What is it with chronic severe asthma, self esteem, self doubt or self worthiness? Why do we tend to hide or downplay our disease or the severity of our symptoms? Why do we delay seeking emergency medical care when it’s so obviously indicated?
I can’t tell you how many people write to me in the midst of a bad asthma flare. They’ll tell me that their peak flows and their O2 sats are super low, and that they’re following their asthma action plans to the T, doing everything they’re supposed to, but they don’t know if they should seek medical attention. They’ll often tell me that while their breathing is labored and/or their asthma isn’t responding to medications, that they’re unsure if their flare up is severe enough to warrant a visit to the doctors office or a trip to the Emergency room. Some feel that seeking emergency care for their asthma is a waste of time because they’ll just be given the same medications they’re already taking and sent on their way. Others will say they hesitate going to the hospital for fear of not being taken seriously or possibly being ridiculed for what the medical staff might perceive as “just asthma”. Many will only seek medical care if they are ordered to do so by their doctors. To that I say, WTF???
Since when is a bad asthma exacerbation unworthy of urgent medical attention? This is yet another example of asthmatics not feeling worthy. Lets be real here, if you had a bad laceration on your pinky finger and couldnt stop the bleeding, you wouldn’t hesitate a moment to seek emergency care . So why on earth would you hold off seeking care if you were suffocating to death? You would be shocked at the things people go the ER for. Minor aches and pains, low grade fevers, the common cold, scrapes bruises, hangovers, etc. So don’t feel bad if you’re there for “just asthma”. If you can’t breath, you are truly sick.
Sadly, many asthmatics who’ve had the disease for a long time (and Ive been guilty of this too), have been conditioned to believe that asthma is not really a big deal. After all, how could it be so serious if so many people have it? Asthma is an extremely common disease and I think that’s part of the problem. Public awareness and familiarity with this disease is often based on almost cartoonish stereotypes, which portray asthma as more of an inconvenience than a hardcore life threatening illness. There’s no distinction between the different forms, phenotypes and severities of asthma. It’s basically a one size fits all–blue inhaler in hand image the world sees. This false narrative needs to change. We need to stop sugar coating this disease and start labeling it for what it really is. A potentially life robbing and disabling disease that causes immeasurable suffering. A condition that kills nearly a half million people a year worldwide. There’s nothing cool, trendy or insignificant about asthma, it’s a god awful disease.
Severe asthmatic or not, the next time your asthma flare is not responding to home treatment and you’ve done everything by the book, don’t second guess yourself or deliberately underestimate the severity of your symptoms, go with the your gut feeling and seek help if you need it. Even if you feel that there’s no more they can offer than what you’re already doing at home, get checked out anyway. A bad asthma flare doesn’t always get better on its own. Sometimes it requires treatment modalities that can only be administered in a hospital setting (ie IV steroids, ventilators, Heliox, close monitoring, etc.) At the very least call your doctor or healthcare provider for advise. If you think you need more urgent type care, go to the ER. Don’t worry about how busy the hospital is or that your symptoms might seem trivial and non- serious to the medical staff. The fact is, most, if not all accredited ERs, put shortness of breath of any kind at the top of their triage priority lists. If you’re having problems breathing you shouldn’t have to wait too long to be seen. It’s also true that the sooner you get checked out, the greater the chance of quelling the attack before it becomes a real crisis or a prolonged hospitalization.
My good friend and Pulmonologist, Dr Sally Wenzel, along with a couple of her patients who echo these sentiments, recently wrote an editorial on this topic, which you can view here. Every person living with chronic asthma and the medical people who take care of them should read it.
Going forward, educate yourself as much as you can about your type of asthma and how best to treat and manage it. Know your body and your limits in dealing with bad exacerbations, and NEVER, EVER, doubt for even a millisecond that you are not worthy of medical intervention for your breathing problems. Say this often and say it loud, I AM WORTHY!
Yes, as people think of Asthma as a very common disease that every third or fourth person has. They should not ignore it to the extent that their lives become endangered. They must openly consult their doctor without any hesitation.
Absolutely and thank you for your thoughts.
One of the things that my husband finds most frustrating about me is that I will tell him “I don’t want to go to the ED, I’m not that sick” or “don’t call 911, they are too busy”. Fortunately, he doesn’t listen to me. He stopped listening to me after I told him to just drive me to my GP’s office instead of going to the ED> I had barely walked in the door before they called 911.
I think part of the problem is that there are still those out there who think that asthma is not a big deal. This includes nurses. I had a former co-worker tell me that I was over reacting because “asthma isn’t that big a deal”. She still maintains this. And I have run into this attitude in the ED also. I can’t breathe, yes I am anxious, please don’t tell me I can’t breathe because I am anxious. I am anxious because I can’t breathe (and they typically don’t put a person on BiPap if it’s anxiety!) That adds to the problem
Right now, I am sitting here hoping the 60mg of prednisone I just took is going to be enough to get me through until the AM when I can go see my pulmonologist. Rest assured though, if I can’t, I will not hesitate to call 911. No one should hesitate if they need medical care NOW
To add my thoughts, as someone else who doesn’t have typical asthma: I also feel like I won’t be believed when I seek urgent care. I don’t wheeze, I get extremely diminished breath sounds. My sats don’t drop until I’m on the verge of respiratory failure, because I breath stack (seriously, my O2 was at 96 less than 15 minutes before I was intubated the first time). I’ve been accused of simply not trying hard enough to breath. Nurses have told me that I’m fine, due to my O2 being in the mid-high 90s. They’ll give me a dose of Ativan, “just to see if it helps” (It doesn’t! But I don’t really mind having the Ativan though, since repeated nebulizers make me shake like a leaf!). Because I don’t always fit the typical asthma profile, I’m afraid that I won’t get the treatment I need. And I shouldn’t have to feel that way about medical care.
Thanks a million for your fantastic blog. My asthma has got so much worse in the last 18 months (doctors don’t see people face to face here any more – no asthma clinic any more either since Covid began March 2020 – even a telephone appointment with a general practitioner doctor takes 3 weeks to get.) I am left on my own with this and my health has deteriorated very badly to where I am breathless crossing the room. I wondered whether trying to walk would help me, found your blog, and started very slow a fortnight ago. In a fortnight I have done 18 miles with a lot of coughing and wheezing, but I feel less desperate and out of control. Thank you so much for this site and all the great writing in it. I hope you are keep well and send best wishes from England.
Thank you so much for taking the time to write. Wow 18 miles, that’s fantastic! It took me a couple years to make it that far.