Monday, April 24, 2023

Monday, April 24, 2023

Tonight's picture was taken in April of 2008. That year Mattie turned six years old. Mattie did have a party, but we also got a small ice cream cake for the three of us to celebrate at home. Ironically Mattie only liked the vanilla ice cream in the cake, and he knew I loved the chocolate. So I would cut out my vanilla and give it to Mattie, and I would take his chocolate. Unlike me, Mattie wasn't fascinated by food. He rarely sat still long enough to eat. Yet by age 6, Mattie was maturing, he was in his second semester of kindergarten, and we noticed a big change in his behavior. He would sit at the dinner table with us, he was braver about trying different types of foods, and we were enjoying this moment in time. Unfortunately, it was short lived, because three months later, Mattie was diagnosed with cancer. 

Quote of the day: People pay the doctor for his trouble; for his kindness, they still remain in his debt. ~ Seneca

While my dad was at the memory care center today, my mom and I joined Peter for a ride to Virginia Hospital Center. Peter was seeing the pulmonologist, to confirm that his issues are indeed allergy related. Since I wouldn't be able to give my mom lunch today, I packed a snack for her to have in the atrium of the hospital while I went in with Peter for his appointment. Typically I take my mom out to lunch on the days my dad is at the Center, but right after Peter's appointment, we had to pick up my dad and then I had to quickly turn it around and go to the cardiac clinic for his yearly electronic check of his pacemaker. So there was no time for lunch, but needless to say, I did a lot of running around!

Certainly Peter is quite competent to go to the pulmonologist without me. But I wanted to go. Maybe for two reasons. The first of which is it is a break for me from managing either of my parent's needs. A sad commentary indeed, no? That I have to go to a doctor to get respite, but this is the plight of being a family caregiver. It isn't unique to me, I know. The second reason I wanted to go was because Peter is NEVER sick. Thankfully! So the fact that he has had a cough since January was concerning to me. I also don't always trust his primary care doctor, who many of know, I call DOPEY. 

The beauty of Peter is he understood why I wanted to go today! He realizes I need moments away from both of my parents, and though it is literally just a moment or two, I take whatever time I can get where I can have normal human dialogue. 

I happen to love our family pulmonologist! He grew up in Rochester, NY and moved to the National Capital area for his residency and fellowship. He is a VERY unique doctor. He comes in and spends the first few minutes getting to know you. Like what doctor does this? He is a human first, which is appreciated by a type like me. Moving passed that, he is highly competent, provides clear and thorough explanations, and you don't feel rushed. He listened to our concerns, he gave Peter an exam, took a chest xray in the office, and then gave him a FeNO test. 

A FeNO (fractional concentration of exhaled nitric oxide) test or exhaled nitric oxide test, in patients with allergic or eosinophilic asthma, is a way to determine how much lung inflammation is present. Nitric oxide is a biomarker for asthma which provides an indication of the level of inflammation in the lungs. The FeNO test, is performed using a portable device that measures the level of nitric oxide in parts per billion (PPB) in the air you slowly exhale out of your lungs. The exhaled nitric oxide test is different from most lung function tests in that you need to blow slowly and steadily, not hard and fast, to get an accurate measurement.

Peter's lungs are clear, he doesn't have asthma, and indeed has allergies. We don't know to what, but it gave me great peace of mind to hear that nothing is seriously wrong with Peter's lungs and on Flonase and Zyrtec or Allegra he should improve over time.

Later this afternoon, I took my dad for his pacemaker check. See that thing that looks like a computer mouse? Well that mouse sits over the pacemaker and provides data into a computer. We learned that my dad's pacemaker is needed 30% of the time. I am so glad we got this surgery done last March, because my dad's electrical impulses were off, and his heart rate would drop in the 40s (normal is 60-100) when actively walking and climbing stairs. Which was dangerous. 

The tech, Bob, was wonderful today. He explained to me and my dad the differences between cardiologists! As not every cardiologist does the same thing. Which truly was news to me. He used caring for an old house as an analogy. This analogy is helpful in making quick, clear distinctions with anyone trying to understand the field of cardiology. So for example the cardiologist who put in cardiac stents in my dad years ago would be considered the "plumber" of the heart world. His official title is an interventional cardiologist. The cardiologist who inserted a pacemaker last year in my dad, is like the "electrician" of the heart. Or better know as an electrophysiologist. Needless to say, I found this discussion clear and useful. Bob then told me that the cardiologist we love and who my parents see every 6 months, is like the "general contractor" of the cardiology world. This doctor knows a little bit about everything regarding the heart, but doesn't specialize in performing the surgeries like an interventional cardiologist or electrophysiologist. Fascinating!