Thursday, July 27, 2006

old injuries, new problems

i spent the better part of tuesday at wash u's lung and asthma center at barnes. i had waited a month for an appointment so i could have some top notch lab coats check out my asthma problem.

first was a chest x-ray in one suite. that didn't take long. a few jokes by the radiologist about my name, a few hold-your-breath's and that was over. a few minutes later i had the x-rays in hand and waited for the next step. i checked out the x-rays while i waited. it was funny to see my left collar bone sticking up in the air, off of the shoulder. and i could see all the now-healed broken ribs, attached sort of like a kid would glue popsicle together. great.

i didn't wait long until a tech called my name and into another suite i went. this time we were doing breathing tests. deep breath, hold it, breath out as hard as you can, stop, breath in, deep breath, yada yada... it was fine, really. the tech was nice and had a lot of comments about the numbers that showed up on the computer screen. bp 122 over 77. hr 52. after a while, she figured out that doing the 6-minute walking test to determine the degree of exercise induced asthma was futile, so she called the doc and got the ok to do the bike test.

the bike was a simple exercise thing with a twist: it had a cool wattage meter with cadence and heart rate functions. i was supposed to warm up, and then pedal for 6 minutes at 10 beats below my expected threshold. she did some calculations, and came up with 154 beats per minute, which, if she meant my expected anaerobic threshold, she was right on the money.

starting off at 100 watts, it was going to take until the weekend to hit 154. i told her to up it. she reluctantly did so, to 200. up it again. 250 watts. up it again. 260. c'mon! i'll never get to the 154 if you don't give me some meat! so she settled at 275 watts. it was too easy, as i was hovering around 145bpm at 90rpm. so i just upped the cadence to around 110rpm, which settled my heartrate at exactly 154. she was chuckling a bit, saying how they don't get to see much more than 100 watts with "sick" patients. after the six minutes was up, i was dripping with sweat. nice way to come out of a doctors office, disheveled and sweaty!

a few more rounds of breathing tests, this time with the use of an inhaler, and i was done.

onto another suite, another weight check, and into a doctors waiting room. i only waited a few minutes, then a nice, young, foreign guy named isakov came in. he was interested, easy to talk to, and overall not like most doctors. we did the usual round of questions, he checked out the x-rays, went over the breathing tests, and finally asked me what sort of accident i had encountered.

i told him i hit a tree, seperated my shoulder, broke my scapula in two places, and broke 8 ribs. he nodded, and began pointing things out on the x-ray. i never really thought much about the accident having long term effects. he showed me where the ribs had healed in an overlapping fashion, and what appeared to be scar tissue on the lung and between the ribs. he also pointed out to me that the rib cage is a bit crooked, which schmatz had mentioned to me the last time we rode together (you look crooked on the bike!).

so although there was a component of exercise induced asthma, reactive airway disease, a larger problem for me was mechanical...not being able to fully inhale or exhale due to the trauma around the lungs, particularly the left one. nothing i can do about it. he did tell me that we should do a cat scan of the lungs to make sure the dark features in the x-ray were indeed scar tissue and not "something else". and maybe do a cardio pulmonary stress test (vo2 max test, to you and me) to make sure that the restrictions were actually air-related and nothing else.

ok. i'll hop through a couple more hoops. if nothing else but to make myself feel better because i know there is a problem other than the fact that i just suck. and suck air.

No comments: