Tag Archive for asthma

Summer 2014: ER Visit #1

So it happened, and on the first day of summer no less.  For three months I was doing “OK” needing no more than one or two uses of albuterol a day until June arrived.  I’m trying to be proactive – I really am.  I made a point to go see my local pulmonologist a little over a week ago.  He agreed I was doing the right thing and bumped up my daily prednisone from 5mg/day to 40mg/day with a slow taper back down to 5.  The past week has sucked.

  • Every morning I wake up with peakflows around 60%
  • I’ve been spending every day at work in shoddily air conditioned offices, but am thankful I’m not having to be in the buildings with no air conditioning
  • Every night between 8pm and 1am things get bad for an hour or so
  • Every night/day things have been getting a little worse
  • After an hour in a hot conference room on Friday I started hardcore wheezing (wheezing is not a common symptom for me)

Last night things started going south around 9pm.  By midnight I had done three consecutive neb treatments in three hours w/o successfully getting my peakflows up above 350.  Liz ended up staying home with the kids and El Cuñado gave me a ride, being the awesome dude he is. As usual, I get there and they immediately put me into a room.  A nurse of some sort was in there and a respiratory tech came in right away to have a listen.  She declared my breaths sound ok, AKA no wheezing, and said they’d be right back to start some meds.

Two hours later the doc came in apologizing for the long wait and immediately told me there was a 50/50 chance I’m not going home because I’m hardly moving any air. I got the standard IV line, solumedrol push, blood tests, x-rays, and neb.  A couple more hours and the x-rays show no pneumonia, the blood tests are good, and my breathing has slightly improved.  Sound familiar?  So at this point the doc comes back and says normally he’d admit someone like me, but taking my history and rock-star-respiratory-system into account, he wants to send me home so I don’t accidentally pick up pneumonia or all the crazy viruses people keep sharing.  And as always, “come back if things start to get like this again.”

El Cuñado takes me home, peakflows are still at 350, I do a little more self-medicating and get a couple hours of sleep, later waking up a sweaty mess and needing more albuterol.  Sometimes I wish they’d just keep me at the hospital because I have a good feeling history will repeat itself.  If my sensible gut feeling proves right, I’d like to get a hold of someone via the physician’s answering service to tell me to head back in instead of wasting a lot of money to do what I could at home in a much more comfortable environment.

Now I just have to figure out what to do about work since I have no sick, vacation, nor FMLA time remaining with which to stay home and attempt to recover.  Next week’s forecast is once again hot and sweaty, and they still don’t have the AC fixed.

Asthma statistics by state

I came across this article from nerdwallet the other day showing:

  • 2012 Adult Self-Reported Asthma Prevalence Rate (%) by State
  • Lifetime Adult Self-Reported Asthma Prevalence Rate (%) by State

I find it interesting that none of the places I’ve lived are in the top states, yet they are neighboring state are places I like to visit.

I wonder if states with high rates of asthma contain environments that are good or bad for asthmatics.  One would think there’s something in the state causing asthma, but maybe it’s a good place for asthmatics to live and that’s why they are there.

With the new regulations for coal burning plants recently unveiled by the EPA and President Obama, it sickens me both literally and figuratively that people are immediately fighting against them because the regulations could affect jobs.  I received a newsletter from a state senator stating just that because for some reason WE CAN’T FIGURE OUT HOW TO ADAPT BY 2030.  I wrote back telling him this is ridiculous and we should be more concerned about the millions of people suffering from respiratory related illnesses than some jobs we can plan and adapt for between now and the next 15 years.

Supposedly this data comes from the CDC, but I’ve had a hard time finding the actual data the article references.  I’d appreciate a link if anyone finds it.

 

 

Summer is back

As a kid summer was my favorite time of year as I got to spend most of my time outside.  It was often full of runny noses, sneezing, and watery eyes…but I had fun nonetheless.  Last summer was my worst asthma-allergy season ever, but I’m really hoping to not repeat it even though they say it’s another record year for pollen.

My week days generally consist of:

  • Waking up at 6AM and feeling awful
  • Turning off my alarm at 6:30
  • Checking my peakflow to see I’m once again at 60-70% or worse
  • Use my nebulizer before taking my morning maintenance meds so I don’t just cough all my Dulera out
  • More lying around waiting for the meds to kick in while constantly checking the time
  • Eventually forcing myself out of bed to get ready for work
  • I then roll into work later than I should but not too late to be a problem
  • Re-check my PF numbers and decide if I need more albuterol after I’m settled
  • Try to act like I feel ok all day
  • Stay late to make up for arriving late
  • Go home, take some meds, lie down for an hour, and remind myself it was a good idea to take a break from grad school for the summer
  • Help out as I can with dinner and getting the kids into bed
  • Ride my bike slowly, really slowly, or not at all
  • Take more meds
  • Try to get some sleep before it’s time to turn my alarm off again

Weekends are more of the same with me trying to rest up enough so I’m not too tired on Monday, and don’t start my week badly.  Liz asks me off an on if I need to go to the hospital, but I’m slightly more than determined not to because I can’t afford to miss work.

May is Asthma Awareness Month

The month of May is Asthma Awareness month, and with an estimated 25 million in the US and closer to 250 million worldwide suffering from asthma, there’s a good chance you know someone with the disease.  Contrary to popular myth, asthma is not curable nor is it something you can grow out of.  For some it is hereditary and for others it can be more of an environmental problem.  With so many people suffering from this respiratory condition, there is also a wide range of symptoms and severity meaning what you consider to be “asthma” may be very different for someone else.  As with other things, it’s good to be aware of what you’re doing that may be positively or negatively affecting others with this condition.  If you’re interested in learning more, here are a few links that may be of interest.

A couple of my online friends are also taking questions for a recorded Google Hangout if there is something specific you’re hoping to know about asthma and how it affects those you know.  Leave a comment on Breathin Stephin’s post to ask a question for their discussion.

New Rx assistance program for asthmatics

I am very fortunate to currently have a full time job and decent health insurance through my employer.  Unfortunately, that hasn’t always been the case for me and there have been times when I haven’t been able to afford all my medications or was rationing what I had to forego going completely without a prescription.  The Prescriptions Assistance Program through Allergy & Asthma Network Mothers of Asthmatics (AANMA) provides patients and their families with discount cards “accepted at more than 56,000 national and regional pharmacies around the country, including CVS, Walgreens, Rite Aid, Walmart, Kmart and Target.”

“We hear far too often from patients who cannot afford their life-saving medications or don’t take the full amount recommended,” says Tonya Winders, AANMA president and CEO. “The Prescription Assistance Program helps relieve a huge financial burden many families with chronic illnesses feel at the pharmacy counter and helps keep families healthy.” A 2003 study published in The Journal of Allergy and Clinical Immunology estimated the annual costs for asthma treatment at more than $4,900 per person.

If you’re interested in joining, all you need to do is visit AANMA’s website.

http://www.marketwatch.com/story/allergy-asthma-network-launches-free-prescription-assistance-program-2014-04-30

New way to diagnose asthma

I came across this article a couple weeks ago about researchers at University of Wisconsin’s Madison campus finding a new way to test for asthma.  One of the difficulties of being diagnosed or treated, is actually being able to replicate your problem in the doctor’s office.  My symptoms are always worse at night time, but when I see my doctor it’s usually between 9am and 3pm.

The Key To Asthma Diagnosis Is In The Blood

I don’t fully understand what the process is, but according to the article they do a blood test to check the levels of neutrophils, a type of white blood cell, in your body.  In the past the process to do this type of test required a large amount of blood and special equipment.

Traditionally, a clinical study of neutrophils required so much blood work, specialized equipment and processing that it was impractical to use in diagnostics. However, UW-Madison students developed the kit-on-a-lid-assay (KOALA) microfluidic technology, which allows them to detect neutrophils using just a single drop of blood.

This is very cool and I kind of wonder how long until I’ll be doing a blood test to check in on the status of my asthma management.  I don’t know if the groups of researchers are working together, but I do know one of the SARP sites is at UW Madison.  This is the quality and type of development being done through the Severe Asthma Research Program and I’m proud to be a part of it.

CPAP as a possible asthma treatment?

I came across this article tonight where continuous positive airway pressure (CPAP) machines are being used to treat asthma

CPAP for asthma – http://www.news4jax.com/news/cpap-for-asthma/25308408

This is interesting to me for several reasons, and it reminds me of one of my ER visits last year where the respiratory techs, there were two working together that night, asked if I used a CPAP and if it ever helps when my asthma is acting up.

CPAP machines are generally prescribed to those suffering from sleep apnea.  They force air into your respiratory tract through a mask that covers some or all of your face.  The air forces your airways to stay open helping the patient to breathe better, sleep better, stay asleep, and keep their oxygen levels from dropping.  Another treatment option for some suffering from sleep apnea is surgery to cut away extra tissue and open up the airways.  While this may work for some, it’s not a guaranteed treatment and has the risk of complications.  This is why using a CPAP machine while sleeping is a relative easy and effective solution.

Many asthmatics take one if not many medications to help control their condition.  Those with asthma often have secondary conditions (such as GERD, obstructive sleep apnea, allergies, high blood pressure, hay fever, sinusitis, rhinitis, vocal chord dysfunction, and anxiety or mood disorders) that work together to complicate everything.  These medications have side effects that can sometimes make one feel just as bad as not taking the medication.  An easy treatment such as a CPAP could be a great solution for some.

I’m not sure on all the details of this study, but being an asthmatic who also has obstructive sleep apnea, I wonder if any of those being studied have both conditions.  The good news is the American Lung Association (ALA) is involved and it sounds like they are looking for people to participate in the study.

ALA Research protocols currently recruiting – http://www.lung.org/finding-cures/our-research/acrc/protocols-recruiting.html

2014 is supposed to be another bad one

Remember last year when they said it would be a bad year for allergies in 2013?  Well apparently it’s going to be bad again this year.  Part of me wants to worry and part of me wants to be all laissez faire about it.  The good news is I’ve had some time to recover from last Spring, Summer, and Fall.  I have by no means rebounded back to normal, but my symptoms are relatively under control, I haven’t been to the hospital in over five months, and I’m not needing eight nebulizer treatments a day.  The real question is what can we (the royal) do about it?  Here’s my plan of action:

  • Continue rinsing my sinuses on a daily basis.  One of my lung docs has told me to do it twice today.  This is an easy way to clear your sinuses without taking meds if that’s important to you.
  • Exercise as much as possible.  I’m back to doing something almost every day.  That can be riding my bike, taking a walk, lifting some weights, etc.  Even if walking to the mailbox is all I can do, at least I wasn’t lying down all day.  As soon as you stop being active, it takes a lot of work to re-activate yourself.
  • Stay on top of things.  Historically I have a penchant for just waiting to see what happens.  I can’t just hope I’ll get better or wait just one more day anymore.  Unless I want to start visiting the hospital again on a semi-regular basis, I have to more actively respond to and plan for what’s happening with my health.

Smoke

From time to time I’ve talked about tobacco smoke and smoke in general.  At times I declare that I hate smokers, when really I’m just having an extreme reaction against the smoke they’re generating.  I truly try to avoid smoking-designated areas and stay in my no-smoking designated places, but when the smoke comes into my safe-zone it’s hard to stay Dude-like.  For example…

This morning on my way into the building at work I started to smell cigarette smoke as I approached one of the side-doors.  I work on a no-smoking campus so people aren’t supposed to be smoking anywhere on the property.  If you pay attention you’ll notice pathetic huddles of people puffing literally feet away from the property line in certain places.  This winter they’ve been reminding me of that I.T. Crowd episode where Jen is still smoking.

Anyway, I really have no option but to breathe in this lung irritant for about 40 feet and then as I get close to the door I see someone left a lit cigarette burning on the stairs.  Because of the placement of the door, overhang and direction of the wind, this cigarette has continued to burn and there’s a giant pocket of smoke trapped at the entrance along with smoke in the entryway being sucked in every time the door opens.

For most this is no big deal.  I have friends and family who would not even noticed the smell.  For the past 4 hours this morning:

  • I can’t breathe in as deeply as before
  • There’s a sharp pain on the left side of my chest below my collar bone every time I breathe in, which almost always means I’m wheezy
  • I’m coughing
  • My voice is affected
  • My sinuses hurt
  • I feel like crap

I got into my office took some meds, have been taking it easy and have taken more meds in the meantime.  I’m in no way bad enough to warrant urgent medical care by any means, but this is what people like me go through just from smelling cigarette smoke for about 15 seconds in their day from a single, abandoned cigarette on the ground where it’s not supposed to be.

Last week I read a post on Asth.ma where Dr. Wu, the blog’s author, was surprised to learn people smoke outside the entrance to the hospital where she works.  This is something I feel like I’ve been dealing with my entire life.  As a kid my dad used to smoke around me, people smoked in planes, people smoked in most businesses, and there were always crowds of people smoking outside of a hospital.  I think I can even remember people smoking inside of hospitals.  The worst situations are when I’m heading to a doctor’s office or going to the hospital for emergency care and I have to encounter this, at times, life-threatening smell before getting inside the building.  I take the risk of sounding whiny here, but it’s really not fair.

The crazy part is other than last night when I saw someone smoking close to this entrance, perhaps the same person who left their cancer-stick this morning, I haven’t even encountered smoke for weeks.  I feel very fortunate to work at a place where smoking is banned.  No one smokes in my household, for obvious reasons, and I can fairly easily avoid smoke when I want to in my town and state.  The hard part is when I’m away from home and traveling, staying at hotels, and flying on planes.  Even though people can’t smoke on planes or in most airports anymore, 3rd-hand smoke from people who were around smokers or were previously smoking is just as detrimental.  I’ve had to ask for a different seat on a plane or move on a bus before due to this.  I understand people have the right to smoke, I just wish there was a way to keep the smoke away.

Some days asthma makes me cross

My breathing problems affect my life on a daily basis.  Every morning when I wake up I take a handful of pills and puffs off inhalers.  I track peakflow numbers and sometimes take note of my oxygen saturation.  I must pay attention to my body and symptoms in an attempt to catch any flare up, attack or exacerbation before it gets bad.  I have to avoid smoke.  I can’t hang out around cats.  I have to stay out of musty/moldy buildings.  I have to limit my activity in extreme temperatures.  I must pay attention to the weather.  I must manage my stress levels.  I can’t let myself become too worn out or tired.

If I fail to stay on track with these things and others things can quickly go downhill for me.  I may not notice right away, but the longer I wait the worse it gets.  My rate of inhalation increases.  I may breathe shallowly.  I don’t always breathe with my abdomen well.  I over-utilize my auxiliary muscles to breathe.  I act irritated about everything.  I become sluggish and less responsive.  I slouch.  I become still.  I quit talking and start using other means of communication.  Oh yeah, and I can become irritable like a 3 year old who desperately needs a nap.

I’ve snapped at my wife, yelled at my daughter, blown people off, acted rude and have probably looked like an idiot at times.  I don’t like being this way and don’t try to act this way.  It’s just what happens sometimes when I can’t keep a lid on it anymore.  That stabbing pain every time I inhale or the constant struggle just to appear like I’m breathing normally without gasping for air in the middle of a meeting.  It can be rough sometimes.  I haven’t had a day where I’ve felt great since 2005 or so.  Invisible diseases are tough.