Hernia and Aspergillus (ABPA)

Hernia and Aspergillus (ABPA)

 

 When I was 9 years old, I was taking a shower and noticed something concerning. There was a lump sticking out near my groin. It really popped out when I would cough. I had no other symptoms. It wasn’t painful. My parents promptly made an appointment with my doctor and she informed us that the lump was an inguinal hernia and it was caused by coughing. It was nothing to be too concerned about but it would require surgery. I didn’t feel scared or anxious until the very moment I was being wheeled into surgery. I brought my stuffed animal in with me.  The team made him a fake ID bracelet, wrapped gauze around his head and attached a wadded up blue hair protector to it. I think there was one other thing they did but I can't remember. The surgery was a success and I stayed in the hospital for a few days. I remember needing CPT the next day and being worried that my coughing might pop a stitch or open the wound. I would put my hand over the bandage and apply the gentlest pressure every time I needed to cough. The surgeon would come by each day to check on me and see how well the incision was healing. After a short time, I was discharged. My incision healed well and I never had another hernia again.

    In August of 1994, age 12, I was feeling quite ill. A sputum culture showed I had Pseudomonas, Aspergillus, and Staph growing in my lungs. I can’t remember if this was the first time I cultured Aspergillus or not. My brother was also quite sick at this time. He ended up being hospitalized while I was told I could be treated from home. I was put on two oral antibiotics and 30mgs of Prednisone. The prednisone led me to develop a moon face, a large number of small pimples on my forehead, and muscle fatigue. I was unable to get rid of the Aspergillus until I received a double lung transplant. The infection was referred to as allergic bronchopulmonary aspergillosis, or ABPA for short. Aspergillus is a ubiquitous mold found especially in soil and decaying vegetation. I had always loved being outside and could often be found playing in the dirt or leaves as a child, which is where I most likely picked this up. The ABPA would be managed with varying doses of steroids throughout my pre-transplant life along with oral antifungals. I often had malaise; low-grade fevers; wheezy, tight lungs; and flushed red cheeks. The symptoms were always worse during my monthly cycle . I would become dependent on Ibuprofen just to get through my days. ABPA also caused small infrequent bouts of coughing up blood. When this would happen, I would need to sit up and try to stop coughing to let things calm down. It usually happened during CPT, sometimes with exercise, or when I was laying down. As time went on, the frequency of these bouts would increase. The steroids would cause a number of side effects over the years as well. They would cause frequent urination, acne, moon face, mood changes, increased facial hair, muscle weakness, increased energy, insomnia, among other things. Later in life, as my adrenals wouldn’t function properly due to constant steroids, I would become lethargic from the steroid bursts and lose my appetite. It would also lead to bone problems later in life.