Well just when I was thriving the middle of May kicked me in the chest. The month started out ok but I was having some small issues at pulmonary rehab. A couple of times I wasn’t able to finish the exercises on my normal 4L and I had to raise it to 6L to be able to finish. I didn’t think much of it, thought maybe I was just going too hard or some days were a little hotter or a little more humid. But then I noticed every day seemed just a little harder than the last and it got to the point where I was getting concerned. I thought maybe I had picked up “a bug” on my outing with my son to Cleveland. We did a quick trip early in May so that he could be a little familiar with the area around the Cleveland Clinic, then visited the Museum of Natural History, went to Cheesecake Factory for lunch and then checked out Trader Joe’s. Well, it was a Saturday and the Trader Joe’s was packed and I didn’t wear a mask.
By Monday, May 11th I was feeling pretty short of breath and I could hear my own breaths in the evenings, kind of sounds like Rice Krispies – that’s what I sounded like when I was first diagnosed. I had gone to my grandson, E’s baseball game that evening as usual but his mom was very concerned about me, she could see the change in me and I think for the first time I may have actually scared her. She told me later that the area under my eyes was purple and she knew I wasn’t getting enough oxygen. So I made plans with my middle one to get a ride to the ER the next morning with her on her way to work at the hospital. We decided that I would take some of the prednisone I had on hand and use my asthma inhaler but if I got worse we would just go! By morning I seemed to be doing a little bit better, I decided to use pulmonary rehab as my gauge of whether I needed to go to the ER or just call my doctors and manage at home. I was able to do the whole 60 minutes without adjusting the oxygen so I contacted both my primary doctor and my local lung doctor, described what I was feeling by MyChart messages and waited for replies. I continued to take a small dose of prednisone and use my inhaler. My PCP ordered a steroid taper later that evening. On Wednesday, I went and had my 6 month bloodwork done for upcoming tests with my rheumatologist and my PCP. By Thursday morning, the labs were all back and some of the labs were “off”. I went to pulmonary rehab and then messaged my PCP about my elevated white cell count. His nurse practitioner met with me online, we reviewed the past few days. She ordered a chest x-ray and two antibiotics “just in case” since my system doesn’t work like everyone else’s. Got the chest x-ray the next day, it was normal so I decided to NOT take the antibiotics as I knew by this time that it was an exacerbation of my pulmonary fibrosis. I completed the 10 days of prednisone that my PCP had ordered and was feeling somewhat normal. And then two days later, the wheels fell off. I got up to go to pulmonary rehab and my lungs were burning and I could literally feel the inflammation in them. I went in to rehab on my normal oxygen liter flow but I was NOT doing well, they wouldn’t let me even attempt so I knew at this point I needed help. I went back out to my car after resting for a few minutes, they offered to take me to the ER but I’m stubborn and stupid and hate looking weak and needing help so I declined. I call my daughter that works at the hospital and try to explain what’s going on but I’m so out of breath she can’t really tell what I’m saying other than going to ER. She met me in the parking lot with a wheelchair and I’ve never been so grateful for a wheelchair in my life.
I pretty much get right in (I won’t explain how, I’ll just chalk it up to God working thru people). I didn’t want to go to the hospital because our little hospital is busting at the seams since the other local hospital shut it’s doors last year. And going there, quite frankly, puts me a greater risk of getting something. BUT, I KNEW I NEEDED to be there, I had already tried to manage at home. Well, I bought myself a three day hospital admission with very high doses of IV steroids/antibiotics/respiratory therapy. The antibiotics were stopped as soon as all of my cultures came back negative. BUT the IV steroids have caused my blood sugar levels to go into the upper 300-400 range. The day after the ER they start me on finger stick blood glucose levels and a sliding scale of insulin. The next day I’m put on Lantus insulin every day because the sugar levels just won’t budge. In the meantime, every day the lung doctor decreases the steroid dose as every day my respiratory status is getting clearer and I’m able to do a little more with less shortness of breath. Friday evening they decide to discharge me home. Slow steroid taper to get me through to my next Cleveland Clinic appointment in a couple of weeks. Two insulin pens and check my blood sugar four times a day. Yay! This should be fun!
I was very fortunate to have family and co-workers visit while I was there. My three youngest grandchildren came to see me and drew me pictures. My sister brought me in snacks because I stayed longer than I was prepared for- and this worked out good because when I went home I was so concerned about my blood sugars dropping in the middle of the night so I use her snacks at night and THRU the night to get me until morning.
The prednisone is NO joke either. My eyesight has become very blurry and then when the blood sugar spike happens at noon it gets even worse. My blood sugars continue to be in the 300 range until about 8-10 pm and then they slowly come down to ALMOST a normal fasting level by morning. AND now I have insomnia most of the night. By 4 AM, I am so jittery I can’t lay still. I think I’ve slept maybe two nights since May 25th.
I went to see my primary care doctor today (this was a scheduled visit from December, how fortunate). He reviews everything and says “well, Carol, I know the prednisone is making your blood sugars very high but unfortunately your lab work before the prednisone taper I gave you in the middle of May shows that you are type II diabetic. The good news is you now qualify for the GLP-1 that the transplant team wanted you on so if that’s what you want to try I think we can get it approved now and maybe you can loose a little more weight and get these sugars at a more manageable place.” I don’t know whether to be grateful, sad, frustrated, I kind of feel them all right now. Just another downward slope on this roller coaster ride I’m on. Physically I’m getting back to where I was and I will restart pulmonary rehab on Tuesday and that will be a better defining activity for me to see just how much of a set back May may have been for me (hence the title of the post “May be a set back” as in ‘maybe a set back” and yet “MAY” was a set back.) Hopefully some of you get my weird word usage. I’ll write again after my Cleveland Clinic appointment. Not sure what all of this will do with my criteria.

















