The impatient patient

Posted on Posted in Asthma, Asthma exacerbations, Asthma hospitalization, Intubation, Marathon Training, Marathon walking, Portland Marathon, Steroids ( prednisone), Ventilator
Im not crazy, I swear
Im not crazy, I swear

Oh goody, another post about asthma exacerbation recovery.

After being discharged from the hospital only 3 days ago, it’s probably a little early to be writing about this topic again, but something is definitely different this time around. The recovery seems excruciatingly slow( gee, where have I heard that before?).

In my mind I should be healing much faster than I am. This recent 8 day stint in the hospital has not only wiped out all the walk training gains I made earlier in the month, but it’s also left me with a huge deficit. So much so, that Im not sure I’ll be able to catch up in time to get the amount of training that I need to safely finish the race. I was fully aware when I started this quest that something like this might happen, it’s just that I need to know as soon as possible, what my chances are of resuming training for this race. With less than 2 months left, Im getting down to the wire. Training and building the endurance required for me to just walk a marathon, is a big deal. I have to train continually and meticulously. In a sense I have to over-train to make sure I have enough reserve. Most marathoners will tell you, it’s those last 6 miles that are the worse. For me it’s more like the last 20 miles. It’s harder than it looks to walk continuously for 7 or 8 hours when you can’t breath.

The physical issues that are plaguing me the most right now aren’t so much my lungs. Because I havent weaned off the roids yet, Im actually breathing pretty well. It’s my leg muscles that have me really worried. I can barely stand up, let alone walk. Normally at 3 days post hospital Im back to walking at least 1.5 miles, albeit at a slower pace. Yesterday it took me almost 50 minutes to walk 1.25 miles. At that rate it would take me 20 hours to do a marathon. Another issue has been my balance. I walk like Im drunk. I start spacing out and I almost fall. Part of that is probably from the steroids, some dehydration and lack of sleep, but once again, Im not used to these problems lasting so many days out. Why is it happening now?

That said, here are some post asthma exacerbation FACTS that Im using to convince myself that Im just impatient. Maybe this will help others who are experiencing something similar:

Starting with the evil candy, prednisone can cause steroid myopathy making skeletal muscle really weak. They also mess with the electrolyte function involved with muscle contraction. We all know how fun steroid induced muscle cramps can be. And while I was on a relatively short course at the higher dose range, with steroids there’s an accumulative effect over time. The more you cycle on and off the drug, even if for just short periods, the more damage they do to your body. Many Pulmonologists believe that it’s easier on the body to stay on a low maintenance dose ( 5-10mg) permanently , than to repeatedly bolus. Having been on this drug for the better part of 50 years, my opinion on this is somewhat mixed. I think it all depends on whether the drug is actually preventing or lessening the severity of flare ups. There comes a point for many ( including myself) , where the side effects are worse then any potential benefit.. Suffice it to say, if it’s not helping, why take it?

Secondly, there’s the issue of age.( Ok, I can hear my young friends giving me the “you’re not old” talk ). I walk tons of miles every week. Other than crappy lungs, Im in pretty good shape… but my body is old!! Im not pushing 40, I’m pushing 60! No matter how well you take care of yourself, things are bound to start wearing out and breaking down as you age.

Finally, there’s the problem of being bed bound for a week. It’s amazing how fast your muscles deteriorate when you don’t use them. Being intubated and asleep on a ventilator seems to hasten and intensify this effect. Im not an expert in the subject, but I think it might have something to do with the anesthetic drugs they use to keep you asleep, in my case Propofol. Being placed in an induced coma for a couple days isn’t the same as sleeping. It gives you a break from the chore of breathing, but that’s about it.

Probably the biggest problem Im experiencing right now is impatience. There you have it. By jotting down my thoughts on the matter, Ive just proved to myself that what I am going through is probably normal for what Ive been through. I tend to start thinking negatively if things dont go well immediately after a bad flare. No matter how many times I go through this, I always say the same thing.. Why is it taking me so long to recover??? I know many of my readers ask the same questions, because that’s how they find my blog.

I gotta cut myself some slack, and if you have bad asthma, you should too! Stuff happens when you have this effing disease. If I’m impatient, it’s because I wanna cram as much into my life as I can while Im still able. Sounds reasonable to me.

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5 thoughts on “The impatient patient

  1. I just made someone aware of the SARP research, thought of you, so was wandering around your site. I didn’t realize you were pushing 60, your pictures seem younger. I’ve got asthma, but also had an orthopedic injury earlier this year….seems the tendon and the cartilage said “we’re not gonna take it” (Twisted Sister) as one spontaneously tore and the other either tore or just has a lot of inflammation. I had surgery, and am the same way as you….I want to get things done, I want to get back to life, but everyone tells me it takes several months and maybe even a year to fully recover and to just relax and stop being impatient. Not the same, but similar. I’ve been there with the asthma flairs, but not as much as you. Anyway, best of luck with the marathon training.

    1. Ah thanks for the compliment, and thanks for referring someone to SARP.
      I understand about wanting to get things done. With tendon issues it definitely takes time though.

      Not sure a marathon will be possible now, but I’ll keep trying to train until the last minute.:]

  2. Having been intubated for 2 days due to anaphylaxis back in May, while it was just 2 days I was on the vent, those 2 days really messed with everything. I went from biking 11.5 miles a few days before, to barely being able to walk 3 yards when I was discharged after a week in the hospital. How you manage to walk for 50 minutes straight so soon after getting home, I don’t understand! Now, 11 weeks later, I’m able to walk, bike 16+ miles, run, and all. But those first 3-4 weeks were rough. I hope I never have to go through it ever again. The leg pain (ask the dog about those nights I was screaming at 3am and he was barking at me to try to calm me down), the bobbing like on a boat despite being on dry land, fluid retention from and evil dose of the steroids, and the emotional toll from the trauma… friends tell me I’m really strong to make it through what I’ve been through, but for you to have been through it so many more times, you deserve a special award!

  3. Hi, Thanks, that’s very kind of you.
    Yeah, it’s becoming increasingly more difficult each time to bounce back from these exacerbations, but I know if I don’t push myself hard I’ll never make it back to baseline.

    Sorry to hear that you got so sick. I can totally relate to everything you described during your recovery. Do you have asthma too?

    Be well :]

    1. Yes, I do have asthma (which is really flaring this week), which adds to the challenge of recovery. I completely get it about pushing yourself to get back to baseline… If I hadn’t pushed to get back to baseline, I probably would be struggling a whole lot more even now, 3 months out. Physically I’m back to where I was before… Mentally…. Now that’s another story. I was reading Penny from Heaven last night and towards the end there was a line that hit me: “almost dying is awfully easy. It’s the living that’s hard.” I fight every day to keep pushing forward and not give up. It’s especially rough when just accidentally getting too close to someone eating nuts can kill you. I’m reminded of it all every time when I go for a run now as I ended up with numbness and weakness in my left foot. But I guess I’m more determined than I ever was before to not let little things stop me from doing stuff and reaching my dreams. 🙂

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