Thursday, July 18, 2013

I Can Breathe!

I've been quiet here lately because I have spent the last couple of months trying to breathe.

Never have I been so happy to start a marathon training program as I am right now. Yesterday I returned to work and also began my 16-week New York City Marathon training program. This after I was finally diagnosed and treated for an "irritated larynx" probably caused by a reflux disease that has required me to change my diet, which I needed to do anyway as a runner. So far so good.

It all started when I was in St. Louis in mid-May for my son's law-school graduation. My sinuses began draining and after a 5-hour delay at STL's airport I came home to NY with an upper-respiratory infection. That began a string of doctor visits -- urgent cares, 2 hospital ER visits, family doctor, one pulmonologist who ran out of ideas and then another pulmonologist at Columbia Presbyterian who finally came through.

Bottom line, I was having trouble getting a full breath. Gradually I realized that it was especially problematic whenever I talked. For someone who interviews people for a living, that's not great. Tests included:

-CT scan of chest with contrast
-CT scan of neck without contrast
-Echocardiogram of heart
-2 EKGs
-Ultrasound of abdomen
-Respiratory stress test
-X-rays, breathing in and breathing out
-4 bloodwork sessions

Weeks went by, six, seven...still shortness of breath. It can be very scary, and the worst thing was gradually getting used to breathing that way, almost forgetting what it felt like to be normal.

My current pulmonologist had me take a VO2 test. I have always wanted to do that anyway, seeing elite athletes all hooked up and running. I was put on a stationary bike, sensors hooked up to me, and then a tube running to my mouth where I bit down on a mouthpiece. I was asked to ride for 10 minutes as they gradually increased resistance, and I was asked each minute to point at a chart that showed 0 to 10 in terms of difficulty, with 0 being easiest. I constantly pointed to 0 for legs and 0.5 for breathing. They were beyond impressed. One of the two doctors who administered the VO2 told me that I am "interesting to the medical community." I finished above average for the test. That only made it more mysterious, but the good news was that my heart and lungs were fine. Yet another "rule out" test completed.

Then my pulmonologist referred me to a head and neck surgeon (ENT) at Columbia Presbyterian. She tested me on a machine (pictured here), where I held a sensor against my neck and made vocal sounds per her instruction. She was able to look into my throat, at my vocal chords. When she was finished, she let me look at the video of my larynx area and gave me a printout of images she took.

It showed that my larynx was bright red and a bit inflamed -- irritated, she said. That was clearly the reason that talking was making me cough, and the dry hacking cough was making it worse. I am on meds as a result, Nexium in the morning (antacid help for reflux) and amitriptilene at bedtime (neuropathic med to help regulate breathing), and at this point am ready to be taken off of them. But what was the cause?

a) It was either Gastroesophageal Reflux Disease (GERD) or Laryngopharyngeal Reflux (LPR), a disease that requires change in diet and habits, such as eliminating or using in moderation caffeine, sodas, alcohol, citrus, chocolate...basically whatever I really like. I am emphasizing the "moderation" part.  ;)

b) Or it was a result of the courses of Prednisone I had been prescribed early in this quest, a prescription that had done absolutely nothing to help.

c) My next step is to see a top Allergist in NYC on July 23. Bloodwork had showed that an antibody level in one's immune system, which is 30 to 40 in normal cases, was a soaring 5,000 in my test. That meant something was "revving up my immune system." What that something was, I have no idea. But I am pretty sure I am super-allergic to a lot of things, and maybe this time it caused or exacerbated my condition.

In any case, whatever the cause and cure, on this day I am finally writing on my blog about a return to RUNNING! I went two months without my favorite activity, except for one ill-advised participation in the Wall Street 3M Run a week into my problem. I was pretty normal, except for having lost much of my fitness base. I'll be combining running and strength training and swimming in my backyard pool (right), and I will be ready for the NYC Marathon, my 12th race of at least 26.2 miles.

First up is Saturday's Boomer Esiason's Cystic Fibrosis "Run To Breathe" 10K at Central Park. It could not be more appropriate. His son Gunnar has lived with cystic fibrosis, and the pulmonologist I am seeing is based in an office dedicated to Gunnar. "Run to Breathe" -- perfect words for how I feel right now. This will be my seventh New York Road Runners race of 2013, moving me closer to the 9+1 guaranteed placement in the 2014 New York City Marathon as well. It's time to train!

I have been blessed to have so many family and friends keep me in their thoughts and prayers, and to work for a company that looks after its own and was able to get me into the office of top physicians. That has meant a lot. Never take for granted every breath you take, for it is a miracle inside of you that makes you run.

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