I thought Id do something a little different with today’s post and teach some Respiratory Therapy 101 to my fellow asthmatics . A mini series if you will, on topics that I think every asthmatic should be familiar with.
Things like.. Dyspnea, what exactly is it? Or,Air-trapping? Or how about,Obstructive lung disease..what is it? I’m sure most of you have probably heard of these terms before, but do you really know what they mean? I think the more you know about your disease and how your lungs work in general, the better you’ll be at treating your asthma and the better you’ll be at communicating with your medical provider… and maybe even teach them a thing or two.
Before we get into any of these lessons, I think it’s really important that we review some breathing basics. We already know(at least I hope we do), that the reason we breath in the first place, is so that we can get oxygen into our body and carbon dioxide out. For the purpose of this review however, let’s focus on the the mechanics of breathing itself. In other words..the act of taking a breath in and then blowing it out… how does it all work? It’s pretty amazing actually Let’s call today’s episode, the “Breathing Cycle”.
Most people think that the act of breathing is simply a matter of taking a breath in, and then blowing it back out. Actually, there are 4 distinct phases to the breathing cycle; There’s the Inspiratory phase , the Inspiratory pause , the expiratory phase and the expiratory pause phase. When everything is working right, the process is effortless and we’re not aware of it. Add asthma to the mix, it’s a different story. For now though, lets see what happens during normal breathing.
To help you visualize what I’m talking about, I found this really cool video (courtesy of the nice folks at Interact Medical), that illustrates beautifully,the mechanics of normal breathing. They do a great job of depicting the diaphragm’s role in breathing (shown in yellow).
Here’s what’s happening:
1) Inspiration(the act of inhaling or taking a breath in), is an active process. By active, I mean that it requires muscle power to do it. In this case, it’s the diaphragm that’s doing the work. A signal from the brain tells the diaphragm muscle to contract. As the diaphragm contracts and pulls down, it creates a vacuum inside the chest cavity (kinda like drawing back on a syringe) and by doing so, enlarges of the abdominal cavity. This in turn causes the lungs to be pulled down open, which allows fresh air to rush into them. When you take a breath in, you are literally sucking the air into your lungs. (During normal breathing, this is not noticeable.)
2 Inspiratory pause As air is drawn into the lungs, tiny stretch receptors tell the brain when the lungs are full enough. The contraction of the breathing muscles then seizes and the air is held in the lungs. This is part of the breath cycle that we call the “inspiratory pause”. It only lasts a fraction of a second, but it’s there.
3) Next we have the expiratory phase( the act of exhaling). Assuming that you have healthy lungs, expiration should be totally passive. The diaphragm and the other breathing muscles simply relax to their resting postion and the air is expelled from the lungs.
4) Finally, we have the expiratory pause, which is just the pause between exhaling and taking the next breath in. This phase can last several seconds depending on the body’s need to start the cycle over again. Pretty cool eh.
Now that we know how this all works, let me throw some numbers at you just for fun.
If an adult person with healthy lungs takes 12 breaths ( breath cycles) per minute, this means that it takes appx 5 seconds to complete each breath cycle (12 breaths x 5 seconds=60 seconds or 1 minute). Within that 5 second period, appx 1.5 sec will be spent in the insp. phase, 0.5 secs in the insp pause phase and 2-2.5 sec in the exhalation phase. In a person with healthy lungs, the expiratory phase is usually 1.5 to 2 times longer than the inspiratory phase ( what we call the I:E ratio). In a person with chronic asthma or COPD, the expiratory phase can be many times longer than at. With my own asthma, when I get really tight or I’m trapping a lot of air , it can take me a full 15-20 seconds to exhale a single breath. If it was taking me 20 seconds to exhale a single breath, I would only be able to take 3 or 4 breaths per minute, right? Well, if that were the case I wouldn’t stay conscience for very long. Actually, when asthmatics get really tight like that, we’re forced to terminate the exhalation early, so that we can make room for the next breath. Because we’re continually terminating each breath early , we end up having an abnormal amount of air that stays trapped in our lungs. ie…air trapping! (More about air trapping in a future lesson).
Here’s another RT tidbit for you: Did you know that no matter how hard you try, you can never exhale all of the air out of your lungs? If that were the case, your lungs would totally collapse and you would not be able to overcome the resistance that it would take to re inflate them again. In the Respiratory field, we call this residual lung volume.
I hope I’m not jinxing myself by writing this post, but if you’ve been monitoring my little “days out of the hospital” widget, then you know that this week makes 6 months that I’ve been hospital free **YAY!**
I wouldn’t break out the campaign bottles just yet, as I still have twice as long to go before breaking my own record, but I think it’s a milestone which deserves at least a little recognition.
And to what do I attribute this extended reprieve? I’m not really sure. Most likely, it’s a combination of better dyspnea coping tools (opiate medications, relaxation techniques and exercise), a much better diet (organic with less sugar), less stress, and somewhat better weather this year. It could also be that I’ve just become more stubborn and have raised the bar on what I consider to be hospital worthy exacerbations.
Whatever the reason behind this good fortune, I sure hope it decides to sticks around for a while. Staying out of the hospital is something I could really get used to. Wouldn’t it be something if I could break my all time record of 13 months hospital free?
Of course, being hospital free doesn’t necessarily mean that I’ve been symptom free. Most severe asthmatics never reach 100% symptom free status, even for a single day. Still, it’s encouraging to know that Ive gone a half a year without becoming critically ill again. It gives me hope that I still have a lot of good days ahead of me.
Carolyn Scott Kortge’s new book is finally out and guess who’s in one of the chapters?
Carolyn contacted me about year ago for this project. She thought I had an interesting story to tell, and that it would fit in nicely with the motivational theme of the book. It’s really cool to finally see the finished work. She did a great job on it.
Healing Walks for Hard Times, maps a path through life’s difficulties with walks that tap the healing power of movement. She demonstrates how walking can restore momentum in lives that have been jolted by illness, cancer, grief, depression or trauma. With a focus on walking for wellness rather than walking strictly for fitness, it offers a path of resiliency in the steps of a familiar exercise.
More than an exercise guide, Healing Walks for Hard Times acknowledges recovery not only as a physical process, but also as an emotional, spiritual and mental journey—-a journey of Survivorship.
Carolyn lays out a progressive, eight-week walking program that encourages readers to get their feet on the ground and move forward, one step at a time. Included are personal stories from survivors of heart disease, cancer, depression, diabetes, chronic pain, natural disaster, and of course severe lung disease, that inspire and reassure. Week by week, walk by walk, readers regain balance and footing on a path that leads to healing, step by step.
Below are a couple of the pages I’m in…….
( Excerpted from HEALING WALKS FOR HARD TIMES by Carolyn Scott Kortge, (c) 2010) (Published by arrangement with Trumpeter, an imprint of Shambhala Publications, Inc., Boston)
(www.Shambhala.com)
Looks like I jumped the gun on this one. After polling my family, friends and doctors, and after reading up on high altitude hiking, Ive decided to heed some good advise for a change and will not be participating in the Mt Evans COPD Challenge hike.
The elevation just makes it too risky for someone with lungs like mine. There’s just too great a chance that I could get really sick. My travel schedule wouldn’t have allowed me enough time to acclimate to the higher elevations of Colorado anyway, so that would have put me at an even greater risk for high altitude complications. I would hate to ruin it for the other participants if something were to happen and I needed to be taken off the mountain for emergency medical care.
To say I’m a little disappointed would be an understatement. I’m the type of person who thrives on mental and physical challenges, so making the decision to withdrawal from this event was tough for me. I was really looking forward to pushing my body to the limits on this one and to see this magnificent mountain range up close and personal. I suppose I’ll just have to get my kicks in a safer , more familiar fashion.
Though maybe not as challenging or as memorable as doing a walk two and a half miles up in the air, later this year I’m planning on doing back to back half marathons ( 4-6 weeks part). I haven’t chosen the exact races yet, but Ive narrowed it down to the San Jose Rock &Roll , the Spirit of Pittsburgh and the Las Vegas half marathons, taking place in October, November and December.
Training for the those races begins for me in less than two weeks.
To the wonderfully wacky people who haven’t chickened out of the Mt Evans Challenge, Good luck up there!
I often find it frustrating that here I am, a life long asthmatic, a Respiratory therapist and an asthma educator, yet still unable in normal conversation, to describe what makes my type of asthma so different from others. When asked to define asthma in general, I usually give the spiel about how asthma is an inflammatory disease of the airways, and blah.. blah.. blah .
But lately it’s hit me that the explanation Ive been giving for so long, though medically correct and easier for lay people to understand, doesn’t really paint an accurate picture of what’s actually happening with MY own asthma. So, I’d like to take this opportunity to explain more in depth why my type of asthma is so different. I hope I can do this without boring you, or worse, loosing you.
What makes my asthma so different from others, is that are actually TWO distinct processes going on in my lungs. A “double whammy” if you will. Both of these components are related to, and caused by asthma, but they are uniquely separate medical entities. One of them I have control over, the other I don’t . Let’s break these components down;
The first and primary component of my asthma, is pretty much the same one that all asthmatics have to some degree, and that is, hypersensitive, mucus producing-inflamed airways. When you have an asthma flare up, it’s the swelling of the lining of the airways, and/or the excessive mucus production, and/or the tightening of the muscle bands that attach to the outside of the airway, and/or ALL all of the above, that causes you to wheeze and feel short of breath. No one really knows why this happens, but luckily, most of these symptoms are treatable, and even preventable, when following an asthma action plan and taking the proper asthma medications. So, as with most asthmatics, this is the part of my asthma that I some control over.
My Bronchioles( sorry, it’s the best illustration I could find)
In addition to having sensitive and inflamed airways however , I also have a 2nd component which is more commonly seen in people with COPD and Emphysema, but is now showing up more and more in extremely severe asthmatics. This component involves scarring and/or the loss of what they call “alveolar attachments” (essentially, elastic fibers which help pull the alveoli open from the outside).
Years and years of unchecked asthma exacerbations and multiple intubations, has left the inside of my airways severely damaged and scarred (what they call remodeling). The tissue that lines the inside of my breathing passages is literally scarred over, causing permanent narrowing ( see illustration above). Scarring of the airways looks just the way you would imagine any scar tissue to look. It’s thick, fibrous and pale looking. ( Click here to view the inside of my actual airways). Because of this scarring, my lung capacity and lung function are severely diminished. The combination of a loss of elastic recoil and a loss of alveolar attachments, makes it hard for me to empty my lungs completely (air trapping), which results in chronic breathlessness, sometimes severe.
The damage caused by lung scarring, cannot be reversed. Hence, this is the part of my asthma that I cannot control. Short of lung transplant surgery, there’s not a lot that can be done. All I can do is try and prevent the deterioration from getting worse. Ironically, it’s thought by some asthma researchers, that this kind of scarring might actually have a protective effect on the weaker airways and alveoli by preventing them from collapsing in on themselves. This would probably account for why I’m still alive.
So anyway, because of this double whammy effect on my lungs, what might be considered a minor flare up for some asthmatics, can turn into a life threatening one for me. Essentially, I have no reserve left. The inside of my air passages are so narrowed from all the scarring and inflammation, that even the slightest bronchospasm or inflammation of those airways can cause them to completely close off.
The message here is simple, if you wanna maintain control over your asthma, take it seriously from day one. Do everything you can to keep your symptoms in check, so that you minimize your chances of developing “Double Whammy” asthma. If you find that you have “difficult- to- control” asthma, try to get evaluated by a board certified Pulmonologist who specializes in severe asthma, as soon as possible . I can’t tell you how many general practitioners Ive seen over the years who claimed they knew everything there was to know about treating my asthma ( but that’s another post).
Addendum : There is a small glimmer of hope out there, that at least some forms of severe asthma might actually be treatable someday. The key, is asthma research and finding out why scarring occurs in some asthmatics and not in others. This is why phenotyping of severe asthma and the work of people like Dr Sally Wenzel, is so crucial.
If you have asthma, please consider being a volunteer for SARP. Help the researchers find the answer, so that we can all breath better. If you’d like to read more about my type of asthma, check the “About my Asthma” section
In just a few weeks , if all goes as planned, I hope to be standing on that very same rock with a half a dozen of my COPD friends.
The brainchild of my Boston marathon walking partner Mike Mc Bride, the “COPD Mt Evans Challenge” as he calls it, is simply about a bunch of friends with severe lung disease, getting together for a day and hiking to the summit of one of the tallest mountains in the Rockies of Colorado…. just for the heck of it! No, we’re not going to scale an entire mountain, but we will be walking up the steepest portion of one.
Starting in Idaho Springs,elevation 8,700 ft, we’re gonna drive up the mountain road 9 miles to Summit Lake, which is situated at the 12,800 ft level. From there we’re gonna hike the last 5 miles on foot up to the summit of the mountain, which sits 14,220 ft above sea level. My COPD friends will be using high -flow oxygen @ 15 lpm to make the trek up the mountain I hopefully, will not need supplemental O2, but I’ll be closely monitoring my O2 sats just in case.
As you can see in this photo taken earlier this year during a race up the mountain, the grade along certain portions of the road is pretty steep. The part that we’re gonna be doing, gains approximately 1600 ft in elevation in just over 5 miles.
( Mike Mc Bride and Roxlyn Cole testing out their oxygen equip)
What makes this particular walk such a challenge for me (and for the other lungers), is the altitude and the steepness of the climb.
Excluding being a passenger in a pressurized airplane, this will be the highest altitude my body has ever been exposed to. The last walk I did that involved a mountain, was back in 2008 when I did the ET midnight marathon in the Nevada desert. And while it was a much longer walk ( 13.1 miles) , we only reached a maximum elevation of 5,500 feet during the race. The summit of Mt Evans is almost 3 times higher.
My lungs are not a big fan of climbing hills. I can barely walk uphill the two blocks it takes to reach my house, let alone 5.5 miles up the side of a mountain. Putting the physical challenges aside though, the main reason I wanna do this is, is to take in the sheer beauty of it all. I think Mountains are awesome.
If you’d like to read more, or maybe even join us, check out at Roxlyn Coles blog
It’s been almost a year since Ive updated my asthma status. Here’s the latest report card. For the year, I give myself a C +
In general my lung function has only declined a couple percent which is good. The problem of course, is that when you’re down in the lower ranges like I am, even the slightest change can have a huge impact on the way you feel. My baseline FEV1 now ranges from 33-42%, compared to 36-47% a year ago.
Probably the most noticeable change, and my biggest complaint by far, is that I get short of breath much faster now when engaging in even physical activity. Magnify that 3 or 4 fold when I do activities like racewalking or marathon walking.
My dependence on opiates and anxiolytics to quell my breathlessness keeps growing. Where I used to only take these drugs occasionally, I now take them on a daily basis.
The good news is that they do help and have probably kept me out of the hospital on more than on occasion.
My medical establishment labels are unchanged ( no big surprise there). Under the GINA guidelines, I’m still labeled a severe persistent asthmatic. Under the brand new SARP phenotypes for severe asthmatics, I’m labeled a Catagory/Cluster 5, Childhood onset asthmatic. ( Thank you Dr Wenzel)
Symptoms
I’m pretty much short of breath to some degree all the time now (even when I’m in my green zone). Most of the time it doesn’t bother me because I’m used to it. But in addition to the low level chronic breathlessness, I’ve also been getting these short, but very intense bouts of dyspnea which seem to spring out of nowhere. The sensation is like that of sudden suffocation. It’s like someone put a bag over my head. It feels like my respiratory muscles are too weak to expand my lungs when I take a breath in. The sensation makes me anxious, which then perpetuates this viscous cycle of not being able to catch my breath. It’s awful. This video ,which Ive used before in my blog posts, does a great job of depicting what these intense mini attacks kinda feel like. The only difference is that I don’t struggle the way the actor does in the clip.
Thankfully these bouts only last an hour or two and are usually relieved with meditative breathing, multiple back to back neb treatments and sometimes opiates. Unfortunately, these intense flares seem to be occurring more frequent now….almost daily. They’re probably a result of declining lung volumes and increased sensitivity to air-trapping.
For the last 6 months I’ve also noticed a slight, but persistent audible insp wheeze when I breath. Hence, the “Inhaler voice” It’s more annoying than anything else, but I hate the way it makes my voice sound. ENT actually checked my vocal cords and they look fine ( no stenosis)
It’s becoming increasingly more difficult for me to sleep laying flat. I now have to pretty much sleep with my back propped up, almost to a sitting position. Last year I switched from a conventional bed to a foam bed, which helped ease my lower back pain.
A noticeable decreasing tolerance to exercise and physical exertion in general. I get winded much easier now when I do any type of exercise or walks.
Incarcerations
2 hospital admissions so far this year, totaling 12 days. 8 of those in the ICU, and 2 of those on a ventiltor.
Ive had one intubation this year, bringing my lifetime total to 16 ( we’re talking Ripleys Believe it or not stuff)
Fitness and Diet
Despite my worsening dyspnea, I still force myself to walk at least 4 days a week ( 4-6 miles per walk) and even farther when I’m training for a race.
Earlier this month, I switched to an all organic diet. Additionally, Ive cut my sugar intake in half and eliminated HFCS almost completely. It’s way too soon to see how much of an impact this new way of eating will have on my health in general, but I suspect it will eventually be a positive one. How could it not.
Bronchial Thermoplasty is no longer an option for me. My asthma is too severe, my lungs are too scarred. (* Speaking of Bronchial Thermoplasty, this is one of better articles Ive read on the subject. It’s objective, factual and well written)
I’m waiting for clinical trials to begin ( hopefully by this time next year) on some new Th2 (IL-4/IL-13) blocking drugs.
Th2 blocking drugs (if they turn out to work), block protein factors related to, but not the same thing as, allergy. These blockers are believed to work “higher up” on the immune inflammatory cascade (where things are getting started) so that they “could” block more things of relevance to asthma. I have a problem with mucus blocking my tiniest airways, which causes me to air trap. (air trapping is the number 1 cause of my suffering). We’re hoping that this new class of drugs might help with that. ( per Dr Sally Wenzel)
Here’s a question Ive been asking myself a lot lately (thanks to a most cool brother);
When it comes to improving my fitness, why should I go through all the pain and sacrifice of exercising my body hard everyday, if I’m gonna continue to throw toxic chemicals into it? Doesn’t make much sense.. does it?
Good old fashioned common sense (which sometimes eludes me), tells me that eating healthy and natural untainted foods, surely must be better you for you than ingesting food that is treated with hormones and pesticides. How could it not?
Convinced that this is not only the right thing to do, but also the wisest, I’ve decided to switch from a conventional diet, to an all Organic one.
Ive already started with fruits and vegetables because they’re easier to find at the local markets. As I get better at doing this, I’ll start including dry and canned goods, and then eventually on to meats and dairy. I’d like to be 90% organic in 3-4 months.
Going Organic is obviously more expensive, but cost shouldn’t be an excuse. I spend $60 on gym fees and $25 for a haircut every month without batting an eye. Why would I even think twice about spending a little extra on something that can only make my life better. Besides, there are informational web tools out there that can help you get the biggest bang for your organic buck… you just have to be a savvy shopper and know what to look for. Remember too, that locally grown food takes less gas to transport it to market, which means less environmental pollution. So there’s a positive impact on more than just ones own body.
Without getting into politics of what’s considered safe and healthy, the turning point for me was this; Why do something only half right? Improving your health requires more than just working out regularly, you also need to fuel and nourish your body with clean natural food.
I love this line by Michael Palin…… “All I ask of food, is that it doesn’t harm me.” (Monty Python’s Flying Circus)
For 5 years now, I’ve been heralding the benefits of daily exercise in people who have severe lung disease. That message is plastered all over this blog, and I believe is the reason that Ive lived so long. But wait, just as with every other facet of this frustrating disease, there’s a catch 22.
While there’s no argument that exercise can make a huge difference in the lives of people suffering from lung disease, Ive long suspected that too much exercise also carries with it, the potential for some not so pleasant side effects. Namely, dynamic hyperinflation, aka…. air trapping.
Here’s the deal…. if you have an obstructive lung disease and are prone to air-trapping (which is usually the case if you have severe asthma and to a greater degree if you have COPD or Emphysema), you need to be aware that any physical activity that makes you breath faster and deeper for prolonged periods of time, can also cause you to trap more air, which in turn can make your dyspnea worse and can even trigger a serious, life-threatening exacerbation. That’s right, you heard it from the king of asthmatic marathon walkers… If you exert yourself too much for prolonged periods, you can actually make yourself sick(er)…at least in the short term. The severity of ones lung disease and the propensity for air-trapping (as indicated by TLC and FEV1 ), probably adds to the likelihood that these negative side effects will occur. It also appears that this increased “air trapping”, at least in part, contributes to the delayed onset of symptoms that sometimes follows strenuous activity.
(Btw..the symptoms of air -trapping should not be confused with exercise induced asthma, which is totally different).
Now that’s not say that you shouldn’t exercise. In that regard, my message is the same as it’s always been, and that is….If you have asthma or any obstructive lung disease, you need to get out there and exercise your butt off regularly! Just don’t over do it, and always be aware of your breathing pattern.
Oh..and I should also point out, that it doesn’t seem to be how much exercise you do, but rather, how intense the exercise is , that determines how severe the air-trapping will be. If you participate in a sport such as running or jogging ( and yes, that would include racewalking), you’re probably going to be much more prone to developing increased air trapping than you would with regular fitness walking or from milder forms of exercise.
(Was finishing this Marathon worth the the nightmare that followed?)
So for me, does this mean I should stop training and/or stop doing marathons? Probably. Will I follow through on my own advise? Probably Not.
I’ll be the first to admit that I have a bad habit of over do it. But, out of the 19 races Ive completed in the past 5 years, only 2 of those landed me in the hospital. And don’t forget, non-asthmatics end up in hospitals too from “over-doing it” too.
Hey, I’m short of breath 24/7 anyway, so if pushing myself to the brink is what I need to do to really feel alive, then regardless of the consequences, that’s what I’ll do. I’m willing to take that risk because Id rather be sick and feel happy , then to be healthy and feel miserable. Sounds contradictory I know, but it’s really not. We all deal with our afflictions in different ways.
Following up on a previous post, I’m happy to announce that the state RCP board has accepted my RCP renewal application. I now have a valid license to practice Respiratory Care in the State of California. Yah….I’m legal again!
I have no plans on ever returning to the traditional work force as an RT, but there’s definitely a sense of security and satisfaction, knowing that I could if I wanted to.
I’m also considering sitting for the National Asthma Educator Certification exam later this year or next. I already do quite a bit of asthma educating from the sidelines, and having official recognition of that skill would be nice to have.
Just as with the RCP license, becoming a “certified” asthma educator is something I don’t really need to do, rather, it’s something that I want to do.
I receive of dozens of letters from people living with really bad asthma, but this one really touched me, because the person who wrote it….. is only 16 years old.
Hey Stephen,
Read your website have to say it was quite intriguing! Just want to say you are a hero and a role model for me. Quite amazing what you’ve been through and I take my hat off to you dude! I am a 16 year old guy from Victoria BC Canada writing to you from my hospital bed on the pediatric 4d north tower. I also have neutrophillic predominant asthma I used to have eosinophillic asthma as my IGE level was 16,000 ug. Since then it has changed into neutrohilic and harder to take control of – I feel like you. Sorry if that offends you because I know it offends me when people ask me in the hospital what are you here for? and i say asthma they reply with oh yeah my son has asthma blah blah blah when they really have no idea…when I read your website I saw life through my moms eyes Pretty scary since im used to it. But I was wondering did you ever have high IGE at one point and then your lungs like changed into neutrophillic predominant? and like when you walk don’t you get out of breath at all? it was quite amazing how you walked al those miles. And have you ever used oxygen at home? And whats you’re criteria before you get to go home? for me its Q4 Nebs and 50% FEV1 which takes about 2 weeks every admission! WTF such a flipping frustration I’ve never met anyone like me before and I seem to see it in you. I’ve also been to national jewish hospital in america for further evaluation from ” the big shots” . My FEV1 varys from 45- 50% and FVC of 65%.
Drugs – Spiriva ( for copd) have you ever been on it?
Oxygen 1-2L nasal prongs when in hosp
Formorteral (oxeeze) 12mcg
flovent
azithromycin antibiotic apparently it helps with inflammation in the airways – that’s what they said in Denver at National Jewish hospital – Have you been there?
Ventolin Nebs Q4
Q30 mins when in hospital.
Prednisone 10mg one day 5mg the next alternating when in hops 60mg for 3 days since i had a steroid myopathy I cant get steroids for a long time because there worried abut that happening again ( Diaphragm paralysis) my diaphragm stopped working which made it hard for me to breath was on Bi pap for 6 months
I HATE PRED!
flutter – Chest physio
IVIG every 3 weeks
I am also getting a bronchoscopy which should tell them more about whats going on, as requested from Denver National jewish.
I’m sorry if im bugging you – just thought your page was really inspiring and something to look up to. Thanks for your time Stephen
Darcy Ablak
No Darcy, thank YOU for YOUR time. It’s people like you who inspire ME ! Your letter made my day.
This is what I call my Hospital survival kit. Always packed and on standby 24/7, my HSK is a small carry bag I keep in my bedroom, that’s filled with everything I might need for a hospital stay.
If (or when) I get sick and have to go to the hospital, all I have to do is grab the bag and GO!
When you spend as much time in the slammer as I do, there are certain essentials you’re going to need to make your stay a little more bearable.
So what do I have in my HSK ?
*Introduction note: (See this earlier post for more details), but basically it’s a note from your personal physician summarizing your medical condition.
*List of medications: Since I’m probably not gonna be able to do a lot of talking to the triage nurse or the doctors, a pre-written list of all my medications comes in really handy.
*Extra clothing : Underwear, t-shirt , Socks etc.
*Toiletries: A few of the things that can make you feel like a human again, especially if you’ve been on the ventilator for a few days , are some clean underwear, a shave, a shampoo , some deodorant, and of course some good oral care help.
*Extra inhalers: As crazy as it sounds, an extra albuterol inhaler is an essential part of the HSK. Even though you’re in the hospital, it can sometimes take too long to get a PRN neb treatment. I can’t tell you how many times having my inhaler, saved me from crashing. ( If you carry one, my advise is not to tell them or they might confiscate it.)
*Phone and Charger: Hospitals can be very lonely places. Not to mention the hospital room phones can be pretty gross. My cell phone or computer is often my only connection to the outside world. Since I’m sometimes too short of breath to talk, texting is the way to go. And of course the camera is useful for blogging purposes ( as we all know).
* Pencil and paper: If you have a breathing problems, or wanna remember peoples name, or just wanna be able to fill out the food menu without tracking down a nurse, these simple items can be very useful. If you end up on bipap or a ventilator, they’re absolutely essential (unless you’re good with sign language.).
* Credit card and cash: Hospitals are more like prisons than you might think. It’s always good to have a credit card or a little cash on hand, in case you need to buy something.
So, what do y’all carry in YOUR Hospital Survival Kits?
Here we a have medication list, contacts and a summary of my medical history
