Fear, Faith, and Family

This Friday I will undergo my very first bronchoscopy. I am nervous because my CF doc tells me that most patients end up with an exacerbation post procedure. That does not bode well for me. Any exacerbation is terrifying because I am so close to losing lung function that an infection will debilitate me. My transplant doc promises me that he will be very careful and he will not do the lavage part of the procedure, which is apparently the reason why most CF’ers get sick after. I’m still not 100% convinced so I have been upping my treatments,feeds, vitamins and exercise to be in tip top shape as well as avoiding crowds, since its cold & flu season. The only thing I am looking forward to is the good drugs.

What is a bronchoscopy you ask? It’s when the doc threads a camera down into my lungs to get a good look at the anatomy and to make sure there won’t be any surprises when they cut me open for the transplant. He may also suction out some goobers if they are in the way. That could be a good thing. I am a little scared but I know He will protect me.

What are the risks of bronchoscopy?
  • Bleeding.
  • Infection.
  • Hole in the airway (bronchial perforation)
  • Irritation of the airways (bronchospasm)
  • Irritation of the vocal cords (laryngospasm)
  • Air in the space between the lung covering (pleural space) that causes the lung to collapse (pneumothorax)

Also this week is the Mexican holiday that I have celebrated since I got my BA in Spanish in 2008. It is called “el dia de los muertos” or Day of the Dead for the laymen. I love the idea that those we loved who passed away return to Earth on November 1st and 2nd. I love the idea of visiting with my loved ones and loved pets. Every time I set the altar aka Ofrenda up and light the candles at precisely November 1 at 12 am I can feel their presence. It’s heavenly.

History

Day of the Dead originated several thousand years ago with the Aztec, Toltec, and other Nahua people, who considered mourning the dead disrespectful. For these pre-Hispanic cultures, death was a natural phase in life’s long continuum. The dead were still members of the community, kept alive in memory and spirit—and during Día de los Muertos, they temporarily returned to Earth. Today’s Día de los Muertos celebration is a mash-up of pre-Hispanic religious rites and Christian feasts. It takes place on November 1 and 2—All Saints’ Day and All Souls’ Day on the Catholic calendar—around the time of the fall maize harvest.

I hope that I am not too high from the bronch that I see my dearly departed. Yikes! Apparently my drug cocktail contains a hynoptic, analgesic, and numbing agent. So fentanyl, ketamine, propofol, midazolam. Can’t wait! NOT!

Appropriate sedation is important for a well-tolerated bronchoscopic procedure. Pre-assessment of the patient is essential in order to anticipate potential difficulties and complications. The available techniques include conscious and deep sedation. Various protocols may be used during flexible bronchoscopy that entail the administration of a single oral or intravenous drug or drug combination (e.g. midazolam, meperidine, propofol, ketamine, remifentanyl), or inhalational agents (premixed nitrous oxide, sevoflurane). Whichever the choice of sedation and the technique of oxygen delivery (nasal prongs, face mask, laryngeal mask, endotracheal intubation), it is essential to maintain and preserve spontaneous ventilation. Controlled ventilation is often used during rigid bronchoscopy for foreign-body removal. The most frequent complication of sedation is hypoxaemia, either as an isolated problem or in association with laryngospasm and/or bronchospasm. Transcutaneous oxygen desaturation can be secondary to partial or total airway obstruction by the bronchoscope and/or depression due to sedation. Pre-operative detection of high-risk patients, administration of appropriate anaesthesia and monitoring of patients are essential for a successful procedure and help to minimize potential complications.

Anyway I am trying to follow a schedule by blogging at least every Sunday. So this is mine. Thanks for reading. Fingers crossed for a non-eventful bronch,

N

Get busy livin’ of get busy dyin’

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