I had my six-week flush (of my porta-cath) this last week, and also saw my Oncologist. We reviewed the two major events that had occurred since I'd seen her last; my trip to Mayo Clinic and the recent test protocol for pulmonary embolisms that turned out to be nothing more than a pulled muscle in my back.
I relayed the Mayo physicians recommendation that nuclear imaging tests be reduced and my Oncologist was in full agreement for two reasons: 1) Since I'm just about at the 2 year mark, reduced testing is justified unless anything unusual occurs, and 2) It's best to limit radiation exposure, especially in patients who have had a lot of chemo or radiation as part of their treatment.
So the good news is that I won't have to have any special tests in October at the 2-year post-transplant mark. Since I had a PET scan in June, she suggests we do the next one a year from then, with periodic blood work now and then as required. Since I have to have a flush of my porta-cath every six weeks, they'll draw blood every third or fourth time for general maintenance testing. I also will no longer be getting a bone-marrow biopsy as a diagnostic test (unless there's some medical reason that warrants it).
The negative is that I passed on a flu shot when I saw my general practitioner last month, thinking I'd get it during the October protocol - and I forgot to mention it to my Oncologist. So not only did I not get a flu shot when I could have, but now I've been feeling like I'm coming down with a cold/flu. Today while working on my computer, I wore my headphones, and noticed something I hadn't before - there's some settling in my chest. Headphones let you hear the internal echo of your breathing - try it!
Since I had pneumonia quite a few times in the early years of my illness, I've grown really good at keeping an eye out for early signs of congestion. When I heard that rasping I immediately pulled out my trusty Voldyne 5000 volumetric spirometer.
This is a plastic device with two channels with floaters, and a breathing hose. The purpose of it is to help people gain lung power after a respiratory illness. It's also excellent for getting your lungs open if you start to feel congestion. Pneumonia is caused by water in your lungs. When it first appears it's usually at the bottom of the lungs, and causes the tissue there to stick together. If the water remains trapped there, or increases, little by little your respiratory power will decrease until you have pneumonia. Using the spirometer even just a few times a day can force your lungs open, right down to the bottom, and give your body the opportunity to drain that liquid. I'll give you a couple of websites in case you want to check it out further. The first one shows what the apparatus looks like while the second site explains how it works. I'll summarize those instructions below.
1. http://www.hudsonrci.com/Products/product_indiv.asp?catalog=1&PageID=10&prod_cat=28&prod_subcat=&keywords=
2. http://wiki.answers.com/Q/How_do_you_use_the_voldyne_5000
INSTRUCTIONS:
1. If you look at the apparatus in the first addy, you'll see the two channels and floaters. Seal your lips around the mouthpiece and breathe in slowly.
2. Try to keep the floater on the left in the best box (from top to bottom it's Good, Better, Best, so you're trying to keep the floater low and steady).
3. While keeping the left-hand floater low (in Best) try to get the right hand floater as high as possible.
4. There's a slider on the outside of the right-hand channel and you can position it for your high-point or your target high point, and increase it as your lung power increases. The scale goes from 0 to 5000 ml. (inspired volume). When I was given this device years ago (I was in the hospital with pneumonia) I could barely pass 500. Today I have the slider set for 1500, because the congestion has brought my respiratory rate down.
Do it in sets of 10 breaths once an hour, or a few times a day - it can make a big difference. I can do it much longer if I'm surfing the web and not typing. It can really make a difference quickly.
When you first start out, you can also just try to get the right-hand floater high with hard, deep breaths out, while ignoring the left-hand floater. This can help open your lungs to clear congestion. Ideally you should try to do both. Doing both ensures that you take long, deep breaths that fill your diaphragm, and not just your upper lungs, so that you can force your lungs open completely, and keep the tissue open/separated long enough to start your body's natural fluid-draining process.
Arizona's air is much dryer than Minnesota's, so the extra water in the air is a reminder for me to keep on top of these respiratory exercises. It's good for any respiratory problems (like a collapsed lung, pneumonia, congestion, low respiratory due to being out of shape, etc.). It's amazing how quickly you can cut short a respiratory problem if you recognize the symptoms early and keep on top of it. Get one of these handy-dandy devices, but remember that, for good hygiene, only one person should use it.
It's a real autumn day here in Minnesota, although it's officially still summer. It's a little chilly today, but it looks like we'll have a week of Indian summer next week, which is great since my niece is getting married next Saturday. Fall has always been my favorite season in Minnesota, so I'm enjoying it. I hope you're all having a great September where ever you are!
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