June Rain and Lung Function Drain

For some reason June has been a rough month for me the last two years. Last year I was suffering from, at the time, an unknown breathing issue and I managed to get my first bout of bronchitis from a sinus infection. This year something started bothering my lungs and I am going to write about it in this post. Needless to say, but this has been a disappointing month for me.

I have had a few acute asthma episodes in the past. Most of these acute asthma episodes were significant events that required a doctor visit and dose of predinsone. I had one in October 2010, November 2010, and the big one (airway remodeling event, I suspect) in January 2011(Which I have never fully recovered from). None of them requiring hospitalization but very rough none the less. I have been really lucky in that regard, I have stayed away from the doors of the hospital.

Not sure when this latest bout of acute asthma started. My lungs have a tendency to fester in private and let me have it a later time. In doing this, I sometimes am clueless why and what the trigger was. I did have a 5K run that I competed in and I really pushed my VO2 max limits. I did have the usual cranky lungs after the event but really nothing I was worried about. It had rained a lot the last two weeks and the humidity was nasty also. My thoughts are that the combination of an exercise induced trigger and prolonged days of moisture in the air set my lung function to spiral downward.

My recollection of how I felt the days before seeking help is a bit sketchy at this time, but I will try anyway. I didn’t train the next weekend after the race so I am thinking my lungs a tad twitchy then. I do recollect not feeling well that Sunday when mowing the lawn, which could have been a contender for a trigger. The next day, I started noticing my morning numbers were kind creeping towards yellow zone. So, I took appropriate action and started using my ventolin inhaler. I was not to alarmed by this because I had mowed the day before and usually I snap out of it.

Tuesday, My PF and FEV1 were really slipping and I was starting to deal with dyspnea. I also started to notice that ventolin was not responding very well. So Wednesday, I started to neb half vials of Albuterol Sulfate every 4 hours in hopes that this would get me by, which it did. By evening my breathing had worsened and had very low FEV1 of 51%. I was also getting more and more winded too. Thursday rolled around, I started taking nebs with full vials ever 4 hours because I was starting to have moderate air-trapping. Yeah, that was starting to worry me. November of last year, I was spooked by a severe air-trapping episode and it has become a big red flag for me to seek help. Unfortunately, the only way to get in with my GP is call the office in the morning and they will get me in that day. My evening PF and FEV1 were quite low too.

Friday, My morning numbers were definitely in the yellow, but interesting enough, my morning PF and FEV1 were much better that my evening test. I guess this is because I was really active during the day and it just triggers my lungs to clamp up. Anyway, I called the GP office and they got me in that morning, it kind of surprised me.

The GP visit went well. Actually, this is the third visit I made since he became my GP many years ago. The GP I had before him moved away and they reapportioned  patients to other doctors within the group. In the past, I would visit urgent care for my acute asthma issue, but lately have started to get treated poorly every visit, so I stopped. I went straight to my GP instead, glad I did. My GP listened to me babble (Hey, I have albuterol nebs hyping me up and making me chatty) and he seemed to be interested in helping me. Believe me, it has been a while since a doctor cared about what I had to say. This is one of the problems I am having with my pulmonologist.

GP put me on a 12 day dosage of Prednisone including taper. The rest of Friday I decided to try to go shopping with the family. My Wife needed to pickup some goodies and I felt I could manage. Wrong!!! I was just about on my last leg come evening. I have no regrets, I did enjoy the afternoon with my wife and the boys. That evening my FEV1 was approaching 49% which is my all time low. Let me say, for me, it is not easy breathing at that level. Saturday was not much better, I was short of breath a lot and needed to stay seated for periods of time. I still managed to play with the kids, which I was glad that I was well enough to do. Oh, and before I forget. I also mowed the lawn also. I did find it most unwise but it needed to be done. I was wiped out after finishing. Although, just enough left in me to wrestle with the boys (smiles).

Sunday was not much better because of the after effects of mowing. I was a little less active that day. Monday came up fast and I decided I was well enough to work. Fail!!! I made it to work and realized that I might have bitten off more than I can chew. It was a busy morning and I was short of breath for most of it. Tuesday, I was starting feeling a lot better. I even ended up getting though the day on control meds and 30mg of prednisone. Wednesday, I started to slump a little and needed to hit my ventolin a little. Thursday, I had a good day and managed to get by on only control meds and 30mg of prednisone again. Friday, which is the day of this writing, I am doing really well. I even managed to get out this morning a get a 5K walk in at a fairly nice pace, I’m pleased.

Things I’ve Learned;

1) That my PF and FEV1 after a restful night is better than my readings in the evening. All the activity during the day drives my lung function into the ground.

2) This is the first time that my ventolin inhaler quit responding and I ended up having to switch to nebs. I guess my lower airways were getting so clamped that ventolin couldn’t get deep into my lungs. Nebbing albuteral sure got down there. Although, it did last long and clamped up after a few hours.

3) I found out that I need a more convenient way to neb when I am away from home. I was still able to get a neb in while shopping Friday because my new van has a AC plug-in, but my nebulizer compressor is just too cumbersome. So I guess it is time to get a Pari Trek portable for the next go around. Yes, I wish I could say that this down turn will not happen again, but I suspect otherwise. Having the right tools for combating this disease is a must.

That’s all folks…