As your humble RT and fellow asthmatic, I have created a list of all the different types of asthmatics. Trust me, I have met hundreds of asthmatics, even lived with a bunch of asthmatics once.
See if you can spot yourself or someone you know in one or more of the following asthma types.
Asthma guidelines were written for the typical asthmatic, which generally fall into one (or even in two) of the following 11 types. For the most part, typical asthmatics have asthma under control and they have no symptoms. However, occasionally they do, and usually no more than 2-3 times per week. However, occasionally, they have their bad episodes and end up at a doctor's office or ER. How often the episodes come about depends on the type of typical asthmatic one falls under.
Types of Typical Asthmatics:** 1. Gallant:** These asthmatics are a doctor's best patients because they do everything exactly as they are directed. They have an asthma action plan. They have their bronchodilator with them at all times, but only use it when necessary. They religiously take their controller, anti-inflammatory medicines. These are the patients we see in the ER once, educate them, and never see them again.
2. Goofus: These asthmatics don't like anything to interfere with their fun. They have an asthma attack, go to the ER, half-listen to the nurses, doctors and respiratory therapists, and then take their preventative medicine until they start to feel better. Then they go back to having fun, until the next asthma attack.
3. Phlegmatic: These folks are not easily excited into action. They are very composed and calm even under the worse situations. You may not even be able to tell they are having breathing trouble.
4. Actors: They have legitimate asthma, but they take advantage of it to get out of doing things they don't want to do, like attending gym class, going to work, or going to their mother-in-law's 5th wedding.
5. Martyr: They could by dying and they still don't go to the ER. They are usually tough, macho adult men who only go to the ER at the insistence of their spouses. Their biggest fear, although they won't admit it, is that they will be told their asthma is all in their head, and then they'll feel stupid. So, they think it's easier just to pretend they are fine.
6. The Recovered: Child asthmatics who grow up and no longer have asthma symptoms so they do some unwise things -- like smoke. When their asthma comes back, they are in a world of hurt.
7. Doubting Thomas: These are mostly adult-onset asthmatics who, all of a sudden, develop mild asthma symptoms, but don't want to admit they have asthma. They would rather suffer at home than seek treatment. But when the RT gives them a treatment they will say, "Wow, I didn't even realize I was short-of-breath." Famous Olympic swimmer Dara Torres may have been this kind of asthmatic. But now, I'm sure, she is a Gallant asthmatic.
8. Sometimers: They live normal lives, feel good 95% of the time, and so are in denial about their asthma and don't take their preventative medicines. These are your adult asthmatics who sometimes have mild symptoms, and when they do they take a puff or two or three or four of their inhaler until they feel better.
9. Poor Patients: These asthmatics would be okay is they had different doctors. We RTs hate to bad mouth doctors, but we know that since this patient has been in the ER 10 times in the last year, he should be on some type of preventative, anti-inflammatory medicine and not just a bronchodilator. Poor patients may also be children whose parents don't have a clue how to manage the asthma.
10. Hard-luck Asthmatics: These are the asthmatics who, regardless of how compliant they are with their preventative medicines, still have bad asthma episodes. We don't know what bum luck would cause some asthmatics to get so bad, but some simply develop asthma that becomes difficult to control. This can happen to any asthmatic from infant to adult. They see doctors on a regular basis. They are on all the state-of-the-art medicines (possibly even oral steroids), and yet still have asthma episodes regularly. They end up in hospitals more often than they'd like.
11. Bronchodilatoraholics: These are people who use a bronchodilator frequently. Some may be abusing their medicine, but many are gallants who simply have hard luck asthma.
Abusers don't work with their doctor on an asthma action plan and they may not bother with controller, anti-inflammatory medications. For them, puffing away is like a bad habit - like biting your fingernails. In contrast, some hard-luck asthmatics may just need their bronchodilator frequently - many times a day, every day.
We'll learn more about bronchodilatoraholics on another post.
So, are you happy with the type of asthmatic you are? If not, there is no time like the present to become a better one.
I will go into more detail on all of the above types in my upcoming posts.