The wind crashes outside, slamming up against the south end of our house like a mad thing throwing itself against walls, trying to escape its prison. I look outside, and the brances and leaves of the trees next door writhe; drops of rain hammer incessantly against the window, as if trying to break it down by sheer force of numbers. Through the trees and the rain, the light of the streetlamp a house or two down the street is unsteady, flickering like a distant beacon.
The storm has made me restless. I shift in bed, trying to make myself comfortable. Jennifer shifts in response. “Are you okay?” she asks me sleepily, softly as though she were dreaming. “I’m fine,” I tell her. “Go back to sleep.” She rolls over and her breathing deepens again while I wrap my arms around the pillow anew, and try to sleep.
I’m a natural worrier, of course. I hear the wind and the rain, stronger than any storm I think I’ve seen in my fifteen years in this part of the valley, and I can’t help but wonder if that wind will find some hidden weakness in our windows, some flaw undiscovered since the house’s manufacture, and come roaring in through broken glass and ruined floor.
My imagnation works in overtime. It always has. I’ve never been able to help it.
The day before Thanksgiving, I went to see the new pulmonologist. The old one had retired over the summer, which kind of took me (not to mention his staff and the rest of his patients) by surprise. He’d been the one treating my asthma for something like seven years, after nearly ten years of letting my asthma go unchecked while I was in college and for years after college while I flitted in jobs without health insurance.
The new pulmonologist reads over the results of my spirometry test and reviews my medication regime. “Why are you taking Unidur?” he asks me.
“Um,” I reply medically, “I’ve been taking it since high school. I think. Probably longer. It’s theophylline, kind of the basic drug for me.”
“Hm,” he replies. Then a moment later he asks me, “What about the Atrovent?”
I shrug. “That’s another one I’ve been taking for a long time.”
“Ah,” he says. This pulmonologist is a lot younger than his predecessor; hell, he might be about the same age as I am (I remember this as a warning from someone a few years ago: “Just wait until your doctors are younger than you, then you’ll feel inadequate!”). Reading over my chart again and listening to my lungs with his stethoscope, he comes to a decision.
“Let’s cut out some of these drugs,” he says.
“I’m game,” I say. “Which ones?”
“Let’s try the Unidur and the Atrovent. The Singulair’s a reasonable drug for you to keep taking, and the Advair’s really your first line of defense against the asthma. I don’t think the Unidur’s really doing you any good, and the Atrovent’s probably doing nothing for you but complicating your life.”
I chuckle. “Yeah, it’s just one more inhaler to track.”
“Exactly. And how often do you go through your Albuterol inhalers?”
“About one a month. That’s about right, isn’t it?”
He shakes his head. “They should be lasting you about four months. From now on, whenever you feel like you need to use your inhaler, take a peak flow measurement to see if you really do need it. And if you do need it, take another measurement after you’re done, to see how much good it’s doing.”
I nod and agree to this change. I’ve been thinking over the past few months that maybe I’m using the Albuterol far too often when I really don’t need it; maybe it’s become more a psychological thing for me than a real medical need. I tell that to the doctor, and he says, “Yep, we’ve found that that’s pretty common among long-term asthmatics. And you’ve had your asthma all your life, haven’t you?”
I nod. We talk a bit more about my medications and my lifestyle and the fact that my body has probably added GERD to its repertoire of conditions that shouldn’t hit me for another fifteen years or so but which were probably brought on earlier because of my asthma drugs.
After my appointment with the doctor, I chat with the nurse as he takes my blood pressure and prepares me for my allergy shot.
“So I see he’s got you dropping the Unidur and Atrovent,” he says.
“Yep,” I say. “It’s going to be a big pscyhological adjustment for me. I’ve been taking theophylline all my life.”
“Well, it’s probably not doing you any good anyway since you’re taking the Advair. Hell, you’re probably old enough to remember Marax, aren’t you?”
I blink for a moment; Marax was the front-lnie drug for asthma way back when I was a kid. I think I stopped taking it when my age was still measured in single digits.
I laugh. “Sign of the times, I guess, isn’t it?”
“It sure is, Rich.” He gives me my shot and then we start talking about computers and fishing, just like we always do when I come by the office, even though I know more about the first than he does, and he know way more about the second than I probably ever will.
Earlier this week, I got word from San Jose State University that I’ve been accepted into their Master of Library and Information Sciences program. It was kind of funy, actually. On Monday morning I decided that six weeks was long enough to wait to hear, so I had sent an e-mail to the program director, asking when I mihgt hear on the status of my application. I should have just waited an hour or so; my acceptance letter was waiting for me in our mailbox.
And so now I’m a graduate student, well on my way toward becoming a rich and powerful librarian. Jennifer says she’s just as excited, and she can’t wait until she can get away without having to pay any more overdue library fines. Me, I’m really excited. I’m taking my first class beginning in January; just one this coming semester so that I can ease my way back in to the whole study routne. I tell people I can’t wait to begin the process of juggling classes with this full-time job that’s got me on the road so much. Thank God for on-line learning.
Of course, I feel kind of strange in a way, too. Is it right to study to be a rich and powerful librarian when I’ve got a ton of late books sitting on my shelf?
Sitting here and writing this while listening to Celtic music on my computer hasn’t done much to curb my restlessness. While Jennifer was at practice blasting through her oboe, I was at Borders, dosing up on caffeine. It used to be that caffeine, even late at night, wouldn’t do much to keep me awake so late, but that seems to have changed. I told Jennifer that I think that cutting out the theophylline from my medications might have sometime to do with it; theophylline is very similar, molecularly, to caffeine. Perhaps I’d built up a tolerance over the years which has now vanished since I’m no longer consuming 1200 mg worth of it each day in addition to the coffee? If that’s true, it will be useful when I begin taking classes in earnest and need to stay up late to study.
In our computer room, you can barely hear the storm at all. I’ve stepped back briefly into the bedroom to see if it has died down a bit, and it has. I think that I’ll head back to bed now, stay awake for a bit longer reading, and then finally try to get to sleep.