Yesterday's blog ended with a hint that GERD or better known as Acid Reflux Disease had a role in my dilemma. I will continue to build the history daily as this blog catches up with today’s events and goes forward.
Throughout my adult life, I had this phenomenon occurring that I didn't pay much attention to, since it was mostly annoying.
Regularly, I find myself inhaling fluid coming up from somewhere. It would make me cough violently and sometimes burn a little in my chest. I had no idea it was a problem and I frequently would tell myself to stop breathing and swallowing at the same time. As it turned out that I was refluxing stomach fluid and inhaling it. Little did I know that over the years each time this occurred, a tiny bit of damage to my lungs was occurring.
Fast forward to 2006:
While my diaphragm was paralyzed by the pinching of my phrenic nerves, the reflux worsened, since my weakened breathing mechanisms couldn't clear my lungs as well. The stomach acid accelerated the damage.
About 1.5 - 2 years after the paralysis of my diaphragm occurred, the nerves began to heal and slowly my diaphragm function began to return. However, I was still very short of breath and pretty confused. I thought that the extra 50 pounds I'd put on the last 10 years probably wasn't helping, so I decided to visit my primary care physician, Dr. Bayles to get checked out. I was determined to lose weight, begin exercising to regain my stamina and feel better.
Dr. Bayles ordered a calcium CAT scan, an experimental procedure to check your heart for deposits and blockages that could cause heart attacks. A cardiac CAT scan for coronary calcium is a non-invasive way of obtaining information about the presence, location and extent of calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart muscle. (http://www.radiologyinfo.org/en/info.cfm?pg=ct_calscoring)
There was good news and bad. My heart was in excellent shape. But even the low resolution images had picked up cloudiness in my lungs. Dr. Bayles referred me to the UW Medical Center, pulmonary specialties clinic to have it checked out. For some reason, that didn't click immediately and all I heard was my heart was great! It wasn't until I had made progress on losing weight but the lack of stamina persisted, that I revisited Dr. Bayles. He scolded me for not paying attention and told me to get to the UW ASAP. I listened this time.
Drs. Benditt and Raghu head up the Pulmonary Clinic at the UW Medical Center. Dr. Benditt ordered a test to confirm GERD. A transducer string was inserted in my nose and positioned all the way down into my stomach. The transducer had multiple acid sensors along its length and attached to a small data logger that I wore on my belt for 24 hours. This test confirmed I had GERD.
Simultaneously, a biopsy of one of the damaged lungs was taken and other testing led to the diagnosis of idiopathic pulmonary fibrosis. Pulmonary fibrosis is a serious disease that causes progressive scarring of your lung tissue. The current thinking is that pulmonary fibrosis begins with repeated injury to the tissue within and between the tiny air sacs (alveoli) in your lungs.
In my case the acid reflux was identified as the culprit. The prognosis was grim. In a typical case where the cause is unknown, the patient’s life expectancy was four to five years. (This was in 2008) If the cause is identified and corrected, the patients could live a semi-normal life. I chose to believe the second alternative. The alternative path is lung transplantation. More on that later. (http://www.bing.com/health/article/mayo-126601/Pulmonary-fibrosis?q=idiopathic+pulmonary+fibrosis&qpvt=Idiopathic+Pulmonary+Fibrosis)
I was placed on the generic version of Prilosec (Omeprazole). (http://en.wikipedia.org/wiki/Omeprazole) Over time, this reduced the PH level of my stomach acid but hasn’t fixed the physical problem of the stomach contents coming up and being inhaled. I continued my weight loss and dropped ~40 pounds. This combination provided marked improvement in how I felt for a couple of years.
This all changed about six months ago. The shortness of breath, fatigue and light-headedness returned. This occurred about the same time as the company I worked for began to feel the effects of the down economy.
It was time to head back to the UW Medical Center. Elaine and I met with Dr. Raghu on January 13, after a full workup of testing. The next segment will bring this blog up to present time. Stay tuned as the saga continues.
Your comments and thoughts are invited and appreciated.
Thanks
Bob
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