My Life Abroad: The Adventures of Two Birds
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Jun '11

Medical Update: Geiger count me out

Well were on to the Dr. House portion of our visit, I’m used to this one…

Was sent to Nuclear Medicine and X-Ray for some scans to look at the inside of my lungs. in three different ways –  I believe they are looking to see if there is a pulmonary embolysm and why exactly they are bleeding. 

         1. Chest X-ray

         2. Ventilation Gas Scan – radiation gas is breathed in through a tube, that mixes with the oxygen and highlights problem areas with regard to air in the lungs during a CT like 3D imaging scan

         3. Radiation particle Scan – radiation in the form of particles are injected into the blood stream to show blood function to the lungs during a CT like 3D imaging scan

They wheel the machine over to me, and I use this tube to breathe in the radiation gas, sit for a second while they use the geiger counter against my chest to make sure there is enough gas in my lungs. I’m radiated!  They show me the scan on the screen and I can see all these little radiation gas floating around in my lungs.  Weird.  It takes 10 minutes for the CT like scan to finish.

The radiation scans are to determine if there is a blood clot in my lungs, i.e. pulmonary embolism.

And the results are back: No pulmonary embolism – hey that’s good… right??

Well, yes and no.  It means that there is no infection in  my lungs but it also means that my Wegener’s is the cause of this problem and that it is the beginning stages of a flare up of my Wegener’s Granulomatosis.  I have to say that I have become much more aware of the reactions of my body since my initial diagnosis in 2009.  I’d say its a clear sign that things are going wrong when the common cold can turn to pneumonia in these bad ass lungs, so I’m lucky that I can catch things early.  This is definitely early.

Vasculitis – Micrograph showing a vasculitis (Churg-Strauss syndrome). H&E stain.

   The constant of drugs include immunosuppressants, steriods and other preventative medications :

Azathioprine (/ˌæzəˈθaɪɵpriːn/) also called Imuran – is a purine analogue immunosuppressive drug. It is used to prevent organ rejection following organ transplantation and to treat a vast array of autoimmune diseases, including rheumatoid arthritis, pemphigus, inflammatory bowel disease (such as Crohn’s diseaseand ulcerative Colitis), multiple sclerosis, autoimmune hepatitis, atopic dermatitis, Myasthenia Gravis, Neuromyelitis Optica, restrictive lung disease, and others.

Prednisolone is a corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions[2] such as asthma[3], uveitis, pyoderma gangrenosum, rheumatoid arthritis, ulcerative colitis, temporal arteritis and Crohn’s disease, Bell’s palsy, multiple sclerosis,[4] cluster headaches, vasculitis, acute lymphoblastic leukemia and autoimmune hepatitis,[5] systemic lupus erythematosus, and dermatomyositis. It is also used for treatment of sarcoidosis, though the mechanism is unknown.

Amlodipine(as besylate, mesylateor maleate) is a long-acting calcium channel blocker (dihydropyridine class) used as an anti-hypertensive and in the treatment of angina. Like other calcium channel blockers, amlodipine acts by relaxing the smooth muscle in the arterial wall, decreasing total peripheral resistance and hence reducing blood pressure; in angina it increases blood flow to the heart muscle.

If I can stay on this cocktail, in high doses for a short time, I may be able to get my Wegener’s back under control then I will be able to bring down my dosage and get back on a managing level of drugs.

The alternative and the option I’m hoping against is the Chemo drugs in place of the Azathriopine, which is called Cyclophosphmade, this is the drug I was on for 8 months in 2009 when first diagnosed. This is the most evasive treatment but effective.  It’s what wiped out my egg supply and made me infertile, so as you can see it is very toxic to the body… it IS chemo:

Cyclophosphamide is a nitrogen mustard alkylating agent, from the oxazophorines group. It is used to treat various types of cancer and some autoimmune disorders. It is a “prodrug“; it is converted in the liver to active forms that have chemotherapeuticactivity.  The main use of cyclophosphamide is together with other chemotherapy agents in the treatment of lymphomas, some forms of leukemia and some solid tumors.It is a chemotherapy drug that works by slowing or stopping cell growth.

Cyclophosphamide also decreases the immune system’s responseto various diseases and conditions.  Cyclophosphamide is also used to treat minimal change disease,  severe rheumatoid arthritis,  Wegener’s granulomatosis, and multiple sclerosis.

I suppose other than the obvious, having a flare up of my Wegener’s – we’re worried about our final attempts at IVF.  If I am to go back on Chemo it will mean that we need to wait until I am back in remission before we can attempt again.  We’re hopeful that we can stay on the current medications that will allow us to continue when I am of better health.

I’m still feeling pretty normal, not sick at all and hoping that I am going to have some good results from these IV treatments and not go straight down hill.  I’ll be finding out my medication regime as soon as they are ready to discharge me tomorrow morning,  For now I’m watching the emergency helicopter  come and go from my 9th story room window, blogging away and watching movies from my not-so-comfortable hospital bed.  Can’t wait go get home to all my fur babies and my love Birdie.

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