So I’m sitting up tonight, too jittery to relax, too scared to sleep, and exhausted to the point I’m going to have to edit this tomorrow and make sure it makes sense. I hate this part almost worse than the exacerbation itself. The fear of resting, that it’s going to sneak up on me and get worse as soon as I lie down and close my eyes. That fear is always there at some level these days, but it’s worse after a bad attack. It borders on paranoia. So I’m going to combat that paranoia for a bit by occupying myself with venting about my day, and a particular incident that happened during treatment.
(Note, this was written about 4am on Easter morning and edited before posting, but I didn't get a lot of sleep, and I'm still not feeling even 80% so please forgive typos et. all.)
First a bit of history. I’ve had asthma since I was 15, and COPD for the past two years (at least, that’s when they diagnosed it anyway). I’ve never smoked. My father did, and the doctor thinks second hand smoke from that played a part, as did genetics, decreased alpha one enzyme protecting my lungs from damage, and being prone to allergies. I’m also a certified Occupational Therapy Assistant, have several family members with asthma, lost an Aunt to it, almost lost my daughter, and used to be a CNA in Geriatrics. Two days ago I felt blah, my throat started to itch, I started running a low grade fever, etc. Last night that changed into insane amounts of sinus pressure, a stuffy runny nose and coughing. Knowing how quickly asthmatics can devolve into bronchitis and pneumonia I started on decongestants as well as my other meds. I also began using my nebulizer every four hours (the last two at home were every two hours), puffing away and trying to keep out of the ER.
Just after six pm I failed in that goal. Caedy went with me, FloridaSNDad stayed home with the kids. Thank God my son could manage the fish sticks and French fries I’d planned for dinner on his own. I’m very thankful we’ve managed to get him cooking confidently enough to handle it in situations like this. Otherwise my nine year old probably would have made grilled cheese sandwiches, because our kitchen is NOT accessible for my other half to cook. This meant that Caedy could go with me and be my voice, because I didn’t have the air to answer the EMT’s questions. I have a med sheet written up and that helps, but they always want more information about when this exacerbation started, etc. Caedy rode up front on the way to the hospital so she wouldn’t be in anyone’s way, after making sure they had the information they needed.
For some reason, this EMT who had never worked with me before, was insistent that it was “just a cold” and I was over reacting because my O2 SAT didn’t drop too low (mine rarely does, and I pay for that with muscle pain the next few days, I was a vocalist in my prime and my diaphragm remembers those breathing techniques). I was however wheezing on expiration as well as inhalation, and I had reduced air flow. The Paramedics, who had taken me in before disagreed and won the argument. Usually I’m chided for waiting TOO long before I go in, because I hate going into the ER. I prefer to stay at home and duke it out with my lungs, sometimes I win, and sometimes they do. But I know my body, and I know when I have to admit defeat and make the call.
So I got the joy of being lectured about ‘waiting for the meds to work’ before calling the EMT’s, that sometimes wheezing was a sign it was working (which I know, but it also means I was worse than I thought when I started), all while I was doing a breathing treatment, coughing, and unable to respond to any of this. By the time the treatment was done, we were almost at the hospital and she’d worn down on the critique at least. Once I mentioned my training (professional) and experience with this, with myself, my mother, my daughter, my other half, as well as various patients I’ve worked with over the years she quieted down pretty quickly.
Then I’m finally in the ER, on the stretcher by the nurse’s station and over heard part of a whispered conversation. Seems this EMT raised her concerns to one of the nurses, who also knows me fairly well from recent frequent visits and admits. I have to say the nurse stuck up for me pretty well at least. She’s probably lucky none of the respiratory therapists heard her. The one who always yells at me for waiting too long was there when I came in, though they were changing shifts.
So after oxygen, a mega dose of solumedrol (not sure I’m spelling that right), a combination neb treatment in the ambulance and two extended treatments in the ER, a chest x-ray, IV meds and fluids, potassium (again, despite supplements I take daily) and a script for an increased dose of prednisone that I couldn’t get filled tonight and can’t tomorrow because the pharmacy near me is closed for the holiday (luckily I have enough of my daily dose to cover tomorrow, but I’m going to have to pay out of pocket for the script, Medicaid won’t cover prednisone twice in one month) they let me go home an hour or so before midnight. That was up for debate at some point, I had been told to expect to be admitted when the first extended treatment didn’t work, and I get the impression the respiratory therapist disagreed with the decision.
My chest still hurts and is tight, I’m still wheezing a bit. But I got to help set up the baskets and point out places to hide the Easter eggs once I finally got my stressed out daughter to sleep (not enough air to do much but sit and point). I was told by both doctor and nurse that had I waited to come in I likely would have been too bad off and they would have kept me at least a few days. I made the right call. I think they were worried I’d let that EMT influence my next one. Luckily I’m a stubborn red head who knows her own body and limits even if I do push myself a bit and the EMT in question didn’t do more than annoy me.
But its allergy and asthma season down here, it’s hit early and hard because it’s been so freaking warm. We also have brush fires (which the paramedics in question were called to, else he would have ridden along I think). I have to wonder how many other asthmatics she guilted and lectured on this shift. I’m hoping she was just having a bad day, was worried about being needed at the fire and was taking that out on me. I’m hoping this isn’t her usual attitude with those who call on her aid. And I’m REALLY hoping that there isn’t another asthmatic, or worse, the parent of an asthmatic child who took similar words to heart and will wait too long next time.