Bronch Me, Amadeus

     I am having my seventh bronchoscopy today.  I've had a few more than is typical in the first nine months post-transplant, but I have had a persistent bacteria that has been hanging around in my right lung (coincidentally, the same side of my body that suffered the severe pneumonia in 2004).  It hasn't stopped me from attaining a PFT that is considered "normal adult" but, you know, lingering infections are bad on principal.  So, now I have become an old pro when it comes to having a bronchoscopy.  Soon after I have the IV placed in my arm and answer a bunch of questions (no, I haven't eaten since midnight, thanks for reminding me), I'm wheeled back into an operating room.

     I've had a different doctor and a different attending doctor ever time, but the nurses has been pretty consistent.  I inhale a gross tasting (but effective!) mist through a nebulizer which numbs my mouth and throat.  During that time I usually watch the numbers on the screen from the wires they hooked up to me back in the prep room.  From there, the doctors clarify how much sedative to give me, and gown/mask up.  They always ask me what procedure they are about to do, so I try to use all of the doctor lingo I've picked up over the years in that moment.  Once I joked that I could just do the procedure to myself, and the doctor said I'd be the first patient to do so, but not the first MD.  To my surprise, he said that doctors often perform the procedure on themselves with no sedatives and minimal analgesics for practice.  Up until 15 years ago, patients were not consciously sedated as they are now, and he even told me that when he was once in Macedonia, he observed that the common practice was to inject lidocaine directly into a specific area of the neck, often without warning the patient.  I count my blessings every day that I live in the time and place that I do.

     When they have me lay flat on the table, they place a lump under my neck (I've never seen what it looks like) and they always remind me that it isn't a pillow, it's to keep my throat open and head titled back.  Then, the bite blocker goes in, so my precious teeth and the valuable equipment are protected from each other.  This is usually one of the last things I remember.  By this point, the IV is sending some mixture of sedatives in me that make me only vaguely aware of the world around me.  Only once did I feel like I had anything resembling consciousness once the procedure actually began.  Typically, I feel like I simply went to sleep and wake up some time later.  That "some time" has usually been an hour, but once it was much longer than that.  I take a while to regain my bearings, sometimes falling back asleep in the recovery area.  Eventually I am "with it" enough to have the IV removed and be sent home, but not before I am treated to a two-page report with a few photos of my lungs, a detailed, jargon filled description of what they saw, and the doctor's basic impressions.  Any real answers will come once they analyze the fluid and tiny bits of lung that they clipped out during the procedure.

     My wife drives us home, as I am not permitted to do so for the rest of the day.  One time I came home and slept for several hours, and then went to bed really early too.  Perhaps I received a bit more sedative that go-round.  But usually, the day is business as usual after that.  The first meal after a bronch (or any procedure that restricts one from eating) is always so satisfying, no matter what it is.  Today's menu is mounds of leftover pasta from last night, with copious amounts of mozzarella cheese.  Maybe, if this bronch comes back a-ok, I won't need to have another one until my one year transplant-averssary in August.  Here's hoping!