Allow me to introduce you to Jake, a Gallant Asthmatic. After spending the day at his friend’s cabin, and as he was getting ready to go out and party in smoky bars with his buddies, Jake noticed he was having increased trouble breathing.
He picked up the phone, and called his friend, telling him “I’m not feeling well, so I’m not going out tonight.”
“But…,” his friend pleaded, “You have to go. All the chicks are waiting.”
“No, I’m sorry. I have to deal with this problem before I do anything else.”
He ends the call, and dials his doctor. “I’ve been using my rescue inhaler a lot the past few weeks.”
His doctor says, “So, what do you want me to do. Get yourself to the ER!”
As soon as he gets his gown on and sets on the ER bed, a friendly respiratory therapist enters the room, and, after a bronchodilator breathing treatment, Jake is feeling better.
“How can I prevent myself from feeling this bad again, or can’t I prevent it?” The gallant is always curving the conversation toward what he can do to be a better patient.
The RT was eager to educate. “There are lots of things you can do to prevent asthma.”
After a lengthy discussion, the RT handed Jake an asthma information packet. Jake stayed up late that night reading the packet, and gathering as much asthma wisdom as he could absorb from the Internet.
The next day Jake saw his doctor, but he was disappointed when the doctor did not recommend anything new. So Jake fired this doctor. He thought he should, he called a new doctor who saw Jake that same day. Jake clicked with this new doctor, who prescribed just what his reading material recommended.
A week later Jake was feeling better, but ended up in the ER after spending a day cleaning his basement.
He called his new doctor right away. His doctor told him he must be allergic to something in his basement and in his friend’s cabin, so he ordered allergy tests, which confirmed he was allergic to dusts and molds.
By his recent asthma experience, Jake learned the following, of which he follows to a tee, as a gallant asthmatic usually does:
1. Education: He knows that the most important way of managing your asthma is know the disease upside down and inside out.
2. Doctor: Armed with the latest asthma wisdom, he finds a good doctor to help him create a good asthma management plan.
3. Compliance: He takes his preventative medicines exactly as prescribed and never stops taking them even when he is feeling well. He knows it takes 2-3 weeks for this medicine to get into his system, and if he quits taking it, it will not prevent asthma.
4. Rescue inhaler: He monitors his rescue inhaler use. When he gets to the point he needs to use his bronchodilator inhaler on a regular basis, he calls his doctor to adjust his asthma action plan. When he uses it he takes one puff with proper technique with a spacer. He makes sure he waits 1-5 minutes between puffs.
5. Early signs of asthma: He is aware of the early signs of asthma which include itchy neck and chin, wheezing, coughing, chest tightness, increased respiratory rate, irritability, and anxiety. When he feels these signs he uses his peek flow meter as a tool as to what to do next. Or he uses his common sense.
6. Peak Flow Meter (PF): He blows into this in the morning when he first wakes up and just before bed. He records the results and, when he is feeling good for at least two weeks, comes up with an average “feeling good” peak flow number.
Then, in the future, when this number drops to less than 80% of his “feeling good” number, he uses his bronchodilator inhaler. He waits 20-30 minutes and checks his PF again. If it is still less than 80%, he calls his doctor. If it is better, he checks his PF every four hours until he starts feeling better.
Of course if he continues to need his rescue inhaler, he also will call his doctor.
Now, if his peak flow number is less than 60%, he uses his rescue medicine and has a friend drive him to the emergency room without hesitation.
7. Asthma journal: In this he keeps track of his peek flow numbers so he can quickly and easily notice undesirable changes. He keeps track of his triggers and early and late asthma warning signs.
8. Asthma triggers: A gallant asthmatic knows his asthma triggers (Irritants that cause asthma). For many asthmatics, these include: animal dander, animals, dust, mold, grass, certain types of trees and pollen.
Aware of his triggers, Jake decides he must avoid places that trigger his asthma, such as his basement, his friend’s cabin, and probably even smoky bars.
Thus, by being a good asthmatic in this way, he never returned to the ER. He has kept his asthma completely under wraps, and now lives a completely normal life.
Yet, unlike the Goofus Asthmatic that I will describe in my next post, he never forgets he has asthma. He never takes it for granted.
A Registered Respiratory Therapist and asthmatic