How I spent my Monday

My asthma started flaring a couple weeks ago, not sure of the trigger. Maybe it was the weather? It had been humid the past week, which can really set me off. I also switched biologics a couple months ago, so it could be that as well. Who knows.. The cause of Asthma flare ups is rarely clear cut.

Anyway, I treated the flare the best I could at home with high dose prednisone and lots of Albuterol. Felt slightly better after the steroids were on board, but a couple days later I started to get bad again and just couldn’t correct course. Fearing that if I let this exacerbation go on for too long Id end up on a ventilator, I reluctantly went to the ER to see if we could nip it in the bud before it got really bad. It usually doesn’t work, but this time it did!

UCSF MyChart – Hospital Admission Notes

It took 29 hours on Bipap, inline-continuous Albuterol and a lot of struggling before it got easier to breath. A day of Bipap might not sound like much, but when you’re in the acute phase of a bad attack and can’t breath, it’s an eternity. Thankfully my blood gases started to improve and by the end of the 2nd day I was trending in the right direction and managed to avoid the need for intubation. Spent a few more days in the hospital and went home more or less intact. Im still short of breath, but much better.

All and all, Id say it was a very successful hospital intervention and only my 2nd admission for the year. The Doctors, Nurse and RTs were compassionate and listening. Can’t ask for more than than that. I think what also helped was my determination to get this through this flare without the need for more invasive treatment, which often comes with severe side effects….namely ICU delirium. I fought harder this time than I normally do and resisted the temptation to agree to intubation too early. It probably also helped that I didn’t have any secondary infections. My chest xray and labs looked pretty good.

Looking back, this exacerbation was probably more severe than I realize, but Im still labeling this one a “mini flare”. Not because I spent less time in the hospital, but because I didn’t progress to the point where I needed a ventilator. It was more of a workout than anything. My Ph only got down to 7.25 and PCO2 in the high 60’s this time. Sometimes my breathing gets so bad during these flares that nothing works and I end up waking up with a tube in my throat in order to save my life. That’s the trouble with really bad exacerbations, you never know what your tolerance to respiratory discomfort is going to be, or how long it will take you to poop out and stop breathing all together.

It’s too soon to tell, but because I was only in the hospital for a few days, Im hoping it will only take a week or two to get back to baseline. It can take a month or more if I end up on a vent. Fast recovery or not, it still means a week of ZERO sleep and all the other fun stuff that comes from steroids withdrawal.

Finally, compared to most hospitalization, I only suffered a couple battles scars. On some hospitalizations, my body looks like its been through a meat grinder.

OK, enough said on this flare. Time to put this aside and get on with the next chapter. Perhaps a new adventure?