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 c
onscious, 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
