Today was my first day back to school after being off for over a month. I actually welcomed the routine again! The only drawback was that my body does not appreciate early mornings and I required a 2-hour 'nap' once I got home...

Good day overall, this is my first semester officially being a part-time student, so I'm going to have to adjust to the reduced workload. Not to mention that there is a possibility of the college teachers going on strike for three weeks, so that will force me to get creative with my time.

Tonight I had to do CPT for the first time in months. This is when my Mom "claps" my chest to help loosen secretions. Usually I just use the PEP or Active Cycle of Breathing, but I needed to add a little extra today because I have been hearing and feeling little cracks and pops in my lungs. This concerns me when it is deeper in my lungs because it means I have phlegm stuck--which is an open invitation to infection. So time to step it up and add an extra physio until that is officially cleared!

I have a confession to make. I have become an avid Dr. Oz follower--a shameless habit I developed since it first aired.  At the end of the show Dr. Oz, who always wears his blue scrubs (to add credibility? or auditioning for Grey’s Anatomy?), reveals his three prescription for health tips.

With experience, we have all become experts in tailoring our own prescription for health. We are constantly tweaking and comparing our routines to others in order to achieve our definition of health. CF forces us to think outside the box, outside of the prescription that has been given to us (mind you, CF or not, everyone should do this). Taking our pills and doing three masks and physio everyday, while good, simply does not cut it.

My definition of a successful routine is having sufficient energy to get through my day (though I still savour my 15-minute power naps in the afternoon), staying infection-free and stable (or better).

So I will share with you what works for me at the moment. It’s the ‘prescription’ that has been in full-swing since March 2009 and possibly contributed to my health staying stable and staying off any antibiotics for 9 months and counting. I’d like to believe it’s not just pure luck.

Please note this is on top of my regular health routine, which includes the following:

• Ventolin puffer daily (amount varies, usually 4 puffs, three times daily)
• 2 Colisitin nebulizers daily
• 1 Hypertonic Saline daily
• 2 PEP masks daily
• 1 Active Cycle of Breathing daily
• 8 ESC 8’s (enzymes) with meals
• 2 Losec, twice daily
• 10 mg prednisone daily (steroid)
• 250 mg Zithromax daily (everyday antibiotic)
• Pulmicort (puffer) 3 puffs, twice daily
• Oxeze (puffer) 1 puff, twice daily
• Actonel (once-a-week)
• 2 ADEKS (multivitamin) daily
• 2000 mg vitamin D daily
• 5 mg vitamin K daily

Now to the good stuff, my personal prescription:

SUPPLEMENTS:
Primrose oil 1000 mg, 2-3 times daily
Helps reduce inflammation. I also use it for my skin since I had a lot of redness and acne caused by prednisone.

Fish oil (omega 3s) 1000 mg 2-3 times daily
Helps reduce inflammation and enhances immune system. While fish oil (pharmaceutical grade) is proven to be good for everyone, there are several CF studies which outline specific benefits (but draw NO conclusions). Although I’m not part of a study, I was surprised to read about decreased sputum production...I just remarked on that last week. I have never coughed up so light and little sputum EVER. Coincidence? You be the judge.

DIET:
Reduce preserves
It’s no secret I’ve never been a fan of the old-fashioned CF diet, where the bulk of advice is to drink pop, eat chips and focus on fattening up. Instead I prefer eating meals that are nutritious and balanced--basically the way everyone is supposed to eat. Mind you, it also helps that I currently live at home and my Mom always makes good, home-cooked meals. Unfortunately this has worked slightly against her in that my sister and I have developed pallets that are repulsed by most packaged foods--you know, the ones that have 10,000 ingredients.  But I will add, I do still enjoy the odd bowl of chips :)

There are simple ways to cut out the preserves like popping REAL popcorn kernels (which takes the same amount of time) instead of packaged bags. Packaged bags are more convenient, but packed with unnecessary additives.

Reduce sugar intake
Sugar feeds infection, reduces your immune response, makes you tired and overall is NOT a good thing. Luckily, I naturally do not crave sugary foods, mostly because my parents have never been big fans of sweet cuisine either. However, I DO have a weakness for chocolate and when I’m in the hospital or on a special occasion I tend to get a lot of chocolate for gifts (which I am definitely not complaining about). So I limit myself, maybe 1-2 chocolates a day--which means chocolate can sit around my house for a long time--but I am still able to have a small treat.

As an alternative, I’ve also developed a taste for dark chocolate, which is actually GOOD for you in small quantities because of antioxidant benefits (make sure it’s 70%+ cocoa though).

IMPROVED NEBULIZER REGIME
Our clinic recently starting reviewing with patients how they clean and care for their nebulizer equipment. Well, I thought I was pretty good until I started going through the questionnaire.

Suffice to say, now I have a sterilizer for my masks. I run my masks, pep, flutter and puffer chambers through a sterilizer at least once a week. And of course wash all of the above items daily in soap and water (formerly I had only done the latter step).

I also let my compressor run for 1 minute (or until the tubing is completely dry) after I finish a treatment. This removes the opportunity for germs to take up residence.

ORDER OF TREATMENTS:
Before: ventolin, antibiotic nebulizer then physio
Now: ventolin, physio then antibiotic nebulizer. Which makes more sense since I'm not coughing up all of my antibiotic.

HAND WASHING
Every time I come in the door, I immediately wash my hands. Sounds simple, but it is also simple to forget.

I keep antibacterial wipes in my car, so when I get in my car after a class I use the wipe. When I’m driving home, I do not trust myself not to touch my face, so it’s just easier to get that out of the way.

I also carry antibacterial with me everywhere, I know there are studies circulating about how it is being overused and creating superbugs, but as far as I’m concerned any bug I pick up now will be a superbug to me, so a little caution won’t hurt.

BUILDING UP A GOOD DEFENSE:
When people are me are sick, I figure my best option is to build up a good defense. While clorox wipes and antibacterial will help, bugs will always find the gaps. In order to build up my immune system I take extra vitamin C and extra strength cold FX (when I feel rundown). I also use a saline nasal rinse which, while not the most comfortable thing ever, certainly works well.

ADDING VARIETY TO PHYSIO:
Doing PEP three times a day can be exhausting. So I like to switch it up by doing PEP twice a day and Active Cycle of Breathing at night. Switching up your routine keeps you more motivated and ensures you are targeting all areas of your lungs.

Here is what I’d like to add to my prescription for health:

• Oil of oregano to boost my immune system (warning: I put a few drops under my tongue the other day and it is incredibly potent)
• Exercise on a regular basis. I am good at working out when I’m on vacation, but once school starts up I tend to put it on the back burner.
• Drink more water. I dislike drinking it, especially when it is cold out... so I will make a conscious effort.

This is quite a lengthy post, but I wrote it with the hope that someone is able to benefit from what I have learned. I also hope others will share their own prescriptions!

Well, I made it! Yesterday was my first 3-month clinic appointment in ages and I made it.

What a boring clinic appt. That's the way I like it. My PFTs are holding at a steady 27% (.80 L) which--for those keeping track or taking bets--has been the same since April. My weight is also steady and all-in-all I am a boring, unchanged gal.

The physio therapist who is always enthusiastic and upbeat, taught me a new huffing technique using my PEP mask. For people (like me) who feel tight and asthmatic in the morning, it is a great alternative. It is difficult to explain what a 'huff' is, to those who are unfamiliar, but I will attempt to anyway. Basically you take a breath in (big or small depending on the area of the lungs you are targeting) and breath out through your mouth as if you are saying 'ha' or testing your breath. If you are targeting your lower lobes, you take a tiny breath in and if you are targeting your upper lobes you take a big breath in.

The new technique involves huffing with the PEP mask still on my face. Whereas I usually take the mask off to do it. Oddly, I am eager to try this new technique when my new PEP arrives.

Over the holidays I have been using a device called a 'flutter', since I am a complete genius and decided that Christmas Eve was an optimal time to break my beloved PEP mask. Well, turns out I've been doing my flutter incorrectly over the holidays. Yesterday I learned the correct way and it is far more hardcore than I anticipated. Turns out the flutter can also be irritating for someone who has a lot of tightness like me, so it is not ideal to use anyway.

I ran into my cysta on my way out of clinic and although she looks tanned and stylish, her lungs have decided to behave badly. So she is whipping them into shape with a course of orals before her trip to Barbados. CF lungs always require a good whip to behave again.

In other boring news, I was able to shop after my clinic appt. which is a rarity. My energy is usually zapped by the time my clinic appt. ends and I immediately require an afternoon nap. Not this time, I was able to go to Sherway Gardens with my Mom and shop for 3 hrs (plus lunch).

I think this is an ideal start to 2010.