Asthma
Thursday, Mar 24, 2016 · 1100 words · approx 6 mins to readἅσθμα. That’s the Greek spelling of asthma, and is their word for panting. Sadly, panting doesn’t even get close to describing what asthma is like, or at least is like for me at any rate. I’ve suffered from it since I was 7. That’s actually a really common age for it to start in kids, and nobody really knows why. If you get it at 7, there’s a chance it might disappear almost entirely for another 7 years when you hit 14. And then it might come back. You get the picture.
I hit 28 and it kind of went. Not entirely, but enough that I’ve gone from needing one or two inhalers a month, to around one or two a year. The nurse that monitors it for me can’t tell me why it comes and goes and I don’t think medical science really has a clue. I’m 36 now and so far so good. Symptoms haven’t escalated in the last year or so, so I’m probably good for another rough 7 year stint of it being really easy to manage.
Except when it isn’t. A few years ago I went out for dinner with a very good friend (and also a very good boss, which is great, because common wisdom says never the twain should meet). It was a 7-course tasting menu somewhere in London and if memory serves we were somewhere in the middle of the meal. There wasn’t a usual trigger for the attack. Normally there is. Most commonly a sneeze, but an overly strong concentration of diluted juice, or a switch from being in a hot place to being in a cold place or vice versa, can also trigger it for me.
In my case, the most frightening attacks are the ones where the bronchospasm, where the muscles surrounding the main airway constrict and restrict the flow of air you can get into and out of your lungs, is slow. I much prefer it when it just hits like an express train. I know what I’m dealing with then, whereas the slow onset attacks can go either way. If I’m without an inhaler when the slow ones hit, it’s roughly a 50/50 as to whether I can control my breathing enough to ride it out. That time at dinner the odds were never in my favour.
I told my friend I was having difficulty breathing. “Do you have an inhaler with you?”. Bit of a silly question in hindsight, because if I had then I’d have been fine. Ventolin has almost perfect success rate for me, and I’m an idiot for not carrying any at the time. I stepped outside for air and I distinctly remember knowing, before I’d even opened the door, that it wasn’t one I was going to be able to control. It was getting worse rapidly and I could barely breathe.
“I need to go to a hospital”. It’s always good to know that yourself, rather than to have other people figure it out for you because you’re no longer able to. So we hopped in a taxi and went to the closest hospital. It was a short journey, much shorter than the time waiting to be seen by a doctor or a nurse. I don’t really begrudge the NHS here in the UK taking its time, not least because I’m acutely aware of trying to get things done and be effective with the bare minimum of resources at my disposal. But right there, in the Accident and Emergency department, I’d had an accident and not taken my inhaler with me and it was now definitely an emergency.
“What medicine do you usually take?”. “Ventolin”. I wanted to shout. Please get me some right now.
Regular pulse oxygen levels, depending on elevation and pressure, are between 96-99% depending on which page you get when searching for it on the Web. It never says 100%. Not sure why. Mine was enough below that — 92% if I remember rightly — and I was having such problems getting oxygen into my blood and my chest was wracked, that hypoxaemia was maybe on the cards and I needed pure oxygen and steroids. Steroids not just to help me recover from the attack, but also to help my muscles recover in the days afterwards. When you can’t breathe and you’re struggling so much for air, you fight against the bronchial spasm that’s holding your airway as shut as it can. Your chest aches for days afterwards.
A few hours on oxygen, Ventolin and steroids later and I was breathing well enough to go home. I knew I’d be OK because I was in a hospital being looked after, but I remember being scared for some reason. And embarrassed. I was supposed to be enjoying a great dinner with a close friend. Instead, he got to watch me struggle to do the most basic thing needed to sustain life because I wasn’t smart enough to have the drugs I need to get through situations like that.
If I don’t have those drugs and I have an attack in the middle of nowhere, with no friends to look after me and take me to the hospital, and I can’t control my breathing enough to have it pass, I’d undoubtedly lose consciousness. Depending on how that went, I could completely expire. I still forget to take them with me even after that episode, but thankfully that’s rare.
If I had the time and energy, I’d campaign for Ventolin to be an over-the-counter medicine in the UK. Today it’s prescription only, and while overdosing does have some side effects (some good, depending on your perspective), that applies to a great many freely available drugs you can buy. The major asthma organisations in the UK don’t seem to push for it, at least from the cursory glance I’ve just had, which is a shame. Easy access to the medicine could save lives; on average, 3 people a day die from asthma attacks here.
There isn’t a point to this post. I’m mostly just long-form stream-of-consciousness writing on my new keyboard again, to keep learning it and committing its foibles and quirks to new muscle memory, so that I’m confident to switch it over to Colemak one day. I realised I’d never written about it before, so here we are. Thank you to all zero of you that’ll probably read this.