Today I had a checkup with my Cystic Fibrosis medical team. I’m a pretty healthy CF patient so I typically only have to go in every two months.
At these regular checkups I typically see the whole team. Today I went in a bit early to have labs drawn, then headed over to the CF clinic. First a medical assistant takes my vitals, then the respiratory therapist comes in to perform a pulmonary function test (PFT). This is the most important part of the visit (to me!), since the Forced Expiratory Volume (FEV1, or “the volume exhaled during the first second of a forced expiratory maneuver started from the level of total lung capacity”) is a pretty solid indicator of how healthy my lungs are. Basically, I take a deep breath, then blow through a tube connected to a computer that measures how hard and fast I can exhale.
Next, my nurse coordinator comes in to see how I’m feeling and update my list of medications, order refills, etc. Then my nurse practitioner comes in to discuss my health in more depth and ask if I have any questions or concerns for the visit. Often I’ll also see the dietician, social worker, and/or research coordinator for the clinic. Last but not least, the doctor comes in to check in with me and resolve any remaining issues or adjust my treatment plan. As you can imagine, this takes a couple hours from start to finish!
Because I don’t tend to have many complications with my CF these visits tend to be pretty simple, with just a few minutes spent with the doctor after the nursing team addresses my questions. I’m really fortunate. In the past when my lung function has been worse these visits become much more frequent, involved, and serious – and sometimes lead to a hospitalization for antibiotic therapy.
For most of my childhood my lung function was around 100% of normal, which is really outstanding for a CF patient. In my teens, predictably, it began dropping into the 90-100% range, and in the last few years it’s hovered between 80-95%. For the last 6 months or so my lung function has been on the low end of that range – around 81% – which has been disappointing. Though it’s still very good for a CFer my age, of course I would rather it be higher.
These past few weeks I had been feeling increasingly worried about this visit. By chance, it fell smack in between my egg retrieval (on Tuesday) and my embryo transfer (this weekend). If for some reason I went in today and had a big drop in my lung function they might recommend that I hold off on the embryo transfer, freezing any embryos and focusing on improving my health through IV antibiotics. That would be especially important because many of the drugs they use – really heavy-hitting antibiotics – can be toxic to a fetus.
So you can imagine my relief when I did my PFTs today and blew an FEV1 of 87%! It’s a lovely jump in my lung function and my team was really pleased with how I’m doing overall. They were so kind and supportive of my IVF plans and everyone wished me the best of luck with my upcoming transfer. It feels wonderful to be going into this with good health and lots of support.
I hadn’t mentioned it on this blog, but I had been so worried this week that I might not be able to move forward with the transfer. It feels like a great weight has been lifted off my shoulders now that I know nothing is standing in my way.
Tomorrow morning I’ll get my next update on our embryos. Yesterday there were nine; I expect there will be some attrition but I just hope we have some strong candidates. If there are a few good embryos but they’re not confident they’ll make it to 5-day blastocysts, we’ll do the transfer tomorrow at 11:00 am. If things are ginning along really well I’ll still get an update tomorrow morning, but they’ll hold off on the transfer until Sunday.
I’ll be back with an update tomorrow!