One of my diagnostics for this hospital stay was a broncoscopy. This was my first broncoscopy and so I thought I'd share my experience.
Because the broncoscopy required sedation, I was given the "nothing by mouth" (NPO) order the night before the procedure. Since I was only on full fluids at the time, it wasn't too difficult to go without food.
My broncoscopy procedure began with medical staff verifying my lack of drug allergies and taking my vitals. Then they began me on an inhaler filled with lidocane. The purpose was to numb my esophagus and lungs. It took 15-20 minutes to complete the lidocane inhaler. The aerosol tasted awful and also caused me to cough. While I was on the inhaler, they began giving me IV sedation medication (I believe the started me with the Versed).
As far as I know, the medical team used Versed and Demerol for my "waking" sedation. Normally I remember some of the procedures when only these two drugs are used for sedation, however, after initially losing consciousness, I don't recall anything before I woke up in the recovery room.
What I do recall before falling asleep was being wheeled into the procedure room. They had the broncoscopy equipment set up in front of me and I could see the screen which would display what appeared in the broncoscope. The nursing staff leaned me back to about a 30 degree incline and that's about all I remember.
The pulmonologist mentioned that they did not notice anything abnormal in my lungs with broncoscope.
When I recovered from the procedure, I did not suffer from coughing fits (although I'm told this is a common side-effect of the procedure). Because I had abdominal surgery a few weeks before this hospitalization, the small amount of coughing I did experience was more painful than normal.
During the procedure, they performed a "wash", "brushing", and "biopsy". The wash / flush just rinsed the tissue with water which was suctioned up and then cultured. The "brushing" took a brush and brushed the lung tissue and then this tissue was cultured. The "biopsy" inserted a needle into the lung tissue and withdrew a core sample of tissue at one of the sites indicated by the chest CT scan. Then this core was cultured for organisms.
The first two of these samples did not culture any foreign bodies. However, the biopsy tissue did culture an organism and this was also the Cryptococcus Neoformans.
Infection with C. neoformans is termed cryptococcosis. Most infections with C. neoformans consist of a lung infection. However, fungal meningitis and encephalitis, especially as a secondary infection for AIDS patients, are often caused by C. neoformans making it a particularly dangerous fungus. Infections with this fungus are rare in those with fully functioning immune systems.
The NIH's comments on C. Neoformans include these comments:
Cryptococcus is one of the most common life-threatening fungal infections in people with AIDS.
Central nervous system involvement often causes death or leads to permanent damage.
Another site indicated that when C. Neoformans progresses to meningitis or encephalitis most people die even with treatment. Most of the people who do survive will suffer from some brain damage. However, in my case there was NO indication that this infection had spread beyond my lungs.
The infectious disease doctor stated that it'll take a minimum of 6 months of treatment for me to eliminate this infection. He also stated that I may never be permitted to use Remicade or other biological anti-Crohn's medications.
Because the broncoscopy required sedation, I was given the "nothing by mouth" (NPO) order the night before the procedure. Since I was only on full fluids at the time, it wasn't too difficult to go without food.
My broncoscopy procedure began with medical staff verifying my lack of drug allergies and taking my vitals. Then they began me on an inhaler filled with lidocane. The purpose was to numb my esophagus and lungs. It took 15-20 minutes to complete the lidocane inhaler. The aerosol tasted awful and also caused me to cough. While I was on the inhaler, they began giving me IV sedation medication (I believe the started me with the Versed).
As far as I know, the medical team used Versed and Demerol for my "waking" sedation. Normally I remember some of the procedures when only these two drugs are used for sedation, however, after initially losing consciousness, I don't recall anything before I woke up in the recovery room.
What I do recall before falling asleep was being wheeled into the procedure room. They had the broncoscopy equipment set up in front of me and I could see the screen which would display what appeared in the broncoscope. The nursing staff leaned me back to about a 30 degree incline and that's about all I remember.
The pulmonologist mentioned that they did not notice anything abnormal in my lungs with broncoscope.
When I recovered from the procedure, I did not suffer from coughing fits (although I'm told this is a common side-effect of the procedure). Because I had abdominal surgery a few weeks before this hospitalization, the small amount of coughing I did experience was more painful than normal.
During the procedure, they performed a "wash", "brushing", and "biopsy". The wash / flush just rinsed the tissue with water which was suctioned up and then cultured. The "brushing" took a brush and brushed the lung tissue and then this tissue was cultured. The "biopsy" inserted a needle into the lung tissue and withdrew a core sample of tissue at one of the sites indicated by the chest CT scan. Then this core was cultured for organisms.
The first two of these samples did not culture any foreign bodies. However, the biopsy tissue did culture an organism and this was also the Cryptococcus Neoformans.
Infection with C. neoformans is termed cryptococcosis. Most infections with C. neoformans consist of a lung infection. However, fungal meningitis and encephalitis, especially as a secondary infection for AIDS patients, are often caused by C. neoformans making it a particularly dangerous fungus. Infections with this fungus are rare in those with fully functioning immune systems.
The NIH's comments on C. Neoformans include these comments:
Cryptococcus is one of the most common life-threatening fungal infections in people with AIDS.
Central nervous system involvement often causes death or leads to permanent damage.
Another site indicated that when C. Neoformans progresses to meningitis or encephalitis most people die even with treatment. Most of the people who do survive will suffer from some brain damage. However, in my case there was NO indication that this infection had spread beyond my lungs.
The infectious disease doctor stated that it'll take a minimum of 6 months of treatment for me to eliminate this infection. He also stated that I may never be permitted to use Remicade or other biological anti-Crohn's medications.
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