Monday, May 4, 2015

Hemoptysis in the Hospital

This has proven to be a different kind of hospital stay for me so far. Many of my stays are exactly the same in terms of how I feel coming in and how I feel going out. I have the usual chest tightness, increased cough, increased sputum, decreased energy, and the list goes on. Generally, I come into the hospital not feeling great in the first few days always have me feeling even worse due to the poison antibiotics running through my veins. After the first few days I start to incrementally improve over the course of the next two weeks usually to be discharged feeling like a million bucks.

This stay started out like so many before it but a recent turn of events have made it unlike any other.

On Wednesday night I was falling in and out of sleep watching Netflix. I woke up around 12:45am or so and decided to put the head of my bed down to be a little more comfortable. And then it happened, a feeling that many of my fellow cysters and fibros the world over recognize, the rattling of the chest and the gurgling in the throat. I knew immediately what is happening as it is a sensation I have felt many times before.

Only a representation of what I remember it looking like :)
I got out of the bed and walked into the bathroom and spit out a mouthful of bright, red, fresh blood directly into the toilet. I proceeded to cough up a generous amount of blood into the toilet before turning to the sink as the blood splashing upon the toilet water and dripping onto the floor was not painting a pretty picture. At this point there was blood on the toilet seat, on the floor around the toilet, in the toilet and on the walls near the toilet. As I was transitioning from the toilet to the sink I let out a cough that I couldn't quite hold in and blood spattered on the faucets and wall behind the sink. I leaned over the sink turned the water on and tried to clean as I coughed. I was doing my best to not get the blood everywhere, as evidenced by my hands which were now covered, but my attempts failed as the bathroom looked like a murder scene and I was the prime suspect.

In between one of my coughing fits I managed to press the call light to try to get some assistance. At this point I was feeling a bit lightheaded and worried that I wouldn't be able to stand much longer. I can't imagine what my nurse thought as she walked into my room well after midnight not finding me in my bed but instead covered in blood in my bathroom. If it's any indication her first words were, "Oh no!!"

Within minutes there was a rapid response team in my room. I stayed in the bathroom until the blood ceased and when I walked out and saw 8 people standing in my room or immediately outside of it and I said, “It's not that big of a deal guys!". I was sat down in the chair and the questions ensued.

Yes, this is happened before.
No. There hasn't been this much blood since 2009.
Yes, I feel lightheaded.
No, I don't feel dizzy.

Since the active bleeding stopped and my vitals did not look alarmingly bad, they just decided to order an x-ray and different blood panels.

On Thursday morning I felt like I had coughed up a lot of blood the night before.  I had body and joint aches and my lungs were experiencing a bit of pain.  I also sat up for the rest of the night as to try and avoid another bleed.  The rest of the morning was normal with doctors coming in and out of my room and breakfast nourishing my body. Then around 1:30pm or so, it happened again.

This time I grabbed a nearby bucket that they had given me the night before as I new they would want to get a measurement. The rapid response team was again called and as a result of my prior history and the fact that I had coughed up an additional 100 mL on top of the estimated 150 to 200 mL the night before, I was sent to the ICU for observation. They wanted to be sure I was in a place that I could get immediate attention if a massive hemoptysis visited me again.

After consultation with the pulmonary team and interventional radiology it was decided that a bronchial artery embolization (BAE) was needed. I've had two of these procedures in the past, once done to both lungs and once done to only one side (forget which one). I was admitted to the ICU on Thursday afternoon and wheeled down to have the procedure on Friday at 5 PM.

Not my lung. My bleed was from my left BA and they used foam and beads.
The procedure took about two hours to complete and according to the surgeon's notes and also the fact that I have not coughed up any more blood, it seems to be a success! I can will bleed again in the future and just pray that it will be at least another 6 years before it is an episode that needs to be addressed.

I was moved back to my regular floor late Saturday night and I'm very grateful to the ICU nurses who took care of me, the interventional radiologists who did my procedure, all those involved on the rapid response teams, my nurses and techs on 3NE, my pulmonary and CF teams, and all my family and friends.

Side Note: I have to brag a little bit about my family support. Mandi was at our home in Chandler when the second episode of hemoptysis occurred.  In fact, she happened to FaceTime me as I was holding the bucket of blood. The concern on her face was of course expected and immediate. I told her not to worry and that I would call her with an update. Before I had the chance to call, she let me know that the girls and her were on their way up to meet my in-laws at a halfway point between our houses. Eric and Nancy didn't think twice about taking the girls for an unknown period of time even though they had just picked up dear friends from the airport who were in town for a visit. I am so very grateful. I'd be remiss if I didn't mention that my wife ended up driving back to Phoenix the next day to get the girls and bring them back down the very same day. They arrived shortly after my procedure and were with me while recovering (Friday night) and the entire weekend. When my wife wasn't by my side, my mom was. And finally, I received many texts and prayers of support from my family and friends.

And finally, honor and praise to my Lord and Savior Jesus Christ who guided the hands of the IR team, protected my wife on the roads and sustained my health and spirit throughout the entire process. God is always good.

Sunday, May 3, 2015

22 Weeks Pregnant!

How far along: 22 weeks pregnant...well on the day this is posted, I'm 22.5...but I took the picture on Thursday, exactly 22 weeks. Due September 3rd!

Gender: Officially a baby BOY!!

Total weight gain: Up 10.5 lb.

Exercise: Unfortunately, my exercise plans for this pregnancy look very different. Between the subchorionic hemorrhage and the complete placenta previa, I have been limited to just walking. However, this week my placenta has moved, so I was cleared to do light jogging and weights, so I jogged twice this week. It felt AMAZING!! Shockingly, I wasn't winded and I had to hold back. I'm hoping that my placenta continues to move, and I'll be cleared to get back at it!!

Maternity clothes: Still no maternity clothes. I live in workout clothes, dresses, and the pair of normal shorts I bought a couple sizes up.

Miss anything: This isn't pregnancy-related, but I'm missing my hubby. We are 2 weeks into his hospital stay, and I miss him!

Movement: I'm feeling this little guy move all the time. He's an active little bugger. I love it!

Have you started to show: I think so, especially at the end of the day. I'm pretty sure anyone that sees me would guess I'm pregnant, unless I'm holding Baby N, then it's debatable if it's just a lingering baby bump from the 5 month old in my arms.

Stretch marks: This is a tricky one. I never got stretch marks on my belly with Mckenna. But ever since puberty I've had stretch marks on my thighs, tush, and hips. They are very fine and you only really see them when the light hits them right. So there's a good chance that I got more with Mckenna, I just have no idea. My guess is I may be getting more as we speak, I just can't see them in comparison to what is already there!

Belly button in or out: It's in...and looks like a massive goiter in tight shirts.

Wedding rings on or off: On, when I actually wear them! I take them off for exercise, showers, and sleeping...and with my baby brain and pregnancy brain, I often forget to put them back on!

Sleep: I sleep like any other mom with a 3.5 year old and a 5.5 month old! I have been a little more tired the last couple weeks, but I think just from single-momming it!

Labor signs: None. I'm hoping none for a very, very long time. But I am having noticeable Braxton Hicks contractions already. I get them when my bladder is full, during exercise, when he's really active, and for no reason at really, I just get them all the time.

Best moment of this week: This week we had an ultrasound to check on my complete previa - to see if it had moved since our ultrasound 4 weeks ago. The ultrasound tech (4 weeks ago) said that she didn't know if it would move, that the end of it looked pretty "fixed." Studies show that complete previas are the least likely to move by delivery, so I wasn't very confident that it would move very much in 4 weeks, or delivery. But ever since that ultrasound I was praying, boldly, that at this ultrasound the placenta would have moved, and not only moved, but that it would only be a marginal previa. It was a bold request, but I know our God can do anything. Well the ultrasound showed my placenta moved...and not just a little. And it's not even considered moved more than that! It now is considered a low lying placenta. It needs to move more for me to be totally cleared on my activity restrictions and to deliver vaginally, but there is plenty of it's looking good. GOD IS SOOO GOOD!!