So I went back to the allergist's office yesterday. To put it mildly it didn't go well. We went round and round. I got fed up and walked out of the appointment. I have no plans to go back to that clinic. I heard for the millionth time that perfume can't cause anaphylaxis it can only "irritate the lungs". Riiiiiiight. Everytime I hear that I want to scream. I asked what in the world the difference is because I can guarantee you that to the person in the ER or ICU there's not one. I don't care what you call it but I promise perfume can drop me like a stone.
I also got the typical lecture about how often I use my epipen. Its like doctors think that somehow this all escaped me. No I was clearly unaware that using an epipen could seriously impact my heart. It's only my heart that is racing and going berserk. Yep I completely missed that the last time I was hooked to a crash cart after epinephrine was administered. The doctor also did the epinephrine is a serious medicine and should only be used in emergencies lecture. So apparently I also completely missed the signs of when I should use an epipen. I was under the impression I should use it when I'm doing badly enough we need to call 911 or to you know maybe take the medicine early enough so I don't have to call 911. Maybe I was wrong. Maybe next time I should just wait till I stop breathing completely and someone else has to administer it. Yeah that sounds like a fantastic idea. Or I guess I'm just unaware of what anaphylaxis is. I don't know what else to call it when your throat swells closed, you
have an audible stridor, severe respiratory distress to the point of
turning blue, itchiness in the mouth, blood pressure that drops like a
stone, heart rate that goes bananas, turn bright red and burning hot
before turning whiter than a sheet from not breathing, tingling in the
mouth, tingling in the hands, dizziness, and that wonderful sense of
impending doom i.e. utter panic. Last time I checked that was called
anaphylaxis. But hey according to the guy with the degree I'm wrong so clearly he's right. Riiiiiiiiiiiight.
I've come to the conclusion that doctors use people like dartboards. (I said doctors not nurses for a reason. If health care was run by EMTs and nurses things would probably go much better.) They throw medicines and treatments at you until something sort of kind of sticks. Well if nothing sticks then clearly you're beyond their help or better yet you're to blame. The greatest irony of the whole situation is that I typically wait till the last minute to use an epipen. I have been flat out fussed at by the EMTs that have shown up at the house because I waited so long. When I have to deal with idiot doctors I want to make them go work a few days in the ER to remember that medicine doesn't always fit into your nice perfect little box. Instead of giving up on the patient or punting them to someone else maybe you, the doctor, are the problem.
I've met a lot of people that wonder why I have such a bad attitude about doctors. Days like yesterday are exactly why I'm such a sour puss. It doesn't make anyone happy to be dumped by one doctor and punted by another. It's frustrating beyond all reason to be lectured again and again. It's infuriating to be poked and prodded endlessly with no answers or end in sight. The worst part is there is no amount of explaining or hospital reports that will convince some doctors. Moments like this are when my desire to take my hands off the wheel comes flaring up. By that I mean I want to say well fine if everything you said is true then I can stop all of this medicine and we'll just see what happens. I can just not bother going to the doctor because clearly you have no idea what to do with me. Based off my hospital records you don't seem to be doing me much good either. It's also moments like this which reinforce my standing opinions of not dealing with doctors until I'm seriously, seriously ill and that modern medicine treats people like one of two things idiots or dartboards. Which I am neither.
Tuesday, October 15, 2013
Thursday, October 3, 2013
I like those odds
Some days I really think that if I wasn't Mormon I would play the lottery. One in a million odds seem to be my specialty. I can give a great example. Yesterday I had a methacholine challenge test. If you're scratching your head wondering what that is don't feel bad. I'd never heard of it either until my allergist mentioned it. It's to confirm or rule out a diagnosis of asthma. It's important to know if you're dealing with asthma and allergies or asthma-like symptoms and allergies.
The premise of the test is that a pulmonary function test (pft) is performed to get a baseline. Then you breathe in a saline solution. Another pft is performed. Finally in stages you breathe in methacholine and take another pft after each stage. In theory what should happen in someone with asthma is the following: the lungs should react and there may be mild upper airway constriction. It causes a very distinct and noticeable drop in pulmonary function. If they see this drop in pulmonary functions then it's considered a positive test result which is an absolute indicator of asthma. Now it should be noted that a negative test result doesn't necessarily completely rule out asthma it just argues against asthma.
In theory no one should have an allergic reaction to methacholine. That should have been our first clue. The test has been around since the '40s so it's considered very safe. Well you're looking at one of the very few people to manage to buck that trend. The test was going fine which should have been the first sign something was bound to go wrong. I'd had the first dose of methacholine administered to me and the pft done. While I waited for the next dose I started coughing. Now that isn't at all surprising I'd been coughing already for two days from being off most of my medications. Also methacholine is known to cause cough in some people. The problem is that methacholine should respond almost immediately to albuterol.
When I started to flush the respiratory tech, Micheal, started to get a little panicky. I can't blame him, if you've ever seen my list of allergies you might panic too. Then I asked the question that really made him panic, it is normal to feel itchy? That was the big red flag that something was going wrong during this test. So he started a nebulizer treatment but my coughing got worse. This was the point he switched to oxygen and paged the doctor. I managed to get two doctors and another tech in the room. Benadryl, oxygen, and a little bit of time later I was back to stable again. I did manage to give them quite the scare though with my heart rate. It was bouncing all over the place from 105bpm up to 140 bpm and everywhere in between.On a positive note the pulse oximeter didn't register a drop in O2 saturation so that was good.
So the moral of the story is that it is unlikely that I have asthma. The evidence just doesn't support it. Do I have something that looks and acts remarably like asthma, yep. Is it actually asthma? Probably not. Also they were able to draw blood to check a particular level in my blood. It's called a serum tryptase level. For several of the diseases they are considering an elevated level is a clear indicator. The other moral of the story is that I run the odds and well. If there is a one in a million chance of it happening you might want to plan on it with me.
The premise of the test is that a pulmonary function test (pft) is performed to get a baseline. Then you breathe in a saline solution. Another pft is performed. Finally in stages you breathe in methacholine and take another pft after each stage. In theory what should happen in someone with asthma is the following: the lungs should react and there may be mild upper airway constriction. It causes a very distinct and noticeable drop in pulmonary function. If they see this drop in pulmonary functions then it's considered a positive test result which is an absolute indicator of asthma. Now it should be noted that a negative test result doesn't necessarily completely rule out asthma it just argues against asthma.
In theory no one should have an allergic reaction to methacholine. That should have been our first clue. The test has been around since the '40s so it's considered very safe. Well you're looking at one of the very few people to manage to buck that trend. The test was going fine which should have been the first sign something was bound to go wrong. I'd had the first dose of methacholine administered to me and the pft done. While I waited for the next dose I started coughing. Now that isn't at all surprising I'd been coughing already for two days from being off most of my medications. Also methacholine is known to cause cough in some people. The problem is that methacholine should respond almost immediately to albuterol.
When I started to flush the respiratory tech, Micheal, started to get a little panicky. I can't blame him, if you've ever seen my list of allergies you might panic too. Then I asked the question that really made him panic, it is normal to feel itchy? That was the big red flag that something was going wrong during this test. So he started a nebulizer treatment but my coughing got worse. This was the point he switched to oxygen and paged the doctor. I managed to get two doctors and another tech in the room. Benadryl, oxygen, and a little bit of time later I was back to stable again. I did manage to give them quite the scare though with my heart rate. It was bouncing all over the place from 105bpm up to 140 bpm and everywhere in between.On a positive note the pulse oximeter didn't register a drop in O2 saturation so that was good.
So the moral of the story is that it is unlikely that I have asthma. The evidence just doesn't support it. Do I have something that looks and acts remarably like asthma, yep. Is it actually asthma? Probably not. Also they were able to draw blood to check a particular level in my blood. It's called a serum tryptase level. For several of the diseases they are considering an elevated level is a clear indicator. The other moral of the story is that I run the odds and well. If there is a one in a million chance of it happening you might want to plan on it with me.
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