Friday, July 11, 2008

Why do I keep repeating the same dumb cycle?

Many of you, essentially everyone who's actually potentially reading this, know that my lungs are a mixed bag. I'm incredibly blessed by their size, their power, their capacity, etc. I can hit 130+% on most lung function measures when things are good. On the other hand, things often aren't entirely good. I have issues with inflammation, hyper-reactivity, swelling and gunk that are known to pull my function down. This is something I really should know.

The plus side is that until I get to exceptionally bad levels of inflammation or infection, my baseline function is so good that I'm able to function pretty dang well. The down side is that unless I get to absurd levels of inflammation, I am able to keep functioning and am not forced to even notice consciously that I'm having issues much less take action to deal with it.

Between my pulmonologist and my allergist, they have identified a great regimen of drugs that work not only to keep me functioning at my top levels, but to allow me to engage in pretty much any activities I want to with minimal potential side effects. Take a tiny pill in the morning, two at night, do two inhalers twice a day and nebulize one drug and I'm pretty much guaranteed to be problem-free unless I have an infection. The problem? Me.

I start feeling better lungwise every year around May and then I drop a drug here and a drug there until I suddenly haven't taken anything in a month. I think I'm fine. In fact, I'd normally keep thinking I was fine until September or so. In reality, I'm adequate, but definitely not fine or ideal. Why do I do this? I really think it's just laziness. It really isn't much of a hassle to stay on my meds. The only one that presents a problem at all is the nebulized drug and my doc is okay with me just doing it weekdays and I can do it at my desk while I'm sorting my email and looking through my workload for the day. It's just easier to not. And since some of the drugs have lasting effects and I start from a top-notch shape, the descent into problems is gradual and I just don't notice it.

I'm writing this because I went to the allergist for a regular appointment today. Just an annual because you have to do those to have them keep seeing you happily when you have problems. I walked in with a declaration to the PA, who I absolutely love, that I was healthy and that was something she wasn't used to seeing. Well, she subtly made me keep talking and moving and things throughout the appointment including a lung function test and by the end of the appointment, got me to admit that I was not in great shape. That I was experiencing distracting, though clearly not life-threatening, tightness in my chest at least a couple times a week. They have a brilliant computer system that allows her to fax the prescriptions straight to my pharmacy while I'm sitting there, so she faxed over fresh prescriptions for all the drugs after getting me to state that I should be taking them. Not only that, but she loaded me a hefty bag of samples of everything I'm supposed to be taking so I could go ahead and get restarted right then.

Well, it's only been one night, but based on how I felt waking up this morning, this is why I was so tired and just puttering. I wasn't breathing as well as I can and so my sleep was no where near as a high a quality as it should be. I had actually gotten to the point this week that I was trying to figure out what doctor to talk to in order to get serious amphetamines or something. Who would have thought that the solution was just to respirate to my full potential?

So, props to talented, patient medical professionals who really care about their patients and how they are and are willing to work to fix a situation even with the patient doesn't see that it's there.

I'll leave the debate about whether I should have an Epipen within a foot of my person at all times for another day. Medically, I know the answer, but I really do think you have to balance that with other life issues.

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