My asthma doctor was right....

I should record the news I got a couple weeks ago. (It's long and boring, so I inserted some photos along the way that are mostly irrelevant :) 

You think you know yourself. You think you've got a handle on things. And then you find out differently.

About two years ago, I decided I was done seeing my asthma doctor, because he wanted me to come in every 6 months for evaluations. I was diagnosed with asthma at age 5 while living in Oregon. I've never known life without asthma. I felt at this point, I was well qualified to tell him how to treat my asthma....
So, I refused appointments, and his office refused to write prescriptions. Luckily, my brother-in-law and a good friend who is a doctor were both willing to call in the scripts I was currently on. And so two years passed.

And my symptoms worsened.

Just last week, I made an appointment with a new doctor. The nurse gave me a spirometry test, which measures how much air you are able to pull into your lungs and how quickly you can force it out. Then the nurse asked me to repeat the test... six times. At which point she began saying, "Everything's alright. It's ok. The doctor will talk to you. It's ok."

I wasn't worried. I'd taken this test every six months for years of my treatment.

When the doctor came in, he asked, "Have you ever taken a spirometry test before?" Yes. "Do you know what it means?"

Actually... no.

"See these markers here? [the cube dots] They indicate the minimum normal values.

[picture of 3 of my spirometry tests]

"See how your outline is well below those markers?" [the left-most scoop shape in the left graph]

"Yes"... I happen to know I don't breathe very well.

He continued, "I hate to be the one to tell you this, but you have COPD (Chronic Obstructive Pulmonary Disease).

HUH?

"Spirometry is a key measurement in determining the staging and progression of COPD. I believe you have irreversible lung damage."

"Yes, my doctor at the Heart & Lung Institute told me about 7-8 years ago that I have moderate permanent damage. I just didn't understand what that meant, I guess."

He explained that COPD is a progressive disease, made up of two conditions: emphysema and chronic bronchitis. Emphysema means the air sacs of the lungs are damaged and enlarged, causing breathlessness. Chronic bronchitis means that the mucous membranes in the bronchial tubes are chronically inflamed. COPD is progressive and develops from Mild to Moderate to Severe. He said, "It looks like you are at the Moderate stage. If you manage it well, you can slow the progression of the disease. Most people who have COPD are smokers or former smokers, but since you've never smoked, yours was likely caused by undertreated asthma."

Yes. I remember severe asthma attacks while growing up. 

During the most severe attacks, I wasn't able to say two words together for lack of breath and didn't have the energy to even walk around the house much. I remember my mom walking into the kitchen/family room where I was lying on the couch. She checked a couple of window frames thinking one was cracked and letting the wind through. She suddenly turned to me and said, "Oh, it's you!" My windpipe was so constricted I whistled as I breathed. 

My parents told me we were moving from Oregon to Utah for drier weather in hopes of improving my asthma.

(Btw, just noticing how much my face changed over the years —that's my high school senior pic above)

So, I had experienced the equivalent of the Severe stage of COPD occasionally while growing up, although it wasn't permanent at the time. I remember well and can relate to the chronic smoker with the hacking cough who wheezes with every breath. I've always known my breathing was not what it should be and that my asthma wasn't typical. And I'd often joked that I'll be the grandma dragging my oxygen tank behind me. What's weird is, I'd never really acknowledged to myself that my compromised breathing had anything to do with the fact that I can't run faster than a 10- or 11-minute mile. Or that hiking at high altitudes and swimming were almost too hard for me. 

For the first time I'm realizing why I don't have a lot of stamina for singing. And why I can't blow up a balloon. And why I'm out of breath when I run up our house stairs. I'd always thought that was pathetic, considering the fact that I've exercised "vigorously" for at least an hour Monday/Wednesday/Friday for my entire adult life.  

My brother-in-law, the cardiologist, said, "Running with moderate obstruction is like a healthy person running while breathing in and out of a half-inch tube." (Or something like your chest closing in on itself like this....)

What a paradigm shift. I thought I knew my body. I thought I had a handle on things. Looking back two years ago, I'm realizing that my old doctor understood my condition and the need to monitor it regularly. The problem was, he assumed I understood that, too.

So, my new doctor, like my other doctors over the years, is recommending additional medications and... allergy shots. Nineteen shots for the first 19 weeks, and then a shot a month for 3 to 5 years. (This doesn't sound awesome to me...)

In the past, I'd always opted to just avoid my triggers, but my doctor said, "You can't avoid your triggers [animals of all kinds, cigarette smoke, pollution, pollen, dust, humidity, eucalyptus, cinnamon, cedar, grasses...]. You're in a constant allergy state. Maybe with shots we can calm the inflammation so you aren't triggered as often and your COPD doesn't continue to worsen." 

So, crap. I feel old.... I'm like one of those grandmas in the rest home talking about her best friend (her doctor) and expounding on her joint pain and kidney function and all her medications....

[I'm going to start asking for Senior discounts]

Ultimately, this is good news. My health will improve in the sense that I am now taking it seriously and will work to prevent as much lung scarring as possible in the future.  

The End