Catching Up

I have a bad habit of being quasi anti-social when I am in the hospital (of which I was for the better part of last month).  Although I wasn't terribly sick upon being admitted, I had been out of the hospital for a considerable length of time (for me).  In addition, a mild virus / cold decided to make its presence known around the time I was admitted precipitating yet another round of Prednisone.

Prednisone and I have a love / hate relationship, at best.  I started and finished this course with the usual range of side effects, including CF-related diabetes.  In the past, I've had to treat blood sugars while on Prednisone (with insulin) but my sugars tended to normalize once the course was complete.

Apparently my pancreas has decided that it doesn't want to participate in this little game any longer.  I'm now an official insulin-pen carrying, blood sugar checking member of the diabetes world.  Of course, CF-related diabetes is something that tends to be expected as Cystic Gal's age gracefully, but it wasn't something I planned on encountering anytime soon.

Speaking of planning, I'm fast discovering in the diabetic world that daily life requires some amount of planning, scheduling, and thinking ahead.  As living by a "schedule" is the bane of my existence, it's taken some time to adjust to this new lifestyle.  Of course, having experienced a few true diabetic "lows" over the past week has proved to be a great source of inspiration in getting with the program.

Along with "di-a-beet-us" (so said Wilford Brimley), I've been dealing with high blood pressure.  The prevailing opinion is that the high blood pressure is because of, and/or related to the diabetes and that with control of one will come control of the other.  But until it normalizes, I'm taking a small dose of blood pressure medicine once a day.

Learning to manage diabetes in the hospital was much easier than doing so at home.  Rightfully so, when your food is delivered to you three times a day on silver plastic platters.  But I'm adjusting to being home.  It's been a process and I am trying to steadily improve my rather erratic eating habits and curb my consumption of the nectar of the gods (it's not my fault that I'm a good Southern girl who enjoys the occasional gallon of sweet tea).

Other than that, life is good and quickly returning to normal.  Here's to another round of good health bolstered by an extra dose of healthy eating.

And the verdict is...

FRIDAY!

Did PFTs this morning and saw a definite improvement in #'s. Back to normal (or "baseline") and actually I think a little bit higher. As much as I hate to say it, my lungs like the prednisone. I may hate the side effects (in case you haven't figured it out yet), but it definitely does work wonders on the airbags.

I also promised one of my doctors that I'd give him a shout out on my blog. During rounds last night we laughed at the fact that he hardly even needs to come see me, he just has to read my blog to be in the know.

So, without furher adieu ...

"Hi, Dr. Y.!" [waving]

In other news, Miss Hallow Kitty is going to the vet on Friday morning. Even though she's just four months, she's decided to flaunt her womanly wiles already. Cheryl (or Alex) will have to drop her off at the vet on Friday morning and I'll be able to pick her up on Saturday morning. Then she will have the rest of the weekend to recover at my house by herself and I'll pick up the boys and bring them home on Sunday.

Hospital, Day 17.5

Time keeps on slippin', slippin', slippin'
Into the future
Time keeps on slippin', slippin', slippin'
Into the future

I want to fly like an eagle
To the sea
Fly like an eagle
Let my spirit carry me
I want to fly like an eagle
Till I'm free..

Sorry, I was channeling my inner Steve Miller Band. Yes, I'd really like to go home right now, but that doesn't appear to be in the cards. My goal is to be out of here by Friday (3 weeks) and back to work on Monday. Back to REAL life and not this-so-called-life that I've been partaking of.

My Prednisone dose has been cut back to 20 mg/day, which means the chances of me biting your head off for looking funny isn't quite as likely, but I do find that EVERY. little. THING. is frustrating, especially when it isn't done right the first time.

The 'roids still have me hyped up ... I've exhibited a few feats of superhuman strength (a la Mighty Mouse) ... for example, while trying to change out the tubing from one nebulizer to the other, I was pulling on the plastic tubing with all my strength and I ended up breaking the nebulizer into two pieces. No, I'm not kidding. If I hadn't of been so irritated about it, I would have taken a picture. Instead I just threw the nebulizer against the wall. =)

I've survived the last few days by catching "cat naps" here and there, but I don't remember the last time I had a entire night of what could actually be called sleep.

In other news, my drug levels are still not right. The lower dose of Vancomycin (1250 mg) caused my trough level to drop to 10.6, which means the medicine wasn't working as effectively as it should be. The pharmacist has now changed my dose to 1500 mgs / q 12 hours. Hopefully (fingers crossed) that will be the magic number. I am guessing they will re-do my levels after about four doses to see where I'm at. Who knows?

Off to do PFTs tomorrow.

I'm now taking suggestions on what movies to watch to kill time. Next up is the re-release of Friday the 13th (2009). After that, I'll be relying on my Netflix instant queue for entertainment.

Lah!

Hospital, Day 12 (No new news...)

is good news. Right?

WRONG! At twelve days into this visit, I was hoping to see some improvement across the board. Instead I've been plagued by shortness of breath and a low O2 saturation (%SpO2) for the past several days.

My body is used to dealing with my O2 levels hanging out in the low 90's on room air. In all honesty, I don't really start to notice a difference in my breathing until I start hitting #'s in the mid-80's. Well, for the past few days I've been monitoring my O2 saturation levels a bit more closely because I would find myself out of breath with any form of exertion, and in some cases, even while talking.

To my chagrin, I found out that my #'s were staying in the 80's most of the time, barely reading in the low 90's, even with supplemental O2. Since that's kind of out of the ordinary for me, I ever so nicely asked my doc to figure out what was going on. (Actually, given my temperament of late, it would probably be more accurate to say I asked "Dr. Y., what the hell is going on?"

So today, Day 12, I went and had another CXR (chest x-ray). According to my nurse practitioner, I essentially had shown no improvement on my x-ray over the past two weeks and that I am still showing a lot of "junk in my trunk."

Also, it seems as if my body is not enjoying the lovely doses of Vancomycin that I've been receiving. With most antibiotics, doctors will typically monitor the peak and trough of the medicine in your bloodstream. My first trough level came back high (27.9, I believe) and it was thought that it may have been a fluke, or a bad sample. Either way, we skipped the next dose to allow my blood serum levels to return to normal. Today, upon re-check, my trough level was 31. With two high trough readings and a slightly out-of-sorts BUN (blood-urea-nitrogen level) the Drs. decided to change my dosing, by lowering the amount of Vancomycin that I receive (2 grams --> 1250 mg) and changing the timing (q 8 --> q 12 hrs).

Along with that, the evil little drug, Prednisone, decided to make a suprise appearance in my medicine cup this afternoon. I am NONE too happy about starting Prednisone as I hate. Hate. HATE. the way it makes me feel. But I'll survive.

Fair warning to all of my friends, family, co-workers, and assorted blog readers, I am laying all blame for any antics that ensue over the next few weeks on the drugs. I will not be able to accept responsibility for being very un-Brandi like, at least until I kick the Prednisone.

Without much else to report on, I want to leave you with an invite to Cystic Life, a great social networking service for CF patients by CF patients that has been in the works for a while now. Cystic Life was the brainchild of Ronnie (of RunSickBoyRun fame). It's where all the *cool kids* hang out. =)

Hospital Stays By The Numbers (2009), Part IV

Hospital Round 4 / September 28, 2009 to October 19, 2009:

This was my most recent hospital visit (until now) and all that I can recall is that it was completely uneventful. I'm not sure if that's a good thing or a bad thing! I did discover that UAB finally came to terms with their internet services and I could now Facebook or blog as much (or as little) as I wanted.

My goal was to make sure I was healthy for Halloween, even if I did have to miss the Kings of Leon concert. My timing was perfect ~ I was able to dress up, have fun, and party like a rock star on All Hallow's Eve.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Total # of Days Admitted: 21 Days

Total Amount Billed: $104,289.84

Average Cost Per Day: $4966.18

Hospital Stays By The Numbers (2009), Part the III

Hospital Round 3 / July 28, 2009 to August 18, 2009:
Other than a diagnosis of pneumonia, this trip was fairly par for the course. What I hated the most was the fact that Katey and I were due to fly out to San Francisco the next day to go to the NACFA Conference. I did get to make up for my missed vacation by going on a two day trip to Vegas.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Total # of Days Admitted: 21 Days

Total Amount Billed: $101,227.57

Average Cost Per Day: $4820.36

Hospital Stays By The Numbers (2009), Part II

Hospital Round 2 / May 27 - June 10, 2009:

I was hospitalized from May 27, 2009 to June 10, 2009 for a pretty uneventful hospital visit. I was able to be discharged in 14 days, which was FAN-F'N-TASTIC, since I honestly can't remember the last time I've done less than 21 days. I guess this visit could be packaged up with a pretty bow and called a "tune-up."

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Total # of Days Admitted: 14 Days

Total Amount Billed: $77,564.02

Average Cost Per Day: $5540.29

Again, my only out of pocket expense for my hospital stay was $250.

Hospital Stays: By The Numbers (2009), Part I

Hospital Round 1 / February 11 - March 13, 2009:

I was hospitalized from February 11, 2009 through March 13, 2009, to be treated for a Cystic Fibrosis exacerbation. During this time, I had major sinus surgery which kept me under lock and key the entire time.

Welcome to "Club Med":

Unfortunately, our accommodations aren't quite so nice:

I was trying to come up with some intelligent reason for writing this post, but I couldn't. I am bored, and looking for ways to pass the time. I decided to figure out how much work I missed last year and also how many day I spent in the hospital. Then I decided to compare the costs of each visit.

Below is a partial list of the medicines and treatments I receive when I am in "Club Med Dread."

1. Private Room (per day) - $1210.00
   
2. Oxygen Use (per day) - $320.00
3. Ultrase MT20 (100 capsules) - $484.40
4. Meropenem Injection (2 Gm Vial) - $247.50
5. Vancomycin Injection (1000 grams) - $17.44
   
6. Ceftazidime Injection (2 gram Vial) - $73.22 / per dose
7. Pulmozyme - $221.22 per dose
8. Albuterol - $14.45 per dose
9. Colistimethate Injection (75 mg) - $72.27 / per dose
10. Budesonide (Pulmicort)
    
11. Neb Bronchdil TX SubSeq - $95.00 / per nebulizer
    
    • At UAB, this means your Respiratory Therapist sticks his head in your room, and leaves your evening aerosol / nebulized meds.
12. Chest PT CF Pateient Subsequent - $144.00 / per session (usually TID)
13. Zolpidem Tablet (Ambien) / $8.72 each
14. Tramadol Tablet 50 mg / $7.26 each
    
15. Benzonatate Perles (100 mg) / $30.00 each
    
16. Aquadeks Soft Gel Tabs (Vitamins) - $15.44 / per dose
17. Nexium (2x/day) - $14.36 /per pill
18. Montelukast Tab 10MG (Singulair) - $25.38 / per pill
19. Ferrous SO4 Tab 300 MG (Iron) - $14.11 / per pill
20. Guaifenesin LA Tablet 600 mg - $8.75 / per pill
21. Azithromycin Tablet 250mg (x2) = $36.40
    
22. Acetaminophen Tablet 325 mg - $0.08 / per pill Yes, folks, that is OTC Tylenol

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Total # of Days Admitted: 30 Days

Total Amount Billed: $314,611.38

Average Cost per Day: $10,487.05

My out of pocket expense is $250 for each visit, but I work hard to keep my benefits with BBVA Compass and our heath insurance provider, Blue Cross / Blue Shield.

Hospital, Day 7

Nothing of much excitement to report this time around. I settled in on Friday and got a CXR (chest x-ray), got my port accessed, and took some time to settle in. The Pulmonary Function Clinic was packed on Friday (they had several bronchoscopys waiting to be done), so I was not able to do my PFTs on admission.

Spiromety (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs), measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled.

The two major #'s that my Dr. look at are my FVC and FEV1.

On Monday, January 11:
Forced Vital Capacity (FVC) is the volume of air that can be forcibly be blown out afer full inspiration, measured in litres. My FVC was 41% when I was admitted last Friday, January 8th.

Forced Expiratory Volume in 1 Second (FEV1) is the maximum volume of air that can forcibly blow out in the first second during the FVC maneuver, measured in liters. My FEV1 was 36% on admission.

Along with FVC, FEV1 is considered one of the primary indicators of lung function.

After a week of IV meds (the same cocktail that I had last time) my #'s have improved slightly to 49 / 46). Given that I had just finished my ventolin aerosol, it might not be the most accurate representation, but I'll take whatever I can get.

After a run-in with a bitch (she who shall not be named) nurse the other day, I was a little irritated. Little John, was my nurse today and I felt bad for taking my frustrations from the day before out on him. Because I have so many allergies and I have to be pre-medicated to almost every antibiotic I take, if my schedule and pre-meds are a bit out of wonk it puts a kink in the system. And I'm the one that as to suffer from that kink. So, I *think* things are back to order at this point.

Tomorrow = Day Eight! (I'm not sure how long I will be staying for sure, but either way you to do the math, I'm either 1/2 way there or a 1/3 of the way. Calgon, take me away!!!

Hospital, Day 2

It's official. I'm back in "Club Med" (or "Club Dread," depending on your perspective). After 80 days of freedom, it was time for a tune-up. I accomplished my goal of staying out of the hospital through the end of the year (a challenge that I had with my boss) and even made it almost a week longer.

(80 days?!? I can't believe I made it that long. I should get a gold star.)

In all, I don't feel terrible. I certainly don't feel great and I know it was time to come in, but there have been times that I've been here that I have felt much, much worse. I would love for this to be a 14 day visit rather than my normal 21, but I'm not going to jinx myself by making plans for a 14 day stay. Not yet, at least.

They started me on the same schedule of meds, pending the results of my sputum culture. I've been very tight and most of my congestion seems to be confined to my upper lobes (on both sides). My bases actually sound fairly clear, which is a nice change. I have not had the opportunity to do PFTs yet, so I don't know what my current functions are.

My port went on strike. When I first accessed it, we were able to get a small amount of blood return and it was sent off for labs. By the time the lab received it, the blood was clotted and the sample was useless. When they came back for more, my port decided to have a temper tantrum and wouldn't draw back at all, although it flushes perfectly fine.

In all likelihood, I have a fibrin tail at the end of my catheter. I've had this happen several times before, so I wasn't too surprised or concerned about not being able to get a blood return.

For those of you not familiar with the wide world of ports, fibrin is a fibrous protein involved in the clotting of blood. Fibrin starts to build up on a catheter without completely enclosing it. A small piece of fibrin may hang off the catheter tip. This is known as a fibrin tail, which also represents a persistent withdrawal occlusion. These can sometimes be resolved with an infusion of low-dose alteplase.

Two doses of tPA later, I am the proud owner of a port that flushes with ease and gives a beautiful blood return. Whew!

I think that's about all the new news for now, so I'll sign off.

Monday Night Madness

And no, it doesn't involve football. I spent a great night with my aunt, C., and cousin, A., having dinner at Cheesecake Factory and then hitting up Barnes and Noble to do a little post holiday shopping.

My family knows (one of the many ways) to my heart is through Barnes & Noble Gift Cards. I even managed not to spend them all at once. So, two new calendars and seven new books later, I arrived at home, a happy little Brandi.

The latest additions to my collection include:

`

These should (hopefully!) last through my upcoming hospital visit. If not, I might have to send Cheryl off to B&N for backup.

A day in the life of...

...a hospital junkie.

Just jokes. Spending time in the hospital is definitely not on my bucket list.

But I thought I'd give you an idea of what my schedule is like when I am here. These are the scheduled times of my meds and aren't necessarily the actual time that I receive them (for sanity's sake, I try to stagger my doses so that I get a little free time).

0800 - 1000:
25 mg Phenergan IV
50 mg Benadryl IV
4.5 grams Zosyn IV

1100 - 1200:
Free time!

1200 - 1400:
50 mg Benadryl IV
1 gram Vancomycin IV

1400 - 1700:
25 mg Phenergan IV
2 grams Tazicef (Ceftazidime) IV
4.5 grams Zosyn IV

1700 - 2000:
Free time!

2000 - 2400:
25 mg Phenergan IV
50 mg Benadryl IV
1 gram Vancomycin IV
4.5 grams Zosyn IV
2 grams Tazicef (Ceftazidime) IV

0200 - 0800:
25 mg Phenergan IV
50 mg Benadryl IV
1 gram Vancomycin IV
4.5 grams Zosyn IV
2 grams Tazicef (Ceftazidime) IV

As you might have noticed (if you were really paying attention), I am only unhooked from my IV for about four or five hours everyday.

This schedule doesn't include the handfuls of pills that are delivered throughout the day: Nexium, Reglan, Lactobacillus, Guafenisin, and AquaDEK (vitamins).

Oops, don't let me forget to include the inhaled (nebulized) medications that are also part of the routine:
Ventolin
Pulmozyme
Colistin
7% Hypertonic Saline
Pulmicort
Spiriva

And that, my friends, is a day in the life of hospital junkie. And you wonder why I never get any sleep?

Almost Done

As Piper much more creatively put it - that "e"vil little miracle:

Powerful drug,
Regretfully necessary. An
"Evil little miracle,"
Drowning sanity (and sleep) as you wash away inflammation.
No, I don't like you;
I both love you and I hate you. And I'm
Sorry for the indecision, it's
Only that I'm feeling a little flustered, mixed-up,
Not quite myself, which might have something to do with you, or
Everything.

has done it's work. I managed to get my FVC / FEV1 back in the 40's (my baseline) after 19 long days and I am going home tomorrow. Fortunately I wasn't on a really high dose this time around (30 mg, now down to 20 mg), so I won't have to do a really long taper. Thank the gods. I need to be off this devil drug before I go back to work on Monday.

I don't want to jinx myself, but we (Cheryl, Alex, and I) leave for our whirlwind, two-day, show-seeing tour of Vegas on Friday morning, returning Sunday evening. That's one more item crossed off my mini-bucket list of seeing Phantom of the Opera in every major tour city.

That's all for now, folks.

"It's 5:00 somewhere..."

Here. I've always loved that thought, especially when it pertained to enjoying a tasty beverage or two (or three). But right now it's 5:11 AM and I've been staring at the clock since about midnight.

Dear Nurse: Please bring benadryl and phenagran, STAT.

Longer post later. Only change is that they've added a round of prednisone. Can you tell? Should be going home next Tuesday (3 weeks), then off to Vegas to see Phantom of the Opera with Cheryl and Alex. Woot!!!

And the verdict is...

I have pneumonia, AGAIN. Actually, I shouldn't really say AGAIN with such emphasis because it has been three years since I had pneumonia. However, I have it AGAIN.

I noticed on Thursday and Friday that I wasn't running on all eight cylinders and I attributed it to not sleeping well those nights. When I woke up on Saturday morning, I was very congested, short of breath, and exhausted (after 12 hours of sleep). I decided to take it easy that day - Katey and I went to visit Tony for a few minutes and I rested the remainder of the afternoon before I went to Angela's final birthday celebration. I had already decided that I was just going to dinner and not going out partying with the rest of the group b/c I knew there was no way I was going to make it.

Sunday, more of the same. Monday, the same. I noticed that I was feeling quite like I did when I had pneumonia in the past so after much nagging on my father's behalf, I went ahead and called the nurses and scheduled a tune-up.

When I checked in Tuesday, I must admit things had gone from bad to worse, pretty quickly. I was admitted with a temp of 102.2, O2 levels of 91% @ 3L, and respirations of 34. My nurses quickly got me settled and started the same drugs that I finished up on last time. I had my CXR (chest x-ray) late last night (around 11 PM) and PFTs early this morning. PFTs were definitely not my best event - my highest #'s this time around were 35% / 32%. Yes, these are low, but not out of line, when you take the pneumonia into consideration. Once I start clearing out the pneumonia and I'm not quite so short of breath, I am positive those #'s will return closer to my baseline.

In either case, I'm sitting here today waiting for drug cultures to come back to determine that I'm on the right abx to treat this pneumonia.

The worst part of this? I had to cancel my trip to San Fran and the CFRI Conference with Katey. Fortunately, we are going to get back all of the money that we had spent, but these are definitely one of those moments where I am not enamored with having CF.

On the plus side, I am in the bariatric room on our floor. The room is HUGE (YYYYOOOOOOOOGGGGGEEEE). My only complaint is that the bathroom door weighs about ten times more than any other door on the floor (in other words, don't be in a rush when you've got to go) and the toilet is made for people of the ... hmmmm .... beefier side. It kind of reminds me of a super industrialized over sized toilet that you would see on an airplane.

That's about all the news I have for now. I will try and keep everybody posted as I know more information about the game plan.

Ronnie, glad that you are home!!!

Hospital / Day the Fourth

Just a quick update to let everybody know that I am still alive and (mostly!) well here at Club Med. I think I managed to let everybody know that I was admitted on Wednesday and have just been letting the meds do their job for the last few days.

I was lucky to get a bed ~ our pulmonary unit has been overflowing with CF admits for the last three weeks (we've had up to 17 CF admits on the unit at one time). I think there are around 13 of us in right now, which is still a pretty big census. My friend, Katey, was admitted on Wednesday as well. Although she normally goes over to HTICU (as do all the post-txp patients), she was admitted off unit. We are on the same floor but in different units. I've been over to her room a few times and she's journeyed over to mine, but mostly we've been texting and chatting over the computer. How lazy is that???

Currently I am on three IV meds - Cefepime, Zosyn, and Vancomycin. I tolerate the Cefepime without too much trouble, but still end up needing phenergran and benadryl to deal with the other two, especially the Vanc. I have a fairly common reaction to Vancomycin - Red Man Syndrome, which is:

a syndrome, usually appearing within 4–10 minutes after the commencement or soon after the completion of an infusion, characterized by flushing and/or an erythematous rash that affects the face, neck and upper torso. [...] Symptoms may be treated with antihistamines, including diphenhydramine.

For those of you not in the medical field, I have to take a fairly large dose of Benadryl (50 mg) to avoid the above reaction. Even with that I sometimes still end up having to take an additional 25 mg. And, of course, Benadryl makes me hyper, whereas with many other people it knocks them on their ass for a few hours.

I am not sure exactly how long I will be in this time. I wasn't terribly sick, but it was definitely time for a "tune up." My PFTs were 44% / 42%. I typically end up staying 21 days, but I am kind of pushing for a 14 day stay instead.

OK - I know that is probably more of a medical update than you ever really wanted to know. =)

I am trying to plan a short trip to the beach when I get out of here ... 4 days, 3 nights. I would love to go down to Seaside , FL. I've never been therefore but it sounds like a beautiful place. Honestly, though, at this point I would probably take whatever beach I can get to the fastest. Any ideas? I'm undecided as to if I want to go by myself, but most of my friends have so many other commitments that it's hard to plan a trip.

Enough for now! Any suggestions on ways to keep myself sane while I'm in "Club Med"? And please don't suggest reality TV -- I have already been sucked into Daisy of Love and Charm School this season. I really need to get out more often!

Laters ~

GI Appointment & CT Scans

I had my appointment with my new GI doctor, Dr. Lawrence F Johnson, MD yesterday. I was VERY pleased. Dr. Johnson was a really nice guy who actually took more than two and a half seconds to listen to my concerns and decide on a course of action. I also met with his fellow, George B Smallfield III, MD, who was very friendly as well. Compared to the monkey I went to last time, I felt like this was a much more productive visit.

So right now the plan is to have an endoscopy done while I am inpatient this time and I may also have a repeat of the Barium Swallow study. He wants to take a closer look at some of my lab levels because upon palpitation my spleen felt enlarged. He said this could simply be due to the fact that I am currently fighting off an infection, but just wants to make sure.

I also had a CT scan yesterday for my sinuses, so will need to schedule an ENT consult while I am inpatient. I already know from the way my sinuses feel that a sinus surgery is probably in my near feature and I *dread* that fact. I swore off all sinus related procedures about ten years ago when my last sinus surgery didn't go well.

Well, that's all for now folks. UAB just called to tell me that my bed is ready and I haven't packed a bag yet. I will update later and let everybody know where I am.