This blog is an accounting of my personal journey to find fitness. All the content on this blog should be read as a biographical piece of literature, not a medical resource. I am a physician, but I am in no way giving medical advice or establishing doctor patient relationships with my readers. I am simply keeping a diary. If you are starting a diet or exercise program or require medical evaluation or advice, please see your own family physician.

Tuesday, June 28, 2011

Doctor, Doctor.

Well here I am with another day in the books. It's been a pretty busy summer for me, but I'm beginning to realize that my life is always busy. On the bright side it is a very full life. As I sit here listening to Daddy tickling one daughter while the other plays "Twinkle, twinkle" on the piano, I am reminded again how lucky I am.

On the diet front, things went well today. I ate well and on plan. I drank all my water. It's not hard with this heat to be reminded to drink often. At lunch I went to TKD class. It was pretty rough today. I woke up with a splitting headache and felt like crap. I told my friend that I felt like I had a hangover and that was extremely unfair since I had none of the fun.

My asthma is acting up today and I had a rough time breathing all day. There were times where I got very winded in class.  Ozone is up around here and that definitely effects my breathing. Plus I'm not the most compliant patient with my inhalers. I know, I know. I always pre-medicate before class, but I've been bad about taking my daily medication. I use it during this time of year, or at least I'm supposed to. Also I'm wondering if my airway issues are back.  It's been 2 years since I had the laser surgery for my subglottic stenosis, which is a condition where you get scar tissue in your airway causing a blockage.

I was diagnosed with this several years ago and I've had to have the procedure 3 times, a year apart, but this time I've gone 2 years. I don't really want to go back to the ENT because I know he's going to look down in there. Ugh I hate that. He sprays this nasty numbing spray in my nose and down my throat and then he threads a small scope with a video camera through my nose and down into the back of my throat so he can see below my vocal chords. It doesn't hurt, but it's really uncomfortable and then I can't swallow right for a few hours. It's yucky. However, the phsyician part of me is telling me I'd better go.

I learned my lesson the hard way trying to second guess and treat myself. For years I thought my asthma was just really bad and was treating myself with medications. After the birth of my 3rd child when it was really severe, I couldn't climb the stairs without severe shortness of breath. Even for a fat lady, it was ridiculous. I couldn't read out loud to my kids at night. I went to see an allergist thinking I needed allergy shots. He said I do have some allergies and asthma but that the breathing test showed a blockage in my airway. He recommended I see an ENT.  The man saved my life, I'm pretty sure.

I saw the ENT and he diagnosed the blockage. He said my airway was the size of an infant's. It was like I was breathing through a coffee stir stick. He said if I'd been in a car accident and needed to be intubated, there was no way anyone but an ENT could have gotten an airway in me. He sent me to a sub-specialist who confirmed the diagnosis and said I could either have the laser procedure which wouldn't be permanent and I would need it repeatedly or I could have a big surgery where they cut out that portion of the airway. That surgery would require at least a week in ICU on a ventilator, and 8 weeks recovery. No thanks. I went for the 15 minute laser procedure done by my ENT.  Yes, I had it once a year for 3 years, but I can have it on Friday, be back to work Monday with no more pain than strep throat.

It's a really rare thing, usually seen in people who have had trauma to the airway or in small children after severe infections. Sometimes it's seen in people with connective tissue disorders like lupus or Rheumatoid arthritis. I've been tested and my tests were normal. But, there is a lot of these types of problems in my family so who knows.  Seems it is more common in women of child bearing years when it happens spontaneously like it did with me. They think there is some kind of hormonal trigger and it usually just stops on it's own at some point. I was hoping it was gone for good, but I think it's back.

And it's starting to affect my ability to exercise which I will not allow. The inhalers don't help as much now when I'm really doing strenuous cardio, like at TKD. So despite my not wanting to see a doctor, I'm going to have to.

It's a very weird thing for a doctor to see another doctor. Knowing more doesn't help me or my treating physicians. I think it makes doctors nervous to know they are treating a colleague. They never want to insult my intelligence by over-explaining and they certainly don't want to miss something on a friend.  I really hate being a patient. But, we all have to see a doctor sometime or other.   I think it helps that I know how to navigate the health care system. I speak the language at least, but sometimes I think knowing all possible outcomes of a situation is a detriment.

This experience and the one with my gallbladder last fall certainly give me an empathy for how my patients feel. If I get scared and I understand all the lingo I can certainly imagine how someone feels when they can't speak the jargon.  I always try to watch for that look of, "I have no idea what she just said" in my patient's eyes when I'm explaining something technical. And there is a definite and obvious look. Usually it is accompanied by an uncomfortable nod and patients will not always tell you that don't understand for fear of looking stupid. It's really important for doctors to ask if the patient understands things. Even then sometimes they will say they do when they don't.

As a doctor, I will tell you that I do not mind questions. I would much rather answer any questions you have than have you run home and google something and end up with a lot of misinformation. The internet is great and horrible for us doctors.  I have to spend all kinds of time de-bunking stuff patients have read on this site or that. But, the good news is that in a computer savvy person, I can refer them to websites for credible information.

Tomorrow I'll be working out in the morning since I have an appointment to get my hair done at lunch. We must have our priorities, right?  I still have some work to get done, so I better get on with it. Night All!


  1. I am always impressed with your ability to exercise during your lunch hour or during other odd hours when you can fit it in. I know what your priorities are. I am glad with your very busy schedule that you make time for yourself.

    So, sorry about that airway mess of yours. Do you ever get panic attacks when you struggle to breath? I know I do, or would. Thanks for sharing about your own medical issues, but also the plight of being a patient as a doctor. Great inside perspective for us, but definitely a double wammy for both of you (doc and doc).

  2. I read on the internet that the Cowboys are going to play Pop Warner to improve their record. Must be true!

    Seriously, hope you are doing well. That sounds like no fun.

  3. Well, I guess I'm glad to know that even other doctors have problems with doctor appointments & procedures (I don't feel so alone). I hope you get it sorted out though. Sounds like it could be a pain in the patootie or painful.

  4. I know it's hard to face something medical, even when you KNOW it will help you in the long run (see: me, my deviated septum and over 10 years of sinus infections before I finally got it fixed for an example, lol); but your breathing is nothing to mess with. And afterward, when you are breezing through your workouts, you'll wonder why you waited so long to do it!

  5. Idiopathic adult subglottic stenosis - who knew?

    Hey, listen to your body. Be brave. Do what you need to do.

    It might not be the stenosis at all - just some tweaking of your asthma meds by your pulmonologist (you do have one, right?) and adherence on your part.


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