The following originally published 9/11/13 at healthcentral/asthma
So, how do you know if you are a severe asthmatic? First of all, we need to define severe asthmatic. I like to refer to it as hardnosed. That in mind, below is my definition.
Hardnosed Asthmatic: It's asthma that is not ideally responsive to conventional asthma medicines, often requiring more aggressive use of conventional medicines, or trials of medicines that are either experimental or not necessarily considered front line. It consists of about 5-10 percent of asthmatics. It's generally associated with mild, moderate, or severe shortness of breath that improves with therapy, but rarely completely. In other words, you may always be mildly or moderately short of breath, even after using your medicines. Synonyms: Severe Asthmatic, Gallant Asthmatic, Hardluck Asthmatic. Antonyms: Goofus Asthmatic.
So, now that we know what it is, how do you know you have it? First of all, you'll need to make sure you really have severe asthma, as compared with Goofus Asthma.
Find out if you are a Goofus Asthmatic here. If you pass that test, you can move on to the rest of this post.
Okay, so along with the usual laboratory testing and physician's assessment, the following are some indicators you might be a Hardnosed Asthmatic (please note this is not scientific).
- You are at least a tiny bit short of breath even on a good day
- You use your rescue inhaler more than what is recommended, and your doctor knows it
- Your pharmacist lectures you about using your rescue inhaler too much
- You ask your doctor about excessive rescue inhaler use, and he says, "What choice do you have?"
- On a good day, you can exhale for a prolonged period of time
- You are still at least a little short of breath after using your rescue inhaler
- Your doctor increases the strength of your inhaled corticosteroid
- Your doctor prescribes systemic steroids at least once per year
- You are short of breath and can still function
- You become adept at feigning that you are not short of breath
- You know your asthma triggers better than your friends on Facebook
- You say the following to each new doctor who treats you: "My asthma isn't like everyone else's."
- You take more than two asthma medicines a day
- You take medicines to treat the side effects of asthma medicines
- You're short of breath and still have more empathy for others than yourself
- You start using your rescue inhaler in public places, not caring who sees you
- You start telling everyone you meet about your asthma
- You had really bad childhood asthma
- Along with asthma, you also have really bad allergies
- You skip calling your doctor and go right to the ER on a gut feeling
- You skip calling your doctor and go right to the ER so you can get systemic steroids started NOW!
- You get that feeling of impending doom
- Someone asks you to participate in the Severe Asthma Research Program (SARP)
- A doctor unfamiliar with your case treats you like a normal asthmatic
- A doctor unfamiliar with your case says, "If you need to use your Albuterol every hour, you need to come to the ER."
- A feeling of joy rushes through your veins as your wife says to the doctor in #25: "Look! Rick has bad asthma all his life. He even spent 6 months at a research hospital once. He uses his rescue inhaler every 4 hours on a good day. If he came to the ER every time he used it every hour, he'd be here every day."
- You know you should go to the emergency room, but you don't want to wake your wife (parents) up
- You have to see a doctor more than twice in a year
- You have more than one unscheduled doctor visit in a year
- You make frequent ER visits for your asthma
- You know the names of all the nurses and respiratory therapists at your local hospital
- You have more than one nebulizer, sometimes one in various rooms, and maybe even one in your car
- You are a bronchodilatoraholic
- You have to skip out on things you really want to do (camping, parties, etc.)
- You have to make "lifestyle" changes due to your asthma