I had a consult with our in-house cardiologist this morning and she interpreted that the fluid in the space around my heart is minimal.  She said that it usually doesn’t exacerbate although heart problems would be among the complications of my illness.

I also learned from her that if my attending wants to rule out pleural effusion, he should have ordered for chest x-ray.  (I have mentioned in my earlier post that I just had a chest x-ray at LCP and I found out that my chest is clear of any negative findings. For sure, the radiologist is not just looking for tuberculosis signs but other possibile lung conditions that might be contagious or might affect me carrying out my trainee duty.)

She just informed me to continue taking in the diuretics so as  to  avoid over accumulation of fluid and she will see me after a month and she will order for a repeat 2D echo-cardiogram after three months.

She also asked me if I am seeing an immunologist.  I said not yet because my attending who is a nephrologist if focused on my proteinuria.

Actually. I have been asking myself if I need to have a immunologist consult.  I will be asking my nephro in my next check up.

In my last check up, I asked him if my diagnosis is final. He said that we have to wait if I will respond positively to my  6-month treatment. By then, if I have not, then he will order for a repeat biopsy.

Honestly, I am having mixed emotions on this thought. If I did not respond well, then I might have been misdiagnosed and  I could have a common curable disease but if I did, then it confirms my life long health condition and I have just gone on remission and just wait  for the will pray not to have the next exacerbation in ten years.

Oh God, help me.

First of all, I am having severe leg cramps, yet again. It is my second day on Burinex and Aldactone. My doctor instructed me to pop these pills whenever edema sets in my feet.

As I had to evenly space out my medications, I decided to take them in around lunch time right after my dental check up. These diuretics are expected to kick in from 15 minutes to 2 hours so I need to be near a comfort room to go.

I have been to St. Luke’s and Lung Center of the Philippines and fortunately, their comfort rooms really offer comfort. I also had to use Chow King’s rest room which is clean too on my way to LCP.

I got the result of my 2D echo and the finding s are mostly normal except for:

- Minimal pleural effusion

- Mild mitral and tricuspid regurgitation

I’m a nurse but I don’t know that exactly they mean but from the sound of it, they are on the lighter side. Well, I don’t want to second guess, I will be having a cardio consult with our in house cardiologist.

I also went to see a doctor who specializes in physical medicine and rehabilitation. Gosh, I have to check what these doctors are called.

Anyhow, I arrived around 1 p.m. and I am already 10^th on the list. I have waited for almost an hour and when there was no sign of the doctor’s arrival, I told the secretary that I will just be back.

This is why I hate doctors. They make you wait forever as if they are the only people in the world who are busy.

I need to go to LCP to complete my requirements for the nurse trainee program.

I arrived at LCP before 3 p.m. and went straight to the training office. I wore my mask on. It was the Lung Center of the Philippines, which means every possible lung disease are existing there and afloat. Good thing, wearing masks there is highly encouraged.

After reviewing my requirements, the administrator gave me an order to get chest x-ray and PPD (Purified Protein Derivative) test. These are the tests required to all the trainee applicants. Although I had my chest x-ray last March, the result would no longer be reliable according to her. SO I obliged. Anyway, I also want to know if my lungs are still healthy. I could have the test performed in our office lab but I had to justify my request and I need to have the result interpreted by LCP’s radiologist which will also cost me some money.

The chest x-ray was available immediately. It’s like Polaroid! I was called by the receptionist and the first words that came out of my mouth: Are my lungs okay?

The receptionist replied that they are okay and the result will be sent to the training office. I felt relieved. I was scared that they might see some problems like pleural effusion – the thing that my nephrologist wants to rule out.

Then I headed for the PPD test. It is a skin test to check if you have been exposed to TB bacillus and do not ask me why it is called PPD. I was asked to be back on Friday for the reading and as I look on the test site, there has no signs of wheal formation. Maybe because I lost all the protein in my urine. Ha-ha. If you get 10mm or more of induration, you might be considered positive for exposure but it’s non-confirmatory.

I finished all the tests before 4 p.m. and I headed back to St. Luke’s. I arrived around 4:30 and went in to see the secretary. He told me that I have been called already and just wait to be called again after the patient then being seen by the doctor. Well, not bad. At least I had no time wasted.

I was called in after 15 minutes and related my back problem to the doctor. She ran some physical exams and the last thing she did was like sort of massaged my back really hard and I was in pain. She told me that there is muscle spasm on my back and it is called the MPS or Myofascial Pain Syndrome.

She ordered a 6 physical therapy sessions and ordered me to plot a sked at the rehab department. She also gave me some muscle relaxant. Another pill? Aaargh!

I chose to get the thrice a week session in the morning. I am planning to head there right after my graveyard shift so I could have longer and uninterrupted sleeps when I get home.

I hope that this MPS thing will go away after the complete session. I will be evaluated after 6^th session.

This is a very tiring day for me, although my plan was to hit the gym after running the errands, I begged off. I have done so much cardio running from one floor to another and from one place to another.

I need a cold shower to relieve my leg cramps.

I just came from my routine check up. I also got my lab results and why am I surprised to see that my urine creatinine protein ratio shot up, yet again. Other lab tests are normal:  serum creatinine, liver function, potassium but heck my choleseterol level is a bit alarming. It’s 300+. I am guilty on this aspect because i pigged out on red meat in my attempt  to increase my protein intake. I slobbed on slab  of baby ribs, pork steak and barbecue.

Now, I am back to white meats. Say hello to tuna and chicken. My sister whom I have told about my cholesterol level has started to serve steamed chicken breast and veggies – just peppered and unsalted.

Oh, and I contain myself in snacking on roasted garlic bits as it is known here in the Philippines for its natural way of lowering blood pressure and cholesterol level.

My doctor said that I am just on our eighth week of my 24-week therapy so it’s not alarming to see that my creatinine-protein ratio gives a see-saw pattern.

Right now my concern is mainly about my heart.  I feel it hurts when I’m lying on my side as if it’s being pressed against my chest wall.  My doctor has ordered for a 2D-echo cardiogram to  rule out pleural effusion (pleural effusion is an accumulation of fluid between the layers of tissue that line the lungs and chest cavity.) but it’s non-urgent because he set up my next appointment on June 1st.

He warned me to be extra careful not to catch any infections and has asked me if  I got the flu shot already

I pray that everything is okay.