Saturday, February 20, 2010
Headaches
Actually I have dulled it with an Ultram, but it's still there. I woke up at 2 a.m. with this headache so bad there was no way I was going to go back to sleep, so I got up and took two 500 mg Tylenol. I have to take that much, because one never quite cuts it.
I knew this was not a Tylenol headache, though. Yet I had to try it. I had to try something before I took an Ultram. I had to because once I take an Ultram, once it kicks in, I have to write. Doesn't that sound weird. Yep! Ultram relaxes me to the point, puts all these ideas in my head, and I have to put them on paper. I've written some good stuff while on Ultram.
Ultram dulls or gets rid of my headaches no matter how bad, it's the first drug I have ever taken that gives me at least some degree of relief. However, even though it is not an opiate, and my doctor says it's safe to use it and work, it gives me the feeling that about three cups of coffee gives me, although without the side effects such as shakiness and such. It just makes me feel euphoric, and happy.
So, Ultram is a good medicine. Like I wrote above, I always take something else first, and if that works I don't take the Ultram. However, the neat thing about Ultram is that I don't have to worry so much when I get a headache. It used to be that I would get headaches so bad that I'd have to almost take something for it prophylactically. Seriously.
In fact, I would take ibuprophen for a while, and when that quit working, I'd switch to Tylenol, and when that quit working, I'd switch to ibuprofen, and so forth. I even tried extra strength medicines such as Exedrin, although after a while, that quit working too. Then I went on an aspirin kick.
In December of 2008 I woke up one morning throwing up blood, and yes, it was coming out the other side too. Sorry to gross you out there, but that's what happens when you get a GI bleed. My wife and doctor were convinced I had an ulcer, and that it was exacerbated by the fact I was thinning my blood with Asprin at the time.
So, that was when my doctor prescribed Ultram.
Now I put myself on the spot, and I feel I have to back up a bit and explain something. When I was a kid I was the anxious, often depressed type of kid. Again, I don't' know if that had something to do with asthma or not. I don't know if that had something to do with the fact I was slowly realizing I was unique, not much of a socializer, had to do things different, couldn't hang out with the guys so much in the woods, in the baseball fields, and such. You know, that causes stress for a kid. And, worse of all, I was severely bullied as a kid in school.
So, needless to say, those things caused me stress. And, sometimes I wonder if that caused me to get these severe headaches when I was a kid. I remember my doctor prescribing one medicine after another for me to take for the headaches, and none ever worked.
This brings me to the asthma hospital in 1985. While there, yet again, I had bad anxiety. One of the major problems of the asthma hospital was severe homesickness that often had to be dealt with among the kids. I was no exception. So home sickness anxiety, coupled with the anxiety that already existed, coupled with the fact that I'm not much of a socializer and was among socializers, and away from my family, and away from my mother of whom I was attached (you hear that a lot about asthmatics, that they get attached to their mothers).
So, needless to say, I got severe headaches there too. And, since I was in a hospital, and the doctors wanted to make as much money off me as they could (a little humor there), they tested me for head problems. They had me see a psychologist, had me run through a series of tests such as an EEG, and the end result was that I was normal.
At one point while I was at the asthma hospital I participated with other kids and a specialized trained nurse on how to relax. I do plan on writing about this in more detail later on this blog. The psychologist, counselor, and the relaxation classes changed me quite a bit. I actually turned into an equanimitous asthmatic (equaniminous is not a real work, but I like it). I am cool, calm and such even during the worse attacks, and I'm better capable of dealing with life in general. When my asthma attacks, I do what I was taught in these classes, and I'm telling you, it works.
However, I digress. I quit getting headaches for a while. Yet, now that I'm an adult, I get those things terribly at times. I never said anything to my doctor. I didn't mean not to say anything, it's just that I never related it to anything other than just normalcy.
Yet, when I ended up in the hospital with a GI bleed, my secret was out. Well, it really wasn't a secret because I didn't intend on not telling my doctor, it's just that I never thought of it unless I had a headache. You know how that is I'm sure. The last thing I wanted to do was take yet another pill.
So, here I am, up at 6:00 in the morning, writing. I'm writing with a dull headache, numbed by the powers of the Ultram. Is it an asthma related headache? I may never know. And, quite frankly, you can thank the Ultram for this post.
Monday, February 15, 2010
Two-years old and all alone in a hospital crib
The reason I mention this here is because the kid, when I entered the room, was crying. He kept saying over and over, "Mommy! Mommy!" Yes. He wanted his mommy. He wanted the one person he is most attached to. And yet, she was no where to be found. Once the child was admitted, she went home.
So, after I gave my treatment, I sat with the kid. I put on a cartoon on the TV, and I talked to him. It took a while, but I eventually had him calmed down. Then I sat with him for a while, as he snuggled with his little stuffed puppy.
This kind of reminded me of when I was two and my parents left me in a hospital all alone. Yes, I was 2 years old in 1972, and my parents left me alone. There was a policy back then that parents weren't allowed to stay in the hospital after hours, so once visiting hours were over, they had to go home.
I remember a room where a bunch of hospital cribs, which were actually metal cages, were all lined up. I was put in one, and the side was raised. I remember standing up, all sad, as my mom and dad said good-bye. I remember them slowly walking to the door, looking back, and then exiting the door.
I also remember mom and dad looking in the little slit of a window on the door. They stood there a while, and then left. I was sad. I remember the nurses coming in every once in a while to put something in my bottom. I didn't know it then, but it was probably the temperature probe.
I was in the hospital because I had bad eyes, and the doctor was going to operate in the morning. I had a wandering eye, and the doctor had to tighten a muscle or something. Surgery may not be needed for this in 2010, or if it is, it would be an out patient procedure, but back in 1972 I had to stay the night for whatever reason.
I remember after the surgery, having a patch over my eye. I kept trying to take it off, so the doctors actually wrapped my head so I couldn't do it. I also remember leaving the hospital. I don't remember mom being there, but she probably was. She probably stayed in the hospital to do paper work or something while dad took us kids out to the car.
I remember my older brother Bobby, my younger brother David walking along side me. I was in a wheelchair, being pushed by dad, or, perhaps if my memory fails me, maybe it was a nurse. Regardless, I remember my brothers (one or both) wanting to ride in the chair, and dad saying something like, "Rick's the sick one. He gets to ride in the chair today."
I remember the car. It was a station wagon with brown and white wooden side panels. That's the memory. That's how I remember it. And, yes, I was only two.
I told my memory to my mom once when I was a 10 or so, and she confirmed it. Yet, I brought it up a few years ago to her, and she said what I described was not how it was. She said my brothers wouldn't have been there, and stuff like that. However, I think my memory is accurate, as it happened to me, and mom didn't have a need to remember it the way I did.
Anyway, sitting there with this kid kind of reminded me of this episode, when I was a kid left all alone in the hospital. It's episodes like this that give me empathy for kids, especially kids that are left alone by their parents in a hospital, and the kid is all sad.
The kid was calm, staring at me, the ceiling, and occasionally getting lost in the movements of the cartoon on the TV, and I was hesitant to leave him all alone. Yet, remembering that I tolerated it somehow when I was a kid, I was certain this kid would do just fine. Perhaps, as it may have done me, strengthening him somehow.
Friday, February 12, 2010
Unique Asthma and common sense
Now I'm not saying my doctors aren't concerned, just that I've been fortunate to have doctors that understand that not all asthmatics fit into the "guidelines." Sure most asthmatics shouldn't need to use their rescue inhaler more often than once or twice in a two week period, but some asthmatics -- like me and perhaps you -- need it more often.
I wrote about how I was a bronchodilatoraholic (well, I suppose, once you're a bronchodilatoraholic you always are) once or twice on my other blogs, and I have had people email me to tell me my asthma is out of control if I use it as much as I claim. When, in fact, my asthma is controlled. Thus, rescue inhaler frequency isn't always an indicator of asthma control.
My family members who have seen my asthma first hand (my wife, my mom and dad when I was growing up, my brothers, grandparents, uncles and aunts, coworkers and the like) never question that I'm taking my inhaler. They never say things like, "Golly gee, don't you think you're using that a bit much!"
In fact, my doctors are the same. It's called common sense. Like with any other thing in life, nothing goes according to the plan. You can't go to doctor school expecting every time you have an asthmatic you can give the exact same analysis, the same medicine, and expect the same results. Why? Because in the real world, people have unique asthma
And, thankfully, people in my life, including my doctors, have always had a certain level of common sense not to make me feel uncomfortable about my inhaler overuse, my bronchodilatoraholism. However, I usually don't give them the chance, since puffing was usually done in private.
Today I couldn't care less, but when I was a kid I felt stupid enough using that darn thing. I wrote about it recently on this blog how carrying that thing in my pocket in itself was embarrassing. And, to use it in front of people, only generated looks and questions I didn't want to deal with.
So, understanding that perhaps, my doctor never questioned me. Perhaps the common sense part of his brain understood that Rick Frea has unique asthma. He has asthma that does not fit into the textbook.
And, when you have unique asthma, you need to treat it in a unique way. When you're short of breath, you test that rescue inhaler more often than you should. Then you realize the relief you get from it is worth any side effects that might transpire (Side effects are pretty minimal anyway).
Thankfully, most of the doctors I've had are wise to this fact. Considering I'm the worst asthmatic most of my doctors (minus the doctor's I had at the asthma hospital) ever treated, I often wonder how they obtained such patience with my asthma.
Common sense, people. It comes down to common sense. Either you have it or you don't, because it cannot be taught.
Wednesday, February 10, 2010
Allergies suck worse than asthma
Yes, I did say that. I think allergies suck. Asthma is actually easier to control than allergies. Even after I was on Advair and finally had my asthma under control, the allergies continued to irritate the crap out of me.
Sure there are allergy shots, but those things did nothing for me but sting my arm once a week for three years.
Sure there were antihystamines and decongestants and nasal sprays, but if I'm around one of my allergens, those only took the edge off of that annoying feeling you get in your sinuses and nose. You sneeze. You get a runny nose. You feel down right miserable.
I'd rather have an asthma attack. A worse case scenerio for asthma is you have to go to the ER. Yet, even in the ER, there is nothing they can do for allergy symptoms.
This did change, however, with the invention of Singulair. Man that drug is awesome - for me anyway. Advair really helps too. Now I can actually be around something I'm allergic to and survive -- like during this flare up.
With Singulair my asthma flares still occur if I'm exposed to my allergens, although the flares are not near as bad as they used to be.
Monday, February 08, 2010
Extra-Allergy Perception (EAP)
Okay, so I suppose you're wondering what EAP is. Well, it's the ability to know when something around you is one of your allergy triggers. It's the ability to know what places you need to avoid.
Actually, it's quite a neat skill. As far as I know, I'm the only person alive with this skill.
I'll give you an example. As I enter another person's home, I can "sense" as soon as I walk in if that person has a dog. And I know I need to either get out, or prepare myself for an allergy or asthma attack.
As I enter my dad's cabin, for example, I can sense that there are a lot of dust mites and molds, and that I must not stay long. I also get this feeling as I enter certain homes.
My EAP is pretty accurate too. For example, when I went to Florida a few years ago, my wife wanted to spend the night at her cousins. Well, as soon as I entered that house I had this feeling I was going to have trouble. I told her I was going to have a rough night.
"Oh, you'll be fine. It's all in your head," she said.
Voila, at bedtime, my allergies and early warning signs showed their ugly faces. I was puffing on my inhaler all night, and I was tired the entire next day.
When I got to my parents home the next day I received no such sensation. I knew I'd be safe during the rest of the vacation.
My allergies are so bad, that I find it better not to plan on spending the nights at relatives or friends, and to pay for a nice hotel room instead. Of course that brings up another issue. Cheap hotel rooms are a gamble when you have allergies as bad as I do, and is why I include this as one of my 11 tips for traveling with asthma.
I think one of the reason's I developed EAP is because I grew up with this disease. I think if I had developed it as an adult, I never would have developed this skill, and my EAP never would have had a chance to develop and flourish.
Likewise, due to the fact asthma wisdom and meds were primitive when I was growing up compared with all we know today, I had many asthma and allergy experiences during my life. Because asthma wisdom has improved, I doubt there would be many new cases of EAP -- assuming I'm not the only one with this skill.
However, whether you have EAP or not, it's always a good idea to premedicate yourself with allergy medicines prior to visiting someone else's home for the first time. Or, another viable alternative is avoidance.
Saturday, February 06, 2010
My unique asthma flares
Well, it probably doesn't help that I've been cleaning the upstairs bedrooms, but that's done now. Keep in mind I'm not as bad as I would be if I weren't on all these great new controller meds, although I can definitely notice my early warning signs:
- Tight chest
- Itching feeling in neck area
- exhaustion
- Urge to sneeze
- Nasal congestion
- Runny nose
- gut feeling
- Ventolin isn't working
- Can smell all the allergins in the air (a unique skill I have. More on this later)
Now, I've been meaning to talk about this for a while, but my asthma is unique in that no matter how I feel my peak flows do not change. For example, I just blew into my peak flow meter, and my PEFR was 690. Keep in mind my personal best is 730, so 690 puts me right in my normal range.
In fact, as I track my peak flows, I've noted feeling mild or "undetectable" shortness of breath on days when I've blown a 650, which is in my green range, and I've noted breathing normal on mornings I've blown as low as 550, which is in my yellow range.
This was not true when I was a kid. However, as an adult, my PEFR is not representative of how I feel. In fact, back in 1998 when my asthma was so bad I could barely take in a half a breath, and ended up in the ER, and later admitted for 10 days, my PEFR was over 700 for the entire stay. Go figure that out.
The Asthma Guidelines do note, however, that both symptom monitoring and peak flow monitoring are equally effective. The only problem with symptom monitoring is it's hard to really know it's time to give up and go to the ER (No, I'm not even close to that point, but I'm just saying).
If you monitor peak flows, and you blow a 60% of your personal best (for me that would be 438 or less), then you know you better take action quick and get better, or get your lungs to the ER.
Of course, whichever method you use, it's always hard to make the decision to go to the ER. It's easier to be modest and try to treat it yourself. It was this thinking that prompted me to write "Having asthma symptoms? Here's five tips to help you decide what to do."
So, needless to say, I have to monitor my symptoms as opposed to my PEFR. Now I still continue to monitor my PEFRs in a peak flow flowsheet I created (you can link to it here) just in case, although I do tend to slack in this area.
It's for this reason I'm usually relegated to being observant to my early warning signs as a cue that I need to stop whatever I'm doing and take action. However, still, that is easier said than done, especially when you're involved in a task you're enjoying.
Wednesday, February 03, 2010
Time released meds great for asthma compliance
If you want a good example of what I'm writing about, click here. I was on so many meds back in 1985 that I was taking some asthma medicine at least every four hours. While it got better by 1998, I was still taking meds every four hours. Theophylline was every 8 hours, Azmacort was 4 puffs every 4 hours during the day, and plus there were a few others mixed in.
Finally in 1998 Flovent came along. It was a stronger inhaled corticosteroid and was only needed twice a day. That solved the problem of the Azmacort. I actually liked the taste of Azmacort, but there was no way I was going to lug that big thing around with me. So, basically, the only times I took it were when I so happened to be home.
My point here is, that asthmatics today should be very happy. I was a little slow getting on this train, but in 2007 I was finally started on Advair. Actually, I was introduced to Serevent CFC back in 1998, but the side effects were too great. Advair, however, made my life so much easier. That's 2 puffs a day. One puff when you brush your teeth in the morning, and one puff when you brush your teeth in the evening. That's it.
I remember just before I was admitted to the asthma hospital in 1985 my doctor put me on a time delayed theophylline pill -- the first of its kind -- so I only had to take it twice a day. My doctor at the asthma hospital said those time delayed pills were a bad idea, and he put me back on the 300 mg dose every 8 hours.
I guess he was a little behind the times, as it was 25 years later most asthma controller meds are on a time released system. The time released system allows for asthma meds to be taken twice a day and that's it. It's great.