Friday, June 7, 2013

Bronchial Thermoplasty At Last

One week ago I had my first Bronchial Thermoplasty procedure at Cleveland Clinic, FL.  Dr. Oliveira did a flawless job!   Just the week before I was scheduled for an adminstrative law judge hearing to appeal my insurance company's decision to deny covering this procedure; but, strange timing, my insurer called me the day before and said that they had reconsidered and would cover it after all.  A recent 5 year study release on the continued benefit to  the initial test subjects, apparently lent itself to my insurer's change of heart.

The first of three procedures treated my lower right lobe.  My FEV1 was 42% before the procedure, I did a peak flow as I was leaving the hospital a few hours after; it was 296, which is on the high end for me.  I believe that the anesthesia and other drugs kept the swelling at bay initially, so I was more clear for a moment.  Then the area treated swelled closed entirely--I could hear the density when I tapped on that part of my lung.  But I felt a little more energetic than normal, I suppose because of the temporary lung volume reduction, though my peak flows were still low.  I was on prednisone for about 5 days after and I have been using Xopenex in the nebulizer but alternating with magnesium sulphate solution and an Agricept-L solution.  These two treatments I am doing to help reduce inflammation and prevent infection.  My post anesthesia sore throat went away quickly with these.  I am also inverting myself periodically to prevent any fluid build up.  Initially my peak flows were close to 200, but now they  are closer to 250, and gaining stability.

Part of the reason I sought out the alternatives to use in my nebulizer was the vaso constricting effect of the typical bronchodilators; my primary Doctor had me unsettled with his feeling that I was starting to have some pulmonary hypertension.  I had worked out before my last visit to him, and he was concerned about my bulging neck veins.  A subsequent echo cardiogram, that I also did post workout, apparently suggested that an estimate of my pulmonary artery pressure was around 40mmHG, which would place me in the PH realm.  However, echo cardiograms are not used to diagnose PH, only a right heart catheterization can do that.  A visit to a cardiologist and his manual exam determined that PH is not an issue for me, yet anyway.  It is always darkest before the dawn.  Now with the BT, I have some hope of relieving some of the pressure that the 27 years of out of control asthma has or could have on my heart.  So now, post procedure, I am able to be somewhat stable with 2 Xopenex nebulizer treatments and one magnesium and one Agricept-L per day  (these have a more subtle bronchodilator effect, raising my peak flow about 10 points).

I inadvertently found a therapeutic island in the open ocean currents off of St. Thomas USVI.  My husband was on a work circuit ride for two weeks in March and again in April of this year.  I had been kayaking to small islands just offshore of Cyril King Airport; the Flat Cays.  And in taking my regular peak flows noticed when I had kayaked and spent several hours on this particular island, Little Flat Cay, I would not need to use my bronchodilator to row back, and the next day my peak flow would peak at around 300.  My conclusion is that these open water currents (it is about 2 miles off shore) carrying water from the North Polar region as part of the North Equatorial Gyre, must be full of negative ions and very positive energy.  These islands are very barren wildlife refuges, but anytime I am back, I plan to get out there myself or with help.

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