Saturday, September 25, 2010

Cough Hack Wheeze Update

Image found here. 

Gee. I'll bet everyone is sitting around this morning over their Saturday cup of coffee wondering, "Hm. Is Julia's cough improving?"

Don't disillusion me here. I actually know better, but it's fun to hang out in foggy Julia-land.

So. I won't keep y'all waiting. Yes, my lungs are slowly becoming less cranky overall. But I did realize that even though I have been seen by two very good family practice doctors regarding the whole asthma/bronchitis/pneumonia adventure, I had to eventually present myself to my rheumatologist to get his evaluation of the situation. Because both F. P. doctors very firmly told me so in no uncertain terms.

It would have been really easy to put off yet another visit to the clinic by rationalizing that things seemed to be improving. Slowly, yes. But definitely better. My attempt at procrastination was foiled by a very alert medical assistant that notified my rheumy's medical assistant that I needed to be seen.

Rats. Caught by effective communication and competent staff. Ah, geez.

My appointment was yesterday, and I have to grudgingly admit that it was probably a good idea.

Did I mention that I have yet another new rheumatologist? My previous dr. was fabulous, but very overburdened with clients, as well as becoming the rheumatology department chair, so I scouted out yet another doc in the same department. I was worried. How many fabulous physicians could there be in one department? As it turned out, my new doc has his own brand of fabulousness. I'm one lucky Sjoggie.

So fabulous Dr. J. brought my latest round of Xrays into the exam room, gave my lungs a thorough listening-to - that's auscultation for you medical types - and pulled up a chair. "Well," he said. "Overall I agree with what you've been told on your past two visits."

Whew, I thought. Alrighty, then. See ya later, doc.

"Not so fast."

Drat. But doctor, check out my most recent chest films. I stood up to gesture toward my xrays hanging on the exam room reader. Look. They're gorgeous, if I do say so myself.

"You're right. Clear as a bell. BUT." Here he gave me a stern look. "I'll bet that you know that we need more information than a simple chest film."

Drat again. This guy IS good. I sat back down.

"Look, I know that diagnostic stuff is no fun, but we both realize - stern look again - that at the very least we need to do some pulmonary function studies here. If those are good, then we can agree that your continuing cough is related to dryness and hyper-reactivity of your airway passages. If they are less than optimal, then we need to do some more evaluation."

But wouldn't anything else have shown up on a chest film?

"Not necessarily. And while we're at it, let's get a bunch of labs, oh, and I see you're due for another pneumovax immunization..."

I slouched down in my chair. Well, dagnabit. I thought I had this all figured out. Looks as though I have some more research to do regarding other Sjogren's related lung issues, what diagnostics are required, and what normal and abnormal results would look like.

Which leaves me here on the Saturday morning searching medical literature like crazy. And drinking MY Saturday morning cup of coffee.

As always, I'll keep you posted. Carry on, people.

1 comment:

Anonymous said...

OMG! This is becoming a soap opera. I know EXACTLY how you reacted
when going in to the doctor again, just KNOWing "all is well". Oh krap!
The doc has ANOTHER agenda for me. Good luck; hope those results show
that the patient IS usually right! Whose body is it anyway???