Asthma: "You Know This Will Kill You, Right?"

Asthma can be very serious
So there I was, innocently minding my own business late one evening, trying to fall asleep watching some droning late night show, when I started really struggling for air.
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In the mid 1980’s in Texas, asthma wasn’t a “thing.” If you couldn’t run the mile in PE, it probably meant you just wouldn’t run it. Even if you’d spent a good part of your twelve short years in an allergist’s office getting poked in the back with scratch tests, or you’d spent an afternoon watching your parents learn how to inject an orange with a hypodermic needle (you know, in case going to the doctor’s office every week for allergy shots became a problem), asthma wasn’t a disease you could see. The PE teacher just looked at you as you stood there, huffing and puffing, bent over at the waist and gasping for air, and told you to walk it off.

So, I grew up, more bookish than athletic, never allowed to have a cat, avoiding rolling in the grass, armed with an array of foods from my “do not feed me these unless you want me to die” list, and figured asthma was just one of those nuisance diseases. If I didn’t expose myself to the triggers, it wouldn’t be that big of a deal.

Over time, I outgrew most of my allergies (except shellfish – a major bummer if you grow up on the Gulf Coast and have already developed a serious hankering for shrimp), and I quit thinking about most of those triggers. As an adult, I no longer took allergy shots; I took decongestants. I managed to live with the pets my children adored by keeping eye drops around in case of accidental cat-hair-to-eye contact.

Basically, I coped. The only time I dealt with asthma in my adult life was when I was pregnant with my daughter, and I learned that having an asthma attack while pregnant would get you a front row, all-access pass to the ER, and would allow you to take a nebulizer home with you. But once she was a real person, and not just a tiny human parasite, the nebulizer and the leftover Albuterol went to the back of the closet, never to be needed again. Not even while I was pregnant with her twin brothers. In short, I kind of forgot I had this thing on my medical records.

So there I was, innocently minding my own business late one evening, trying to fall asleep watching some droning late night show, when I started really struggling for air. At first it was mild, like those days out running the track in Texas. Then it was more like one of my toddlers sitting on my chest. Then it was a pallet of bricks.  I went digging and found the nebulizer, and plugged it in. I still had some vials stored in the machine, so I cracked one open and started sucking air. Immediately, I could feel my heart rate speed up a little, which told me the drugs were getting in. After three minutes of concentrated nebulizer-breathing, I turned it off and went back to bed. But it wasn’t any better. I sat up and tried to relax. I made myself some hot tea, but my lungs wouldn’t loosen up. Eventually, I went back for a second breathing treatment. Again, I could feel my heart rate speeding up, and I hoped this time my lungs would open up like the Grand Canyon so I could finally get some sleep.  But after the second breathing treatment, things still weren’t any better.

At this point, I actually started to get nervous. Maybe it was the asthma attack, maybe it was the Albuterol, or maybe I was experiencing my first full-blown panic attack, but at 11:00 that night, I decided to drive myself to the emergency room. I hated overreacting, but I hated the idea of breaking my back trying to suck in air the rest of the night even more.

I walked in to a fairly busy ER that Wednesday evening, figuring I’d register, hang around while they ran my insurance information, sit next to some guy with a nasty, hacking wet cough, only to be told to take a breathing treatment and go home.

Apparently, emergency rooms think asthma is a big deal when you’re not pregnant, too.

I don’t remember how I got to the triage room; I only have flashes of being in it. The respiratory therapist came in and had me take a nebulizer treatment, which had about the same effect as the two I’d already done. I remember the heart monitor seemed to be making a lot of racket, and I remember several guys in white coats in my room. That’s it.  

The next morning, I woke up in a hospital room when a nurse was injecting something into my arm. I was strapped to an IV drip with an oxygen tube up my nose, and I had a catheter attached. I asked what she was giving me, and she said it was a blood thinner to counter the fact that I wouldn’t be getting out of bed for several days. This confused me terribly; after all, it was only asthma.

The answers came a short while later when the internist arrived. He sat down on the edge of my bed and asked me to tell him what happened. I walked him through the evening, up to the time I sauntered into the ER, and told him after that, I had very little memory. And I laughed. “I don’t get what the big deal is,” I said to him. “It’s just asthma. I’ve had it all my life.”

I stared at him while he told me this story.

“We weren’t sure you were going to make it through the night. When you arrived last night, your pulse-ox was down to 65, and your heart rate was already 180. We gave you a breathing treatment, which did not improve your pulse-ox, but your heart rate jacked up to 225. At this point, your heart looked like that of a 75-year-old man, not a 30-year-old woman, and we were concerned you were going to have a heart attack. So we sedated you and admitted you. You’ve been here for about eighteen hours now. You are receiving a steady stream of antibiotics while we test for pneumonia. You are bedridden until your heart rate stabilizes; if you get out of bed, even to use the bathroom, I am afraid your heart will overreact. We are giving you regular injections of an anti-coagulant since a 30-year-old body is not accustomed to being immobilized. You will remain on oxygen until your levels have recovered. I’m not sure how long you can expect to be here, but it will be at least another 48 hours before we talk about you getting out of bed.”

I was stunned. Eighteen hours? That meant I had missed work and no one knew where I was! As I panicked and told the doctor I needed to report in immediately, he raised an eyebrow and said, very matter-of-factly, “You do know this can kill you, right?”

At last, he had my attention.

After all those years in middle school being told I couldn’t get out of running outside, someone finally drilled it home. I had a disease. A bona fide, treatable (potentially deadly) disease. And also maybe pneumonia.

For five days I stayed in the hospital while I worked through both short-term and long-term treatment plans. I had always understood that my asthma triggers were allergies and exercise. Now I know that one of asthma’s major triggers is stress.

Stress?

In August of 2003, I was two and a half years into a protracted custody battle with my ex-husband. I had been fired as a client by my divorce lawyer when I ran out of savings, and was representing myself in court. I had dropped out of law school after my first year because of the stress of the custody litigation, and was working against a clock to re-enter school and finish within ABA timelines. I was being sexually harassed by my boss, and was struggling with his hostility at work on a daily basis. I was being treated for postpartum depression. I was a single mother of three kids under the age of five, and my family lived 1200 miles away. My support system of friends had all but dissolved when my ex and I split, and I had moved recently enough that I knew virtually none of my neighbors.

And because I apparently wasn’t at a big enough risk with the stress, I also lived with two cats in a duplex with a mold problem, and mowed my own lawn on a weekly basis.

Talk about setting yourself up for failure, right?

I was released from the hospital on a Tuesday morning. My discharge papers instructed me to remain off work for another week. Against medical advice, I went home, showered, and reported to my office to pick up work that I could do from home for the next week. I was met at the door by our office manager, who handed me my personal things and a severance check, and told me I had been replaced when I didn’t show up for work the week before. I went home in a total fog, completely uncertain what to do next. I checked my mailbox on the way into the house, and inside I found an acceptance letter from The Ohio State University Moritz College of Law, offering me a spot as a transfer student, with orientation starting on Thursday.

And so, peppered with bruises from injection sites, muscles weakened from lack of use, and fighting regular nosebleeds in the aftermath of the oxygen tube, I walked onto the law school campus ready to start a new chapter of life. And I did, armed with the knowledge that my future healthy life would mean regular physical fitness, ample stress management, allergy awareness, and of course, a rescue inhaler always tucked into my purse. It took a near-death experience to make me aware of my body’s limitations. At the same time, I learned firsthand the value of reducing stress and meeting medical adversity head-on.  It’s been nearly seventeen years since that eye-opening trip to the emergency room. It made me a healthier person, and gave me an entirely new lease on life.

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