Monday, July 03, 2006
Asthma 101 for Bystanders
At the time, I didn’t quite know how to answer him. If he were to ask me today, I’d have to say, “Well, no.”
I don’t generally give those kinds of answers to people outside my immediate family. Right now, I’m on a college campus, in the dorms. I share a 4-person suite, with a common room in the middle. I’ve been sitting there for over 2 hours.
I woke up coughing around 2 am. It was the characteristic dry, unproductive cough of an asthmatic. Cough drops don’t help much, if any. The problem isn’t to calm down the cough (at least from my perspective), it’s to medicate to make it more effective in moving that gunk in the lungs.
In asthma, the bronchial tubes narrow. Initially, it’s a spasm that makes it hard to move out of the lungs. Funnily enough, getting air in is not a problem. The bigger issue is the build-up of CO2. Later, the respiratory system becomes swollen and inflamed, making it necessary to use medication long after the initial attack.
Triggers for attacks vary. Many asthmatics have allergies, and experience seasonal recurrences. Catching a cold generally will mandate increased vigilance in monitoring, as a side effect is to exacerbate the condition.
Right now, I’m at the end of a sinus infection, which led to an acute episode at the end of May. I’m still experiencing difficulties. I just finished a round of steroids, which usually lead to a bout of insomnia, in addition to the weight gain and stomach distress. Hours of fun.
One of my roommates came in with cough syrup. I declined the offer, which puzzled her some. She then offered cough drops, which I accepted.
I started to explain why cough suppressant wasn’t a good idea (I’m trying to move stuff out of my system, and the coughing, while annoying, helps that process). But then I realized that a deep discussion wasn’t indicated at 3 in the morning, and took the offered assistance.
Some things to know if you meet an asthmatic in distress:
- If they’re coughing uncontrollably, don’t ask questions. We can’t answer when we can’t breathe. If you feel the need to help, try getting some water, and leave it nearby. Offer to take them to the hospital, but if they decline, accept it. Generally, an adult asthmatic knows what to do.
- Don’t feel compelled to offer gratuitous comments (i.e., “are you coughing up a lung?”, “do you know how irritating that is?”) I’ve heard them before – yes, I do realize how irritating that continual dry cough can be – you should hear it from my side.
- It’s a bad idea to try to suppress that cough. The better plan is to make it more effective (usually with emergency meds, like the inhaler). It won’t stop immediately after use, so don’t be surprised that we continue coughing. Hopefully, after a while (15-30 minutes for the hand-held inhaler, sooner for the nebulizer machine), you’ll hear the even more irritating sound of a barking, productive cough. That’s a good thing, although somewhat gross for others of delicate sensibilities.
- Yeah, I know it’s ruining your sleep. I don’t do it deliberately. It’s ruining mine even more. I have to stay relatively vertical. Laying down makes the situation worse. So, expect me to be dragging the next day. I’m used to it. However, I really like it when you take over the next afternoon and I can get a nap. I really do try to keep from disturbing others. Sometimes, if I can, I leave common areas entirely. I’ve been known to spend time sleeping in my car if the house is small. In a strange city, that’s just not safe.
- For my breathing ease, cool is better. Even with a cold, it’s easier to breathe when the air is cool. So, don’t turn up the thermostat – grab a sweater. In the summer, air conditioners are a lifesaver. Ignore the cost of running it, and keep it on. Stuffy rooms set me off.
- Don’t suggest I take off work or school. I can’t afford it, and I’m not contagious. Cut me a little slack to leave the room to medicate or get some water or tea.
- Asthma is called ROAD – Reversible Obstructive Airway Disease. It can be manageable with medication, and, if properly controlled, doesn’t have to shorten my life. When not in crisis, I’m as healthy as anyone.
- Never, never, never smoke around an asthmatic. We won’t drop dead right there, but later we’ll flare up in an acute attack. Be careful about seating at barbeques also – smoke is smoke, and it drives me nuts. I’ve sometimes had problems with nearby neighbors in the city. Consider using propane rather than charcoal – the smoke is less.
- Young adult asthmatics generally don’t show major problems. By that, I mean you don’t hear the wheezing, and sometimes they think they’ve “outgrown” the problem. Don’t you believe it. They still have the condition, although they aren’t showing obvious symptoms. That’s because the larger bronchial tubes of an adult move air without the audible wheezing sound. But, they’re still twitchy, and can be damaging the respiratory system. A better indicator of distress is the peak flow meter. Asthmatics should have one handy, and check several times a day. Waiting until symptoms present is a bad idea. It’s better to rely on the meter, and adjust medication appropriately.