Our Boat

Caloosa Spirit

Catalina 42 mkII

Log #91 What I Did This Summer

Well, the ordeal is finally over and the tale can now be told. Of course, in real life, unlike Hollywood drama, no story is ever completely ended, and this one does indeed have something of a “to be continued” at its conclusion. For now, though, we’re satisfied with the current status quo. But in talking about the story’s end, I’m obviously getting ahead of myself. So let me start at the beginning.

A couple of months (or more—I’ve lost track) before returning to Indianapolis, I developed a chronic cough that just kept hanging on. I didn’t feel sick, so I had no idea why the cough would crop up for a day or so, then disappear for a few days, only to reoccur. It was annoying enough to send me to my doctor a few days after arriving in Indy. We always get complete physicals each summer, but mine wasn’t scheduled until August 1, and I decided to look into this condition sooner. A chest x-ray indicated some congestion and possible scar tissue in my left lung (likely from an earlier bout of bronchitis), but my doctor took a conservative approach and first started me on an antihistamine and an acid reducer. Heartburn? Well, not really, but who knew that the third most common cause of chronic cough is acid reflux disease, often absent symptoms? At first I thought the over-the-counter duo was helping, but a couple of weeks later I developed a low-grade fever. Back to the doctor I went and she then prescribed an antibiotic. I soon felt much better, but still the cough persisted. I was due for another chest x-ray at the time of my annual physical.

From August 1 things heated up. The second chest x-ray showed some improvement in my left lung, but not enough to ignore the situation. I was sent for a CT scan. After once almost losing my sanity in an MRI machine and once almost losing my lunch in an injected dye test of some sort, I was more than a little apprehensive about the CT procedure, since it involves some similarities to both of those procedures. But compared to past experiences it turned out to be a piece of cake. In view of the improvement in the chest x-ray, I wasn’t overly concerned about the CT results—until I got a call from a pulmonologist’s (lung specialist) office for an appointment. The next day. Hmmmm. This wasn’t looking good.

The very patient pulmonologist first talked with me about my symptoms, listened to my chest, and speculated that I had a condition called “bronchiectasis”. But he couldn’t be sure until I had more tests. Then he showed us the images from the CT scan and compared them with the chest x-ray. In the middle of looking at pictures of my personal insides and hearing the word “disease” associated with them, I began to feel the weight of my situation. My stomach starting churning and I quickly felt light-headed. Choosing the better part of valor, I asked to sit down before my legs went on strike. So we returned from the radiology viewing area to the exam room where the discussion continued—minus my input. All I could do was sit, listen, and try to keep my stomach in check. I had one of the strangest and eeriest experiences of my life when the voices of Jim and the doctor began to sound as though we were all in a tunnel. Concentration on the topic was becoming more elusive, so I asked to find a restroom, where my intestines finally relaxed their knots. Jim stayed with me (yes, in the ladies room), and he helped me regain my equilibrium. We eventually left the pulmonologist’s office with an appointment (again, the next day) for a bronchoscopy, and the expectation of another test the following week.

I had some concerns about how quickly the doctor was pursuing this diagnosis. Did I possibly have some dire condition (read, lung cancer) that needed immediate treatment? When I had raised that question with both my primary doc and the lung doc, they both had said not likely. In view of my history of never smoking and my relative lack of symptoms, they both leaned toward bronchiectasis (although a disembodied radiologist had speculated about a tumor), but the further tests were needed to be more conclusive. Both docs are aware of our temporary status in Indianapolis, so that could also explain the hasty approach.

The bronchoscopy was a relatively easy procedure to endure—mainly because I was wonderfully sedated. (Such a peculiar experience it is to suddenly be asleep and unaware, and then just as suddenly to return to consciousness.) I wanted no awareness whatsoever of having some mini-camera-on-a-straw inserted through my nostril down into my lung. No, thank you. Anyway, afterward the doc started out by saying, “What I saw was quite impressive.” That sounded encouraging. Then he added, “especially considering your minor symptoms.” There went the encouragement. He went on to say that he saw lots of bloody mucus, inflamed bronchial tubes, and general gook (my term) in my lung. The possibility of a tumor was still real, although he was pretty sure any such growth would be benign. He wanted me to start on Advair, a bronchial inhaler usually prescribed to treat asthma, with the likelihood of adding another antibiotic after cultures he had taken matured. The aftereffects of the sedation kept me from absorbing much more of what he said, but at least I was happy about it!

The next day I got scheduled for a PET scan. I don’t know what the letters stand for, but it has nothing to do with cats and dogs. From what I understand it’s another scanning test that looks for cancer cells throughout most of the body. By now I was starting to feel some depression. Nothing so far had turned out the way I wanted, and I was beginning to worry about the prospect of surgery. I had been reassured that lung cancer caught early was easily cured by removal of any small tumor. Still, I dreaded the possibility of losing part of my lung, the long recovery process, being unable to return to the boat in the near future, and what might ultimately happen to my singing voice. I became listless, and combined with some achiness and a sore throat left over from the bronchoscopy, I was pretty unhappy. My family (including my church family) was completely supportive through the whole ordeal, and they buoyed my spirits greatly.

The PET scan was a long, but not arduous, affair. I was first injected with some radioactive (no, I didn’t really light up) fluid, then left in a dark room in a recliner with nothing to do but take a nap. I was told that brain stimulation by reading a book or listening to music was off limits so that the fluid would circulate evenly throughout my body. My first reaction was “ugh, how boring”, but I did find myself dozing off, and the hour went by quickly. For another hour I had to lie quite still on a table with my arms above my head, as the table passed several times through two donut-shaped machines. Fortunately, my nose never itched and my arms never cramped. There was a point, though, when I irrationally began to wonder if the machine was really working, and would I have to go through it all again! Somehow the fact that the tech running the machine would be able to detect a malfunction didn’t register.

We didn’t expect to hear the PET scan results for a couple of days, and information about the biopsy/cultures from the bronchoscopy was also slow in coming. All the while we were in a kind of limbo where we couldn’t make any definite plans about when we would return to the boat. We were trying to remain positive and still held to our original plan to leave Indianapolis soon after Labor Day, but we also knew that whatever I had wrong had to be treated here. We considered the possibility of follow-up treatment with a doc in Florida, but the reality is that we don’t have a home base there. Also, we both like the pulmonologist that I started with here, and want to see it through with him. Surprisingly, he called the day after the PET scan. Again I was concerned about the haste with which he was following up with me, but his first words were, “You have nothing to worry about.” Apparently the PET scan indicated no cancer cells—wonderful news indeed—so he’s going with the bronchiectasis diagnosis. There may still be a small benign tumor, but it will stay there for the time being. He gave us the go-ahead to return to the boat, with the request that I have another CT scan and probably another bronchoscopy when we come up to Indy for Christmas. I readily made the appointment. I’m to use the inhaler for the indefinite future and he prescribed another antibiotic, with the possibility of more to come.

So, dear reader, if you’ve made it this far in this saga, you must by now be wondering, “So what exactly is bronchiectasis, anyway?” A few weeks ago I couldn’t pronounce the word (bron-chi-EC-ta-sis), but it’s falling easier off the tongue these days. It’s a chronic disease (possibly caused by scar tissue, aspiration, or some other unidentified event) whereby some of the bronchial tubes and passages remain weakened and inflamed. Untreated it can become a degenerative condition as more of the airways break down, so I’ll do whatever it takes to keep it in check. That includes using the bronchial inhaler Advair twice a day, which, fortunately, has already all but cured my cough. That’s the very-expensive-because-of-its-advertising Advair. When Jim returned from the pharmacy with the bill, my first reaction was, “We can’t afford for me to use this stuff!” The $161-price tag is unconscionable, especially since the advertising costs are surely being passed on to the consumer. And that was for just one month! We’re talking possible years here! Yes, I have insurance, but I was told that I would get no coverage for a pharmacy purchase—a relatively new state of affairs. Upon investigation I learned that my mail-order insurance would provide a three-month supply of Advair for the astounding cost of—wait for it—$12!!! How does that work?? Well, upon further investigation (not to mention a few rants), I was told that I had received erroneous information, and that I would indeed get 80% coverage (beyond my deductible, which has surely been met by this time) of my pharmacy-purchased prescription costs. Exhilarating news, especially after the $75-price tag of the antibiotic I also had to buy. I won’t know the true insurance coverage until we see the reimbursement checks, but we’re hopeful that my medications won’t send us into the poor house—since we already feel that we’re on the doorstep. In any case, it’s obvious that mail order is the only way to go for the Advair, so presently we won’t leave Indy until I have that package in hand—hopefully in early September. Considering that I was looking at a month, two months, or more of delay in returning to the boat, an extra week or two won’t be noticeable.

So that’s the story of our pins-and-needles summer. It hasn’t been all anxiety all the time, though. We’ve helped Lauri and Alex do some work on their house and yard. We’ve gotten Mom a handicap placard for her car and a wheelchair to use for family outings. Jim’s follow-up health care visits and blood tests have been positive—well, negative for anything troubling. We’ve enjoyed an outdoor Fourth-of-July symphony concert,
Symphony shell

Indianapolis Symphony Orchestra

a wonderful day at the zoo,
Indianapolis Zoo lion

Indianapolis Zoo zebra

Indianapolis Zoo flamingoes

Family at the Zoo

walks on the downtown canal, bike rides, visits with old friends, our church picnic, the Indianapolis Museum of Art, and lots of family and church time. The weather has been mostly fair with pleasant temperatures and humidity. It’s been good to be here for the last couple of months.

But we’re feeling the need to get back to Caloosa Spirit. We wish we didn’t have boat work looming, but such is life. Jim is still planning to do the bottom job himself. I’m afraid I won’t be much help, since I’m now leery of being around any dust or fumes. While he’s scraping, sanding, and painting, I can work on getting some things done inside the boat to ready it for moving back aboard. We hope to move from Ft. Pierce to Marathon this fall, but otherwise our cruising plans for the coming season are nebulous. We know we have to be back in Indy for Christmas, so we’ll have to find a place to leave the boat then. That’s the extent of our foreseeable plans so far.

Thanks to all who have held us in thoughts and prayers. We miss our cruising friends when we’re ashore and we miss our land friends when we’re aboard, but we are so richly blessed to have all of you in our lives.

Fair winds and a faithful wake until next time,
Alice & Jim Rutherford
s/v Caloosa Spirit

P.S. Our son-in-law Alex is a gem who periodically helps us understand the best ways to use this website. We will now be allowing any comments to appear on the site itself, rather than just keeping them to ourselves. In the interests of privacy e-mail addresses will not appear, however. We always appreciate hearing from any and all.

Posted Monday August 25, 2008

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  1. Jim and Alice, it is good to hear from you, sorry we were unable to see you when you visited with M & L. Alice we will keep you in our prayers, Thankfully the issue has been identified and is treatable. I am sitting here listing to the weather forecast for the East coast of Fl and the Carolina’s. I am not sure I would want to be out there with that kind of weather. Jim, I like the beard. Ashley and Joe are doing well, it’s hard to believe it will be two years since the wedding. Keep the logs coming and stay well, God speed and prayers.

    John and Pat
    — John T. Craig    09/03/2008 10:49 AM    #
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