Toilet seat inhaler

As I've written many times I lose inhalers left and right.  My son must have found one and was playing with it when I suddenly heard a slam in the bathroom.

My initial reaction was that he had his hand slammed in the toilet -- again.  Yet upon entering the room he was just standing next to the toilet crying.  I picked him up and end of story.

Three hours later I'm at work and my wife sent me the following picture.  Apparently he was holding the inhaler when the seat slammed.  I just thought I'd share this with my readers. 

10 Reasons chronic lungers should work in a hospital

My dad recommended when I was in high school that I get a job working in a hospital.  He likewise recommended I become a respiratory therapist.  I heeded my dads advice, but didn't go to school to be an RT until I was 25 only because I was afraid I'd fail chemistry.

Yet working in a hospital sure has it's advantages when you're an asthmatic, or if you have any lung disease for that matter.  So, listed here are the advantages of working in a hospital if you have a lung disease:

1.  You become better educated about your disease

2.  You have access to all the best medicine

3.  You work with doctors and nurses who can treat you if you're ill

4.  Nurses can suck the excess wax out of your ear

5.  Observant nurses can observe that your asthma is acting up and that you need help

6.  Air conditioning

7.  Clean and safe work

8.  You can rest often

9.  You get to hang out with other patients with similar diseases

10.  You can take treatments at work

Ear wax and infections

It's seems as though the asthma body leads us from one ailment to another.  If it's not asthma its hay fever.  If it's not hay fever it's a wandering eye.  If it's not burning flat feet it's a headache due to sinus problems.  If it's not that it's an ear ache and a sense of fullness in an ear or two.

That was my most recent problem.  My right ear has felt full the past several months.  I actually saw my doctor a couple weeks ago and that was the only day my ear wasn't bothering me, and for some reason he didn't check my nose and ears.  

Yet yesterday my ear totally plugged off, a headache raged through my head, and the ringing was terribly annoying.  Plus I was working.  Then I decided I couldn't stand it no more so I wandered down to the ER clinic room and asked a PA if she'd do me a favor and check my ears.

I have a history of wax buildup in my ears, and I have a history of ear infections too.  Yes, I know otitis media is a disease that kids get, but I get it too.  I remember as a kid getting ear aches so bad I couldn't stand.  I don't have that problem any more, yet the sense of fullness is equally annoying.

A few years ago an ER doctor found that I had an ear infection and gave me a prescription of antibiotics.  It's nice to have doctor friends this way.  This time, however, the PA said I had an impaction in my.  She asked a nurse to flush my ear pro bono.  Yes, it's nice to work in a hospital sometimes.  

Walking back to the RT cave I could hear sounds I didn't even know existed, and that I didn't hear on the way to the ER clinic.  It was so nice to have my hearing back.

All she did really was flush my ears out with warm water.  She put the warm water into a syringe and squirted it into my ear.  It felt funny but good.  The excess water dripped into a basin.  It's probably a remedy you could do yourself at home.  

Yet I suppose so long as I have access to such good friends at work why would I need to do such a thing myself. Yes, working in a hospital is nice.  

My review of Dulera, Symbicort

I will never shut the door on future experiments with newer asthma medicines based on past experience.  I once rejected Serevent, yet Advair ultimately rid me of my infestation of hardluck asthma.  Yet my recent trial with Dulera didn't go so well, and I ended it.

The problem I encountered was not with the steroid but with the long acting beta adrenergic Foracort.  While it was nice that Foracort was quicker acting as a rescue medicine, it made my heart pound like Alupent used to make my heart pound back in the 1980s.

There were some nights back in the 1980s where I'd use my Alupent before bed and my heart would pound so hard I was afraid I wouldn't wake in the morning.  When I started using the Albuterol inhaler in 1985 and Albuterol nebulizer solution in 1991 this feeling ended.

Yet Formoterol brought it back.  There were a few nights, and mornings, after taking Dulera that my heart pounded.  I never once had that feeling with Advair.  So I decided I could no longer take it.  

I like to think Dulera and Symbicort are basically the same medicine because the LABA is the same in each one (Foracort).  

I also would like to add here that other than the occasional heart pounding the Foracort caused, I felt really safe using any of these LABAs. I have taken extra puffs from time to time with good results as far as my asthma is concerned.  It's a great medicine and it's safe.

I like to think the black box warnings are wrong and basically scare people away from using good medicines.  So long as you use them as prescribed, and so long as you treat your asthma appropriately and don't think your Advair or Symbicort or Dulera will cure your exacerbation, I think you'll be okay.

The first time I tried Advair I basically had to wean myself onto it, and that may be what I have to do with Dulera. Only Advair works so well for me I don't see any point in doing that at this time. However, if you have hardluck asthma and are looking for a good asthma medicine, I highly recommend you try one of the above named medicines.  

Don't give up if you don't get immediate results or if the side effects hit you. Try one and if it doesn't work try another.  Wean yourself onto them slowly while you wean yourself off extra puffs of your ventolin.  You may find that after using a combination inhaler for a few weeks that your ventolin usage declines, and your side effects go away.

That's my advice.  What's yours????

Let'

1840: Is asthma just emphysema?

Even though it had been proven by Dr. Charles J.B. Williams in his 1840 experiments, Dr. George Budd continued to deny that bronchospasm had anything to do with asthma.

Yet there may have been some bias here. He had done experiments on his own, and even made "Remarks on Emhysema of the Lungs" in 1839.

As Dr. J. B. Berkart notes in his book, "On Asthma: It's Pathology and Treatment," Budd repeated Williams experiments and failed to repeat the results. Budd "therefore, rejected the theory of a bronchial spasm, and even doubted whether the circular fibres were muscular, as alleged."

The thing about reading about this in their original works and by the original authors, is that when I was reading about the description of emphysema I was confused. After a while I realized that my problem was because I was going by today's definition of emphysema and not the 19th century definition.

Today we define emphysema as loss of lung tissue that causes air to be trapped in the lungs, and this results in a barrel chest appearance. In the 19th century emphysema was simply air trapping.


Berkhart (page 26) describes how one doctor (Dr. Longet?):

"not only confirmed in the main the results obtained by Williams, but added that in his experiments irritation of teh pneumogastric nerve always produced spasmodic contraction of the brnchi, whereas section of the nerve led to emphysema... since section of the vagus causes emphysema, i.e., distension of the air vesicles, there must be muscular fibres which, if liable to paralysis, are liable also to spasm."

So you see, emphysema is air trapping. It's air being trapped in the lungs due to narrowing of the bronchioles (air passages in the lungs).

What both Williams and Budd may have failed to observe was that they were both onto something. Emphysema (air trapping) is secondary to bronchospasm. Yet it may have taken a few more years to juxtapose these ideas.

The long walk of death

I don't know if this is a figment of my imagination or not, yet I have a memory from my stay at National Jewish where all of us kids were in the gym at the Kunsberg School and our assignment was to run around the gym until we couldn't breathe.

I almost want to say this really happened.  I don't remember how long I was there before we did this, although I almost want to think we did this more than once.  Was it done once a month?  I don't know.  I have no way of finding out.

I remember having a discussion with our PE instructor, or whomever was in charge of us during this test.  Yet I remember this person telling us that this was a test to see how well our current medicine regime was working.  We'd premedicate if that was indicated, and then we'd start running.

Some of us dropped right away.  The first time I did this I made it one or two laps and I was out.  Of course I could be wrong about this too, yet I also remember sitting on the bench and the PE instructor not allowing me to go up to 7-Goodman to get a treatment.  He also wouldn't give me a puff of the Albuterol inhaler either.

I remember someone getting me a glass of warm water.  That's what we were supposed to do during an attack.  And I remember other kids having asthma attacks, and some of them just kept running.  They kept running and running.  Yet it's all a blur.  It's a blur because all I could think of was my breathing.  I was in a panic.  I had to go upstairs.

It must have been just after I was approved to participate in PE, maybe within the first month of my stay.  So either it was late January or early February.  I remember I got so bad I was panicky and the PE instructor told one of my peers to show me up to 7-Goodman.  I knew the way, but we weren't allowed to go on our own during an attack.  That was rule #1.

So I finally made it to 7-Goodman thanks to my good friend Sari (last name long forgotten), and the nurse, whomever it was, refused to give me a breathing treatment.  She said my wheeze was in my throat.  My wheeze was often in my throat, and I was still short of breath.  Yet she refused to give me a treatment on the grounds my wheeze was in my throat.

You see, whether you got a treatment was often at the discretion of the nurse on duty, or if we were off campus the PE instructor with the Albuterol inhaler.  If you were having an attack you had no control.  You had to do whatever that person wanted.  But this time I was panicky. 

She kept telling me to sit and to relax and to concentrate on my breathing.  And I got ticked at her and told her to shut up and give me my treatment.  I just want to breathe.  Yet she refused.  Finally some other nurse got tired of seeing me suffer and she intervened and I finally got my treatment. 

The mean nurse kept telling me to concentrate on my breathing, yet I couldn't even get a tenth of my breath in.  I literally thought I was going to die that day.  I had many attacks in my life, and yet that day, at the asthma hospital that was supposed to help me, I thought I was going to die.

Yet I survived. 

A month later the same thing happened, only this time my asthma was more stable.  This time I lasted two laps instead of one.  And this time the PE instructor let me upstairs right away with Sari leading me.  And this time I got a treatment right away.

Yes, that's right.  When an asthmatic says he needs a treatment he needs one.  That should have been rule #1. Yet  don't remember ever having to go through that again.  And even after I was discharged from NJH in July, and after I started school at home the next fall, I was excused from participating in gym class.

Yet I never had to endure that short walk of death ever again. I imagine after failing it twice -- literally -- the asthma experts at NJH learned that running was not for this hardluck asthmatic.  I don't know if it was a scheduled run by my doctor or what.  That part of my medical records was destroyed. All I have is the shortened version.

This memory kind of reminds me of Stephen Kings The Long Walk.  It's a story where these kids enter a run and if you slow down you get a warning.  If you get three warnings you are shot in the head.  Only one winner. 

Well, the winter of 1985 at National Jewish I was among the first out.  I wish there was someone I could talk to to learn more about this memory.  It doesn't matter so much anymore, I'm just curious.