Tunnel-digging

Spoons are at the ready and I've started digging my tunnel out of here ... which may come as a bit of a shock to those below me as I'm on the 4th floor. Never mind, the adrenaline from the shock it'll give them when I crash through the ceiling might give them just the boost they need to get better ;oP

The consultant, Dr H, came round this morning, waking me from my post-breakfast slumber by joking that, 'just because [I'm] doing an OU degree doesn't mean [I] can behave like a student.' ;oP After feeling completely exhausted yesterday, I'd had a bit of a better night's sleep last night and I felt more alive after my morning rest today, so it was agreed that we'd try to get the aminophylline down today. It's always a bit of an anxious time, because there have been many times when this hasn't been a smooth process and I've ended up back at square one. I was a little more relaxed about it this time though as 'square one' hadn't been anywhere near as critical as it usually is. However, it's still been a bit stressful wondering how things have going to be, but so far so good and the infusion came down at about 3.30pm so I reckon we're in safe territory now :o) This is a major step forward in my recovery and signals that discharge is approaching. In fact, if I can manage to get off the oxygen tomorrow then I may get home on Sunday, which would be fantastic. I know that as usual I'm going to be worn out when I get home, especially as the run up to this admission was such a long, drawn-out struggle, but at least we seem to have beaten the pneumonia bugs and the inflamation that they set up is more under control than it was. My peak flows are still low, with my highest pre-neb PEF today being 130 and my highest post-neb PEF so far today being 210, and they're still rather erratic, but they're going in the right direction. As for spirometry ... well, I don't think they've dared to do them again after the dismal result the other day. Maybe they think I'm better off keeping what breath I have for breathing, rather than wasting it by blowing it down a tube that draws a graph ;oP I don't mind - I'm not a fan of spirometry, because it makes you feel as though your head is going to take off and splat somewhere on the other side of the room while your chest implodes.

I'm really hoping that tonight goes okay without the aminophylline, and it should now that I've been off it a while and have started back on the oral theophylline, but night times are traditionally more difficult for asthmatics than day times. This is in part because of the body's natural cycle of cortisol - the steroid that the adrenal glands produce. The levels of cortisol fluctuate throughout the day, usually troughing between 2 am to 5 am, which is when many asthmatics experience more difficulty. The oral steroids (prednisolone) that I and many other 'unstable' asthmatics take raise the level of the naturally occurring cortisol (a healthy individual produces around 7mg per day) in an attempt to settle the asthma. In theory the dose of prednisolone can be split so that half is taken in the morning - the usual time to take pred - and half in the evening, so as to avoid the night time dip. However, the night time dip plays a role in sleep, and if you muck around with the cortisol/pred timing then you can end up getting very little sleep, which ultimately won't help. High doses of prednisolone can already affect sleep, whether or not the dose is split, and seeing as I'm on a whopping 75mg/day at the moment (!) it wouldn't be a good idea to further compromise the likelihood of good quality sleep that's going to rest my body and help me to get better. So yes, in theory the dose can be split and the night time dip can sometimes be averted, but in practise it is hardly ever done. End of pharmacology lesson ;o)

And now I've forgotten what I was saying before I rudely interrupted myself chuntering on about prednisolone and cortisol ... *scrolls back to look at the beginning of the last paragraph.* Ah yes, it was something to do with getting through the night and hoping it'd be okay now that the infusion is down. I'm sure it'll be fine. I hope it'll be fine. It will be fine. *crosses fingers* [pauses while blood pressure is checked ... it's all fine :o) ] Who knows, now that I'm line free, even if I'm not cannula free, I might even sleep a bit better as I won't be tying myself up in knots and pulling the line when I roll over. Oh, and the machine won't be having hissy-fits and beeping for no apparent reason in the middle of the night. Ahhhh, freedom :o)

Now then, where did I put that spoon? I need it to get back to my tunnel-digging *wanders away wearing a hard hat and looking for excavation implements*