Personal Medical Advocacy & The Doctor Patient Working Relationship

As witnessed by this blog, my life has not been easy, especially my medical concerns. My mother, the matriarch of our family, was a classic Grandiose Narcissist with Psychopathic tendencies.  So she never wanted to be upstaged, not even by her child, especially a girl child, when it came to attention seeking for her medical issues. The conditions I and my daughter have run through the female line of our Sicilian family, but this was not yet known when I was a child, so my mother took my medical issues as an affront to hers, and at worst a form of competition. For example, two years after a diving accident left my spin greatly sublexed, and was beginning to cause chronic pain, numbness down my left leg, and black outs at the age of 15, we went to see a chiropractor for the first time in our lives. The doctor looked at our x-rays (mother and I) and told my mother that though her spin was slightly curved, she was in good shape, but I, on the other hand would be in a wheelchair by the time I was 30. Being a dancer and training for a career in dance since I was 8 years old, this was horrible news, to say the least. My mother's reply to this news: "Yes, but what about me, what about me?". The poor confused doctor explained it all once again, emphasizing how well she was despite the slight curvature, and how direr my condition was, and my mother, bless her narcissistic heart, said, "Yes, I understand that! But what about me, my spin looks worse? What about me?"  The doctor, now in shock looked at my mother, than at me, than back at my mother and said "I just told you that your daughter will be crippled in the next 15 years if she does not get immediate treatment for her damaged low back. Doesn't that mean anything to you? You are fine, but your daughter is in need of treatment right away." My mother looked at him with confusion on her face, then suddenly realized how she looked to him, and suddenly tried to quickly backtrack and feign concern for me. This was not the first time she treated my medical needs as an insult to her, just the most egregious at that time. Later, about 2 years or so, she came in, saw me laying on the floor in the living room, stretching, and pronounced that she could no longer afford my chiropractic medical treatments and that I would have to learn to adjust myself. Two weeks later she came home with my older brother, a prodigy on the guitar, toting a brand new electric guitar and amplifier. My step-father was angry, stating that we could not afford the several thousands of dollars the equipment cost, but my mother insisted he needed the upgrade to promote and support his talent. I sat there stunned, finally knowing fully what my mother thought of me and how little she cared about me or my career as a dancer. I never told my step-father, so afraid I was of loosing him as well, should this cause him to leave her and us.

The reason for this sorted story? To show why, and how often, we need to become our own medical advocates. If your family is there for you, that is great, but often those with undiagnosed and/or difficult medical issues either never have or loose the support and advocacy of family and spouses, especially true for women. Study after study shows that when men become chronically ill or disabled, their wives tend to stay with them more times then men do with a disabled and/or chronically ill wife. "Indeed, research suggests that ... women are more likely than men to be victims of what's known as partner abandonment. A 2009 study published in the journal Cancer found that a married woman diagnosed with a serious disease is six times more likely to be divorced or separated than a man with a similar diagnosis. Among study participants, the divorce rate was 21 percent for seriously ill women and 3 percent for seriously ill men. A control group divorced at a rate of 12 percent, suggesting that if disease makes husbands more likely to split, it makes wives more likely to stay" -  http://www.oprah.com/relationships/why-men-leave-sick-wives-facing-illness-alone-couples-and-cancer#ixzz4O2VJaokJ and yes, this also happened to me with my now ex-husband.

So, when we become disabled and/or chronically ill we often have to go it alone.  Not only do we often have to go it alone, we are often forced to fight with doctors, nurses, specialist, insurance agencies, and benefit programs, to receive the best care we are in need of and are entitled to. It took me a long time to both trust myself and to confidently speak up for myself and my needs. I think having a disabled child as well helped with that development. I may have been raised to not fight for myself, but that did not keep me from fighting for my daughter. Before the internet, I spent hours and days in the library combing through medical journals, the professional edition of the Merk Medical Manual, and the PDR (Physicians' Desk Reference of drugs and medicines). I learned a great deal. I became educated in the ways the human body is normally and the ways in which mine and my daughter's were not. Back then if you came into the doctor's office with this type of knowledge you would be pegged as a malingerer, especially if you were a woman, let alone an over weight woman. If you were on welfare as well, forget it, they dismissed you completely. The more educated you became, the harder it was to work with your doctor. I was all those things: educated, smart, female, over weight, and on welfare because I could not work. So what I would do is pretend to be less smart and educated as I was, so as to not challenge the ego of the doctor, and tried to ask leading questions and such, to get us in the right direction. It was both exhausting and galling. The funny thing though is that as the diagnosis and positive results began to pile up, I was still treated like a hypochondriac imbecile by many doctors and other medical professionals, even to this day.

Because of all of this, my daughter and I have learned to interview new doctors. When we had to change our primary after our beloved doctor of 20 years died suddenly, we decided to interview prospective doctors rather than simply trying them out. And yes, we told them they were being interviewed. It set the possible relationship on the right footing from the get go. Our second interview ended up going so well, we feel in love with him, AND he with us. For the past five years we have had a magnificent working relationship. Yes, a WORKING relationship. We are partners in my and my daughter's medical care, and it works wonderfully! And because of the success of this relationship, I have become more confident, even outwardly so, with my knowledge and my autonomy. It is hard to advocate for yourself when you must rely on the good will of your medical team, and it can often become a battle of wills, especially with those medical professionals who are so threatened by you that they are willing to lie, in writing, about you and your condition. This has happened to me and my daughter more than once. I have successfully had such things ex-sponged or circumvented when they have happened, and I advise that you should always challenge such actions, for it will make getting the help and treatment you need easier in the long run.

These days, with the internet, we have access to so much more information, though a lot of it is junk, or badly created. To suss out the good from the bad, stick to medical journals of high repute, that doctors and researchers look and refer to. Pub Med at the NIH (National Institute of Health - https://www.ncbi.nlm.nih.gov/pubmed) and the CDC (https://www.cdc.gov/) are great places to start. From there, there are the New England Medical Journal and Lancet magazines, as well as specialty magazines for each field of medicine and often for particular medical conditions. Often I use Wikipedia to get me started and to give me a general overview. I of course take what I read in Wiki with a large grain of salt, but often the info is good and can give you an overview of what you need to know and can take to your doctor. From there, there are footnotes in the Wiki entries, with links to actual medical journals and reports for both better study, and to asses the accuracy and validity of their claims and studies. Learn about what makes a good research study and what does not. Be analytically critical of all you read, and what ever your medical team claims or says. Do your own research and be armed with well sourced knowledge. Also, if possible, train someone to be your advocate if/or when you are not able to be. My daughter and I advocate for each other all the time. We go to doctor visits together, and to medical procedures as well, so that we can advocate when needed for each other. 

Having a good and honest working relationship with your medical team is paramount to having good medical care, and can even save your life. It is your life, your body, and no one else has any rights over it. Remember that when visiting a medical professional. You need not be rude or arrogant, that is a given, but you may often have to stand firm, and even ask for a second opinion, or to change professionals. Also, your responsibility in a working medical relationship is to stay informed, to be in contact, and to not take your doctor for granted. Most medical professionals went into the profession to help people, but they lack the training in working relationships with their patients. You will need to train them and show them that you can be trusted with such a relationship. Doctors are also human, so treat them as you would a friend or family member with the same respect and kindness, as well as telling them how much you appreciate them and how well they are doing. They need to hear this as well, and makes working with you easier for them. The bond between you and your medical professional can and will become stronger, and the both of you will benefit from it, and so too, will your medical care.    

Why the need to share my life with others

This post was begun last winter, but was never published. Why? Because this last year has been hell on wheels in both good and not so good ways. Last winter and spring saw the joy and stress of a wedding in the family. My niece, to be precise, who is more daughter than niece. This summer was awash in the increased inability to breath, and all that comes with that. And here it is now fall and Halloween is just around the corner. It seems that my life is becoming this roller coaster ride more and more so with each passing year. And since I seem to have a breather at the moment from that wacky ride, I think I should finally post several of the blog entries I have been holding aside till now.

Here is the first, from last winter:

At the beginning of August 2015 I expressed on Facebook, to family and friends, how I had a growing need to share my and my daughter's life with them all. I felt the need to show the reality of it all, the need to be understood. It was scary, and writing about it, creating the list was often like smashing one's fingers in the car door. It hurt. It hurt to see it, write it, to have to pay attention to it all at once. Normally we ignore what is not being a squeaky wheel, and "that" is how we do it. "That" is how we survive. So writing it down, having to organize it all, THAT was sheer pain, emotional pain. And it still hurts. In some ways I am in shock. I keep seeing the vastness of it and mentally shaking my head, saying over and over again "That is not possible! That just can not be real, that can not be our reality! No one could survive that, let alone decades and decades of it!" And I haven't even listed all the endocrine and family Metabolism problems. Yet it explains how I feel now and the quickly growing incapacitate that I am going through. Soon Mulu will have to bath me because that is becoming an issue. She already has to brush my hair because my hands, arms, and upper body are in so much pain, and dysfunction. Most of you do not know, but as a child I was always moving. I danced, and cavorted, stretched, twirled all the time. Even sitting I was in motion. Now I sit perfectly still, for doing so minimizes the pain that is all over my body, even the soles of my feet and palms of my hands, hurt all the time. These days the emotional suffering is as bad as the physical. I cry because I want, need a hot bath, but can not fit in my tub. And if I do manage to sit in it, I can not get out without wrenching my back, and often throwing some of my rib heads out. I often lay on the couch dreaming of hot bath water. Showers, though great, just do not cut it anymore. So it is difficult to see my life diminish more and more everyday, and to do so virtually alone. That, I think, was the impetus to share the reality of our lives with all of you. That is why I am writing this blog.

I have been thinking a lot about all that everyone has posted to me this past week, as I had my emotional melt down. Thank you, by the way LOL. One friend said that looking for a "heart connection" via FB is probably not a good idea. I agree. But that is not what I was seeking, though that did come into it afterwards. What I was trying to do was be seen and to be heard. Do you know how many times I get "But you don't look disabled!", "You don't act disable! Good for you!", "You seem to be handling it well! You are so happy and cheerful! How wonderful!", or even "Well you don't act or look disabled, so it must not be that bad." Now these come from both strangers and friends, mostly unwittingly, and even from doctors and therapists. It seems people have the need to diminish the severity of your condition and life, to look at the bright side, as if you are not already aware of that. It makes them feel better and they think they are helping, or that that is their job at the moment. Denying a person's reality makes you feel better, but only harms the person you are speaking to. Empathy and compassion are more important and helpful than trying to "fix it", unless you are asked to.

So, writing this blog was born out of the realization that my needs are not being met, unreasonable expectations are being made of me, and people get frustrated or disappointed in me for not performing as they think I should, because they are unaware of my actual life. Like when I go to sleep and when I wake and thus have an inconvenient schedule, or how hard it is to be on time because I am fighting massive pain and/or exhaustion, or I simply can't breath and move fast at the same time. I realized that by not opening up about the realities of my life I was doing myself a disservice. It is not about "Oh pity me", though it can feel like that when speaking up, it was and is meant only to make people aware that when I say I need help, that if I do not get help, then what ever I needed help with never gets done. Or I injure myself trying to do it by myself. It is also so very hard to ask for help. I hate it with a passion, but as I get older, I need to. I am also so very tired of having to explain myself, my actions, my choices, and so forth, over and over again to people I know and love. I hate burdening people, but I also realize that my pride also gets in my way when I do not share all this.

Also, another reason for the "dreaded list" is because when people ask you "How are you dong." and you tell them honestly, even just a little, you soon realize they did not want to really know. So I and others like me say "Oh I am fine." Even when we are not, which is usually the case with chronic illness and chronic pain. There is only levels of bad and not as bad, never "fine". I had a friend once who would ask how I was, and when I said that I was doing better they would get very happy. But when I would say that things were bad she would get upset with me, or confused. I finally figured out and asked her if she thought that when I was better, that meant I was "getting over" my medical issues. And yap, that is exactly what she thought. I had to explain that "better" was relative and that I would never really be fine, but that fine to me meant that I was tolerating all that I had to deal with better than usual. After she realized that, our whole relationship change and improved.

So that is my thoughts on all this. And, though it was hard, and I cried more than once, it was good to write that long dreaded list, and a lot of good came out of it because of all of you that replied and acknowledged my situation. Thank you all for that. It got me through it!

The Gauntlet

Everyone has an opinion of what you are going through and experiencing. Some are good hearted and attempting to assist, but often they do not understand that all they are doing is ignoring what YOU say and end up invalidating your own truth. Some just like being in control, or contrary, or simply "right". Some, and these can be the worst, are experts on the subject or in that field or tradition, and they simply talk over you, sweeping away with a irreverent hand your attempts to disagree and convey what it is you are experiencing and what you know. I find this true most often with doctors. Every new doctor I see brings anxiety and stress over the anticipation of yet again training and educating a new doctor. This is particularly difficult if the doctor is just evaluating your condition, such as for a disability claim.

All in all it can feel like you are running a gauntlet between bombarding opinions, expertise, research (or lack there of), folklore, current or old assumptions, that you no longer know what to think or how you feel. At some point you just have to simply trust your own personal learned knowledge and experience when it comes to you and your own body. This is something we, especially women, are usually taught not to do. Often trusting ourselves and our perception of our reality is badgered, even beaten out of us, especially by those in authority, and/or sanctified institutions, like the medical community. Trusting what you know to be true for you is not only important and healthy, but can save your life. No one lives in your body but yourself, and in the end you are the expert, the authority when it comes down to it. Yes, you need to be open minded, flexible, and willing to try new things, but you are still the authority over your life and your reality as you experience it. Nobody else has lived your life, learned what you have learned, been where you have, know what you know, to the deep intimate and viscera level, with you and your body, that you have. Be open to self examination, self truth, and honesty, as well as to the possibility of being incorrect, or needing to learn more, or a different point of view, but never, ever give up your personal authority, and autonomy. That has been a hard lesson to learn for myself, else self doubt, anxiety, and chronic searching outside of your self for the answers, rather than trusting what is with in, will plague your life.

Sometimes living is so damned hard for me ...

Sometimes living is so damned hard for me. Sometimes .... actually quite often .... okay, every day ....... I loose hope, I dread the future, I contemplate leaving this mortal coil, this day in and day out of living life under physical and mental siege, but then something like this comes a long. And even though it is about death, dying, and loosing a loved one, it is also about not loosing sight that life, in general, and the world we live on, is beautiful ...... and maybe, just maybe I will stick around a bit longer and enjoy it while and how ever I can ....... 

https://www.facebook.com/humanthemovie/videos/468301476675049/?fref=nf

The gifts just keep on coming -----

The gifts just keep on coming ----- Spent nearly nine hours in bed curled up in a ball moaning and whimpering over an IBS flair (Irritable Bowl Syndrome) all day Wednesday the 30th. A lot like mild to moderate labor (even comes in waves, last for about one minute to five, with one to two minutes between bouts on average - FUN!). Major difference is that the pain is concentrated at the area of the beginning of my transverse colon, rather than all over the abdomine, as is true for labor. Did Bradley labor contraction technique for the spasms, still works like a charm. After 4 hours trapped in bed with this called my son-in-law, he came feed the cats, fetched me my codeine (risky, this slows down movement in the bowl) and water. Soon after, my daughter came and spent several hours taking care of me: Making sure I had something mild to eat, that I took my insulin, checked my blood sugar (the prednisone I am on right now for the fun visit to the hospital for Asthma last Monday, must be monitored for blood sugar rise every few hours), refilled hot water bottle, listened to me make bad jokes, made tea, and just visited. ..... so upside, got the gift of several hours of quality time with my daughter! LOL

We must count ALL our blessings!  ;-)

Lilith

ASTHMA: Not the emotional, dweebish, nerdy crutch we still think it is!

ASTHMA: Not the emotional, dweebish, nerdy crutch we still think it is. Even the entertainment industry believes and uses the crutch stereotype as a plot device: EXAMPLE - Guy is nerdy, insecure and afraid, finds courage (usually because of a girl/woman, or proving his manhood in front of other males, especially adult males), and at climatic peak he pulls out inhaler, looks at it, gets determined and enlightened look on face, throws inhaler away, and saves the day.

Now exchange inhaler with insulin, heart med, or any other life saving medication with the inhaler (an inhaler is a life saving medication, by the way), and you get what I mean.

So why write about this now, you ask? Well you have probably already guessed:

Since this last August, when the seasonal trees started shedding their pollen and some weeds, like ragweed, did so as well, I went into my annual asthma season, which usually runs Aug- Oct. This year, with the help of smoke from all the fires in the neighboring county of Napa, it never stopped, and actually continued to get worse. Then this past week, it finally hit a critical breaking point. Just before Christmas Eve I started to have problems with shortness of breath, and typical asthmatic wheezing when ever I moved or used my arms, bent over, or basically with exertion of any kind, small or large. By the time Christmas Eve came, it was bad, but I decorated that Christmas tree!Oh yes, I decorated that tree! I was bound and determined to do so. No slowly dying from lack of oxygen was going to stop me and my tree decorating!

Come Christmas morning and afternoon, I spent the day sick in bed feeling unidentifiably sick. Kept fading in and out. Could barely get up, let alone breath very well. By Saturday I was struggling to breath even when I was perfectly still. I could not get enough air into my lungs because I could not expel the air already deep within. It was trapped there, and would not let the lower half of my lungs expand. It was as if my lower lungs were filled with wet soggy cement.

Me being the stubborn person I am, and having lived with this asthma for 50+ years, I kept trying all my personal, at home, treatments that usually work: Using my two inhalers several times a day (Albuterol - a dilator, and Dulera - a steroid anti-inflammatory); Going out into the cold damp air; Inhaling hot steam from a rapidly boiling kettle; Taking a hot shower, and so on. But none were working very much at all this time. Finally late Sunday afternoon, I could barely breath in or out. I even started to black out in the shower at one point from the lack of air, so I tried one more thing: Going shopping in my Wheelchair/Scooter in the damp dark cold air after sunset, and when I got home, I was better.

Though I felt better after shopping, I tried to sleep, but my breathing would slow, then stop, and I would wake every hour or so gasping for air. Gasping for air like that when you are still asleep jars you awake violently. Not at all pleasant. By 7:00 am Monday morning (the 28th) I could not move at all as I lay in bed, for if I did, I would loss my breath completely. I had sent an e-mail the night before to my doctor explaining that my asthma was having a serious flair up, and laying in bed that morning, after many tries, I managed to roll over, grab my phone and text him that I was going to emergency as soon as my care-worker (she, who is the boss of me) came at 11: AM.

Now here is where it gets weird. My doctor's nurse called and said that my doctor wanted me to come to the office for the treatment, instead of emergency, so that he could see me. The nurse wanted to make an appointment or give me the number to call back. I was stuck in bed, unable to move anymore, even to fetch a pen and paper to write upon, and told her so, and that my care-worker would not be here at an exact time. I asked her to call me back in an hour. She never did. Worse yet, hours later, I called the Kaiser advice nurse (after layers and layers of robo phone directions), and was harassed, delayed and even questioned as to whether or not I really had a problem. The hardest part of it was that I had managed, with my care-worker's help, to bath, have tea, and eat, so that by just sitting I could breath shallowly and maintain a low level, but not dangerous, saturation of oxygen in my blood. It prevented me from wheezing, but I had to speak softly and low. I dare not move, because my lungs would seize up immediately. I quietly explained this to the nurse, but she seemed to not believe me, and harassed me about what was my condition, abilities, and that she could not put me through to the doctor's office, and asked me several times why I could not simply go to the emergency. I explained that emergency would just send me to my doctor's office without treating me. Been through that before. Plus he had requested that I come to the office instead. I was trying to do what my doctor advised, but the nurse was fighting me over the need to even contact my doctor at all. As my breathing became a bit worse under the mounting stress, and I was getting upset, and the lack of oxygen was rattling my brain, she continued to argue with me. Finally I gave a weak whaling cry and said that I was on the very edge of screaming from frustration, and could she please just switch me over to the office or call them herself and tell them to call me! Which was my original request when I called 10 or so minutes earlier in the first place! She said that at this point she could only send them a message since they had already left for lunch.  I left a message saying I would go to emergency if I did not get a call back from them when they returned from lunch at 1:30.

In the emergency room, triage basically sets these conditions as priority: heart, lungs/breathing difficulty, bleeding out, head trauma, and acute injuries, the rest are assessed for severity. This nurse knows that, yet she kept me on the phone arguing with me over my simple request, thus risking my life and delaying treatment.

In the end I had my care-worker take me to the hospital and rolled into my doctor's office. I was in one of theose blue wheelchairs Kaiser has, barely breathing or able to talk, or even using my hands. I was now experiencing a bit of hallucination, with dizziness, and some vertigo, and yet I still had to wait half hour to be seen by the nurse, and have my vitals checked. I had hoped to reduce the amount of wait time if I went straight to my doctor's office, rather than going through emergency first. I quickly regretted not going straight to emergency. When the nurse came, we had to go through the procedure of recording vitals, then went to the exam room, talked some more, waited for my doctor, and then was finally able to see him. I had been in the office for approximately 45 minutes before seeing my doctor, and I still had not had a breathing treatment. I knew I was tupdset and worried, and that I was fading quietly away, unbeknownst to anyone around me, yet I did not realize just how upset and distraught I was until my doctor, with his lovely bright smiling face popped into the room from around the door and greeted me. Immediately upon seeing that wonderful face my inner child came leaping to the surface, with a rush of emotion that cried the equivalent of "Daddy is here! He's going to save me!" It took all I had to maintain my calm composure and try not to stand, fall into his arms and cry piteously upon his chest ... I covered it well! LOL   Then, and only then, after we talked treatment options, did I got my breathing treatment. I do not fault my doctor in any way for this. He was relying upon his support staff to asses the situation and my condition. If he had known how serious it was and how quickly I was fading away in silence, he would have treated me accordingly. By the time he came in, I was too sick and fighting too hard to stay conscious, for me to be able to tell him the real condition I was. I was just so happy and grateful he was there that I eagerly worked with him to get to the breathing treatment. When you can not breath, like a person drowning, you become increasingly quiet, seemingly calm, and your movements slow down, because you are using all your strength and focus to get as much air into your lungs before you drown or pass out. Most people see this and do not know a person is drowning, or as in my case, slowly losing their ability to breath on their own at all. This is why having an advocate with you is always a good idea, often a life saver. With the condition I was in, and the deteriorating effect it had on my brain's ability to function cognitively, and to communicate, I was not able to convey my needs and my situation on my own well enough. It cost me time, and possibly many brain cells, and who knows what else, let alone the frightful emotional experience of having it drag out for so long a time before getting treatment what so ever.

Like I said, I do not blame my doctor. I do blame the advice nurse on the phone, with her lack of compassion, understanding, and her argumentative harassment of me on the phone. Harassment that worsened my condition both physically and emotionally that by the time I got to the office I was barely able to hold it together and make my needs known, and put me at a greater risk. I also blame the staff of my doctor's office, though it grieves me to do so. Knowing that I needed a breathing treatment, and that my doctor requested they call and get me in ASAP, they let the matter slip through their fingers by not calling me back in an hour as they said they would when my care-worker was there and could help arrange the visit. They called at 10:AM, I called the advice nurse around 1:30 PM when they failed to call back, and my care-worker had managed to help me get up and functioning. I waited till 2:30 or later before leaving for the doctor's office. From the time they called me, to my arrival at the doctor's office, nearly 5 hours had passed. Yer nearly another hour passed till I actually had my breathing treatment. This was and is unacceptable!

I sat there breathing in the misty medicine of my breathing treatment for about 45 minutes. About 25 minutes in, my lungs, which were still not expanding downward, but only sideways out, below my ribs, and painfully raising my chest to the max, suddenly let go, and I took my first easy deep belly breath since this all started days ago.

My doctor explained that the two inhalers I had were the best (the breathing treatment is a concentration of those meds over a longer single treatment period), and really the only place I could go from here was to take a short limited treatment of Prednisone (a powerful steroid). I was not aware of this limited amount of choices before for severe Asthma, and it worries me still. The problem with taking Prednisone is that one dose sends my blood sugar into the 300 to 400s (100 is normal). As a diabetic, this is very dangerous. My doctor looked at me, and holding out his hands clutched in a fist as if holding something, palm side up, bounced one hand in they air saying "blood sugar", then switching to the other hand bounced it in the air gently, saying "being able to breath", repeated this two more times, stopped, looked at me and said "I think being able breath is the priority here. We can increase your insulin to deal with the side effect of raised blood sugar, but not breathing will kill you." We both laughed (I coughed and laughed actually), and I picked being able to breath as my choice ... I love my doctor LOL.

The long and short of this: Asthma is a lung DISEASE, not an emotional crutch, or just allergies. It often gets worse with age, and is a major killer. According to the CDC: The number of people with asthma continues to grow. One in 12 people had asthma in 2009; 185 children and 3,262 adults died from asthma in 2007.

My asthma is part of a complex auto-immune cluster of disease linked to eczema, and air born allergies (A pandemic of ailments called the "allergic march" -- the gradual acquisition of overlapping allergic diseases that commonly begins in early childhood - http://www.uphs.upenn.edu/news/News_Releases/2011/08/allergic-march/). They had all improved greatly when I went gluten free, but this flair up, the first in a decade, reminds me that they are better, but not gone. I have even had a small patch of eczema flair up during the past month as well, along with the increased asthma.

So when you see a movie or TV show that uses asthma as a character's plot device crutch, or someone besmirches someone with asthma in your presence or social network, PLEASE inform them that asthma is a lung DISEASE and can be very deadly, very quickly, and you can not get over it by simply choosing to and throwing away your inhaler.

Thanks for listening, Lilith