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Friday, December 7, 2007

Asthma patients: I've been there, done that

Growing up with bad asthma: Chapter 1

Though this is not why I became an RT, I can tell you that I have more empathy for my patients than most of my coworkers here in the RT cave. Unless you are like me, I probably have more empathy than you too.

I say this not because I'm a more loving person, but because I've been there, done that.

When I was a kid I visited the ER for asthma attacks fewer times than I should have, and I spent at least 2 weeks a year as an in patient more often than I wanted.

In the next few weeks I plan on publishing some pithy posts about what it's like to grow up with bad asthma. If you ever had similar experiences as me, I'd love to hear about it because I know I'm not the only one.

It is abnormal to be short-of-breath (SOB). I know I'm stating the obvious, but I think it's important to state that mainly because I was SOB many times as a kid and nobody noticed. Therefore I suffered unnecessarily. Why? Because it's abnormal; and people who have never been SOB don't think to recognize that someone else is SOB. Why would they?

My parents rarely recognized that I was SOB when I was a kid, and I never thought to tell them. I mean, think about it, I was just a kid, how was I supposed to know it was not normal to be SOB. Therefore, I suffered more than I should have. I didn't go to the ER many times that I should have, especially when I was really little.

I remember one time I was about 8 YO I was really SOB on vacation, and my parents didn't bring my medicine. Actually, they left the responsibility on me, and I forgot. But, in retrospect, they were my parents so they should have made sure I had my medicine. Right?

No parents are perfect. I'm not trying to make my parents look bad. I'm just stating the truth here as I remember it. My memory could be flawed.

I didn't want to ruin everyone else's vacation, so I sucked on cough drops all night. I remember I almost choked when I fell asleep with one in my mouth.

Even when I got older, and my rescue inhaler ran out, I would be reluctant to tell my mom I needed a new inhaler because, well, she just bought me this one 2 weeks ago, and it was supposed to last 6 weeks, or at least a month.

Then I finally got the nerve to tell her I needed a new inhaler, but didn't tell her I was SOB because I didn't want her to know. Now was that stupid or what? But I was a kid.

I remember staring out the window waiting for mom to come home. Dad was home and he had no clue as he watched his football game or took a nap. My brothers were playing in the dusty basement, but that's probably how I got SOB in the first place, so I didn't want to go back down there to play with them now, even though they kept pressuring me to do so.

I remember staring out the window for hours waiting for her. I was calm, because I was good at hiding I was having trouble. And, so you don't think my dad was a bad guy for not observing I was in trouble, I was really good at staying calm and not letting others know. I was a professional asthmatic.

And when I went to bed that night, my inhaler was right there in my grasp. It stayed there even after it was empty a week later, and my stress about telling my mom it was empty was renewed.

Here's my favorite story: I remember when I was a teenager going outside and playing football when smoke was billowing from neighborhood chimneys and having an asthma attack while playing and not quitting. I didn't want to disappoint my brothers.

I would take breaks occasionally, walk into the house gasping for air, try not to make it obvious to my parents as I walked through the house to my bedroom, take a quick treatment, and go back out for more punishment. I might repeat this 2 or three times.

I just wanted to be normal. I wanted to play football. I was needed to make the teams even, and refused to be the one to disappoint. I was not a quitter. Stupid? Maybe. But I had fun playing football and I don't regret it.

Today I'm on preventative medicines and live a normal life. I think there is no excuse for anyone not living a normal life. Asthma should rarely be used as an excuse not to do something, especially with all the new medications. However, that doesn't mean you shouldn't avoid certain things, like a dusty basement, or a friends house that has a pet you're allergic to.

Then again, even the best of us asthmatics conveniently forget we have asthma sometimes, and do things we know we shouldn't, like clean a dusty basement, or visit that brother who has 6 cats and 2 dogs and a huge musty basement you know very well you're allergic to.

While I'm on preventative medicines, I still use my Albuterol at least 2-3 times a day. However, when I clean my basement because no one else will, I often have a reaction, and that entails me to abuse my inhaler for 2-3 days until I get back to normal.

I know some of you will cringe at this and tell me I should go to my doctor instead of treating myself, but if you've had this disease as long as me, you learn how to treat yourself. Who wants to go to the doctor every time you have an attack. Not this guy.

I know there have been occasions I should have at at least seen my doctor, but I'm so used to it I just suffer through it. My wife teases me that one of these days I'm going to be an end state COPD patient on oxygen. It's possible I suppose.

And I've never missed work because of it. I might if I was a construction worker, or if I worked in a musty, dusty factory, but I was smart and became an RT where I get to work in a nice, clean environment.

So, when I find an inhaler hidden in a side table drawer of an asthma or COPD patient, I'm not one to tell them they can't have it. I might educate them, but I won't take it away. And this is one of the reasons I wrote Rescue bronchodilators: Here are my unfettered answers to all of your questions about them a few weeks ago.

Just now I was called down to ER to care for an asthma attack. The order was: Duoneb now and then in one hour. I cringed. What a stupid order. I'm nice and just give the treatments as ordered, but it's not at all how I would deal with this patient. I wonder if that doctor has ever been SOB.

So, when I say I understand my patients, I really mean it. When I say I know when a patient needs a treatment, I really mean it. When I say Ventolin is a safe medicine, I really mean it. I've been there, done that.

For part II click here.

3 comments:

Amy said...

Hi there, and thanks for stopping by since it let me find your excellent blog.

Your point about non-asthmatics not recognizing SOB symptoms is so on target--my daughter's asthma went misdiagnosed for 2 years, and when it came I was shocked, exactly because I didn't recognize the abnormality of her breathing. She was my first baby, after all, and I had no experience with/knowledge of asthma.

Great post (and blog)! Valuable information with a good dose of humor is my favorite kind of reading/writing, and the humor part keeps me halfway sane about asthma.

Thanks also for posting about your childhood--I can do all my research, monitor peak flows, and stay alert for symptoms, but at the end of the day I have no idea how it actually FEELS for my daughter to have asthma. Keep writing 'em, and I'll keep reading.

Asthma Mom

JinglyJon said...

Hi, and let me first off tell you that I am extremely thankful for the time and effort you put into this blog. I check for updates daily. Second I am a respiratory care student aspiring to be a (hopefully) great future therapist. Third I am also a severe asthmatic. After a bad attack a few years back, I decided to change majors in college to respiratory care. I've been symptomatic all my life, spending many weeks in a hospital yearly up until the last few years asthmatic/pneumonic/bronchotic symptoms. I feel yours and many,many others' pain and frustration that comes with uncontrolled asthma. I've used and abused mine and possibly dozens of peoples' share of beta-2 agonists. I've been on a vent for a week, had a few pnemothoraxs. The list goes on. I'm not throwing a pity party, merely expressing some experiences. As of lately, minus times of respiratory infections and "over doing" some exercises, I've been able to get my asthma mostly under control. Maybe your frequent use of rescue meds is a sign that your current treatment regime is inadequate. I'm not questioning your expertise or opinion, just giving you my opinion. Anyways, just wanted to say thanks and give a little tiny input. I've been reading your blog since the very first post. It's been a great ride thus far! Keep up the great work!

mielikki said...

I also know what it's like not to breathe. It's frightening, and uncomfortable, but I hid it very well. Most of the time. A friend of mine had her 5 year old nephew die on a playground related to an asthma attack that went too long without treatment. The more education that can be done, the better. Great post.