Saturday, February 22, 2014

Latest Lung Transplant Update - Some Issues

Those folks not bored by elderly health problems who have been following my progress will recall that the biopsy from the bronchoscopy on Thursday, 2/6/14, showed zero rejection . That was the good news. But my spirometer numbers only ticked up a bit, and have been slowly declining since. I started a heavy, productive cough when I use the spirometer or the incentive spirometer. The mucus is clear, so no infection, but it is good to get it out. The coughing is getting worse, however.

This past Thursday I had another bronchoscopy to clean the lung out. The Transplant management pulmonologist said there wasn't that much, which you couldn't prove by me with what I cough up. He said, however, there was a lot of slough (dead cells) built up on the wound (where the new lung joins the old body), that he couldn't dislodge. They are going to schedule another bronchoscopy in the next two weeks with the surgeon who put the lung in, to have him debride the area. My spirometer numbers have continued to drop, and last night, Friday, I started coughing hard without using one of the machines. I note that I breath hard after even light exercise, but that my oxygen saturation remains in the 95% range ever when I'm working out hard in rehab. This is a good thing. I do not know how serious it is when the surgeon has to do this, and there is probably no use asking. I asked the pulmonologist if the potential that I would need a balloon to expand the lower lung lobe was serious. He said, "It could be," which tells me nothing. So could crossing the street. (He didn't mention the balloon this time, but maybe because the slough is a more serious concern?) They and I think the decline in the spirometer numbers is due to this and to the coughing, not to rejection. I assume I will know more after the bronchoscopy with the surgeon--we will see. I have great faith in my healthcare team at UW/VA, but there are no guarantees in medicine. I'm aware that this could go south at any time.

All my blood numbers, weight, blood pressure, blood sugar and temperature readings are great, so that is positive. I started a small head cold on Thursday, 2/13/14, but had shaken it by Sunday. I upped the Neti Pot to three times a day, and explained to my body that the lung was on our team, leave it alone or we would all die, but it should muster the remnants of my immune system, the old men and boys, into a Volksgrenadier Division and throw it hard at the virus. Apparently it listened. No fever, no sign of infection in the lung, and a very short head cold.

One funny note: The nurse came in to put in the IV for the bronchoscopy, with a student nurse. The student put it in, but drew no blood out. The nurse said, "You blew it, Stephanie, you'll have to try again." Apparently things are looser at the VA--in private healthcare, they'd never say someone 'blew it" in front of the patient, for fear trial lawyers would crawl out of the drains. You'd say, "That vein doesn't seem to be cooperating (making it the patient's fault), we'll have to try another." She got it right the second time. I wasn't upset, no harm done and students have to learn.


  1. keep conversing with your body.

  2. Bob, Wally here. I wish you well. I know they pain and strain of your efforts. It, at times can get disheartening, but keep your head up and yourself moving forward. I do want to express a concern my friend. Having read that you are using a Neti pot concerns me. I have had friends have less than desirable problems after having used these devices. Just be cautious my friend. Keep us posted on your progress.

  3. Bob....I wish you well in your continued recovery. One thing about going through a transplant, there will definitely be little set backs here and there. Just keep your head up and progress moving forward. Having read your blog. I want to express a concern about your use of the Neti pot. Please be cautious in regard to the use of this device. I have had a couple of friends develop a bacterial infection during and after the use of a Neti pot. I know you are a well informed and intelligent man. I just want the best for you Bob.

    Good luck and continued good health,

    Wally Holmesly
    U.S.N. Submarine Service. '78

  4. A tsunami of good will headed your way from Arizona, my friend. Keep talking to that rascally immune system.

  5. We are still counting on you to deliver our eulogy.

    As for "you blew it": some years ago I was having a test that involved radioactive dye. The nurse straightened up oddly after sticking me one or two times, and fetched someone. I was told I might be having a "reaction" and spent the rest of the afternoon cooling my heels in an empty room, bored silly, before being sent to, of all things, a cosmetic surgeon.

    When I was finally sprung (I was beginning to think I would need a writ of habeas corpus), I went to see the doc who lived across the street, and worked for a different medical provider. He laughed and explained that the nurse had evidently missed the vein and put the radioactive agent into my arm. I had been put under observation - and the cosmetic surgeon put on call - in case the tissues of my arm started dying, and amputation became required.

    Happily, I was spared that "reaction."

    Oh, to rub salt into the injection wound, my employer carried the malpractice insurance for the medical provider....

  6. Hang in there brother.

  7. Gee Bob - coughing and sloughing, at least it's poetic.

    You are right about who know what any little procedure means, at least they keep doing them.
    Good luck. Just keep going and the rest of you will follow suit!

  8. Keep at it Bob. It's good to know you have good medical people. I am constantly amazed at the marvels of modern science. I am about to turn 70 and never would have made it this far without a bunch of good docs.

    Mike G