Monday, January 25, 2010

Undetectable bronchospasm

Well, I've been a little slow getting this blog off the ground. The battle of keeping my blogs going is a constant challenge as I also have a job, three kids, a pregnant wife and a life to balance around. And I assure you I rarely spend time at the computer when my kids are around, or if I have real work to do at work.

Plus writing has been a challenge since I am no longer working nights 36 hours a week. When I was doing that, there was plenty of time for writing at work. Days here at Shoreline Medical are a lot busier than nights -- most of the time anyway. Despite adjusting to my new life of working mostly days, and trying not to melt in the daylight, I still have the undying urge to write, although less writing (blogging) time.

Since I'm stuck working a rare evening shift tonight, and since work is exceptionally slow, I find I have time to jot a few notes here (let's pray the beeper stays silent). The asthma is doing exceptionally well of late. I say that even though I spent several hours in the basement cleaning yesterday. That's something I never would have been able to do three years ago without having a bad attack. So, I'm living proof things can get better.

Like most asthmatics, and like most days, I woke up feeling sort-of tight this morning. I believe, however, that my description of tightness would be "undetectable" by even a majority of asthma experts. My parents never noticed when I was a kid, and my wife rarely does today. I'm pretty certain I could sit in my doctor's office and he'd never have a clue unless I said something.

However, I have a Hardluck Asthma friend (of whom I promised in my last post I'd write about), who does notice even my "undetectable" asthma episodes. How she can tell I have no clue, yet I imagine it's because she has similar episodes. Plus she's observant, a skill I lack.

So even on my good days -- which all my days have been the past few years (fingers crossed) -- I wake up with "undetectable" tightness. Sometimes if I'm patient, I can simply take my Advair, wait an hour or so, and this "undetectable" tightness disappears. Although most of the time I'm too impatient. Either that, or I just love the taste, the feel, of that inhalant in my mouth.

Still, this "undetectable" tightness is nothing compared to what it used to be. Yet that's a discussion for some other post.

I took another 2 puffs of my Albuterol about 2:30, and then I came to work without my inhaler. For some reason, I find I rarely need it when I'm working. Although, you must consider I work in a hospital, and I'm a respiratory therapist, so if I need a bronchodilator all I have to do is reach into my pocket and find a quiet room. While I've done this even as recently as a week ago ( I had a cold), I have managed to make this a rare occasion these days.

My boss found the evidence that I took a treatment at work once, and she was fine by it. Of course it helps that she was an RT who took care of me when I was a kid. I wrote about this here.

In fact, I actually feel a little "undetectable" bronchospasm as I write this, yet I have no desire to use my rescue inhaler. Well, of course it helps that I don't have it in my possession. Yet, I also find that if I wait it out, the long-acting bronchodilator that is in my system usually comes to the rescue at some point.

Of course you guys should also note here I'm a recovering bronchodilatoraholic, and when you're recovering it's best you don't have the substance. Yet, when it's breathing we're talking about, it's hard to get away from the substance. It's kind of like trying to overcome an addiction to eating when you HAVE to eat to survive.

So I can pretty much assure you I will not use my rescue inhaler (old faithful Albuterol) until bedtime, which, since I don't get out of work tonight 'till 11:00 p.m, will probably be around midnight. I'll use it whether I need it or not.

This may sound funny, but even when I don't need my rescue inhaler, if I use it I still get some relief. I think this is because I have some degree airway remodeling. I don't know if this is true, but this is what I believe.

When you suffer an asthma attack, all the systems that work to cause your body to attack itself, to cause the bronchospasm, cause damage to your airways. When the attack is over, or ending, your body has to heal itself. In the process, a certain degree of remodeling is inadvertently caused.

This is ironic, considering our immune systems are meant to attack real threats to our bodies, and asthma (and allergies) attacks "perceived" threats, or things that are not harmful at all to people with normal lungs. So here, in the process of healing from our bodies own attack on itself for no real reason (or for inexplicable reasons), permanent damage is caused.

So this remodeling, this permanent damage, however slight, often provides me with some degree of shortness of breath, however "undetectable." In this sense, this permanent "undetectable" bronchospasm I have, might be what is referred to as the link between asthma and COPD.

For those who aren't so fortunate, these permanent changes lead to difficult to manage asthma, and perhaps even permanent dyspnea that is only partially reversible with asthma treatment. This, most definitely, is within the Asthma-COPD link.

However I digress. Yep, at the moment, as I take in a deep breath (yes I can get it in all the way comfortably) I notice very, very mild "undetectable" bronchospasm. It's there, but I barely notice it as I go about my business. You'd never know it either. You'd think I was just a normal person with normal lungs.

Well, you wouldn't because you knowI have asthma. But you know what I mean.


  1. Rick, are you in my brain? I have thought of this undetectable bronchospasm thing a LOT, except I was never able to phrase it right. Though I'm not a hardluck asthmatic, I definitely am able to level with this sensation.

    Great post!

  2. It's definitely hard to explain to a doctor who's never had asthma.