Another Appointment and Next Steps

 I had an appointment on Wednesday morning at my normal clinic. It was supposed to be with my PCP but I ended up seeing a nurse practitioner *eye roll*. 

I really liked her as well as the one I saw last week so I guess all is well but the medical field in this state just SUCKS!!!  I had a 9:00 appointment and there was only one other patient in the office at the time so...where are the doctors?   They don't make hospital rounds anymore so....hmmm.  Moving on.

My heartrate was down to 88 so the 5-day dose of steroids seem to have worked. I'm not sure why I wasn't discharged with steroids but whatever.  My blood pressure was also good. 

The next step will be for the doctor to find a rheumatologist who can prescribe a round of two of some kind of immunotherapy to tame down my overactive immune system.  I was looking into Otezla.  

We are also just waiting on the blood tests to come back to pinpoint my autoimmune disease. I'm still sticking with Fibromyalgia. I would be very surprised if it were anything else. 

Health Update

 I have a feeling that my road to recovery will be long and possibly even complicated so I thought I would keep a record here of doctor visits/medications/tests/etc.

My discharge papers list my official diagnosis as acute non-ST segment elevation myocardia infarction. According to what I could find on Dr. Google 

- this is a form of a heart attack

- it is a less serious form because it usually will not cause damage to the heart (as in my case)

- the diagnosis is made through a blood test that will show a higher level  of cardiac enzymes and on an EKG the ST segment will be depressed instead of elevated (as with a STEMI heart attack)

 - this happens when your heart is not getting the oxygen it needs

- there are several causes but mine was  caused by inflammation in the wall of my coronary arteries or heart muscle. 

From WEB MD

NSTEMI. In this form of ACS, your heart is getting some oxygen but not enough. It may be caused by any of the conditions listed above. An NSTEMI is diagnosed when your EKG does not show the type of abnormality seen in a STEMI but your blood tests show that your heart is stressed. 

WHERE DO WE GO FROM HERE

I had an appointment yesterday at the clinic in Ocoee.

-  My heart rate was still high (114 bpm)

- Blood Pressure was back to slightly elevated 132/90

Summary of the visit

    It's safe to say there is some kind of autoimmune situation going on. The issue is there is no test for Fibromyalgia so that is usually a diagnosis that is made once all other autoimmune diseases have been eliminated. Well, I have not been tested for any autoimmune diseases so on on Monday I will go for bloodwork and that is where we will start. 

The doctor I saw (not my primary) has given me a 6-day supply of steroids that I will hope will help reduce the inflammation. 

I have an appointment on Wednesday with my primary. At that appointment I am hoping to switch to a pill for the psoriasis. The doctor at the hospital prescribed a cream that seems to be working well, however it comes in a 5 milligram tube and I empty a tube in two days because I have to apply it to every inch of my legs. I also have some spots on my back that  cannot reach to put cream on. Because of the severity, I think I need an oral alternative. 

Because I am switching insurance companies in August (because of course I am -  now that I have met my deductible for the year!!!!!!) , I need to coordinate a care team that takes both insurances so I don't have to switch doctors.

 - Oral Antibiotic- Cefuroxime Axetil 500 mg twice a day for 5 days

- Lotion for Psoriasis - Triamcinolone Acetonide Cream USP .05 %

Twice a day

- Loratadine 10 mg  As needed for itching

- Steroid-MethylPrednisolone Tablets USP   4 mg 21tablets

Hospital Adventures

 

Sometime around February I began suspecting I was having an autoimmune flare. At that time I began noticing that I was getting frequent abscesses, fungal infections, and the rash (which I thought was Eczema but later learned is psoriasis) was slowly crawling up my legs. 

Then in March, things really ramped up. I had another abscess on my leg which, when ruptured, quickly became infected and turned into cellulitis. I was fortunate that, while extremely painful and dangerous, I was able to treat it at home after receiving a shot of antibiotics at the Emergency Care.

Three weeks later (mid April) I had another abscess which seemed to attack my whole body resulting in intense vomiting and 101* fever for about 24 hours. Two weeks later (May 4), another abscess with vomiting and fever. And another two weeks (May 18) I had a UTI with the same vomiting and fever.

Then, on June 5 about 2:00 in the afternoon I felt ANOTHER UTI starting so, in frustration, I got in the car and went to the Emergency Room of Orlando Health. 

I wasn't there long when I noticed I was getting A LOT of attention and I just had the feeling that this wasn't a good thing. I soon realized they were focusing on my heart and I was given an EKG, bloodwork, and asked a few separate times if I was having any chest pains (no).

The doctor came in and told me I was having tachycardia (rapid heart rate over 100 BPM) and that my bloodwork contained alarming levels of Troponin which is an enzyme that is released after a heart attack. And, oh yes, as the doctor put it I had a "rip roaring UTI." How the UTI got so bad in just the two hours I was experiencing symptoms I don't know. 

Even knowing all of this I was caught off guard when a woman from admitting came in to talk to me. I said, "What? I'm being admitted?"

The first night, I got NO sleep at all!  Every hour someone was in my room to check my vitals or to take some blood to check the Troponin levels. It was explained to me that the bloodwork had to be repeated ever two hours until the levels started to drop. Even though I had an IV in the crook of my left arm, the blood had to be drawn directly out of a vein in my right arm. UGH!  I was hooked up to a little hand held machine the whole time I was there that monitored my heart rate -  which continued to be high.  And I had a very slow drip of Heparin going that night so each time my arm was bent for too long the machine would beep and had to be restarted (which they showed me how to do myself). Trust me, it happened a lot because I would forget about the IV! Also that first night, a woman came in at 12:30 a.m. to do an ultrasound on my heart. 

The doctor came in my room the next morning and started questioning me about having Lupus and not Fibromyalgia because "Fibromyalgia is not an autoimmune disease." But this is a post in and of itself so I'll move on. He was, in all other manners, very kind. The cardiologist came in and said the heart ultrasound looked completely normal, but that I needed a catherization to ensure there were no blockages.  My foolish, foolish self believed if the catherization was negative, I'd be able to leave that night. 

The procedure itself was not bad but I did not enjoy having to lie on my back completely still for two hours afterward.  I received more great news that I did not have any blockages.  However, my heart rate remained high so I could not go home. I also was still getting IV Rocephin for the UTI. At least that second night I did not have the heparin drip and did not need bloodwork so I slept pretty well. They came in my room at 11:30 and 3:30 to check my vitals and then woke me up at 7:30 for a nursing change. 

Day three was a lot of sitting around waiting for a heart MRI which did not take place until 5:00 which meant another night in the hospital waiting for results. I was also scheduled for another dose of Rocephin and I got a shot of Heparin in my stomach. Night three was much like night two.

Thursday, the cardiologist FINALLY came at 3:00 to give me the final read from the MRI which was normal. All this was pointing to severe inflammation from the autoimmune flare--up putting stress on the heart causing it to release the Troponin. One more dose of Rocephin and another shot of Heparin and I was allowed to leave!  

A shower and my bed never felt so good - for some reason they don't let you shower in the hospital!  

Now I need to get in to the rheumatologist for immunotherapy to suppress my immune system and stop it from attacking my body. 

My Year Is OVER!!!!

For only the second time in my teaching career, I am not upset or disappointed that the school year has ended.  

This year has been an uphill climb that never ended and every bit of it has affected my overall health, especially over the past two months (more on that later). 

When the year began, I knew I was getting a couple of students with behavior challenges. Along with these two impulsive boys who lacked impulse control and empathy, I had an additional 3 or 4 boys who were prone to poor decision making on more than a few occasions.  This normally doesn't bother me as behavior management is my strong point. 

I managed to control their behaviors for the most part but that is the point - I controlled their behavior...there was never any self-regulation of behavior.  This was apparent whenever my teaching assistant was in charge.  They did not listen to her at all!!!!!   I loved her and appreciated her greatly, but she and I were never on the same page as far as setting the bar high for behavior expectations and holding them accountable for their poor behavior. It became so frustrating.  

I can sum it up like this --- as long as they were in the classroom and confined to their desks, and I was in front of them, things went smoothly. We spent the vast majority of the year this way and it was not very much fun at all.  

The second tier to this highly unusual year was that I was given 5 students who were reading at a Kindergarten level at the beginning of the year.  They had a first grade "teacher" who really wasn't a teacher at all!  Her major was Art Education and she had no idea how to teach the students to read.

I couldn't blame her - but it created for me a LOT of extra work this year to get them caught up. I worked my tail off and got some satisfaction from the end of the year testing  which showed 3 of the 5 improved to mid-late 2nd grade, 1 improved to early 2nd grade, and 1 was sooooo low, we knew from the beginning of the year he would be retained. But even he reached the goal we had set for him which was mid 1st grade level. 

I was proud of all of them because as a class, they improved by 152% in Math and 191% in Reading.  It's nice to see your hard work paying off with results like those - even if I felt like a dictator all year!  

When I was hired by this school 2 1/2 years ago, I thought this would be the place I'd stay until I was ready to hang up my teaching hat. I was happy and content here and worked with some great people. Unfortunately, sometimes God's plans are different and because of a certification issue, I was forced to find employment at a private school next year. 

I will be teaching 2nd grade at Central Florida Christian Academy. I am very excited about this - my favorite teaching years were at Oshkosh/Valley Christian. 

But for now, I am going to relax for the summer and try to get my health back on track.  I am guessing I am having an autoimmune flare-up. This has resulted in uncontrollable psoriasis and three serious infections in the past two months. These infections are "full body" response infections complete with vomiting and fever.  

Not fun!