Welcome to my world…..
This scenario plays itself out pretty much on a monthly basis for me. The only thing that really changes is how bad things will get and whether or not Ill end up on a ventilator. Be it be 1 or 2 weeks in the Intensive Care Unit, or in and out of the hospital in one or two days, the length and severity of my asthma exacerbations (and I’m sure those of others), seems to be totally unpredictable. One thing’s for sure, long or shorter stints, these exacerbations happen way too often and make living a normal life nearly impossible.
The latest example of this unpredictability factor, is hospitalization #142 which occurred May 26 through 28th 2019. I was recovering slowly but steadily from a previous much longer hospitalization just 9 days earlier, then woke up one morning and suddendly couldn’t breath again. I went back up on my pred and toughed out the next couple days with home treatments. On the 2nd day things weren’t improving so I texted my pulmo for advice. He was sympathetic to me not wanting to return to the hospital so soon, but with all that had been happening with my vocal cords, recent intubations and the fear that I might be rebounding from the earlier flare, ( which can be more severe than the original flare ), he recommended that I bite the bullet and go in anyway, of which I reluctantly did.
Things were pretty dicey for the first 24 hours in the hospital, but then my lungs suddenly pulled a welcome 180 and opened up. By the second day, almost like magic, my ABGs improved and I began to move more air and breath easier. It was actually kinda weird.
Perhaps the only indication that this flare wouldn’t get as bad as the previous, is that my oxygenation remained pretty good throughout. I only desatted during the early phases of the flare. After that, my O2 sats remained in the low to mid 90’s the entire time. On bipap with 35% O2 my sat was 100%. I was able to come off oxygen completely after only 36 hours. Pretty amazing, considering that just 9 days earlier I was on a ventilator and every time they would take the breathing tube Id crash and theyd have to put it back in and put me back on the ventilator.
Nothing was done differently treatment wise this time, for whatever reason my lungs just responded faster. In fact, in trying to delay the possible need for another intubation, they actually treated this flare more conservatively . I did 15 hours of Bipap (settings of 15/4 with O2 at 35%), Albuterol at 10mg per hour X 24 hours via Aerogen cont neb system, Ipratropium Q4 hours, Advair BID, 2 grams of Mag Sulfate, IV steroids, IV Fentanyl for air hunger and some fluids. Pretty much the same stuff as the last admission, only this time I didn’t tire out or go into respiratory failure.
You just never know with asthma how long a bad flare will last or how long you might be laid up in the hospital. There seems to be no rhyme or reason, my lungs do what they want. This rapid kind of turn around is a rarity for me. My last admission lasted 11 days, this time it was on 2 and a half days. Boy, I wish all of my asthma hospitalization were only 2 days affairs… and without the need for intubation or a ventilator. Im sure the government and my insurance company wouldn’t mind either. ( My hospital bills so far for 2019. This doesn’t include the doctor bills, just the hospital)
As with most of my asthma hospitalizations, as soon as I turn the proverbial corner and am not in danger of actually dying anymore, I ask to go home as soon as possible, which is usually the following day. Most of the time Im discharged directly from the ICU. I have no desire to continue my recovery in a hospital step unit or ward somewhere. When I start to feel the slightest improvement I ask to go home and recover there. I wanna get as far from the place as possible.
Moving forward, Im hoping to achieve and maintain a degree of stability over an extended period of time for a change I guess in my case that’s anything over a month, which interestingly is about the same amount of time it takes me to taper down off the steroids. The longest I’ve ever gone in between hospitalizations is 8 months and that only happened one time. Despite the cutting edge medical care and all medications, including experimental therapies I receive for my asthma, I still end in the hospital every 1-3 months … its just the nature of extremely severe asthma.
A break from these exacerbations/hospitalization would allow me to start refocusing on my fitness regimen and start to enjoying life again. I still need physical therapy on my knees, but my bad breathing seems to be in remission at the moment, so that makes me feel a little more positive about things.
Here’s a brief photo summary of my 2 day hospital stay….