain in my left forearm when I rotated my hand/wrist to the inside (diagnosed as tennis elbow when I finally went to the doctor two months later)—it’s now finally healing as a perverse side effect of the other, more threatening issue.

Came to work one day and found this as I unloaded my backpack.  Farley's handiwork, and a reminder of where I'd rather be (at home tossing this endlessly for him).  He so sly.

Came to work one day and found this as I unloaded my backpack. Farley’s handiwork, and a reminder of where I’d rather be (at home tossing this endlessly for him). He so sly.

The doctor prescribed a special brace for my arm, a prescription of naproxen and a muscle relaxer, and a recommendation for PT. The naproxen made me dizzy and the brace and PT are helpful, but really, what my arm needs is rest. No feeding sheep, no hauling hay, no toting a 3-gallon chicken waterer up the hill to the coop, or a bucket of feed out there. No raking or yard work, no cleaning of the sheep pen. In short, no farm work, and of course this is impossible. Or so I thought.

In late November I had a few days off around Thanksgiving. I was home and enjoying time with the dogs, and each day would take one of them out for a long walk to the river and back. The river was in flood stage mode, so it was fun to go see each day’s development. On the second or third day, I walked part way there and ran into a brick wall of just zero stamina. I’d never felt this feeling before, so of course I kept going. I had Daisy with me, and she can pull pretty good, so once we got up the steepest hill it got a little easier. Still, it was a weird feeling, like all of a sudden I just couldn’t go another step. That evening I felt a little under the weather; maybe this was a touch of flu?  No congestion or coughing, no sore throat or any other typical flu symptoms, but the low/no energy was strange. I realized I wasn’t able to get a deep breath, and felt some heart palpitations, but attributed this to my thyroid condition (I get these symptoms frequently on the medication to treat hypothyroidism). Over the next few days and weeks I became more aware of symptoms: loss of stamina, inability to get my breath, chilled at night where I could not get warm, then, when I finally did warm up after huddling under a blanket for a couple of hours, it was like I’d stepped into a furnace, and I roasted for the next several hours. My skin would become ultra-sensitive during these cold/hot sessions, like when you have the flu and just the touch of your clothes is irritating. My appetite was down, and even when I was hungry, nothing sounded good to eat (VERY unusual for this chow hound) and I had intermittent, mild to not so mild, headaches . Finally, frustrated (and, honestly, a little scared), I went to the doctor with my grab bag of symptoms. It had been going on for three weeks by this point. I left the doctor’s office with another prescription—this time for an inhaler (bronchodilator). “So am I asthmatic now?” I asked, incredulous, and got the verbal equivalent of a shrug. WTF?

Daisy's handiwork.  Stole it off the coffee table, where I'd left it the night before.  You'd think she was a puppy or something.  Heart her!

Daisy’s handiwork. Stole it off the coffee table, where I’d left it the night before. You’d think she was a puppy or something. Heart her!

The inhaler didn’t help (and the icky, jittery side effects made it something I avoid anyway), and the symptoms continued. A week or so later I went back, even more frustrated. The mildest exertion would have me gasping like a landed trout, and feeding the sheep was like I’d run a marathon. All my chores slowed down to glacial speed, just so I could breathe. Even so, I’d often have to stop to catch my breath, trying to get enough air when it felt like only half my lungs were working and my windpipe burned like I’d just run a quarter mile in subfreezing temperatures. Actually, I need to change that last sentence to present tense, because little has changed. Going back to the doctor had little effect – chest x-rays, labwork, ultrasound, all is completely normal. A week’s worth of azithromycin did nothing. So then it was off to the pulmonary specialist. I went in for a breath test first, and nearly flunked, with the tester-gal threatening me with having to come back if I didn’t get a decent result by 4:30, and she was “booked solid next week.” Of course the passive aggressive attitude from her did little to improve my results (breathing into a little tube, sometimes with no oxygen available because they shut the valve off on purpose), but in the end (9 times through the test) it seemed we got enough results the doctor would be able to work with.

The actual visit with the pulmonologist was a bit of a bust from my perspective. A few questions where she didn’t seem to listen to my answers. “What else.” She prompted, and again “What else” as I struggled to remember the weird grab bag of symptoms that went with not being able to breathe for the past two months (none of which were typical with regard to lung health – no congestion, no mucous, no coughing, no sneezing, no runny nose or eyes – nothing). She kept asking me about any unusual rashes or swelling (ankles or legs or joint), trying to zero in on something, but I had nothing to give her there, there were none. Time for a CT scan.

The sheep, waiting out a rain squall.  You can see the seasonal stream in the background.  Lots of  sky water this year and the hillside is drenched.

The sheep, waiting out a rain squall under the cedars. You can see the seasonal stream in the background. Lots of sky water this year and the hillside is drenched.

Of course as this went on, I talked to a few friends and whined more than I’d like to say. The difficulty breathing progressed to levels that got a little scary at times (since I’m here by myself), with the basic chores reducing me to near-gasping, and even feeling out of breath while lying in bed at night. My friend Laurie, though many states away, has been my staunch support, researching like a fiend (she’s a stupendous researcher). My brother recommended a dehumidifier. I didn’t really get that (thinking, it’s not a typical upper respiratory infection) but took it into consideration. I searched symptoms over and over, with a focus on zoonotic disease. With the dogs, cats, sheep, chickens, and their various and sundry diseases, I’ve never felt threatened by something transferring from them to me since most diseases and parasites are pretty host specific. Well, that viewpoint has changed somewhat, though I’m still not worried that much. For a while though, everything I came up with made me wonder how I’d survived living with and caring for them as long as I have. But still, nothing fit the weird collection of symptoms I had. Every 5 -7 days I was laid low with it, barely able to function some weekends. One day while conversing with my friend Karen she repeated (as she had weeks ago, as my brother suggested, and as Laurie had mentioned early on as well), it really sounds like mold allergies (she has horses, so knows her moldy hay). When I hear the word allergies I think sneezing, coughing, runny nose and eyes, etc. Nothing like this has happened, so when these friends and family had mentioned mold allergies I kind of went “yeah, yeah…” But out of desperation and what the hell, I plugged in mold allergies into the search engine…and almost immediately came up with the “ding, ding, ding” of jackpot.  Huh?  And huh.  Because for mold allergies, we’re into a whole other ball game. And this is kinda serious stuff. Shit.

Dust mask after a week with the dusty hay; before I started wearing this (like for two months with this hay) all this was going right into my lungs.  It's insidious.  And, in some cases, essentially deadly.

Dust mask after a week with the dusty hay; before I started wearing this (like for two months with this hay) all this was going right into my lungs. It’s insidious. And, in some cases, essentially deadly.

I now have a dehumidifier.  And while I’ve been careful to wear a dust mask while feeding the sheep, I only started doing this two or three weeks after the initial onset of symptoms. Like anyone who feeds hay to livestock, I’ve broken open my share of moldy bales, often with a puff of weird smelling dust to the face; some where it’s just a small section, others where the bale turns out to be mostly compost. And the dusty hay!  The two tons of hay I had delivered in October was probably some of the dustiest hay I’d had in a while. Nearly every bale had at least one 5-gallon bucket of chaff and green powder to be swept off the floor. And there was some mold too. I fed the last of that batch by early January, but by then the damage was done.

Right now all signs point to hypersensitivity pneumonitis, and more specifically in my case, Farmer’s Lung. A pretty serious diagnosis, and one I’m still researching. My CT scan was done (Laurie is researching the results there – lots of $40 words on the radiologist’s report, and my god can this woman research! I am blessed!) and after reviewing the results with me the pulmonologist wants to…wait for it…do more testing!  Specifically, a broncoscopy with lavage (this actually sounds good) and biopsy of lung tissue and two lymph nodes (this does not). I’m loathe to have them start cutting on me, and since these tests will likely only rule out some of those $40-word potential diagnoses and not supply a diagnosis themselves, I asked if we could start conservatively with some blood tests to check for mold and bird allergies (in addition to a coop full of chickens I also have a couple of budgies in a large cage the house, with me and the 7 carnivores).  It helped that I was having the best day I’d had, symptom-wise, in probably a month or more on the day that I saw her. Not coincidentally, we were experiencing our third day of sunshine/no rain after what seemed like weeks of rain.

I’m so ready to be back to 100% health, and look forward to taking even better care of myself, to stay strong and healthy as I head towards the second half of my fifth decade. I’m still working on how I’ll do this (there is no cure for Farmer’s Lung, and no treatment other than removing the offending matter; and if you don’t, it’s curtains), but trust me, I will figure it out.

Next post: CT test results and allergy testing and the great, gaping maw of the U.S. medical system.  And let me just say, I now understand why Dr. House’s patients always arrived to his care half-dead.

This post's gratuitous cuteness photo: Because Pal doesn't play with toys or balls, and because he doesn't chew up household items, we just get to see him, not his handiwork.  My good little birddog.

This post’s gratuitous cuteness photo:
Because Pal doesn’t play with toys or balls, and because he doesn’t chew up household items, we just get to see him, not his handiwork. My good little birddog.

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