Confessions of an asthmatic
The importance of detecting and treating asthma and allergies
Hello, my name is Evan, and I’m an asthmatic. It’s been three hours since my last hit on an inhaler and my last dose of antihistamines.
Asthma has long been my secret. Even after working at the CN&R for more than three years, I had colleagues who were unaware of my respiratory restriction. I’d even kept the secret from myself, unaware I was an asthmatic until I started dating a doctor.
See, I’ve had allergies practically my whole life. When I was a toddler, I couldn’t spend much time outside my family’s home in Southern California without turning blue. (Or, so I’ve been told—I don’t remember back quite that far.) Throughout grade school, I got allergy shots.
Sneezing and coughing were the status quo. I accepted them as normal parts of life. I thought nothing of a mild wheeze or robust hack. I’d clear the airways and keep doing what I was doing.
My girlfriend (now my wife) didn’t see this coughing as normal. She insisted—all right, encouraged—that I go see a specialist. Sure enough, for the first time I heard the other A-word, asthma, applied to me.
Turns out it’s not so normal to cough every time I leave a warm building in winter. It’s not normal to wheeze, be short of breath and experience chest tightness during moderate exercise. It’s not normal to get pneumonia after a cold or flu.
Those are signs of asthma. I just didn’t recognize them.
Fortunately, my in-home doctor did. Good thing, too, because I moved from an urban area. The North State is a hotbed of allergic and asthmatic reactions.
Living in a rural area, ripe with farms and forest land, exposes me to a wide assortment of allergens. Particles from auto exhaust, cigarette smoke and wood-burning stoves exacerbate the problem.
Early winter, spring and fall tend to be the worst times for me, but asthma attacks can crop up in any season. It just takes an irritant or allergen to get me reaching for my emergency inhaler.
Turns out I have plenty of company. The National Center for Health Statistics reports that approximately 17.5 million adults and 7 million children in the United States suffer from asthma. That’s more than 7 percent of the population—or, around 15,000 people in Butte County alone.
Nationwide, according to the Asthma and Allergy Foundation of America, 40,000 people miss school or work each day due to asthmatic conditions. Five thousand visit an emergency room, 1,000 get admitted to the hospital and 11 die from their asthma.
Obviously, I haven’t fallen into the latter category, but I have landed in the ER due to allergies. At a seafood restaurant outside Los Angeles, I tried a fillet of shark, wood-grilled with seasonings I’d enjoyed on salmon, trout and other fish at the same eatery. Later in the evening, my face began to swell and my voice grew husky.
This happened before I met my wife. I went to the neighborhood pharmacy for Benadryl, but the pharmacist had a different regimen in mind. “I’m not supposed to give medical advice,” he said, “but go to the hospital now.”
I got rushed into a room for treatment, and a few hours after shots of adrenalin and antihistamine my countenance returned.
That’s how I learned I’m allergic to shark. I also react when inhaling dust, molds, cat dander, fresh-cut grass and fresh-ground pepper.
When exposed to an allergen, my body triggers the allergic reaction. WebMD explains it concisely: “The body starts to produce a specific type of antibody, called IgE, to bind the allergen. The antibodies attach to a form of blood cell called a mast cell; the presence of mast cells in the airways and GI tract makes these areas more susceptible to allergen exposure.” That’s why I, and others with allergies, react to ingested or inhaled particles, though we also can itch when there’s an allergen we’ve touched.
Back to WebMD: “The allergens bind to the IgE, which is attached to the mast cell. This causes the mast cells to release a variety of chemicals into the blood. Histamine, the main chemical, causes most of the symptoms.”
Thus sprang the use of antihistamines to block the histamine reaction and alleviate symptoms such as sneezing, coughing, hives and rashes.
Not all asthmatics have allergies, and not all people with allergies have asthma. Those with both—such as I—tend to develop asthmatic reactions when suffering an allergic reaction.
What’s the treatment? In my case, an allergist (that is, a doctor who specializes in treating allergies) sought to build up resistance to my allergens so I wouldn’t double as a member of the Blue Man Group whenever I stepped outside. He administered tests to determine what I’m allergic to, then had allergy shots tailored accordingly.
I actually did this twice—first as a child, then in my late 20s. Allergies can develop and change over time, so the list from when I was younger changed as I got older.
The asthma diagnosis brought a handful of medications. I take two pills a day, Singulair and Zyrtec, plus twice daily doses of my maintenance inhaler, Symbicort. I always carry a rescue inhaler, Albuterol, in case of an attack. I’ve also kept stored in the medicine cabinet an Epipen, a sealed syringe of Epinephrine, in case of another emergency like the shark incident.
This regimen works for me. It won’t necessarily work for other asthmatics. That’s why the National Heart Lung and Blood Institute, through the National Institutes of Health, recommends developing an “asthma action plan” with a physician.
As the NIH states, “Asthma is a long-term disease that can’t be cured. The goal of asthma treatment is to control the disease.”
Knowing you have asthma is the first step in controlling it.
An asthmatic’s day in the U.S.
40,000 miss school or work
5,000 visit an emergency room
1,000 get admitted to the hospital