The appointment with the pulmonologist Tuesday was super long, but went well. He took a really thorough history and did a few simple tests to monitor my breathing and oxygen levels. Based on all of that (plus the scans), he said that he does not think I have any serious lung problems. He thinks that my trouble breathing while lying down is due to anxiety/stress levels affecting the breathing “sensors” giving me the perception of shortness of breath. I know I gave him a look when he started talking about anxiety being the cause because I thought he was going to say it was all in my head. But he said that in fact the anxiety could change the message being sent to my brain. Obviously decreasing my stress levels would be a good idea, but that is kind of hard, so he suggested that I continue with a low dose of Ativan or try an Advil or Tylenol PM kind of thing. He said that if I truly had a lung problem, such as low dose of Ativan would wear off in the middle of the night and I would wake up short of breath.
As for shortness of breath with exertion, he thinks that may have a different cause. He says the MUGA test did show some decrease in heart efficiency, but that small decrease would only be noticeable in someone who was morbidly obese. He wants me to have an echocardiogram (ultrasound of the heart) to see whether my borderline high blood pressure is affecting how efficient my heart is. It provides similar, but complementary information to the MUGA test I had last week. If there is a problem, I’d need to be followed by a cardiologist and most likely be put on blood pressure medication. If that test turns out fine and I continue to have problems, he might try giving me an inhaler or Advair to see if that helps at all even though he doubts that I have asthma.
All very confusing, but hoping this next test can sort it out. He said that we shouldn’t let concern for my lungs influence chemo choices over possible effectiveness of the drug and is going to talking to Dr. T. about it. So that is good news.
I realized after my last post that I forgot to mention the frequency of chemo for the new drug coming up. Each drug is different, but none of them are more often than weekly, some as infrequent as every three weeks. Many will also require additional visits for blood counts (checking my immune system) and Neulasta (an immune boosting shot). I have an appointment next Wednesday with the oncologist to decide on a drug and I expect treatment will start that week or the next.