It's time to grade your asthma action plan

So I guess if I were to review my asthma action plan and grade myself on how well I adhered to my doctor's recommendations, I'd have to give myself a A+. The main reason is that I've been able to keep my asthma under control without the need for any unscheduled doctor visits since 1997.

My Asthma Action Plan is a bit unique, and perhaps even simpler, than the ones recommended by most asthma experts. Mine does not involve my doctor, and generally incorporates vigilance and common sense.

Myplan pretty much consists of the following:

• Take my asthma controller medicines daily


• Avoid my asthma triggers as best I can
• Monitor my asthma symptoms
• Play it by ear

I have to do it this way because I know me. I know I will never keep a diary. I know I won't do a peak flow on a regular basis, and even if I do I won't remember my personal best anyway. That's me. I know me. I know how I function. And catering your asthma action plan to YOU is what it's all about.

It's about controlling your asthma so YOU can live a normal life. What I wrote above is what I do to maintain control of my asthma based on what I know about myself. And for the most part, it's worked like a charm for 14 years.

I can do better, as we all can do better. Yet one of the main problems I encounter is I like to live a normal life, and I like to, well, clean my basement for example. And I know that most people, myself included, become rapt in certain project they enjoy and want to work until they get the job done.

Yet as an asthmatic I cannot do that. I know If I get rapt, and I don't pay attention to the early warning signs of asthma, and I just keep on a working on cleaning my basement, I will have trouble breathing for the next couple weeks. It will be a major set back. The job will never get done.

So I have learned that a better method, even though it is hard for me to do, is to limit myself to 30 minutes on any given day involved in any project in my basement. Once thirty minutes is up I have to be done. I have to quit at the 30 minute mark. My wife too has to understand that projects entrusted to me might take a while.

You see, if you have asthma you have to make adjustments in your life. You have to do what you need to do to live a normal life the way you see it.

I ask you, my readers, to review your asthma action plans and grade yourself on how well you're doing. What's that? You don't have an asthma action plan? Well it's time you invent one.

You ideally should work with your doctor, and I have done that in the past. Yet as an adult perhaps you'll find you're better at doing one on my own. After all, YOU know yourself better than anyone.

Do you give yourself an A grade? Keep up the good work. Do you give yourself a B? A C? Perhaps you guys should refocus on self-management and consider identifying a “personal champion” for encouragement and support.

Any F’s? Perhaps you should wisit their doctor to reassess your asthma action plan and determine whether alternate treatment options would be better for controlling YOUR asthma. And don't feel bad if you grade yourself an F, because we all start out there -- I did too.

As you learn about yourself, and your illness, you'll learn, perhaps, how to adjust your asthma action plan to your personality.

To learn how to create an asthma action plan click here.

Download Printable Action Plan by clicking here

(May is Asthma Awareness month, and May 3 is asthma awareness day. For more information about asthma, check out the Centers for Disease Control and Prevention/ Asthma.)

Happy Easter!!!!

Happy Easter fellow asthmatics.  The two girls and dressed real cute in matching dresses.  The older boy is dressed nice but more interested in the baseball cards he got in his Easter basket (yes, 12 year olds are spoiled by Easter bunnies too).  And the 8 MO is is giggling and cooing and crawling all over the place looking for trouble.

Sure the squabbles and the occasional wine is normal, and it's on days like this we are reminded of the joys of being a parent.  It always seems there is always one Easter basket that gets hidden really well, even so well that the dad can't even find it.  This year it so happened to my 7 YO, and she was even getting frustrated and thought the Easter Bunny had forgotten her.

Yet when she finally did find it hidden behind the towels in the bathroom, this just made her smile that much bigger.  So here we are ready to set off on another Easter adventure, which will consist of nothing but a modest trip to church and a brief meal with the wife's siblings.  Nothing exciting, yet always special, especially to the little ones.

A perfect dattackescription of the asthma

Consider the following description of an asthma attack:

"In marked attacks not only is the struggle for breath so severe as to make the patient sit or kneel in bed, but he may even get out of bed and stand gasping at an open window, or clutching at any support that will aid the respiratory muscles of respiration. many will not go to bed at all, but sit in a chair all night, dozing when they can."

If that doesn't describe one of my typical asthma attack when I was a kid I don't know what does.
This was written by an asthma expert by the name of James Adam in his 1913 book, "Asthma and its Radical Treatment." After interviewing so many asthmatics in his day, or perhaps due to his own asthma experiences, he had the asthma esperience nailed to a tee.

Henry Hyde Salter

Most asthma experts prior to the mid 20th century were mainly doctors making observations about their own patients.

One of the premier asthma experts of the 19th century was Henry Hyde Salter. In fact, many will even say that he was the asthma expert most respected in the second half of the 19th century.

Perhaps the most proof of this comes from the fact that young Theodore Roosevelt's doctors referred to Mr. Salter's 1864 book "On Asthma" for help managing the young, future Presidents asthma.

Yet as I've written about before, young Teddy mentioned at one point that many of the so called remedies were pure torture.

If you read his book, most of what you'll get from it is that he was very observant of his asthma patients. He studied the cases of asthma that he treated, and from his own observations he came to conclusions.

Salter was also an asthmatic himself, which may have added to his interest in the phenomenon. And based on his own experiences with asthma remedies offered by his doctors when he was affected by an episode of asthma, he developed an interest in the disease.

Thus, based on his own experiments to control and treat his disease, and experiments he performed on his own patients (mainly based on the readings of other asthma experts of the past, plus his own theories and observations), he came up with the ideas that formed the basis for his book, "On Asthma."

So I thought a good place to start in my quest to examine the history of asthma would be with the great Henry Hyde Salter. From there I will flip through the pages of time to examine people effected with this ailment, ancient theories, old remedies, and anything else of interest we can come up with.

God's handiwork

(Editors note: I appologize for the lump paragraphs in this post. For some reason blogger wants to lump my paragraphs together and I can't seem to figure out how to stop this from happening. After 30 minutes on this task I give up) When I was a journalist we'd celebrate when we received letters of criticism regarding the material we w rote, particularly if the criticism was about an opinion in an editorial or column. Today that criticism usually comes in the form on an email, or a comment at the bottom of a blog post. In the e-asthma world, the post I've received the most criticism of is the post where I was the most optimistic about my disease, and the post was "The Seven Benefits of having Asthma." I basically wrote that I find it useless to sit around saying, "Whoa is me!" and more useful to take that disease as a gift from God and an incentive to improve your life. The advantages I see in this disease is that it has given me a unique perspective on life because I've come close to death more than once, a sense of vulnerability in that I know I will not live forever and that I need to make the best of my time here, a tighter bond with God (religiosity), empathy for other people who have a disease, improved intelligence because instead of hanging with the guys I would read and learn, the ability to share my experiences, and the gift of cleanliness because I'm allergic to dust and mold. So why would someone have a problem with that? What do you want me to do, sit around and sulk and feel sorry for myself and live in a bubble and hate my life. Man, I would hate to live that life. Yet this appears to be what some people would like of a poor asthmatic. Consider the following:

"these 7 benefits of having asthma were useless. they didn't help me with anything. you people are so stupid maybe think twice about having those your site. or just find some better benefits because the ones you have are just peices of junk. whoever came up with those must be 5 because those things are super gay"

You see, a comment like that isn't even worth replying to, and usually I don't. Yet I'm posting it here just to make my point. No one would wish asthma on anyone else, yet if you so happen to have it, I can think of many worse things that could happen to a person. Or how about this one:

Although the sentiments in the list of seven are things to strive for; not many people suffering with a disease as serious as asthma or copd or emphysema would consider their conditions "benefits". Imagine if you were a child with a life-long debilitating illness like asthma, or an elderly person barely able to breathe.

Um, I am that person. I was the young kid who could barely breathe, and instead of choosing to sit around wallowing in pity I chose the nobler route. I chose the nobler route when I was just 10. I sat and had many discussions with God about what plans he has for me now that he has given me asthma. The author continues:

You really need to be careful when addressing things to the population you are dealing with. This article had little sensitivity for the sufferer as it was written in what seemed to be rather glib sound-bites. I wonder of the author is an asthma sufferer. Because unless you've been through the near suffocating experience of having to rely on meds breathe, you would write with greater sensitivity and explanation. If the author does have a lung condition than perhaps they need to generate their own "empathy" in a greater fashion when writing such material. In any event, the editors of this site should also be more responsible about what is written here.

If nothing else, this criticism is a perfect example of how you shouldn't criticize someone based on one small clip of what that person has written or said. I didn't feel the need to reply to this comment, yet I was honored to see one of my faithful readers came to my defense. I believe there are two roads one can take once diagnosed with asthma. You can do your best to control it and use it as a tool to better your life, or you can wallow in hate and misery and feel sorry for yourself while you repeat over and over, "Why me?" So what I have to say to those people who are told bad news, or who seem to have asthma so bad they can't seem to get control over it, and they feel down. What I want to say to you guys is watch God's handiwork. When things look like they're real down, when things look bad, look for the good in it all. Because everything works out in the end. Everything works out for the best. It may not be the way we planned it, but everything always works out. A perfect example is the boy who is 12 and is now trying to disprove the Big Bang Theory. When he was a baby he stopped talking and was diagnosed with asperger syndrome. His parents were depressed and wanted to give up on him, yet they didn't. Thankfully they accepted this as a gift from God and tried to find good in it. Now he is in college at Purdue University, and older students call him all the time for math advice. Read more about that here.

Negative Criticism

When I was a journalist we'd celebrate when we received letters of criticism regarding the material we wrote, particularly if the criticism was about an opinion in an editorial or column.  Today that criticism usually comes in the form on an email, or a comment at the bottom of a blog post.

In the e-asthma world, the post I've received the most criticism of is the post where I was the most optimistic about my disease, and the post was "The Seven Benefits of having Asthma."  I basically wrote that I find it useless to sit around saying, "Whoa is me!" and more useful to take that disease as a gift from God and an incentive to improve your life.

The advantages I see in this disease is that it has given me a unique perspective on life because I've come close to death more than once, a sense of vulnerability in that I know I will not live forever and that I need to make the best of my time here, a tighter bond with God (religiosity), empathy for other people who have a disease, improved intelligence because instead of hanging with the guys I would read and learn, the ability to share my experiences, and the gift of cleanliness because I'm allergic to dust and mold.

So why would someone have a problem with that?  What do you want me to do, sit around and sulk and feel sorry for myself and live in a bubble and hate my life.  Man, I would hate to live that life.  Yet this appears to be what some people would like of a poor asthmatic.  

Consider the following:

"these 7 benefits of having asthma were useless. they didn't help me with anything. you people are so stupid maybe think twice about having those your site. or just find some better benefits because the ones you have are just peices of junk. whoever came up with those must be 5 because those things are super gay"

You see, a comment like that isn't even worth replying to, and usually I don't.  Yet I'm posting it here just to make my point.  No one would wish asthma on anyone else, yet if you so happen to have it, I can think of many worse things that could happen to a person.

Or how about this one:

 Although the sentiments in the list of seven are things to strive for; not many people suffering with a disease as serious as asthma or copd or emphysema would consider their conditions "benefits". Imagine if you were a child with a life-long debilitating illness like asthma, or an elderly person barely able to breathe.

Um, I am that person.  I was the young kid who could barely breathe, and instead of choosing to sit around wallowing in pity I chose the nobler route. I chose the nobler route when I was just 10.   I sat and had many discussions with God about what plans he has for me now that he has given me asthma.

The author continues:

You really need to be careful when addressing things to the population you are dealing with. This article had little sensitivity for the sufferer as it was written in what seemed to be rather glib sound-bites. I wonder of the author is an asthma sufferer. Because unless you've been through the near suffocating experience of having to rely on meds breathe, you would write with greater sensitivity and explanation. If the author does have a lung condition than perhaps they need to generate their own "empathy" in a greater fashion when writing such material. In any event, the editors of this site should also be more responsible about what is written here.

If nothing else, this criticism is a perfect example of how you shouldn't criticize someone based on one small clip of what that person has written or said.  I didn't feel the need to reply to this comment, yet I was honored to see one of my faithful readers came to my defense.

I believe there are two roads one can take once diagnosed with asthma.  You can do your best to control it and use it as a tool to better your life, or you can wallow in hate and misery and feel sorry for yourself while you repeat over and over, "Why me?" 

I had a Goofus Asthmatic moment

So I was too busy and too burned out and too lazy to refill my prescriptions last week, and they ran out just before the weekend. Well, too lazy probably fits in there best, because I worked last Monday, Tuesday and Wednesday, and the pharmacy sits next to our department. And the pharmacist is a fellow big-time Detroit Tiger fan and I spent an hour talking with him on Tuesday. So, I guess you can say lazy is the best way to word it.

Rather, you could probably put this in Goofus Asthmatic category. I went the entire weekend without my inhaled steroid. So when I woke up last Saturday night with an itchy neck and a chest that seemed to be burning, recollections of my the days when I truly was a Hardluck Asthmatic ran through my head.

Actually, the feeling was similar to when I used to be dependent on Theophylline, and I'd forget to take that medicine. Yet I was no longer on Theophylline. So I shouldn't feel like this. Yet the Theophylline worked to relax my lungs, the same thing the Advair was supposed to be doing. Yet I had no Advair in my system, and no Advair in my medicine cabinet.

So was I screwed? These thought rushed through my mind in the dark as I lie there in bed. I wasn't terribly short of breath, yet just uncomfortable enough where I didn't think I'd fall back asleep if I didn't do something. I hopped out of bed, and quietly tip-toed to the bathroom. I opened the cabinet. The bottle of Singulair had some pills left in it. Thankfully that hadn't run out too.

I couldn't remember when I took one last, yet I remember reading somewhere that Singulair was proven in one study to help with acute asthma too. So I popped one of those.

Oh, and did I mention that all the Ventolin inhalers I had lying around my room were empty. If there was a full one somewhere around I wasn't aware of it. I'm sure I'll find one in a pair of pants when I do the laundry, or under the bed when I clean. Yet right now I didn't have access to a full one.

So I went back to bed. I still didn't feel the best. So I hopped out of bed again, turned on the bathroom light just so I'd have enough light in the room to see what I was doing, and I reached up onto the top shelf of the closet.

The box with my nebulizer was right where I left it. Back when I was a Hardluck Asthmatic the machine would never make it to a box, yet those were days of old. Now it was used only for a backup system, which was mainly when I lost my inhalers, or, as was the case this night, was too lazy to get new ones.

I dragged the nebulizer to the living room and puffed on it for about two minutes, then shut if off. That's all it took. I went to bed, fell fast asleep. The Singulair must have worked, because I didn't have a repeat of the burning and itching. Yet without the corticosteroid in my lungs, the inflammation was agitated just enough so that I needed a hit of my inhaler at least once every four hours or so the rest of the weekend.

On Monday, just before I got my new Advair, I did a PFT on myself. I was surprised that my pre-treatment FEV1 was 85%, and my post FEV1 was 93%. That's pretty good.

Once I took that first hit of Advair it was like I was cured again. I didn't need my Ventolin again until just before I went to bed. Since that day I've only needed it twice a day, just as before I had my Goofus Asthmatic moment.

So I think I'm correct in thinking that Advair was, after all, still in my system. I think it takes about two weeks until it's totally out of your lungs. And that's probably why my asthma didn't get as bad as it could have.

I guess I just wrote about this episode so that the rest of you asthmatics know that even the best of us, even asthma experts, have our Goofus Asthmatic moments. The ironic thing about me writing this today is I just changed my banner to read: The Gallant Asthmatic. This is a true testament, though, that there really is no such thing as a true gallant asthmatic.

We are all normal in that way. Have you ever had a Goofus Moment you'd like to admit to?