Something new about David's health

Because David had a sore throat we went to see the doctor again today.  Dr. Clemo, our internist, is on vacation and so he saw another doctor in the same practice.  After reviewing all the records, etc. we learned that the sputum cultures were negative for mycobacterium.  (According to the pulmonologist sputum is not indicative if negative, the bronchoscopy goes down to the lower lung where the gunk is, to get a good sample.  Even then, this stuff does not easily grow and there is only a 50% chance it will be detected. ). Anyway Dr. Ameen, the substitute internist, is treating for a yeast infection with flluconazole for five days and said to gargle with salt water.  IMHO the evidence is all pointing to an aspiration-caused pneumonia blocking gas exchange but not an infection per se.  I guess we'll see.  We left the doctor's office and went to Costco for the prescription and shopped for Easter stuff to.  Now we are home watching recorded shows...only David is napping while sitting on the couch.  I hate to wake him up to go into the bed for some real rest.

Good news at Georgetown Hospital

David saw Dr. Davidson at Georgetown earlier today. He examined him thoroughly and scoped his nose, nasopharyngeal down through the vocal cords. I got to see it on the color monitor and was fascinated.  It is all pink and shiny with no signs of a cancer of other problem.  His throat is irritated and there was some mucous probably from coughing.  Nothing at all to worry about.  We are both relieved about that area.  Now he waits until the end of April to see the pulmonologist, Dr. Goyal and will probably have another CT in May to see what is happening with his lungs.  When he has that Dr. Davidson ordered a neck CT with contrast for the usual follow up but does not need to see David relative to that until next March.
While we were waiting there were several children there.  That can't be good.  They were these thinly little kids who no doubt had huge problems.  One mom was clearly on edge and talked to me about not being able to find parking in the garage and not knowing what to do before the appointment.  The parking attendant told her to find another garage with parking and she told me she had no idea how to do that and then find her way to the otolaryngologist' a office.  Eventually she followed someone to their car and took that space.  (I did that too...just like I do at the mall.)  I felt sorry for her being the only parent with this little guy who got referred to Dr. D.
On the way home we stopped by Costco and the audiologist adjusted David's hearing aides and made a new mold for one ear so that is is more securely placed in the ear.  It sometimes gets loose and then he gets terrible whining feedback.

Revised date for Georgetown

Due to scheduling issues, Dr. Davidson's office moved David from tomorrow to next Wednesday at noon.  So, until then, there will likely be no new posts.

Pulmonary report

David saw Dr. Goyal today about his lung issues.  After a thorough medical history and exam the decision is to observe David but not treat anything yet.  If he has trouble we need to call right away.  He needs to do a bronchoscope to get a sample from the lower right lung and then see if it can be cultured.  It could be one of those atypical mycobacterium or it could be a fungus.  Both take a year or longer on several drugs to clear.
David's lungs seem to be improving with almost no blood in the mucus that he coughs up when taking pills.  (The doctor verified that this is because he is aspirating water while trying to swallow.). David is having a lot of trouble speaking.  His voice is very strained so that he asked me to answer out of Dr. Gyal's questions and that concerned Dr. Goyal who recommended that David see his otolaryngologist soon and have him scope his larynx.  We called Georgetown right away and have an appointment tomorrow at 12:45 with Dr. Davidson. We'll leave early in case there are interesting things going on I95!!
Lorrie has been doing distance Healing Touch work on him an overall David seems much better, has more energy, is not coughing much and is not wheezy.
We are both looking forward to seeing Jeff next week and doing as much as possible while he is here.  I think that they plan a trip to a museum in Richmond and the temple is having a Purim dinner and Schpiel.   I will post more after we see Dr. Davidson tomorrow.

Friday news

No big changes.  After a hiatus from Pradaxa for four days, he began it again yesterday and the bloody coughing has not increased.  Today he got up about 5, took the trash cans down to the street, made coffee and came back to bed for a few hours.  He went to Silver Sneakers but is not pushing it and took a nap this afternoon so that we can watch TV together tonight. Unfortunately, I am in the 7th week of a 10 week class and had to make a video, add closed captioning and upload it into the Course Management System. Three hours later I have a 5 minute video submitted.  Now we can watch TV for an hour.  Saturday I'm signed up for a short seminar on campus and he plans to go to Torrah study.   He submitted two sputum samples, one Tuesday and one Wednesday.  Once they are cultured and characterized, the pulmonary Doctor will know how it can be treated.  David is worried and anxious to get that information.  I appreciate your prayers and healing touch work.

David's Leap Day update

After yesterday's bloody sputum started and continued this morning, David saw Dr. Clemo this morning.  She agreed that stopping Pradaxa yesterday was good and said to stay off of it for the next three days and call her if anything gets worse or if he is still coughing blood after three days.  She also gave him sputum sampling cups and he is to get a sample to day, take it to the lab and a sample tomorrow and take it to the lab.  She said that these cultures take a few weeks.  He feels much better after seeing her and her calm attitude.  The fact that he has no fever and that his bp is low/normal indicates that whatever is going on is not urgent.
He is scheduled to work the polls tomorrow for four hours (It is Super Tuesday in VA) to lobby for anti-gerrymandering.  The doctor recommended cutting it back to two hours.
So he is back to the house with me.  I had no classes scheduled today or tomorrow since I assigned an online exam and the students can use their class time to take it but not in the classroom.  That was really convenient this morning.

It's been a long time.  Since David's pneumonia has not resolved since Christmas Eve the following has happened.
Prior to the pneumonia diagnosis he had a lot of issues with hearing in his left ear and took a course of antibiotics and then the dreaded prednisone for ten days.  I think that the prednisone opened the door for the development of pneumonia.  Boo Dr. Franz.

OK so finall in January I dragged David, kicking and screaming to see Dr. Clemo who gave him ampicillin for a week.  She said if he didn't feel better to do a chest X-ray and blood work.  He is reluctant to expose himself to more radiation, with perfect reason and thought he was doing better after a week of antibiotics.  However, the NEXT week he had to stop on his weekly walk.  He had to stop four times, came home and fell asleep.  The next day he had the x-ray and the following day the Dr.'s office called with the pneumonia diagnosis and an appointment.  She examined him and prescribed augmentin.  He had a terrible GI reaction to it.  Since it is the ONLY plausible outpatient treatment, we split the dose into four times a day and added Imodium AD.  He seemed to feel better but was still coughing so a CT was ordered.  Now it gets complicated.

The CT showed pneumonia had not improved AND that the pattern and densities indicate an atypical mycobacterial infection.  He has no fever, no chills (he is ALWAYS cold) and seemed to feel OK so Dr. Clemo referred him to the local pulmonary practice where he has an apt March 10.  She also said she encouraged activity and that he can walk.  So today he went on the Sunday walk for the first time in three weeks.  Then he came home, showered and had lunch and we went up to Alexandria to visit with his cousins at La Madeline.  On the way home I95 was a parking lot and we took Rt. 1 (double time and lots of lights).  He starts coughing...up....blood and was freezing cold.  He declined to go to the emergency room. At home he continues to cough bloody mucous, but his bp and heart rate is normal.  His temperature is low, not high.  But he has very little energy and asked me to crush his pills and pour out his Jevity. I gave him the meds and Jevity but we decided to forego the Pradaxa since he is bleeding.  I will call Dr. Clemo, his internist, in the morning at 8 and hope that she can see him and possibly fast track the pulmonologist apt.  I am extremely concerned and wonder if it is not an atypical mycobacterial and is bleeding in his lungs from Pradaxa.  Hoping and praying that he gets better.