Thursday, August 2, 2012

Answers...FINALLY Got Some Answers

Today was a big day for me. I met with the Pulmonology doctor at Vanderbilt. His name is Dr. Rickman and upon meeting him, I knew I was with the right doctor. One provided, once again, by God.
It all started though with his nurse, Charla. She came in first to introduce herself and get a little health history from me. She was so sweet, and funny. We could totally be friends if I lived in Nashville! We just seemed to hit it off instantly. Although at the end, I said something really "nurse-y" sounding and she asked if I was a nurse and then what kind of nursing I did. When I told her, she couldn't believe I held out on her. I really don't like telling other nurses though that I myself am a nurse because I feel like it makes them feel weird or something. I know that when I had a pediatric patient in the ICU who's parent was a nurse or doctor, I thought to myself, "great, I drew the short straw today" because they (we) watch everything like a hawk. Ha! So I never like to "out" myself because I want them to treat me and talk to me like I know nothing at all about my illness.
Anyways (that was really off topic), here is what I learned today:
1. What happened with the last treatment is NOT the start of pulmonary toxicity. If it was, there would have been fluid in the lining of my lungs or actually in my lungs on the CT scan and xrays. WHEW!!!
2. Dr. Rickman asked about the cough (because I happened to hack like crazy when I had to take deep breaths for him) and then told me that it really sounded like bronchial asthma...the upper airways I have are swelling and constricting causing me to not be able to get air through properly. He then asked if I had a history of asthma to which I replied no. He said that it is possible that I could have developed asthma from the Herceptin but that he didn't know of any real research that showed patients getting asthma as a result of getting Herceptin.
3. When he listened to my lungs with his stethoscope, he could tell I was still tight sounding and not getting air all the way out (another effect of asthma).
4. He did say that he thinks the severe symptoms of shortness of breath and wheezing, etc....that happened last time was either a flare up of asthma or an allergic reaction to the Herceptin. UGH!!!
5. He thinks it is well worth having another treatment (which is tomorrow - Friday) and seeing if it happens again. In order to prevent it from happening though he started me on another Steroid Dose Pack (I will start it the day before chemo from here on out) that I will take for 6 days. Here's to praying that it works!!!
6. He suggested staying in Nashville tomorrow in case anything happens so I would be close to Vanderbilt ER. He doesn't blame me for not wanting to go back to Gateway and was FLOORED that the hospital diagnosed me with bronchospasm and bronchitis but never gave me a breathing treatment or sent me home with a script for one.
7. He ordered some pulmonary function tests that I did right after I saw him. It was hard and left me seeing silver spots from trying to exhale so hard and for so long and left my chest tight and hurting. They gave me Albuterol before I left and within 20 minutes I felt relief. I should have results of those tests from the doctor tomorrow.
8. When I left it was Nashville's rush hour so I was sitting in traffic. I decided to google "asthma caused by Herceptin" and what came back was a study that was done that showed 1% of patients developed bronchial asthma during treatment with Herceptin and most of them developed it in the 6-12 month mark of Herceptin. Well, my horrific cough started earlier than that but has progressively worsened so I fit right in that category.
9. I should have asked him if after stopping the Herceptin next month if the asthma would clear after the medicine was totally out of my body (generally 4-6 months after treatment stops) or if it was a "forever deal." I will ask him when I hear back about my pulmonary function tests.
10. Oh, and he did say that if it does happen again tomorrow, that he will call Dr. Mayer (my oncologist) and have a discussion with her as to whether I should really take the last two treatments due to how my lungs are responding now.

So, again, God went above and beyond in providing clarity and answers through Dr. Rickman. I feel very comfortable and at peace with this plan of care and am grateful to finally know what we are dealing with. I am a little nervous about treatment tomorrow and how things will go afterwards, but I feel confident that God will continue to take care of me regardless of what happens. I doubt I will stay in Nashville tomorrow because my mentor is taking me and honestly, I always just want to get home as soon as the infusion is finished. David suggested going back to Nashville when he got home from work tomorrow and staying in a hotel, but I think we will just play it by ear. If I start to get a little wheezy and short of breath, we will pack a bag and go right away. I have a babysitter lined up on stand by if we do have to go to Nashville. Plans are in place and I feel peace.

YAY!!!!! 15 down, 3 to go!!!!! Just praying I get some sleep tonight because I am all hyped up already from the steroids. I had to take all 6 of the "day 1" pills all at the same time since it is so late in the day. EEEEEK! I may be so wired that I clean my whole house tonight while everyone else goes into dreamland. Hey, at least it will stay clean for a few hours...before they all wake up.

1 comment:

  1. I'm glad to hear you got what you were looking for. Good luck at your next treatment! ((((hugs))))