So,what brings you here?


Over the years Ive built up a pretty loyal following of friends who are interested in what Ive been up to and how I’m doing health wise , but the bulk of visitors to this blog still get here while searching for answers to asthma related questions or topics. The following (in order of popularity) are the top 3 internet search phrases that bring people to my blog. If you’re one of those people, let me help make your life easier by answering those questions for you right now.


Top Search Phrases

1) Recovering from a Severe asthma Exacerbation

Ive written extensively on this topic from personal experience, but this is probably my favorite post on the subject.
The Recuperative phases of a severe asthma exacerbation

2) Can you have a normal O2 sat during an asthma flare?

This is another question that pops all the time, not only in the Google searches that brings people to this blog, but also in my asthma support groups and in private emails. So here’s the short answer:
YES , you most certainly can have a normal or near normal oxygen saturation during an asthma flare up. Asthma is a disease of the airways, NOT the alveoli ( air sacs) where oxygen exchange takes place. In fact, if you’re O2 saturation is low during an attack, this can be an ominous sign. O2 saturation is usually the last things to drop during an asthma flare. Having said that an asthmatic who had a low O2 sat is probably sicker than someone who has a higher sat. Regardless of someones O2 sat, an even more important indicator of respiratory failure is an elevated CO2 level( carbon dioxide). When in doubt, an ABG should be obtained. Here’s an article I wrote about oximeters and O2 sats
Btw, if you’re searching for answers to this question, you’re probably either a physician or a healthcare worker who has encountered a patient like this, OR, you’re an asthmatic who is trying to justify whether they are sick enough to warrant hospital care. Am I right?

3) Hospital Bills for Asthma

With over 100 hospitalizations for asthma during my life time, I know a thing or two about hospital bills. Thankfully Ive been fortunate enough to have fairly good medical insurance that covers most of my medical expenses. Asthma, especially severe asthma, is an extremely expensive disease and accounts for a large chunk of this countries healthcare costs.
The typical 7-10 day hospital for me averages about $180,000. That’s enough to by a small house here in the SF bay area. An ICU bed alone can cost $22,000 per DAY! and that doesn’t include any of the medications or treatments. In the past 3 years alone, my medical bills have exceeded $1 million. This is just one of the many posts Ive written about the topic. It’s getting expensive to stay alive

So what brings you here today?

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8 Comments

  1. Heather says:

    I don’t know if it brought me here, but the answer to O2 sat question has been very helpful.
    I encountered that issue when I was trying to get tamiflu on the weekend from the ER. The doc treated me like I was crazy because my O2 sat was near normal and let me go with nothing. It was a heck of a month, and nobody could do anything because the ‘window’ was closed.

  2. Stephen says:

    Sadly, it’s a pretty common occurrence in ERs. A lot of Physicians and staff mistakenly believe that if their patients O2 sat is high, that they can’t be that sick. The fact is, most asthmatics don’t desaturate unless they are critically ill or have another disease process going on, like pneumonia.

  3. Zim says:

    My statistic are more “common” and of course 99% of them is in Polish language. Questions from Google are mostly about air in my city (Cracow is in the top 10 most polluted cities of world), about my church (Baptist – we are small minority in Poland, so we are “interesting” for others), about books and literature and about history.
    One day I discovered question from Google in… Somali language. It was caused by lyrics of one song in this African language.
    I simply came here… And I really enjoyed Your blog Stephen :)
    Greetings for You.

  4. I would say zero ER personnel understand the O2 sat issue. I don’t know that my CO2 has ever been checked either. I did have a blood gas once when I didn’t look very sick, by the doc’s estimation, and only received nebulizer treatment because my blood gas wasn’t ‘great for my age’ whatever that means. I had to wait an hour for those results, struggling for every breath. (Do people get high off neb treatments? Are these narcotic agents? What gives with the dragging of feet on this?)

    The belief that O2 has to be low to have asthma has really compromised my ER care pretty much universally. Complete with snippy attitudes from physicians and slow motion care, to the point where I was using my rescue inhaler in the ER because they couldn’t be bothered.

    The big problem is now I avoid the ER like the plague, at a time when my asthma is much more severe and dangerous. Not a good combination, but the ER has taught me I can’t rely on them.

    Which is how I ended up in the hospital last time. Trying too hard to work with my pulmo on the phone to avoid the ER only to make things worse with the delay.

    M

    • Stephen says:

      Sad but true. Asthma has become such a common illness that unless you “look” like you’re dying, you’re not going to be given a lot priority.
      Fortunately, Ive only experienced that ignorance a couple times. Maybe its because I’m notorious for going down the tubes really fast, but usually when I go to the ER I get triaged right away.

      Sometimes bringing a note with you (signed by your pulmonologist ) giving a brief history and what the doctors should look for, can help.

  5. RW says:

    Actually, the question that brought me here isn’t mentioned. I’m a fourteen year old girl diagnosed at five (following a hospitalization), and I’m curious to know if it’s possible to get only a 20% ish drop on a methacholine challenge (six-ish months ago) and feel pretty great during that, not at all like I do during a ‘real’ attack, and have asthma like mine feels.
    I have asthma(?) induced by all sorts of stuff- excersise, allergies(!), stress, being sick, ect. Actually, it’s pretty classic moderate asthma except for the methacholine results.
    I’ve been checked for heart stuff, VCD, and a lot of other stuff, and I have all the other components that tend to come with asthma.
    I’m just curious if you have any input.
    Thanks!! Your site is great!

  6. Jacqui says:

    My 18 yr old daughter had her first asthma attack 2 weeks ago. There is no history of atsthma in our family and she has never had diagnosed asthma in the past. Her attack resulted an amubulance trip to hosipital but she was discharged several hours later with a diagnosis of ‘likely asthma’ and some medications. Less than 24 hour later she was back in hospital, eventually intubated and then air transported to a larger city hospital, where she remained in ICU for 2 nights and then a further 2 nights on the ward. This is a total shock to all of us, including I think the hoardes of doctors she has come in contact with (not so much adult onset asthma being the shock, but rather the acuteness of a first attack). It seems like you get more answers from sites like this than from doctors, so I was wondering if you thought that her attack could have been brought on by an apparent chest/respiratory infection she had for nearly 5 months prior? She was coughing a lot on and off and was finally sick of it and started feeling worse and worse, particularly in the fortnight leading up to the attack. She went to a doctor who tested her blood (high allegerns and low iron only found eventually) and offered a ventolin inhaler to give it a go (apparently it didn’t help, according to my daughter) and see if it could reduce the cough. She didn’t have a wheeze so asthma wasn’t really the prime suspect. My hopeful side is praying that now the coughing has stopped since the hospital drama, she may be free of the chest infection at last and should be fine – especially with her preventitative meds. However my worried side wonders if this is just the first of more serious attacks, including one that could end up fatal. We’ve no ideas of what her ‘triggers’ may be so don’t really know how to avoid them. Any advice, stories, thoughts would be much appreciated.

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