Comments for breathinstephen.com

Comment on Asthma guilt trip by mymusicallungs

mymusicallungs — Thu, 09 Sep 2010 05:04:36 +0000

I used to get steroid shots-they were a drug called Kenalog. I got a steroid shot yesterday, but at the hospital!

Comment on Asthma guilt trip by breathinstephen

breathinstephen — Thu, 09 Sep 2010 00:25:46 +0000

That's awful. I think I would have complained .

One thing that might help in the future, is contacting your doctor before hand to let them know you're going in. Then when you arrive at the ER tell the triage Nurse that your doctor sent you. I bet they wouldn't make you wait for very long.

Comment on Asthma guilt trip by breathinstephen

breathinstephen — Wed, 08 Sep 2010 21:33:47 +0000

Haha, I\’ll leave that one for you! We are inhaler stealth experts. The hardest part is disguising the sound.

Comment on Asthma guilt trip by Brenda

Brenda — Wed, 08 Sep 2010 20:50:16 +0000

Wow this is such a good point.. I usually wait to long but am getting better at going earlier. Once the triage nurse didn't believe me made me wait etc. when a ER doc came in that knew me he couldn't
believe they made me wait (and I was getting alot worse) He called me right in and I was really really tight,I did end up in the ICU.. The only good thing was he went right out to that nurse and set her straight and the Nurse Manager someone else… I am on a good streak right now and actually had a dream about going to the ER and how horrible it was….. My mom always made me feel guilty growing up with my asthma..
Thanks for letting me vent…

Comment on Asthma guilt trip by wheezytux

wheezytux — Wed, 08 Sep 2010 20:23:39 +0000

Oh I know this feeling all too well. I always feel silly calling and ambulance to go to hospital when I am kinda mild but getting worse. I feel like I am not as bad as I can get so dont want to waste the drs time. I think it stems from a similar situation you had steve but not as severe. I walked into A and E when I was at uni in the south of england to be told by the receptionist that I didnt look like I was having as asthma so couldnt be that bad so needed to take a seat and wait my turn. I was sat near the triage nurses door. I sat there for about 30 mins before the nurse saw me and took one look and called me through and shouted at the receptionist to let the resp team know I was here. I had my sats done and they were dropping so I was taken through to resus and then sent up to ITU. I always wonder what would have happened if that receptionist had listened to me when i told her my asthma goes down hill very quickly. I always wonder if I would have ended up in ITU.
I have had a few experinces where receptionist and even junior Dr's have been you dont look bad and your young so you will be ok.

Thanks for sharing the story steve. I know I shouldnt hold back in going in but I do. I think it is a fear factor too as I know what it is like and I think I try and kid myself things are not as bad as they are.

Comment on Asthma guilt trip by Sara C.

Sara C. — Wed, 08 Sep 2010 20:21:51 +0000

one often waits that long in the States too…not asthma related, but I went into the ER with A migriane that had me experiencing stroke like symptoms, and I still sat in the waiting room for nearly 6 hours. (thank goodness it wasn’t a stroke)

Comment on Asthma guilt trip by mommato2beauties

mommato2beauties — Wed, 08 Sep 2010 19:54:09 +0000

I will often sit on the couch, not moving air well at all…KNOWING that I'm in trouble, doing piggy back nebs, with the thought of "who is going to take care of the girls if I'm in the hospital" Of course, rationally, I know that my mom, or my mother in law would come to help…but I'm not always rational when I can't breathe. I also need to start asking myself "who's going to take of the girls if I die"

Excellent topic. Next, you should cover why so many asthmatics are so embarrassed to use their rescue medication in public. (though, it might stem from the same place.)

Comment on Asthma guilt trip by breathinstephen

breathinstephen — Wed, 08 Sep 2010 19:34:06 +0000

I used to feel the same way about not wanting to take a precious hospital bed away from someone who might need it more. But the fact is, the majority of patients you find in a typical ER, are there for things like colds, mild flu, sprains and bruises, etc. Hardly life threatening stuff. If you\’re having a severe exacerbation, you\’re probably be one of the sickest patients there, so no need to feel guilty.

Comment on Asthma guilt trip by breathinstephen

breathinstephen — Wed, 08 Sep 2010 19:25:26 +0000

Gayle, you can vent here as often as you like….I totally get it. There are a lot of us flaring right now. Sept and Oct seem to be bad months for asthmatics.
I didn\’t know they still gave steroid shots at the doctors office. I used to get those back in the 1980s. It was a drug called Celestone.
I hope the shots helps turn you in the other direction.

Comment on Asthma guilt trip by melissamashburns

melissamashburns — Wed, 08 Sep 2010 17:00:43 +0000

I have adult onset asthma and part of the reason I used to wait is that I had a difficult time deciding if I was really having an asthma attack. Then I would think I would take time away from the people who were sicker than me. I live in a very small town, with a very small ER and hospital. I have to go to the ER for other things and they have gotten to know me in there. It is kind of embarrassing when you local ER knows you by name.

Comment on Asthma guilt trip by GayleMyrna

GayleMyrna — Wed, 08 Sep 2010 15:35:12 +0000

I tend to procrastinate until I feel I am "bad" enough (increasing use of albuterol, becoming short of breath with less exertion then usual, more sudden symptoms coming on, etc.) before I seek help, usually first choice with primary care physician. Having been through the wringer many times, I tend towards the stoic, go with the flow approach. Don't want to be labeled hysterical female patient. My lungs have been gradually going downhill last few weeks and finally had my routine appointment with pulmo doc yesterday. He got me a steriod shot and put me back on prednisone. Hopefully this flare-up won't get any worse now. Of course, now he wants to do a bunch of heart tests on me to rule out any cardio issues. I fail at the treadmill stress tests because even on my best days I can't walk quick enough before I get SOB to get enough time on the machine for an accurate heart assessment. Bah! Anyhow, thanks for letting me vent!

Comment on Asthma guilt trip by breathinstephen

breathinstephen — Wed, 08 Sep 2010 13:32:18 +0000

Yes it was sparked by a recent discussion, though I actually wrote it a while back.

Comment on Asthma guilt trip by clare

clare — Wed, 08 Sep 2010 10:20:32 +0000

I always used to hide how I felt when I was a kid, I didn't like the attention my mum gave me or anyone else. My mum knew though and I would often wake up at night to find her watching over me as she could hear my dodgy breathing from her room. I used to beg her not to phone an ambulance 'just another half hour please' . I'd crawl to school just to prove I was ok. I also hate my mum visiting me when I'm ill, I used to get really upset and tell her to go home.
I've got better at admitting defeat and going in now, 3/4 nebs and then its ambo time.
We are a strange bunch us asthmatics!

Comment on Asthma guilt trip by Heather

Heather — Wed, 08 Sep 2010 04:00:58 +0000

I have the same guilty feelings about going to the ER. It's probably because as a child, I was kept out of the hospital unless I was seriously, deathly ill. My mom is a nurse, and she really didn't want me to be around all those germs when I was already so sick (and she does have a point). I was really well taken care of. Now though, after being breathless a number of times and going in for them to tell me I'm not wheezing and to go home, I just figure "What's the point"?

Also, I'm Canadian, and while I love free healthcare, I don't love waiting 4-8 hours in a dirty waiting room

Comment on Asthma guilt trip by kerri

kerri — Wed, 08 Sep 2010 02:58:39 +0000

Was this sparked by a certain discussion?

I'm also glad you decided to write about this, because as I've found out, a LOT of us do this. And, all the questions in the third paragraph — I've asked 'em myself, too.

Comment on Asthma guilt trip by Melissa Mashburn

Melissa Mashburn — Tue, 07 Sep 2010 23:03:40 +0000

I do this all the time. I have gotten myself into real medical trouble more than once because of waiting. I am glad you brought this subject up!

Comment on Breathing……the mini series. by Friday Links – Kids’ Health Help Tool, Breathing Miniseries, the Risk of Violence

Fri, 03 Sep 2010 16:40:03 +0000

[...] Steve’s New Series on Breathing and Asthma [...]

Comment on No Thermoplasty for Steve by Steve Gupta, M.D.

Steve Gupta, M.D. — Fri, 03 Sep 2010 01:51:41 +0000

The company conducted a trial, called AIR trial. The FDA approval was based on this trial. The company excluded all of the more severe asthmatics from this study. However FDA approved this device for use only in severe asthmatics!!

Comment on Bronchial Thermoplasty promising? by Stephen

Stephen — Thu, 02 Sep 2010 23:35:19 +0000

Hello Dr Gupta and thanks for leaving a comment on my blog re: bronchial thermoplasty. I’m not a physician, but I totally agree with you! In addition, thermoplasty does nothing to reduce the inflammatory component of asthma. I wrote this particular post while thermoplasty was still in trials and very little was known about it. ( I was actually excluded in participating in the clinical trials because my asthma was too severe. )
Here’s a more recent post I wrote about Thermoplasty.

By the way , to you know Dr Sally Wenzel over at the University of Pittsburgh? She’s one of the SARP investigators and is my personal physician. She’s a great person and feels the someway about thermoplasty as you do.

Thanks again for taking the time to comment.

Comment on Bronchial Thermoplasty promising? by Steve Gupta, M.D.

Steve Gupta, M.D. — Thu, 02 Sep 2010 21:29:49 +0000

Hello. I am an asthma specialist (Allergist). I have analyzed the published reports on Thermoplasty and have found too many problems with the procedure. My main concerns are listed below.
1. There is not even one, independent study showing that it works. All the studies were done by the company that makes the device. There is obvious conflict of interest.
2. The largest and the best study was AIR trial. It was on the basis of this study the FDA granted approval of the device. The AIR study showed that thermoplasty and placebo treatment were equally effective. There was no clinically significant difference between the two.
3. The AIR study had one patient in the placebo group who became very sick after the placebo procedure. He/She required nine admissions in the year after the treatment. If we remove this patient from the calculations, the thermoplasty group had worse outcome than the placebo group.
4. There is no theoretical basis to believe that reducing smooth muscle mass should help asthma. We do not know if increase smooth muscle mass in the result or the cause of asthma.
5. The animal studies with thermoplasty were not at all in concerrence with the clinical studies.