Just when I thought I knew everything there was to know about asthma and COPD in general, a couple of my lung docs kindly corrected me on a few misconceptions I had regarding my own lung disease.

Misconception #1 : I always thought that because I have a chronic problem with air trapping and the breathing discomfort that accompanies it, that I surely must have elements of COPD (emphysema) mixed in with my asthma.

Not necessarily. There are several ways that air-trapping can occur. My Pulmonologists believe that my air-trapping is caused primarily by chronic and persistent inflammation of my smaller airways, rather than by structural changes that you would expect to see in a patient with COPD or Emphysema. While it’s true that I have chronic severe asthma and probably have some airway remodeling, my lung doctors believe that my lung disease is still most likely “pure asthma” and not COPD or emphysema which is caused primarily by cigarette smoking.
A major research study on severe asthma completed last year , the SARP study, seems to support that claim. Something else I learned in that regard, is that air-trapping ( the kind you typically see in people with COPD) can be seen on a CT scan of the lungs. My CT scan shows no signs of that type of air-trapping.

Misconception #2 : During times of breathing difficulty, I always thought that I could “feel” the difference as to whether I was air-trapping or having bronchospasm . I just assumed that when I have the sensation of not being able to exhale completely , that what I’m actually experiencing is air trapping ,and when I have the sensation of having difficulty getting air in, that I must be having bronchospasm.

Again, not necessarily. My lung docs were quick to point out that both air -trapping and bronchospasm can cause similar sensations. Whether the narrowing of the airway is caused by the constriction of the smooth muscle that surrounds the airway from the outside, or whether it’s caused from inflammation and swelling from the inside of the airway, the results are the same….The diameter of the airway gets smaller, making it difficult to inhale AND exhale! Both conditions can cause extreme discomfort.

So does this mean I don’t have at least a little bit of COPD superimposed on my asthma? Probably, but in any case , it now appears that the mostly likely beneficial treatment option for me in the future would be Bronchial Thermoplasty and not Endobronchial Valve placement as I originally thought.

PS…..I still think I can “feel” the difference between air trapping and bronchospasm….Ive been tuned into my lungs for a long time.

I thought Las Vegas was fabulous as usual, but apparently my lungs didn’t share the same view, and as a result, I was unable to do the ET race.

I’m not sure if it was the desert climate or being exposed to the smokey environment of the Hotels and Casinos, but by Saturday afternoon I could definitely feel a change in my breathing. My peak flows were dipping below 300 and the stress of doing a midnight race would have probably put me back in the hospital , so I decided to do the smart thing and not do the race.

Of course I’m disappointed that I missed another event because of my breathing, but I think I made a wise decision. And from what I’m hearing from other people who did the race, sounds like I didn’t miss much anyway. They told me that the event was very disorganized this year and that the breakfast at the Lil alien was less than tasty. Hopefully they’ll work out the bugs for next year.

On a positive note, I got to see 3 Barry Manilow shows in a single week! His Saturday night performance at the Hilton was probably the best Ive ever seen him do. The audience consisted mostly of his die hard fans and you could tell he knew it, because he delivered…big time! He was awesome. His voice, his energy, his range and his incredible note sustaining lung power was nothing short of jaw-dropping. Man that guy can write some powerful songs. As a bonus, I managed to get , not one, but two handshakes at this show. I decided in advance that I wouldn’t be taking pictures at these shows, because I end up spending too much time fiddling with the camera, trying to get good shots, that I don’t really get a chance to enjoy show. I have a million photos of the same show anyway.

What was also kind of funny, is that there was a major Star Trek convention going on at the Hilton . The place was crawling with “Trekkies”. from all over the world. Every time I got on the hotel elevator, Id’ run into one of the crew members of the Starship enterprise . These people really get into it.

Next scheduled race for me, is the San Jose Rock & Roll half marathon in San Jose. Next scheduled Manilow concert for me , is Oct 16th at the Arco Arena Sacramento.

…. ” And would it be asking too much, if you could beam me up to your space craft and zap me a new pair of lungs?”

In just a few hours, this lung defective humanoid is off to Nevada to not only do the ET marathon, but also to attend a string of 3 Manilow shows. (Here’s some photos I took at last years shows)
As far as the race goes,I’m only doing the 10k event this year and I won’t be doing any racewalking at all…just plain old fast walking. My lungs, while doing extremely well last weekend, haven’t been behaving very well this week and I don’t to aggravate things by pushing myself to hard. That, plus it’s kinda difficult to racewalk in total darkness anyway.

Anyways, this is the shirt I’m gonna wear for the race. I purchased the decal at the Lil Ale Inn cafe after lasts years race and I already had this bright ass day -glow shirt, so I threw the two together…and wallah.. I have my costume!

It’s going to be an interesting weekend, because immediately after seeing Barry Manilow’s Saturday night show at the Las Vegas Hilton, I have to drive to Rachel Nevada to do the race. I thought I had the logistics worked out to make this tight schedule do-able, but somehow I miss calculated the distance from Vegas to the race sight. Turns out that its 150 miles from Vegas. Barry’s show starts around 8pm and is usually over by 9:30, so hopefully I’ll still have enough time to make it to the race site before 1am ,which is the start time for my race. The only problem, is that I have to be within 32 miles of my starting area before 12 midnight, because the Nevada state troopers are closing the road for 20 minutes to allow the 51K runners to get their race underway. If I get caught in that mess, I’ll be late for sure. I might just try to sell my ticket for Saturdays show, so that I can get an earlier start.

When you’re trekking through a silent desert, in the middle of nowhere, during the middle of the night, your imagination can run wild,but that’s what makes this event so special and worth all the hassle of getting there. Too bad the Las Vegas Hilton, which is where I’m staying during my trip, doesn’t have the Star Trek Experience Exhibit Thingy there anymore….would’ve been perfect for this kind of weekend.

Unless I’m allowed to use the communication device on board the spacecraft, I won’t be posting again until the middle of next week.
Have a great weekend my fellow earthlings!

Wednesday I have a pulmonary follow up visit at the UCSF chest clinic. What makes this appointment different, other than the fact that I will be breaking in a new Pulmonary fellow, is that we will be discussing some future treatments options, including bronchial Thermoplasty and Endobronchial Valve therapy (EBV) . At the present time, both of these procedures are still considered investigational,but both are in the process of seeking FDA approval . The latter (EBV), has never been done on an asthmatic, but because I have severe air -trapping, similar to that seen in emphysemic patients, it might be an option. I’ll go into more details about these specific treatments options in a future post.

I’m also requesting a referral to be seen at the University of Pittsburgh Asthma Institute in Pittsburgh Pennsylvania . World renowned Pulmonologist and severe asthma researcher, Sally Wenzel who’s part of the SARP team, has agreed to take me on as a patient. Dr Wenzel takes care of some of the most severe asthmatics on the planet and has done some fascinating research in the field. While she may not have much new to offer to my current care plan, there’s a lot that she and her team might be able to learn from me as a research subject, which might then get me in the door for future experimental therapies.

Don’t get me wrong, I have some of the best Pulmonologists in the world taking care of me right here, right now, in San Francisco, but UCSF doesn’t really specialize in the treatment and/or research of the more severe forms of this disease. If you have severe asthma that doesn’t respond to conventional therapies, I think it’s crucial that you seek out alternative treatment options, even if they’re considered risky. Never settle for the status quo. If it turns out that nothing more can be done for me, that’s fine , but at least I’ll know I gave it my best shot…..right?

I didn’t even know that this was out there until an RT blogger friend on Facebook told me. Mike and I are on page 61 of the current issue of the “AARC Times”.

The Times is a publication of the American Assoc for Respiratory Care, a national organization that thousands of Respiratory Therapists belong to. They also put out a science journal called “Respiratory Care” in which I was featured back in 2008.

Click the cover to see the article