I recently had an asthma exacerbation, which was surprising because I had not had one in over 20 years. As an adult, I have always selected the “asthma” checkbox in medical history charts, but I always add, “I don’t have asthma any more, I only had it as a child.”
At the age of 6 (and/or 7?), I was a sick little girl, constantly diagnosed with tonsilitis, bronchitis, and asthma. At my elementary school in Colombia, I enjoyed telling my classmates after having been absent for several days that I had “amigdalitis, bronquitis y asma” which I proudly explained meant I had a sore throat and cough. I remember being tired and never wanting to eat much. When I had trouble breathing, I did not have inhalers to use, but I did get to sit in front of pans with boiling salt water with a towel over my head. I remember screaming hysterically because it was so sweaty and uncomfortable. My mom would restrain me until I took several breaths, hoping the hot and humid air would help. One day, after many months of seemingly never-ending sick episodes, I was informed I’d be getting my tonsils removed. The big day came, and after having a post-surgery sore throat that was 1000 times worse than any previous one I had had, followed by many happy days of only eating ice-cream and pudding, my sick days were over. The only tangible evidence that I have of this period is a childhood picture in which I look emaciated. I won’t post it because I can’t stand looking at it. The first time I saw it as a grown-up my jaw dropped, and I demanded that my parents explain why they hadn’t bothered to feed me as a kid. (No, it was not their fault, that was just my first reaction when seeing the picture). For the next few years, I don’t remember being sick, and in childhood pictures I no longer look like a stick figure.
At the age of 13, I moved to a city in San Diego County in California. Shortly after arriving, I found myself lying face down on a bed unable to breath. I don’t remember how I got there, but I do remember lying there feeling helpless. I could only manage shallow breaths and it felt like there was no air in the room. I watched my fingers, and I thought of moving them, but it seemed too hard of a task. My relatives asked questions, and I would whisper back a word or two. The next thing I remember, we were at a doctor’s office, and he chatted with my mom. He brought in an inhaler (albuterol or the like, I assume), and explained how I should use it. I took a breath of the medicine, and I could breath again! It seemed like magic. The doctor asked if it helped. I smiled and nodded. The hypothesis for why I was sick was that I wasn’t used to Southern California air pollution, having come from a small Colombian city surrounded by lush tropical Andes vegetation, and that my lungs had gone a little nuts over the change. I don’t remember the exact treatment plan, but I do remember leaving with an inhaler and the instruction to use it if I felt short of breath. I was proud to carry the inhaler around with me for at least the following year. I used it every now-and-then, but I never really desperately needed it. Eventually, I abandoned it.
In Fall of 2013, I spent two nights in a hotel room that had been recently renovated. The room looked nice, but it also had a very strong smell of paint. I decided to ignore the unpleasant smell, despite the fact that I woke up with a strange feeling in my lungs the following day. Nothing major, but they seemed irritated. Because I was at a conference that took place inside of the hotel, I didn’t get much fresh air for two days. I arrived home to cold Boston weather, and when I woke up the following day, I thought I had caught a cold. I began to cough often and feel very tired. After 1.5 weeks, I coughed so much at night that I would wake up every 20-30 minutes drenched in sweat. I kept hoping the “cold” would go away, but after four nights of little sleep, I was exhausted. I went to an urgent care clinic where it was pretty obvious to the doctor that I had bronchospasms. I left with standard albuterol and fluticasone inhaler medications, plus a cough suppressant with codeine to help me sleep at night. After a day or two, I was able to get much better sleep, but I still felt tired and coughed during the day. Nearly a week later, I developed a strong sharp pain by some of my ribs. I had pulled a muscle from so much forceful coughing. This pain was tough to ignore, and taking over-the-counter pain relievers didn’t help much. Four days later, I went to see the doctor again. This time, I was prescribed a course of prednisone (an oral steroid) and was given a prescription pain reliever for my sore muscles. The doctor labeled what I had asthma. I slowly walked back to work, guarding my ribcage, and doing my best to suppress coughs. I took the first dose of prednisone as soon as I arrived, and within 10-20 minutes, I suddenly felt better, as if someone had turned a switch. It seemed as if my had lungs expanded an inch within my ribcage, and I was finally getting air that I didn’t even know I was missing. The coughing nearly vanished. That night, as I lay down to rest, I realized I had forgotten what rest felt like. And of course, I realized I had just wasted a month of my life. Wouldn’t it have been nice to take the prednisone and hit the restart button weeks earlier? Ah, hindsight. I sure won’t be staying in rooms with strange smells if I can avoid it.
I am curious about when, if ever, I will have another asthma exacerbation. Will it resemble any of my previous ones or be something that catches me off-guard? What if I lived in the Inner City of a major US city where the rates of asthma are so high? Would I constantly need inhalers and have many more exacerbations?