Saturday, July 31, 2010

the week in review - short term disability and lung recovery

A big work for me this week. Susan and I decided last weekend that I should take some short term disability to be able to really focus on getting through the last month of chemo and recovering from the lung damage the bleo seems to have given me. I was a bit ambivalent about taking this step, because it sort of felt like doing this would be admitting that I had in some sense "failed" the chemo test. But we talked through it and I came to the conclusion that my #1 job right now is to get my lungs healthy and get through the last two infusions without further medical complications.

Once we made the decision, it felt really good. I chatted with the folks at work and we got the paperwork in place for me to take 6 weeks of short term disability. I'm planning to go into the office every Friday morning for a 1/2 day to stay somewhat abreast of what's going on and to avoid going completely stir crazy (as great a cat as Socrates is, conversation isn't one of his strengths).

Having completed one week of ST-dis (note my avoidance of the ST* acronym with it's other meaning..) I can report that it was a really great decision. I've been focusing every day on getting my lungs to work a bit better, eat well, nap when I have to and just putter around the house. I've also had a few medical appointments and paperwork to get through and it's been really great to focus on that without feeling guilty about not doing work-work.

In the early part of the week I wasn't seeing a whole lot of improvement in my health but over the last few days I've definitely seem some big steps. I was having some trouble sleeping because of my lung issues but things have cleared up enough that I'm now getting pretty good sleep. I was also having some pain trying to breath in deeply and that's changed into more tightness than pain, which is definitely progress. I am also getting a bit stronger every day - able to do more walking and bike riding.

On Thursday I had a good visit with the pulmonologist. He's predicting I'll have a good recovery from this damage but that it could take 6 months to completely evaluate where I'll end up after completing the chemo and getting off the predisone. So I've still got a journey in front of me but hopefully I'll end up in a good place. On both Monday and Thursday I had an 02 Sat % of 96 which is very good for living in Colorado. Basically this means that at rest, my lung function is good enough to keep me fully oxygenated. That's a big milestone for anyone coming back from pneumonia as the alternative suggests long  term problems.

The pulmonologist also said that moderate exercise is really a great way to help recovery - I have to retrain my lungs to process as much O2 as possible, both in terms of lung volume and gas diffusion efficiency (getting O2  across from the air in my lungs into my bloodstream). Like any other physical training exercise, this is done my mildly stressing the process you want to improve, then rest, then stress again, rest, repeat.

The obvious delicate balancing point here is that my lungs are still damaged (how much is hard to tell because some of the damage is at a scale below the resolution of a CT chest scan.) And your pulmonary and cardiac system are intimately tied together, so if you hammer your pulmonary system too hard you'll really stress your cardiac system as well and the last thing we want at this point in the process is to create any cardiac issues. So I've decided to use a heart monitor in all my training and and set my max heart rate to 150 bpm (which for me is the top of zone 3). I'm also monitoring how my lungs feels and backing off if I start to cough or get lung pain.

The encouraging news is that my lungs have really responded well to this training. When I get into the moderate hills I'm doing now (~300 vertical feet of gain over a mile), my lungs seems to open up a bit. No pain, I can breathe ok, etc. I'm not generating much power, which is probably due to a bunch of things from the various meds I'm on. But it sure feels good to have a training plan in place and see my body responding positively to the care and attention I'm giving it.

The other equally important part of the equation is rest and it's been really great to be able to lie down and take little naps when I feel like it or just get off my feet and give my cardio-pulmonary system a chance to rest.

So that's going to be my life for the next 5 weeks, I think. Putzing around the house, working diligently to improve my health, eat great food, get lots of rest and get the rest of this chemo sh*t in the can.

BTW, compared to the pulmonary issues, this week after chemo has been a breeze. Have had the usual GI silliness to deal with but it hasn't been bad. I've also been learning how to handle the prednisone effects. It's a big, bad steriod with lots of possible bad side effects but it's big plus is that it should be helping to resolve what's going on in my lungs. So I'm learning to live with that in my care plan - losing muscle mass, feeling aggro at times, blood sugar elevation, sleeplessness, hot flashes. Hmm, sounds a bit like PMS, perhaps :)

Anyway, the other really fun thing that this gave me an excuse to buy The World's Best Bike Toy. See my next post for details on the wonder geek toy called the Garmin 705...

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