today i learned small miracles don't work on demand. they come at the most unexpected of times and it is precisely their unpredictability that makes them precious and magical.
as of this morning, i was awaiting a call from the cath lab to come in for my picc and get admitted to the hospital for ivs. it is now almost evening, my picc-scarred arms remain picc-free and i am a free woman, not a prisoner of my contact-precautioned hospital room. no, they did not have trouble placing the picc and no, i did not flee the state or get snowed in due to an uncharacteristic philadelphia blizzard...this time, at least. something crazier and more amazing happened!
over the past few days, the doxy/colistin combo i began last wednesday slowly started to kick in. it wasn't immediate. in fact, it took a good 4-5 days. but, before my very own eyes, the intensity of my cough gradually lessened, my fevers went away, and i noticed the energy and zest that makes me feel like me returned. let me tell you, it was a welcomed return.
the moment of realization came as i was walking one block from work to night class yesterday. i had a friend's birthday dinner afterwards and, despite notifying her that i probably wouldn't be able to attend (and receiving the most gracious and understanding response), i started to question my decision. i realized i actually wasn't as exhausted and devoid of energy en route to class as i had expected. class came and went and suffice it to stay that my water bottle stayed in my bag instead of on my lap, which shows the infrequency of my cough. i actually left class feeling, well, fine.
so, to the birthday dinner i went. i ate. i celebrated. and still, i was feeling pretty okay.
that got me thinking. questioning, really. is this body that has generously allowed me to go to work, class and a birthday dinner - a busy day by anyone's standards - still sick enough to necessitate powerful iv antibiotics and the complications that accompany them?
as is the case whenever i find myself conflicted or confused, i went to my mom for advice. i tried to invoke my intuition. the answer wasn't coming to me but the idea of resorting to ivs when it wasn't absolutely clear yet that i needed them was making me quite uneasy. following my mom's recommendation, i slept on it hoping to awake with clarity. i did not.
emails and calls to my doctor and nurse followed. i tried my best to articulate how i felt and both sides of my internal debate about whether to go in or not. yes, i'm doing better, but i'm on doxy, my rescue medication, and what comes next when i finish my course in a week? yes, my pfts are only slightly down, but i don't want this to be my new baseline. what is the tipping point for when a gradual decline needs to be stopped by aggressive iv meds? if not now, then when? or at all?
i kept repeating to the nurse, "i want to do whatever is best, i just can't figure out what that is." keep in mind, lacking an opinion is relatively unchartered territory for me. i'm usually the one with too many opinions and strong ones at that! she relayed my situation and uncertainty to my doctor and promised to get right back to me. the interaction absolutely humbled me - from calling my nurse on her personal cell to having her reiterate to me that she wants to treat me, the whole me, and not just my numbers to the clever solution my doctor eventually proposed and the response call i got literally within minutes. it reminded me how incredibly fortunate i am to have medical team that trusts me, listens to me, and is flexible and creative enough to go back to the drawing board and adjust when necessary.
that's exactly what we did. we went back to the drawing board. our solution was to hold off on the hospital stay and do a bronchoscopy on monday to determine exactly what is growing in my lungs instead of shooting in the dark due to my lack of sputum production. once we get the results, we'll see if iv antibiotics are necessary or if there is an oral antibiotic besides doxy that may do the trick. even if i do end up in the hospital in a couple of weeks, i'll know it certainly was not for a lack of trying. we did everything possible to spare my body from the assault of iv antibiotics. that knowledge coupled with the complete faith i have in my medical team and their trust in me is enough to give me total peace of mind.
the small miracle i have witnessed isn't my avoidance of the hospital this time. i'll end up in there sooner or later. rather, the miracle is twofold. it is my body's incredible strength in healing with a little help from its good friend doxy and the ability and willingness of my team - doctors, nurses, family, friends - to reconsider and adjust, as necessary, to best treat me and my CF - complexities, unexpected changes and all.
...and man will my picc-free shower tonight be amazing!