What you see below is a plot of my actual pulmonary function results over a span of 11 years. This is a graphic representation of the decline pattern of my unique case of Cystic Fibrosis. On the graph there are two lines. The blue line shows the Forced Vital Capacity (FVC) and is measured in liters. It shows how much air I can exhale out of my lungs to indicate how much capacity I have. The red line shows the Forced Expiratory Volume in the first second (FEV1) and is also measured in liters. People with healthy lungs should be able to exhale about 85% of their entire capacity in the first second of forced exhaling. Simply put, the FEV1 is the most widely accepted indicator of the lung function in a patient with Cystic Fibrosis, where as, the ratio between the two numbers tells how elastic (or scarred/inelastic) the lungs are, which is also important.
Some Things to Consider When Reading the Above Graph:
The pink line indicates the period of time when I was still riding horses and playing tennis regularly. As time moves forward, I played tennis less but increased my riding. In the end of my riding and showing career, I was on at least one horse 6 days a week.
Between the orange hash marks, I was attending college.
The yellow dots represent the day I quit drinking alcohol.
The green circles represent the day I had my gall bladder removed.
High 3.44L 3/02/02
Low 1.22L 3/16/09
High 2.49L 12/23/03
Low .62L 7/11/06
I was evaluated for transplant in May 2008 and was listed June 11, 2008.
One interesting fact is that I had completely quit doing airway clearance therapy or chest physical therapy just before this graph begins. I didn't even own a vest until September 2005.
I know that the combination of the end of my riding career (the end of exercising) and being away at college (slacking on treatments, drinking, staying up late etc.) had a huge effect on the ability of my lungs to maintain function. Had I known that any of these things would have such a consequence on my health, I would have done it all differently - but what's done is done. The only thing I can do now is share my story so that others don't make the same mistakes!
Lessons I Learned (and I hope you will, too!)
1. Do your CPT, airway clearance, acapella, flutter, vest, whatever you do - just DO it! I spent more time coughing during the day when I wasn't doing these things than I would have if I'd just taken a half hour a couple times a day to sit down and make an effort with whatever method I chose.
2. Get out of breath. Whatever activity that gets you up and moving, something you like, keep doing it. It's much harder to get back strength and function after a period of absence than it is to continue maintaining. If you have to wear oxygen, make it happen.
3. Alcohol in excess is an enemy. It's a Central Nervous System Depressant, meaning it affects your breathing (decreasing the depth and frequency). It may feel nice not to have the urge to cough while you're drinking - I felt normal, like I didn't have CF when I was drinking - but just as with other muscles we don't exercise, our diaphragms lose strength, strength that we need to cough and breathe deeply.
4. Acid reflux in Cystic Fibrosis is common. I never knew my gall bladder could be to blame for some of the symptoms I was having, excessive bloating and shortness of breath (especially after eating). After I had my gall bladder removed, I felt instant relief (once the pain subsided!). I wasn't constantly popping Tums despite taking 20mg of omeprazole twice a day. And I even gained weight, because I wasn't getting sick after eating or avoiding eating a lot because of the bloating. If you're having issues with GERD, ask your doctor about getting some liver blood tests done. If they show abnormal numbers, it might be wise to get your gall bladder an ultrasound.
5. When the doctor says it's time for IV antibiotics and a couple weeks in the hospital - DO it! You don't get 4 airway clearance, all your IVs AND have time to live/work/cook/eat/clean/be a person at home. Don't bother, it's more work than can possibly be done and you're supposed to be getting well! So many times I opted to do home IVs and ended up more run down and tired than I would have been if I'd just gotten admitted. I know it may be difficult to schedule someone to take care of the kids and the house or to miss work/school, but really, everyone wants you around for a long, long time, and if you're not doing all you can to make sure that happens, then you're not only doing yourself a disservice, but you're also hurting the ones you care about most. It sucks giving up the control of your meds and time, to be woken up at all hours, to have a constant stream of people asking you the same questions over and over, to have really really bad food - but trust me when I say that I truly believe it is for the better. The hospital doesn't JUST want your money this time.
6. If the doctor says you need to wear oxygen, DO it! (I think that's my new motto - Nike's not going to sue me are they?) So many times I've been too embarrassed to wear my oxygen in public. I still struggle with it at times or certain places. But, ultimately, it's just going to wear me down and do damage to my heart - the last thing I need is a lung AND heart transplant.
And here, despite everything, I feel absolutely wonderful. I've made peace with the way things are, I don't regret the past, nor do I wish to shut the door on it. I love my family, I have amazing friends and am connecting with so many awesome people in the CF community. If you have a blog - I want to read it! I want to know your stories, share in your problems and work together to find solutions.
I'll leave you with two pictures of me in my prime, doing what I love most in life. One day, after transplant, I hope to be able to return to the show ring.
Right: Columbia, Missouri 2003