breathinstephen.com http://breathinstephen.com Diary of a severely asthmatic wannabe endurance athlete Fri, 30 Jul 2010 23:37:33 +0000 en hourly 1 http://wordpress.org/?v=3.0.1 Dead Last http://breathinstephen.com/dead-last/ http://breathinstephen.com/dead-last/#comments Thu, 29 Jul 2010 15:47:20 +0000 Stephen http://breathinstephen.com/?p=15484 Got my finishers certificate and the official results book for the 2010 Boston marathon in the mail today.

Out of the 23,177 people who started the race, only 22,721 actually finished it. And yours truly has the distinction of being the 22,721st person to cross the finish line. In other words…. I finished the race DEAD LAST! (Pretty cool eh?)
I mean if you’re gonna be slow at something, you might as well excel at it, right? But hey, last place or not, I still finished 15 minutes faster than last year. And who knows, maybe I’ll shave yet another 15 minutes off next years race.


( First place— Cheruiyot, Robert Kiprono 2:05:52)


( Last place— Stephen Gaudet 7:17;47)

]]> http://breathinstephen.com/dead-last/feed/ 10 No Mountain climbing for me :-( http://breathinstephen.com/no-mountain-climbing-for-me/ http://breathinstephen.com/no-mountain-climbing-for-me/#comments Tue, 27 Jul 2010 14:50:44 +0000 Stephen http://breathinstephen.com/?p=15253 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!

]]> http://breathinstephen.com/no-mountain-climbing-for-me/feed/ 9 Recovering Sugar-holic http://breathinstephen.com/recovering-sugar-holic/ http://breathinstephen.com/recovering-sugar-holic/#comments Tue, 20 Jul 2010 12:48:57 +0000 Stephen http://breathinstephen.com/?p=15077
As you might recall, about a month ago I switched to an all organic, non-pesticide treated diet. What you might not know, is at about the same time, I also began to reduce my sugar consumption. I’m slowly weaning myself off one of the most additives compounds known to man. Yes me, Mr. Candy man, is giving up his sweets ( or at least he’s trying).

Don’t believe sugar is bad for you? Neither did I. Actually, I never gave it much thought either way. That is, until someone I really respect (my brother), convinced me that I should educate myself on the subject.

I found that not only is sugar not good for you, it’s downright toxic to your body. Unlike the sugar that you consume when you eat fresh fruit (fructose), refined and/or processed sugars are stripped of any nutrients, making them extremely difficult for the body to break down. And unlike glucose, which can be easily converted into usable energy, the burden of metabolizing high fructose corn syrup falls almost entirely on your liver. Taxing the liver in this fashion creates a ton of waste products and toxins which can reek even more havoc on the body.

Blame it on the steroids I take to stay alive, or on my love for all things sweet, but for the better part of a decade my sugar consumption soared to ridiculous levels. I went from eating the occasional Sunday evening desert, to taking in more than 1,000 sugar calories a day. We’re talking mass quantities of high fructose corn syrup and refined sugar, everyday, 365 days of the year. I was poisoning myself and didn’t even know it.
On a typical day I would eat 2 to 3 candy bars, followed by a dozen or so of those freeze and eat Popsicle thingies. Add in all the sugar I was getting from the the so-called “healthy” foods in my diet, and you start to see why I was having a hard time controlling my weight. Had it not been for all the exercising I was doing, I probably would have developed diabetes and been as big as a house. (Not a good thing when you have severe breathing problems to begin with.)
Funny thing is, I wouldn’t dare eat too much ice cream or cheese, because I considered them too fattening. I fell into that trap of thinking that if something was fat free, that you could eat all you want and never get fat.

Most of us have been conditioned to believe, that other than being bad for your teeth and your waste line, that sugar is a harmless natural food. The fact is, sugar is poisonous to the body. What’s really scary though, is that sugar and high fructose corn syrup have found their way into almost every manufactured food item that you find in the supermarket. The next time you go grocery shopping, read the labels of everything that you put in your shopping basket…I think you’ll be shocked. Even table salt has sugar in it. That’s right, salt has sugar in it. Don’t believe me? Take a look at the label on your Morton’s salt box (dextrose is sugar).

Sprinkle a little sugar on that breakfast cereal, and you’re actually sprinkling poison on top of poison. Most cereals are already pre- loaded with tons of sugar. Some have more sugar than actual cereal! Right now, the average American consumes the equivalent of a half a pound of sugar per day….That’s 48 teaspoons of sugar…everyday! Can you imagine? How on earth can eating half a pound of anything everyday be good for you?

Putting all the politics and science of sugar aside, the bottom line, is that ingesting too much HFCS or refined sugar leads to increased belly fat, insulin resistance and god only knows how many diseases.
Ironically, one of the reasons I got hooked on so much sugar in the first place, was because as my lung disease progressed, I found myself getting really bloated after eating small portions of food. (The last thing you want when you can’t breath, is to feel bloated as well.) I found that by snacking on candy and junk food, that I wouldn’t feel as full or as bloated afterward. Of course that strategy backfires in the long run, because eating all that sugar just makes your belly fatter, which in turn makes it harder to breath.

So, how am I doing with the new organic/ sugarless diet? ( I say sugar-less, because I’m still eating sugar, but much much less of it). Well, about 80% of everything I eat now, is certified organic. As far as my sugar consumption goes, excluding the sugar I consume in the form of fresh fruit and juices, Ive gone from consuming around 80 teaspoon equivalents of table sugar per day, down to less than 2 teaspoons per day and Ive completely eliminated high fructose corn syrup from diet.

Don’t get me wrong, I still have a sweet tooth, but now I get my sugar fix by eating mostly fresh fruits in moderate amounts.

It’s one thing to eat something that you know can make you fat, it’s quite another to eat something you know is actually poisoning you. Once that realization hit me, it was a done deal. Knowing what I know now about the health risks associated with eating too much sugar, how could I not take action. I hope other people will do the same.

PS….Don’t be fooled by some of these pro-sugar websites that claim to be unbias on their views toward HFCS. Most of these organizations are funded by the sugar and corn industries (both of which receive subsidies from the US government.)

]]> http://breathinstephen.com/recovering-sugar-holic/feed/ 6 Double Whammy Asthma http://breathinstephen.com/double-whammy-asthma/ http://breathinstephen.com/double-whammy-asthma/#comments Thu, 15 Jul 2010 15:52:23 +0000 Stephen http://breathinstephen.com/?p=14772 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/or inflamed airways , 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. Basically, I have no reserve left. The inside of my air passages are so small 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

]]> http://breathinstephen.com/double-whammy-asthma/feed/ 0 Be an RCP http://breathinstephen.com/be-an-rcp/ http://breathinstephen.com/be-an-rcp/#comments Sat, 10 Jul 2010 15:34:27 +0000 Stephen http://breathinstephen.com/?p=14695
Check out this nifty little pin the California RCP board sent me…

At first I thought they sent it to me for putting in 25 years of devoted service to the profession, but it turns out that they sent these pins out to every licensed RCP ( Respiratory Care Practitioner) to commemorate 25 years of Respiratory Care as a state regulated profession here in California.

OK.. so maybe I’m not as special as I thought, but if you’re looking for a rewarding career in the medical field, you should consider becoming an RCP. Respiratory therapy has been very good to me over the years, and I can definitely recommend it as a career choice. Check out this brochure

It’s a good field to go into, especially if you’re into helping people who have breathing problems. There’s lots of variety and some great job benefits as well.

And take a look at the average salaries for RTs here in California….
Not bad for a 2 to 4 year education….eh?
]]> http://breathinstephen.com/be-an-rcp/feed/ 7 I think I’ll go climb a REAL mountain http://breathinstephen.com/i-think-ill-go-climb-a-real-mountain/ http://breathinstephen.com/i-think-ill-go-climb-a-real-mountain/#comments Wed, 07 Jul 2010 14:19:10 +0000 Stephen http://breathinstephen.com/?p=15082 How’s this for a view!

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

]]> http://breathinstephen.com/i-think-ill-go-climb-a-real-mountain/feed/ 10 Organic Dairy Question http://breathinstephen.com/organic-dairy-question/ http://breathinstephen.com/organic-dairy-question/#comments Sat, 03 Jul 2010 13:50:40 +0000 Stephen http://breathinstephen.com/?p=14769 Happy Cows

Happy Cows.........

You might remember a couple weeks ago I wrote a post about switching to an all Organic diet?    Well, someone left a comment that raised some very interesting ethical questions regarding the treatment of sick organic dairy animals. Because I’m fairly new to the whole organic food thing, I decided to contact one of the better known organic dairy companies, the Straus Family Creamery, for their thoughts on this subject.

Here’s the comment that was left on my blog:

“I’m a fan of locally grown, and prefer to grow my own when I can. I’m also a huge fan of grass-fed meat and free-range chickens. The one thing I will not buy organically however, is milk and dairy products. My educational background is agriculture. For me, I have the ethical dilemma knowing that often instead of a dairyman treating a sick cow because that would make her no longer “organic”, they allow her to continue to be ill with “name your favorite dairy cattle ailment here” and often feeling pain. I know a few dairymen in the Central Valley who run both organic and conventional dairies so that if a cow needs to be treated, she can be, then moved to the conventional dairy. Without that caveat I don’t feel organic animal products are ethical or healthier (who wants products from a sick animal?) and quite honestly, most organic producers don’t go to those lengths. I feel that the product from an healthy animal who, perhaps some time ago was treated with approved drugs, is still healthier than possibly sick animals producing a product entering the food chain. Just food for thought…”

And here is the Straus Family Creamery’s response to that comment:

“Hello Stephen
Thank you for your email, we appreciate your inquiry. Well, all organic dairies are not all the same. Some do actually care about their health and well-being while wanting to provide the best possible milk for customers.

In general, medical treatment guidelines on an organic dairy are as follows: vaccinations are allowed; antibiotics and hormones are not allowed.

Aspirin is allowed for use on organic dairies and is given to cows to reduce fever and inflammation. In addition, we use homeopathy to treat our cows when they get sick. Homeopathy is essentially diluted herbs.

Albert Straus originally heard about homeopathic remedies on cows in 1992 when he met one of only two large animal vets in North America who were using homeopathic medicines. Albert then began administering homeopathic remedies on our family’s own herd with good results.

On an organic dairy, cows are not given antibiotics unless it is the only way to save a cow’s life. At that point an organic dairy is allowed to keep the cow, but withhold its milk from sale for a period of 90 days. At any of the Straus Family Creamery dairies, if a cow is given antibiotics to save its life, it will then be removed permanently from the organic milking herd.

The most important aspect of keeping cows healthy is to minimize their stress. We accomplish this by providing clean bedding (we add clean rice hulls regularly), room to move (our cows graze from Spring through Fall when the fields are dry), a balanced diet, plenty of space wherever they are, a cooler climate (which is more comfortable for cows since they don’t sweat) and individual bedded stalls for each cow. It’s a pretty good life for a cow.”



I’m not really heavy into eating a lot dairy or beef in the first place, but I thought that both the question posed by the commenter and the response from Straus Family Creamery were enlightening. I definitely learned something.

What do y’all think ?

Organic Dairy Cows

Photos courtesy of Straus Creamery

]]> http://breathinstephen.com/organic-dairy-question/feed/ 2 Annual Asthma Report Card http://breathinstephen.com/annual-asthma-report-card/ http://breathinstephen.com/annual-asthma-report-card/#comments Tue, 29 Jun 2010 14:45:10 +0000 Stephen http://breathinstephen.com/?p=15009

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.
    New Treatment Options

  • 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)

]]> http://breathinstephen.com/annual-asthma-report-card/feed/ 5 A Fathers Day Reunion 50 years in the making. http://breathinstephen.com/a-fathers-day-reunion-50-years-in-the-making/ http://breathinstephen.com/a-fathers-day-reunion-50-years-in-the-making/#comments Wed, 23 Jun 2010 13:16:34 +0000 Stephen http://breathinstephen.com/?p=14322 Hey, I gotta question for you? What’s the longest length of time you’ve ever been separated from a loved one until being reunited with them again? 5 years, 10 years, maybe even 20 years? How does four and a half decades sound?
About a week ago, my brother and I took a very special trip to see our father. It was the first time we saw him in 47 years. Yep. You read it right, 47 years, nearly a half a century!

It’s hard to express in words how it feels to reunite with a person you’ve been fond of your entire life,yet have only vague memories of.  As small children, we knew him as this special character in our lives. To us, our dad (after his divorce from our mom) was more like a favorite uncle who would come by and spoil us , than your typical Dad figure. And through the years, it was special memories of him and the wonderful way he treated us, that actually helped us get through some pretty tough times.

This is me and my Dad the last time we saw each other

And this is me and my Dad now

Getting to spend some time with him again after so many years, was a very surreal, but very worthwhile experience. I mean, here’s the guy who brought us into the world, who up until this reunion, knew very little about us, nor we about him. Yet, almost as soon as we met, we somehow managed to get past that 50 year void in our lives, and had a great time rediscovering things about each other, and putting some of the missing pieces back together. As it turns out, he’s a pretty neat guy.

And guess what? ….. my brother and I found out that we have a 38 year old Sister ( who has 3 children of her own) whom we’ve never met. I wonder if she’s as curious about us as we are about her?

Oh well, it’s been a long LONG time coming, but…

HAPPY FATHERS DAY….TO US!

]]> http://breathinstephen.com/a-fathers-day-reunion-50-years-in-the-making/feed/ 6 Going Organic http://breathinstephen.com/going-organic/ http://breathinstephen.com/going-organic/#comments Thu, 17 Jun 2010 19:07:39 +0000 Stephen http://breathinstephen.com/?p=14498 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)

Buon appetito!

]]> http://breathinstephen.com/going-organic/feed/ 6 My First Adsense Paycheck…Woohoo! http://breathinstephen.com/my-first-adsense-paycheck-woohoo/ http://breathinstephen.com/my-first-adsense-paycheck-woohoo/#comments Mon, 14 Jun 2010 15:46:10 +0000 Stephen http://breathinstephen.com/?p=12980 Wow…Ive hit the big time! I’m major player now. A force to be reckoned with. At the top of my game. Watch out world, I’m going places now!

Today I got one of these… Ben at his finest.
That’s right, my blog is finally paying ME!

So after 5 years, I finally reached the $100 threshold and received my first Google Adsense Payment. That’s a whopping 20 dollars a year. Wow ..I can retire now. Wait a minute …..I’m already retired. OK , well then I’ll take a nice vacation. (just kidding)

Seriously though, I never got into blogging expecting to make money. This little extra ad revenue is just frosting on the cake, and will help defray the cost of hosting this site. Thanks everyone for your continued support.

]]> http://breathinstephen.com/my-first-adsense-paycheck-woohoo/feed/ 6 Is too much of a good thing, bad? http://breathinstephen.com/is-too-much-of-a-good-thing-bad/ http://breathinstephen.com/is-too-much-of-a-good-thing-bad/#comments Thu, 10 Jun 2010 15:38:53 +0000 Stephen http://breathinstephen.com/?p=14132 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.

]]> http://breathinstephen.com/is-too-much-of-a-good-thing-bad/feed/ 2 Born again Respiratory Therapist http://breathinstephen.com/born-again-respiratory-therapist/ http://breathinstephen.com/born-again-respiratory-therapist/#comments Mon, 07 Jun 2010 15:44:40 +0000 Stephen http://breathinstephen.com/?p=12987 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.

]]> http://breathinstephen.com/born-again-respiratory-therapist/feed/ 6 The letter http://breathinstephen.com/the-letter/ http://breathinstephen.com/the-letter/#comments Mon, 31 May 2010 19:06:06 +0000 Stephen http://breathinstephen.com/?p=13608 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.


]]> http://breathinstephen.com/the-letter/feed/ 2 Hospital survival Kit, don’t leave home without it. http://breathinstephen.com/hospital-survival-kit-dont-leave-home-without-it/ http://breathinstephen.com/hospital-survival-kit-dont-leave-home-without-it/#comments Wed, 26 May 2010 16:51:18 +0000 Stephen http://breathinstephen.com/?p=13887 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!

hospital survival kit

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?

medication list

Hospital Intro Letter

Here we a have medication list, contacts and a summary of my medical history

]]> http://breathinstephen.com/hospital-survival-kit-dont-leave-home-without-it/feed/ 17 There’s a lot going on in our small airways http://breathinstephen.com/theres-a-lot-going-on-in-our-small-airways/ http://breathinstephen.com/theres-a-lot-going-on-in-our-small-airways/#comments Mon, 24 May 2010 23:44:10 +0000 Stephen http://breathinstephen.com/?p=13117 You’ve probably heard me talk about the “small airways” in our lungs, but you might be surprised on just how small they actually are.

Here’s a color enhanced photo of the inner surface of our smallest airways taken with a scanning electron microscope. The hollow cavities you see are the alveoli ,this is where the air ends up when you take a breath. We have about 300 million alveoli in each lung. The little squiggly tube thingies are called alveolar capillaries, we have lot’s and lots of those too.

Here we have some red blood cells ( they look like red Cheerios or Lifesavers to me). These guys are great for soaking up oxygen as they pass through those little squiggly tubes that surround the alveoli..

Now, if everything is working as it should, the air that we breath into our alveoli (what we all ventilation), will come in real close contact those circulating red blood cells (what we call perfusion) and presto! ….gas exchange occurs. Oxygen diffuses into the red blood cell where it’s transported to the rest of the body, and carbon dioxide diffuses out from the red blood cells and into the alveoli, where it’s exhaled out of the body.
If you look really closely at the back & white photo, you can actually see a red blood cell as it makes it way through an alveolar capillary, doing it’s thing.

Ventilation and perfusion. Or simply put, the pairing of air with blood in just the right ratio…. That’s what’s it all about. Pretty cool eh?

]]> http://breathinstephen.com/theres-a-lot-going-on-in-our-small-airways/feed/ 5 6th incarnation http://breathinstephen.com/6th-incarnation/ http://breathinstephen.com/6th-incarnation/#comments Mon, 24 May 2010 01:57:55 +0000 Stephen http://breathinstephen.com/?p=13765 Unless you’re new here, you probably noticed that I changed the appearance of my blog… (slightly). This is the 6th makeover I’ve done in almost as many years. Hope it looks OK.

To be honest, I was getting really tired of all those blue colors in the old layout, and the core theme itself, was way out of date. It was just getting to difficult to customize it anymore.

I decided to go with more of a modern magazine style. I think it works well and is fairly easy on the eyes.

Some of my past lives:


2005


2006


2007


2008


2009

]]> http://breathinstephen.com/6th-incarnation/feed/ 4 University of Pittsburgh Newsletter May 2010 http://breathinstephen.com/university-of-pittsburgh-newsletter-may-2010/ http://breathinstephen.com/university-of-pittsburgh-newsletter-may-2010/#comments Wed, 19 May 2010 13:05:46 +0000 Stephen http://breathinstephen.com/?p=13025

( click to view )

]]> http://breathinstephen.com/university-of-pittsburgh-newsletter-may-2010/feed/ 7 ah….the age innocence http://breathinstephen.com/ah-the-age-innocence/ http://breathinstephen.com/ah-the-age-innocence/#comments Sat, 15 May 2010 18:10:31 +0000 Stephen http://breathinstephen.com/?p=12572
Me and my brother at age 5.

Can you tell which one is me ? (girlfriend )

Childhood photo
]]> http://breathinstephen.com/ah-the-age-innocence/feed/ 7 World Cup Racewalking Championships http://breathinstephen.com/world-cup-racewalking-championships/ http://breathinstephen.com/world-cup-racewalking-championships/#comments Fri, 14 May 2010 13:52:27 +0000 Stephen http://breathinstephen.com/?p=13061

Just wanted to send good vibes out to my friend and racewalking coach, Dave Mc Govern who will be competing this weekend at the World Cup championships in Chihuahua Mexico. Dave will be doing the 50K race ….that’s 31 miles!

I was checking the local weather report for Chihuahua, and the temperature for the 50K at race time on Saturday morning is expected to be 70 degrees F, and heating up to 89 degrees later in the day. Yikes.. that’s pretty warm weather to be doing a 31 mile racewalk in, but if anyone can do it, Dave can. Luckily the relative humidity is supposed to below at 25%.

Jeff Savage will be providing some commentary and photos of the event on his website RACEWALK.COM The IAAF will have the official results well.

USA Team Members

Ray Sharp (50K) , Dave McGovern (50K), Trevor Barron (10K Junior),DanSeriani(20K),JonathonMatthews(50K),MaryanneDaniel(MedicalStaff),AlexChavez(10K Junior), Solomiya Logan (20K),Tyler Sorensen (10K Junior), Patrick Stroupe (20K), Jolene Moore (Junior Coach), Philippe Gonzalez (Head Coach)

Good luck to all of our racewalkers !

]]> http://breathinstephen.com/world-cup-racewalking-championships/feed/ 0