Pros & Cons of Pregnancy - 1st & 2nd Trimesters

So many people ask me how I'm doing/feeling on a daily basis, and throughout this whole pregnancy I've been so fortunate to answer "great" every time! As this pregnancy progresses, I wanted to make a list of the things I love about being pregnant, and the not-so-fun things about it, too.

Pros:

• My health has been amazing during this pregnancy (aside from in February when I got sick). When I have been sick, I've been lucky enough to have several treatment options (Tobi, Kalydeco, Cayston) at hand that helped me get back to feeling good again.
• Putting on weight hasn't been as much of a struggle as I thought it would be. This could be the Kalydeco helping out, or just my body responding well to pregnancy -- either way, I'm very happy this hasn't been an issue.
• I love my belly! I'm not one to take pictures of it without my shirt over it, and you'll definitely never see me in a bathing suit this summer, but every time I walk past a mirror, I love what I see. I don't feel pregnant, so I often forget what I look like to others. This belly is a constant reminder of the struggles that we overcame to get to this point and how lucky we are to be going through this experience.
• One perk of being high-risk is monthly ultrasounds! I love that I'm able to see Baby Girl's monthly development instead of just reading about it. It's absolutely amazing to see how much she changes in just a short amount of time.  
• Baby movements! This one might be the best! I felt the first movements right at 20 weeks and have been obsessed ever since! The first little nudges were great, but the bigger and stronger she gets, the more fascinated I am with feeling every little poke, body role and whole-body stretches and flips. Watching her make my belly bounce is hilarious and I often sit in bed on the weekends after I wake up just staring (and poking) waiting for her to dance around. Although, Tim says I have to stop poking her so she doesn't have brain damage... :)
• Bigger boobs -- who can complain about that?! Aside from having to purchase new bras, I can't complain about a little extra cleavage. I'm sure this one's a pro for Tim, too.
• How could I forget....no morning sickness!! I was very excited about this one! First of all, I hate throwing up, so the thought of doing it for weeks on end killed me. Plus I was so worried about managing my weight, especially in the beginning of the pregnancy, that I was very thankful not to have to deal with any nausea or vomiting.
• I've never really felt tired. I think that the typical fatigue that comes with the first trimester was mostly over winter break when I was just bumming around the house anyway. Now that I'm closing in on the third trimester, I do notice it takes a bit more effort to bend and move certain ways, but I still feel like I have the same energy level.

Cons:

• CFRD & sugars: This one isn't really much to complain about, just a small inconvenience. The first half of my pregnancy, I had to check my blood sugar four times a day (fasting and then two hours after each meal). Since I was able to keep them pretty stable, the doctors let me cut down to twice a day around 24 weeks. This is definitely saving my little fingers from being pricked so much, but watching what I eat is constantly on my mind so I don't spike my blood sugar.
• Lack of carbs: I never realized how much I love carb-loaded food until I got pregnant and very strictly had to watch/control my blood sugars. I cannot wait to go on a carb-binge after she's born! I miss giant bowls of cereal and especially whole boxes of mac & cheese! 
• Leg & foot cramps: These are no fun! In the beginning they were sporadic and usually due to dehydration, but as I get into my third trimester, they're happening several times a week (always in the middle of the night). They're more frequent because my legs are carrying extra weight and my expanding uterus is putting pressure on my veins that return blood from my legs to my heart. My uterus is also putting pressure on the nerves leading from my trunk to my legs. (according to Baby Center)  
• Constantly having to drink water and go pee -- This is true of pretty much all pregnant women. We have to stay hydrated to avoid things like swelling and cramping, but the trade-off is frequent bathroom trips. I've had to start taking my class for an extra bathroom break each afternoon just so that I can go, lol. But thankfully I've only had very minimal swelling and it's only been on very hot days. Can't complain about that!
• Gas and bloating - This symptom came out of no where around week 25 and has been very annoying. I feel like I used to feel before I started taking probiotics - very uncomfortable, bloated and gassy, with extra bathroom trips during the day. At first, I thought maybe I should increase my probiotics, but after talking with my doctor and other CF women, it sounds like my insides are just shifted around and taking an extra enzyme with larger meals has helped a little bit. I'm really hoping this doesn't affect my weight gain.

2013

Here's 102 blog posts from this year summed up into one. This year was full of exciting adventures for Tim and I, the most exciting being that we finally purchased our first home!

• At the beginning of this year, I was presented with the possibility of having CFRD. Thankfully after meeting a wonderful endocrinologist in Chicago, he taught me how to adjust my diet to keep my sugars in check without having to have insulin injections, yay!
• In February, unfortunately I had to reset my compliance count due to lovely mail order pharmacy mix ups. I did, however, proudly complete 100% of my treatments for 352 days!! I reset my count on March 1st, which puts me at 312 days today!
• Also in March, we celebrated Tim's great grandma's 99th birthday, learned about the new CFF regulations (which caused a huge uproar and debate among CFers), and we got the ball rolling on the CF Living video phone interviews and plans!!
• April was a busy month! Tim and I shot our CF Living footage which was harder than I thought, but SO rewarding! I attended another Great Strides in DeKalb, the TOBI Podhaler was released, our kitten, Ozzie, was born, and I started taking the best thing ever = PROBIOTICS!.
• May was pretty uneventful, aside from me finishing up my first year of teaching! Tim celebrated his 27th birthday and we were able to spend some quality time with our adorable nephew, Isaac.
•  In June, we finalized our first house mess, and found a house that we both loved and went under contract on it. We traveled to Tennessee to meet our newest nephew, Liam, and spend time with family. Tim also kicked my butt in Brett's Run!
• July was a busy, fun-filled month! I attended my best friend's bachelorette party, spent lots of time with family, brought Ozzie home, went to Country Thunder and became a home-owner!!
• Our first chapter of our Day in the Life series finally came out and I was so surprised and humbled by all of the amazing and supportive feedback. I also started my second year of teaching - this year in first grade. And of course, started taking Kalydeco on August 30.
• In September, Tim and I continued to work on our house, we did our annual camping trip with his family which is always a great time, and we attended the most love-filled wedding I've ever been to - Jessie & Jeremy's wedding. :-)
• October is always special to me because its our anniversary month. We celebrated our third anniversary this year and we're not just married anymore, but we're now married home-owners! Tim and I also went to the Peoria Great Strides which was excellent! I was asked to speak there and we also met my blogger, CF friend, Cheriz. Finally, I had my first post-Kalydeco clinic visit where I gained 6lbs, my FEV1 increased by 5% and my small airway lung function went up by 18%!!!
• In November, Tim and I conquered 58 flights of stairs at our first CF CLIMB! Then I signed us up for the CF Rock Rivers 5K in Michigan in March, put on by the lovely Emily Schaller.
• December was full of ups and downs, and sadly ended on a very low note. We lost our great friend Jeremy on December 31. We celebrated his life in Ohio with Jessie and his family the first weekend in January, and I'm very glad we were able to attend to say our 'see you laters'.

I feel like things can only go up from here and I need to keep that positive attitude. Here's to a happy, healthy, productive and positive 2014!!!

CF Awareness Month Blog #13 - Medical Terminology

Bronchiectasis

Another list of medical terms that probably means nothing to non-CFers, but things that I'm so used to that I don't think twice about some of them. My adult CF doctor is so wonderful about explaining to me the ins and outs of how my treatments work, why I'm on specific medications, and what exactly is going on with my body.

Bronchiectasis: A fancy way of saying scarred/inflamed airways - at least that's how my doctor explained it to me. This occurs from chronic lung infections, typical in CF patients.

Burkholderia Cepacia (B. Cepacia): A bacteria that can get into your lungs which is typically resistant to most antibiotics. I do know that any CF patient who carries this bacteria is asked not to attend any CF related events, such as Great Strides. Definitely something I don't ever want to get!

Tobramycin: Antibiotic used in patients with pseudomonas. I'm currently on TOBI which is a nebulized form every other month so that I don't become resistant to it. I remember when I first started it how much I hated the taste of it. Now it makes such a positive difference in my lungs when I'm on it, I don't even think about what it tastes like.

Hemoptysis: Coughing up blood or bloody mucus. This has happened to me and the first few times it was very scary. Thankfully I've learned to back off my treatments if it does happen, and that unfortunately, it's just something that happens every once in a while.

Hyperglycemia: High blood sugar levels. CF patients are at a higher risk for developing CF Related Diabetes due to scarring in the pancreas and its inability to produce insulin or regulate insulin. This is something that I'm currently considered 'borderline' for. I've been monitoring my blood sugars, keep exercising, and I've made some major adjustments to my diet to help control my sugars. Anything I can do to avoid insulin injections!

LONG Day!

Here's a (long) play-by-play of my visit to the University of Chicago today....well, it actually started yesterday. (Scroll down to the bottom for a very shortened version)

I know I add a traffic picture to a lot of my clinic posts,
but I forget how much I strongly dislike
going-in-the-city-expressway traffic.

Yesterday, after work I set up everything for the sub today, went home, packed my car with all of my crap for an overnight & clinic visit (treatments, medical records, snacks, change of clothes, etc) and headed to my parents' house around 5pm. I arrived at their house around 7:30, ate dinner, chatted with my parents, did my treatments, took a shower and went to bed, only to be up by 5:15am to do my treatments and eat again. Thankfully, my parents house is much closer to the hospital (only about 45 minutes without traffic) so I left their house around 7:15 for my appointment at 9.
I got to the hospital around 8:30 and went to the Endocrinology wing. Surprisingly they got me in a room before 9, but don't get too excited, because of course I didn't see the doctor until almost 10. This was the first time meeting this Endo. and he was wonderful! He listened to me (which didn't happen the last time I saw an Endo.) and I learned a lot from what he explained to me. Basically, since I retested on Monday and the test was pretty much normal, I'm still not considered CFRD (yay!). I'm still borderline. Also, since I've been testing my blood sugars for the past couple weeks, we noticed that I've had a few low sugar times - mostly between breakfast and lunch when I can't fit a snack in at work- so he said he wants me to work on controlling the lows before we address the highs (which I don't have a lot of at all).
My next steps include adding more high-protein, high-fat/calorie snacks into my daily routine, especially during the school day. This will hopefully help keep my sugars more regular throughout the day. I also need to try to add more protein to my breakfast in hopes that I don't get low so quickly before lunch.

This is the poster I stared at for an hour and a half
in my room while I waited to see the doctor. It's a great, simple
explanation of CF lungs. :-)

I finished up with the Endo around 11, just in time for me to go one floor down and check in for my CF appointment at 11:30. They took me in close to 11:30, checked my vitals and I sat in the room until about 1-1:15 until I saw the doctor. In that time though, I did do my PFTs. Going into it I was feeling good. I was a little worried that since my weight has dropped (109.4 today - yikes!) that my lung function would go with it since they usually go hand in hand. But, I was feeling really good, so I was hoping for the best. The first one felt good and when I looked up at the screen, the first number I saw was 79 and was super bummed! And I said, "Oh man! I haven't been that low in a long time!" And the RT looked confused at my reaction and pointed to where I should have looked...the beautiful number: 86! YES! It's not a significant change, but I'll take it! I was so excited. So I did the test again (we always do three) and I blew an FEV1 of 88! Coughed a little bit and said, "Alright, lets go for 90." Well, this one wasn't as great and turned out to be 84. The RT said that I was getting too tired and we stopped there. My FEV1 averaged out to 86% - woo hoo!
My CF doctor was very happy with my results. She said that my graph looked very "pretty" and NORMAL! We discussed my weight loss and attributed it to me burning more calories at work, not in-taking enough calories throughout the day and some malabsorption issues I've been having with my enzymes. We decided to try switching my enzymes to Zenpep to see if that'll help me absorb more calories along with eating more during the day. Other than that, she was very pleased with my health and agrees that I'm still borderline CFRD.

The view of the sunset on the drive home :)

I left her office around 2:00, went straight to the lab to get six vials of blood drawn, then back to the Endocrinology department to meet with the diabetes educator so she could show me how to give myself insulin shots if/when the time comes for me to need that. We figured it would be better for me to learn now, just in case we decided I need it later, then I wouldn't have to schedule an appt with her (3 hours away) just to learn how to do it.
Around 2:45, I went down to radiology to get my annual chest x-ray. Of course I got stuck with the technician who didn't know what they were doing, so he had to take a couple extra shots and ask for help a couple times. My last stop was to pay for parking at 3:30! That's seven hours at the hospital! Needless to say, it was a LONG day. Plus, don't forget the 3 hour straight drive home. Phew!

Here's the short version:

~365 miles of driving

~7 hours of driving

~One tank of gas

7 hours at the hospital

Several hours of waiting

$18.00 for parking

109.4 lbs

No CFRD

86% lung function! = LONG, excellent clinic visit for me! :-)

Another Glucose Test

Just the sight of this picture is making my
stomach turn, eww!

I'd love to say that I took advantage of my day off today by sleeping in, but of course not. I was wide awake this morning at 6am, so I decided to go in early for my Glucose Tolerance Test. The lab is open 6am-6pm on weekdays, and I was planning on sleeping in a little bit and going in whenever I woke up, but of course this morning I was up before the sun. I figured I'd beat the crowd (if there is one at a hospital lab) and just go get it over with. I arrived at the hospital around 6:30, got registered/checked in and had my first fasting blood draw around 6:50am. My blood sugar was 109 (good!) and then I had to drink the lovely glucose drink...this time it was lemon lime flavored -- tasted the same as the others: nasty!

I decided to wear a mask while sitting
in the waiting room for two hours. I
definitely got some weird looks, and no
one sat by me, but I was being cautious.
I was not taking a chance at catching
this nasty flu going around!

This time I was smart, for my two hour wait, I brought a bunch of laminated stuff for work that needed to be cut out. The people in the waiting room probably thought I was crazy, but at least I was getting some work done! Around 8:45, I took my own blood sugar (because I wouldn't get the results from theirs) and it was 137, which I believe is good. So unless it spiked or dramatically dropped over the next ten minutes, this test was more normal than the one I had in November. The fasting sugar was a little high, they like it to be under 100, but at least the two hour was not as high as it was before. I'll be going in this afternoon or after work tomorrow to get a copy of the results to bring with me to my Endocriologist and CF appointments on Thursday. I'm interested to see the Endo's take on the results of this test compared to the last one, plus with the results of my sugars that I've been recording for the past couple weeks. Stay tuned :)

Positive Throughts Thursday

Sometimes I feel like I use this blog to vent/complain about things going on in my life, and I don't want to continue with all of that negativity. So each week I'm going to compile a list of positive, happy, lucky, fortunate things that are going on in my life, or anywhere in the world.

• Saturday was in the mid-50s and it was awesome! Tim and I went outside and played catch in the backyard, opened the windows and enjoyed the spring-like temperatures. :-)
• One more week til my CF clinic and Endocrinologist appointment in Chicago. I'm looking forward to talking with my doctor after not seeing her for six months. I'm also looking forward to getting more answers on if I'm diabetic or not.
• I'm lucky to have a day off on Monday so I can get a repeat Glucose Test without having to miss a day of work.
• My students are hilarious and I missed them. They may be testing my patience a little bit this week, but I'm so happy to be back at work.
• I'm going to Country Thunder this summer and super excited!!! 
• I'm currently listening to this song and I love it!

CFRD Follow Up

1/3/13 - See this post for the first part of the story

I had an appointment with an Endocrinologist today at a clinic closer to home. I thought it would be a good idea to get the opinion of someone a little closer (45 minutes away instead of 4 hours away where my CF clinic is). Well, the problem with that is their specialty is diabetes, not CF related diabetes...
I was a little frustrated because the first doctor couldn't find my latest Glucose Tolerance Test (GTT) results, which made me think she had no idea about me before even coming in. Then while she was searching the computer for the results, she asked me if I had any medical problems...uh yeah...which then confirmed that she knew nothing about me before coming into the room -- that just annoyed me. Anyway, she said that my A1c - don't know what it stands for, but I know its about your blood glucose - was 5.5. I was always under the impression that I wanted to keep that under 6, so I felt that was good news. When I asked the doctor about this, she said that the "normal range" is somewhere between 4.8 - 5.2 or something like that, so mine was slightly elevated which means I'm "pre-diabetic". Okay, great, no diabetes - wrong. Then she said that since my fasting blood sugar was 219 last time, and its supposed to be between 140-160, that means that I'm diabetic.

So, I'm under the impression that I'm just borderline diabetic?? They weren't very clear.

Either way, the first doctor wanted to do a physical exam (check neck, stomach, listen to my lungs, etc) and was surprised by my stomach scars and made a comment about my clubbing. I don't think she's ever dealt with a CF patient before... She told me that they'll probably start me on Metformin to help regulate everything and have me start checking my blood sugars at home. When I told her that I already talked to my CF doctor and she told me Metformin usually doesn't work for CF patients, the Endo pretty much ignored me and said that we'll try it anyway. She said, "Well you take oral antibiotics and those work? So we'll just give this a try." I just smiled and nodded.
I'm not trying to be rude, but I just don't like being seen by people who have no idea about CF or CFRD. This is something completely new to me and I just wish they had some CF background! 

Try and get that ridiculous song
out of your head now! :)

She then left and came back with another Endo who basically said the same thing. Since my 2 hour fasting blood sugar was so high, I'm considered diabetic. He would like me to get retested (good! - not sarcastic) to make sure this wasn't just one abnormal test, but he did say that the next test will probably come back abnormal, too. So, while I'm waiting to get my next GTT, I have to check my blood sugars twice a day, everyday. The nurse then came in with my new medical equipment, which you may recognize: Accu Chek Nano. The nurse did an awesome job showing me how to use my new friend and told me that she liked this one much better than another one she showed me because "its sexier".... Again, I just smiled and nodded. Haha!

These Endos want me to check my blood sugar twice a day, everyday and fax them the results after about 4 weeks. They also want me to get re-tested and follow up with them in April.

My plan: I'm going to check my blood sugar twice a day, everyday, until my appointment with the Endo from University of Chicago in a few weeks. This will hopefully give me and the U of C Endo more information about my daily sugars. I'm also going to schedule my next GTT as soon as possible (fingers crossed that I can get it at U of C on the day of my appts -- that's wishful thinking!). We'll see what my CF doctor and the Endocrinologist say in a few weeks...but I see this Accu Chek and I becoming close friends...

CFRD

11/30/12 - This was originally written on this date, but I wasn't sure if/when I wanted to share this on my blog - especially until I had more information. Look for the "follow up" story in the next day or so.

I saw this on Facebook and I just couldn't stop cracking up! 

Of course about a week later, I was told that I might be developing Cystic Fibrosis Related Diabetes (CFRD). But before I get ahead of myself, let me explain. For the past couple years, I've had to get Oral Glucose Tolerance Tests completed to see if I was developing CF Related Diabetes. Having CF makes me more likely to develop diabetes. And I don't think it's Type 1 or Type 2, which is why they've called it CFRD.

Anyway, I had my most recent GTT completed in the middle of November at a local hospital instead of going all the way out to Chicago to my CF clinic. I've been getting them done in the winter for the past couple years and I knew that I was due for one soon. Since my CF clinic appointment got pushed back til January, I figured I'd get my testing done before I went so that we could discuss the results at my CF appointment. The test goes like this: Fast for 8-12 hours, get my blood drawn/blood sugar checked, drink a nasty glucose drink (this time my flavor was Tropical Punch - more tolerable than the Orange), wait two hours - no eating or drinking those two hours, then get my blood drawn/blood sugar checked again.
My fasting blood sugar was 101 and I went and sat in the waiting room for two hours. Then she calls me back to take my 2 hour blood draw and when she tests it, she goes, "Woah, that's high." So I got a little concerned and asked, "What was it?" And she said, "Well, I'm not really supposed to tell you." How can you sit tehre and say out load 'woah, that's high' and expect me not to be curious?! So she looked around (I guess to make sure no one would hear her) and she said that it was 219 and it's supposed to be under 125 if I remember correctly?
So, she started asking me how I was feeling and was totally freaking me out. She told me that I couldn't leave yet because she wanted to check with a doctor to make sure I was okay to leave. I told her that I felt fine, and that I was just a little bit hungry. She looked at me and said, "Oh, you're hungry?" (Note to self: don't tell a really worried, uninformed phlebotomist that you're feeling ANYTHING, even just a little hungry.)  Anyway, she found the on-call doctor and explain my sugars to him and he said that I was fine to go. They were going to fax the results to my CF doctor and a nurse would call me tomorrow to discuss these results.

The next day a nurse called me and explained that I might be "hyperglycemic" because I have high blood sugars. She said they'll probably put me on Metformin (an oral pill), which is typically what they give patients with high blood sugar. But she wasn't completely sure because she didn't know how it would interact with all of my CF medications. I told her that I'd talk to my CF doctor about it and let her decide since she knows me and my CF much better.

A few days later my CF doctor called me and we talked about the results. She explained to me that I'm "not falling apart" and not to get worried. We kind of knew this was coming because the past couple glucose tests were borderline high. She said she wants to set me up with an appointment with an endocrinologist at the University of Chicago (where my CF clinic is) to discuss my results. She's said I'll most likely not go on the Metformin that the nurse suggested because since it's an oral medication, my body already has a hard time absorbing things, I'll most likely have to go on injections -- yikes!!! That totally freaked me out!! But she said we won't know anything for sure until I see the endocrinologist. I'm currently waiting for that appointment to be set up, which will either be the end of December or the same day in January that my CF appt is on. But my CF doctor explained that if/when I get my sugars under control, it can help with weight gain and lung function = bonus! It got me wondering if this sudden weight loss is possibly due to CFRD? Hmm...guess I'll find out in the next couple months....I hope.

Compliance, Doctors, Exercise & Great Strides

First of all I want to say how excited I am that I hit 200 days of compliance with my Vest and nebs yesterday!! Of course the past month or so there have been a couple days where I've only done one treatment in a day, but that was because of my little bought of hemoptysis which I'm happy to say has been gone for a while now. I'm still counting those days as being complaint because I was following doctors orders!

Today has been pretty eventful so far and it's only 3:15. I had the day off work today due a teacher institute day, so I've been taking full advantage of it. I woke up at my usual time of 5:45 today because I had two appointments this morning beginning at 7:45. I got my treatments done, finished my '30 days of blogging' post, got dressed and headed out the door. I had to be at the local hospital at 7:45 to begin my oral glucose tolerance test at 8am. This is a two hour test that tests for diabetes. Patients with CF have a higher chance of getting Cystic Fibrosis Related Diabetes, so my doctor wants me to get checked annually to make sure that I'm not developing CFRD. This is the second time I've had this test done and I'm really not a fan! I had to fast for 12 hours and if you read my post about irritating things, you'll know that you shouldn't mess with my food schedule. I couldn't eat breakfast this morning before the test, so I wasn't a happy camper, but I survived.

Just looking at this is making my stomach turn.

First they make you give a urine sample to make sure there's no sugars in you, then they take your blood and make you drink the most disgusting "orange" flavored glucose drink. (Every time I burp, I still taste that nasty stuff!) Then an hour later they take my blood to test my blood sugar, and then after another hour they take my blood one more time; so that's three pricks in three hours. The last time I had this test done, I think they had to poke me about 7 or 8 times because they kept missing my veins and I was not happy! This time, the lady was awesome and only had to stick me three times. They should be faxing the results to my doctor this afternoon and we'll discuss the results at my next clinic appointment in the beginning of March.

My second appointment this morning was to get a bone density (Dexa) scan. I've had this test done a couple times in the past also and it's to make sure that I am not developing Osteoporosis or the milder form called Osteopenia. I think it's kind of like an x-ray, but there's no vest or anything that I had to wear. I just had to lay down on the table and the machine scaned my legs/hips - very easy. A few years ago when I had it done, the results showed that I had Ostepenia so my doctors put me on 2 calcium + D vitamins a day. I had the test performed in December 2010 and it showed that I had normal bone density! I didn't get the official results from today's test yet, but I took a peek at the technician's screen and it showed a little mark in the green area, so I think my bones are still going strong!

After I left the hospital I met with Michelle from the Cystic Fibrosis Foundation who is in charge of the DeKalb Great Strides walk this year. We talked about the progress being made about local sponsors, donations and how many people/teams are signed up so far! Looks like we're doing great so far with everyone signing up, but now it's time to focus on bringing in those donations and getting some companies to donate/sponsor us for the walk. I'm really excited about the progress we're making, but there's still a lot to be done. I'm planning on going around the town on Monday to a couple different businesses to see if I can get some more sponsors and donations. Oh, and for those of you on Colleen's Friends & Family, the t-shirts arrived today in the mail, so I'll be getting those to all of you shortly. :-)

And because all of that wasn't enough, I decided to take advantage of the above-average temperatures today (about 50 degrees) and go for a run outside. I ran/walked the Great Strides route which is about three miles. It was harder and much windier outside than I thought it was going to be, but it still felt really good to get outside to run. It was also nice to run outside because I was able to cough and spit while running (sorry to be gross, but it's true). When I run in the gym, if I cough and bring up something, I usually just have to swallow it because I don't want to gross out the other people there. Running outside was excellent airway clearance and I think because I was running against the wind at some points, my lungs worked even harder than on a treadmill. I'm still going to keep running at the gym, but I'm going to try to keep increasing my outside running time each week, until it's warm enough to always be outside, to get myself ready for my first 5K. I've found a 5K in a local town that I want to sign up for that's June 16th - so I've got about four months to get my butt in gear!