Duke appointment

I saw my transplant pulmonologist (lung transplant doc) today at Duke. It's the first time I've seen him since before my kidney transplant. My lung function studies were a little lower than they were last time, and he is thinking it's because of my sinuses. For post-lung transplant patients who have chronic pseudomonas in their sinuses, it is crucial that we keep it from draining to our lungs. Obviously, if your sinuses are draining, you can't help but get some of that gunk in your lungs, but they want us to do the best we can at keeping it from flaring up and draining. We do this several different ways... irrigating the sinuses, using sinus nebulizers, going on antibiotics when you have a flare-up, and/or having sinus surgery. I have been taking oral Cipro, an antibiotic used to treat pseudomonas for a week now. I see some difference, but my doc isn't convinced it's going to do the trick. My ENT and pulmonologist discussed me having another sinus surgery last year, but chose to get me through kidney transplant first. My doc today told me that he is thinking I'm going to need it done soon. My ENT (who I see on Feb 3) doesn't like to do sinus surgeries in the winter time. He prefers to wait until springtime when the humidity level is up. My doc today told me that if he opts to wait that long, I will probably have to go on IV antibiotics before then to take care of this flare-up. The problem with me going on IV antibiotics of course, is that I have to be desensitized to ALL IV antibiotics, since I am allergic to them all. That requires an allergist consult, a hospitalization, and of course the risk that I will have an anaphylactic reaction to it. I am going to stay on the Cipro until I see my ENT, and we will decide the next course of action then. Again, this next sinus surgery will not be an easy one. They will cut up under my upper lip and go into my sinuses that way. It's a very painful surgery.

My labs looked good today, and so did my chest xray. My doc told me that the EBV test I had done 2 weeks ago showed a low level, but not a level to be concerned about. He also said the "knot" on my arm indicated some kind of trauma/hematoma, so again, nothing to worry about.

Because of my sinuses flaring up, my pulmonologist is all in favor of me lowering my prednisone quickly. I am going to call the nephrologist tomorrow and see about lowering my dose again. He says the quicker I get to 5 mg/day, the better.

Jason is working this weekend, so Casey and I are going to have a "girl's weekend". I'm sure it will involve shopping, movies, and cooking, but not sure what else. :)