Tag Archive for asthma

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.

Asthma stats

Did you know 9 people die of asthma every day in the U.S.?  Here are a bunch of asthma stats from AAAAI.  I came across this link while catching the latest at My Life as an Asthma Mom.

February

A lot of things have been happening this past month

  • I had several asthma attacks due to over exerting myself in the snow outside in sub-zero temperatures
  • My prednisone in-take is finally back down to 5mg again
  • I’m finally starting to lose some water weight from the lower prednisone dose
  • I’m not feeling great, but also not feeling awful every day
  • We have a new kid in the house
  • Philip Seymour Hoffman died
  • I heard I might get off the prednisone in 6 to 12 months
  • Jimmy Fallon finally kicked Leno out
  • OLYMPICS

Prednisone:

While I’ve always had at least moderate asthma, there were always a few things that separated me from those with serious asthma problems.  Prednisone was something I had to take every so often, but never longer than a week, two at the most.  Last year I did a taper or two and then have basically been on it since late May.  While it drives me nuts and has some unpleasant side effects, I strongly believe it’s keeping helping me breathe better and I’d rather take these pills every day than end up in the ER on a regular basis like I was doing just a few months ago.  I know some people who have been on prednisone for years and can’t really relate to that.  There’s a good chance I’ll be on these steroids for a while, but at lest there’s a chance I can stop taking them before 2015.

Exercise and activity levels:

You never quite understand exactly what you have until you don’t have it anymore.  I’ve heard this statement so many times, but it’s never rang truer this past year.

  • I used to park half a mile away from my building at work and do the one mile round trip 1-3x a day.
  • I never had to consider just how far away something was on campus before deciding to walk, catch the shuttle, drive or not go.
  • I have to carry a man-purse with all my medical necessities everywhere I go.
  • At some point in time, every day, I feel kind of awful.
  • I try to make plans but often have to cancel them.

I’m trying to walk around as much as possible and not worry too much about doing anything heavy duty.  I think Liz enjoys yelling at me whenever I try to do anything outside.  Last week my local lung doc told me to stop breathing the cold air, so I guess I should probably listen.  Fortunately Spring is on its way so as long as allergies don’t kill me, I’ll be able to start walking outside more as well.

New Baby

Yes, we have a new baby in the house.  I recently listed off a list of possible nicknames for the little dude, but Liz is calling him Neville on the internets so it seems I should too.  Chuck has been great.  She’s very helpful in an appropriate way without bugging or pestering the little guy.  He’s pretty chill and Dude-like, which we appreciate.  He’s also not up every hour all night long so we have been getting some sleep.  While there is a certain amount of stress with taking care of a new baby, the worst is getting busy and forgetting to take my medicine, which doesn’t help at the end of the day when I sometimes crash out of nowhere.

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It’s hard to stay mad at him too long for forgetting to take my meds.  The kid already loves beards.  THE KID LOVES BEARDS.  He also likes taking it easy and folding his arms like he’s in a 90s boy band.

Brandt Died

It was a real shock for me to learn Philip Seymour Hoffman died.  The New York Times posted the story and I learned about it a mere three minutes later.  He was truly one of the few great actors of his generation.  We’ve tried to come up with other actors who are at the same level he was…it was hard to come up with a list of names.  I haven’t been affected this strongly from a celebrity dying since Heath Ledger died, only Hoffman passing is a much bigger deal.  It’s weird to think Jackie Treehorn and Brandt are no longer with us.  I can’t even imagine what kind of roles and performances could have come out of Hoffman in the next 20+ years.

Prednisone refill

This week I had to call up my lung doc to get the prednisone refilled.  When I picked it up the next day at the pharmacy I noticed it has 11 refills between now and Jan 2015.  This either means I’m on the stuff for a lot longer than I want or he’s just tired of the refills.  I’m pretty sure I’m just going to be on it for a while and even though I heartily dislike popping these particular pills every day, it’s a better alternative than trips to the hospital every few weeks.

Last year I was told I basically had three options:

  • Become steroid dependent
  • Look into bronchial thermoplasty
  • Go visit an asthma center and get a full pulmonary diagnosis

Since then I’ve started SARP and have been on prednisone for months.  The good news is I’m at work most of the time and can walk around without feeling horrifically awful.  I still have the occasional setback, but I haven’t been to an ER/ED for almost three months.  I don’t spend all my time in bed or lying down like I used to.  I’ve been able to socialize a bit, cook food I want to eat and do random things here and there.  While I don’t see myself being magically better any time soon, I am seeing very slow and gradual progress towards being not so chronically ill.  I’m really hoping to make some strides this winter and stay away from flu/pneumonia in order to not be knocked off my feet when allergy season starts up again.

Shoveling Snow

…is probably the most stupid thing I’ve done so far this year.  Many of you experienced the snowpocalypse that encompassed a major portion of the country last week.  We had -20F to -40F windchills and on the slightly warmer day I felt compelled to do a little shoveling since our country driveway was knee-deep and pregnant Liz isn’t supposed to be exerting herself.  We finally found someone who could come out and plow a path who also knew how to not scrape all the gravel off into the grass.  While this was occurring I, for some reason, felt the need to clear some fallen branches, direct the plow dude where to go and clear off the sidewalk.

Like most stupid decisions, it didn’t seem too bad until I was about 15 minutes into it and then decided I needed to be done.  The next two days were spent wheezing, coughing, and Liz reminding me what a stupid decision that was.  Fortunately I’m on the mend now.  I’m tapering down on the never-ending prednisone and we’re eagerly awaiting kid #2 who’s due any day now.1506742_741427213553_964906717_n

Getting my throat checked out

Several years ago my allergist at the time thought some of my breathing issues could reside in my throat.  Unfortunately, like many of my other conditions, at the time I wasn’t experiencing enough symptoms for the proper doctor to follow up on that.  Now several years later things like vocal chord dysfunction have been brought up once again and I figured I need to get that checked out.

My first step was to once again acquire a local ENT.  I had a great one before we moved and then had a terrible experience after we moved.  The doctor was so-so and the staff was a nightmare to deal with so I just quit going.  I had some reservations about returning, but decided I needed to just man up and do it.  Turned out that doctor with whom I was not thrilled no longer worked there and the new one they switched me to was amazingly better.  He was somewhat impressed with my list of medications and conditions and thought it’d be a good idea to go ahead and get a video laryngoscopy and see what that turns up.

Last week I went to the rehab center and met with a speech pathologist.  The easy, non-evasive scope wasn’t able to do the trick due to my over-sized tonsils and uvula, those wonderful things that greatly contribute to the OSA and enlarge when the allergies act up.  Everything was a little red which can be caused from the GERD and all the inhalers I use.  There was also some thickening in my vocal chords most likely caused by the years of coughing and throat clearing.  The good news is there wasn’t any blatant signs of VCD, but there’s probably a little something going on there which is contributing to everything else.

For now I’m following up with the speech pathologist who is going over some stretches and voice exercises with me to make sure I’m speaking with the right part of my throat and not tensing up.  The staying relaxed bit is good for several reasons and most of what she’s having me do are things I’ve done in the past to one degree or another when I used to lift all the time.  It’s been a wild and crazy 8 months.  It’d be great if my five doctors could get this figured out for me.

No albuterol yesterday

This may not sound like a big deal…

I didn’t take any albuterol yesterday.

No, I’m not lying, and yes this is kind of a big deal.  Last time I didn’t puff an inhaler or take a neb treatment was April 30th.  This has officially been the worst medical/health/breathing year of my life to date.  Most years the fall is a little rough until the cold weather comes, the plants die, and the farmers quit working in their fields.  That time of year has started and the cold temperatures have definitely brought some relief.  My allergies have been going a little nuts being in some dusty rooms here and there at work, but other than that I’d say I’m not too bad.

My next goals are to continue to increase my physical activity without overdoing it, and to continue to taper off the prednisone.  As much as I’d like to go running or lift some weights, appropriate levels of activity for me are things like walking, one flight of stairs at a time, using 25lb dumbbells at home, and slowly riding my bike.  Hopefully I can continue feeling not so bad and get back to feeling normal throughout the winter.

Spirometry

If there’s one thing that can turn my day into a horrible, sweaty mess it’d be a breathing test.  After I showed up at my lung doc’s office earlier this week to find their computer system in shambles and my appointment lost, they rescheduled me for today.  I showed up 10 minutes before my appointment to find the computer problem even worse than before.  Cardiology was turning all patients away and forcing them to reschedule, but fortunately pulmonology was seeing any patients who arrived.  My appointments were still in the computer from a couple days ago as I was scheduled for spirometry and then a visit with the NP.

So a couple weeks ago I became extremely congested, which slowly moved from my sinuses to my throat to my chest.  I did a measly five-day z-pack, which I was skeptical about, yet they tell me I only have expiratory wheezes now.  I’ll take that over the constant accordion noises I was making at the beginning of the week.  My visit did start out with spirometry which really isn’t a big deal.  On a good day I just exhale as forcefully as possible into a tube and as long as I have three good attempts that aren’t statistically-significantly-different (did I just make that hyphen up?) from each other, I’m good to go.  Not so much today.  Any resemblance of a forceful exhale was sending me into coughing fits and I sounded like those old people who see my doctor.  You know, the ones with SERIOUS breathing issues who are targeted by all the commercials for my medications.  Even the nurse said, “GOOD GRIEF!  Sounds like we’re breaking some junk up in there!”  Eventually I had three that were similar enough to count and I actually felt much better after breaking up all that junk.  Unfortunately that feeling last maybe an hour before I was back to where I was.  This is why trying to stay active is important and why they’re always worried about people lying in hospital beds getting fluid in their lungs.  There’s still no end in sight yet for my prednisone habit, but I’m hoping my exhales can start sounding less like the 70 yr old thankful Spiriva allows him to eat dinner at the table and more like…well, a normal person.