Health Blogs | Asthma

Asthma Twilight Zone

October 4th, 2010 by Stephen Gaudet

Strange title for an asthma update I know, but I just happened to be listening to a compilation of some old Manhattan Transfer tunes in an effort to distract myself from my breathing, when I thought to myself…that’s it. This is what the last couple of weeks have been like for me. (Though in reality it was more like, let’s see how much we can torture Steve without actually killing him, but I thought that might turn people off.) The situation is so absurd, what can I do except make fun of it? If you wanna hear the tune I was listening to,here it is.

Ive said this a thousand times and I’ll say it again; Being hospitalized for asthma marks the beginning , not the end, of an exacerbation. The party is only just beginning when you walk out those hospital doors. This time has certainly been no exception. Except for one or two days, Ive been breathing in my red and yellow zone for almost 3 weeks now. The combination of a really bad asthma flare , not one, but 2 hospitalizations, and a botched intubation where I was tortured alive, have made this an especially difficult recovery. Adding fuel to the fire, was an unexpected and rather bizarre flare up that occurred just a few days ago, which succeeded in scaring the living crap out of me.

In case you missed my sidebar report about that particular incident, Douglas and I were taking a short after dinner walk last Wednesday, when I developed a really sudden and severe bout of breathlessness that almost landed me back in the slammer…. or worse. I was short of breath to begin with, but about 10 minutes into the walk, I started to get extremely tight. At first I just assumed it was because I was still recovering from the hospitalization and was out of shape, but as I continued to walk I got tighter and tighter. Finally after about 5 minutes I had to stop because I just couldn’t breath anymore. It felt like my lungs were gonna totally clamp off. I was actually gasping for air. For a few minutes there I thought this is it, I’m going to die now. I didn’t want to stress Doug out by calling 911, so instead I had him run back to house, get the car, and pick me. When we got home I did back to back nebs, but it wasn’t helping, so I injected myself with one of my epi -pens. It took about 5 minutes, but it finally kicked in and I was starting to open up. The whole incident from start to finish lasted maybe an hour, and by later that evening I was breathing better.

The next morning I woke up in my red zone and have been trying to claw my way back up to normal breathing ever since. I don’t have that crushing feeling of my upper airways clamping down anymore, it’s just the usual tightness and air-trappiness that’s bothering me now.

After reaching out to her, I learned from Dr Wenzel, that Wednesdays night little suffocation party, might have actually been a result of my vocal cords spasming up and/or partially closing up on me, instead of a bronchospastic attack as I had originally reported to her. She doesn’t know sure if this is what happened because she obviously wasn’t there when it happened, but she went on to explain how, that because I’m a really severe asthmatic and because of all the trauma I went through with the recent intubation, that my vocal cords might have been responding in a protective manner to all the air-trapping my asthma was causing. Because I was so air-trapped already from weeks of being sick, the exertion created during that short walk, was probably too much much for my lungs to handle, so my upper airway ( ie my vocal cord) started closing up. My lungs were so hyperinflated with trapped air, that I literally had no room to take another breath in. A discussion on dynamic intra-thoracic airway pressures during a severe exacerbation is probably a little too complicated for this post, but essentially the closing of my vocal cords was creating the same effect that purse-lip breathing would. When you purse-lip breath, a back pressure is created which stints your airways open longer, allowing more time for trapped air to be expelled, which in turn decreases the effort to breath.

Anyway, when she first mentioned that my “vocal cords” might have been the cuplrits behind Wednesday night’s flare, I was a little taken aback. Like most people who work in the respiratory profession, l had always associated VCD with psychological issues, or at least a different kind of upper airway condition, but definitively not a symptom of real asthma. At the time, it almost felt like she was down playing the severity of the incident. Had what I just experienced, not really been asthma related? I know now of course, that this wasn’t the case at all. As Dr Wenzel pointed out, there’s no doubt that I have really severe asthma, so if what happened to me was caused by my vocal cords closing up, then this occurrence was is in addition to my asthma and was probably brought on by the trauma to the cords caused by the intubation a week earlier. Whatever it was, I just hope it doesn’t happen again.

If this all sounds like gibberish to you, don’t worry, I plan to write a separate, more detailed and easier to understand article about this topic. I think it’s important for asthmatics to know the all the variables that can come into play during a severe flare.

As of today, Monday Oct 4th, I’m doing a little better and continuing to hold my own. The re-bolusing of prednisone back to 70mg definitely helped as my breathing isn’t as labored as it was over the weekend. I’m still tight, but at least now I’m getting an occasional break from it. Ive also been able to catch a couple hours of sleep here and there, which has helped tremendously. People don’t realize how breathing hard all the time, can zap you of energy and your will to keep fighting the attack. As far as the intubation incident, I still haven’t come to terms with it the way I should. If and when I get over the hump, I have a follow up appointment with a psychologist who specializes in post traumatic disorders. I’m hoping that by talking about it, that I’ll start to heal. I just want to put all this crap behind me, so I can move on. Mostly though, I just want to get to back to a place where I’m not constantly struggling to breath all the time. It’s a royal pain.

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