Wonderful world of asthma meds

Asthma and bronchitis have pretty much stopped me in my tracks for the last couple of weeks. I got sick very suddenly with a mild cold and low fever and could tell I was on my way to bronchitis. The air felt raw and suddenly I needed to do my rescue inhaler a few times a day. Normally, I just keep one around in my backpack and one in my car, and I don’t think I’ve used it more than once all of last year. So, I kept on doing as much of normal life as I could, worked from home, took Moomin to school and picked him up again, and put off all errands, groceries, and laundry.

Last Sunday I realized it was serious and I couldn’t stay in my boat – the air was too cold – even if I stayed in bed, it was too hard and painful to breathe. It turned out at the asthma doc’s that I was at something like 40% of my normal breathing capacity. That sucked. My sinuses have also been bleeding, my ears hurt, and I’m dizzy. For about a week, I couldn’t get enough air to really talk. Fun times! Now I’m holed up at Oblomovka’s warm apartment with a motherlode of asthma meds, feeling a little better, able to talk now, but wondering when the heck this will end.

Asthma meds have changed a bit since my last bad episodes. I was on prednisone for a week. It didn’t seem to help me as much as prednisone usually does when I have bronchitis. I am doing Symbicort, which is 160mcg of budesonide, 4.5mcg of formoterol; and in the nebulizer, .5mg of ipratropium bromide and 3mg albuterol. Unfortunately albuterol makes me feel shaky, queasy, speedy, panicky, and hideously emotional. Basically, if I do albuterol, I burst into tears a lot, my heart pounds, and I feel kind of irrational. But it’s what gets me breathing.

Albuterol is a bronchodilator and a short-acting beta 2 agonist. It relaxes the muscles around the bronchi and bronchioles, which are probably tight or spasming in an asthma attack. It’s the main “rescue” inhaler most people use when they have asthma, because it works very quickly. It doesn’t help reduce inflammation. Its effects wear off after a few hours.

Ipratroprium, which I’ve taken before under the name Atrovent, is an anticholinergic that works by interrupting nerve impulses to smooth muscle in the lungs. I find that it helps with the pain and tightness of asthma. It’s hard to tell which inhaler is doing what, of course.

Budenoside is a corticosteroid that, taken long-term, helps reduce inflammation in the bronchi. This is the important one that, in theory, will help kick me out of this horrible cycle.

Formoterol is a long-acting beta-2 agonist that should also help over a few weeks to relax the smooth muscle in my lungs or bronchioles or whatver. It lasts 12-24 hours.

So, I have nearly every kind of asthma med here. I don’t have mast cell stabllizer inhalers, or Singulair which is an anti-leukotrine drug… or leukotriene receptor antagonist now that I look up the proper term. For a few days I was also taking some hydrocodone cough syrup at night, which isn’t ideal for asthma but which helped me sleep without coughing and also helped with the pain in my chest, which was pretty bad.

Last week I ended up in the Urgent Care clinic at UCSF where my doctor sent me to get chest xrays. The xrays were okay, and the doctor there gave me some antibiotics and a corticosteroid nasal spray, on the theory that I also had a sinus infection, which was triggering the constant asthma. I’m not sure that he was right, but I can roll with a Z-pack and some fluticasone, why the hell not.

Air still feels like fire going in, and I’m still coughing if I try to walk around. I don’t like being on all this medication, and I’ve been out of work for almost 2 weeks. I’m happy to be on the mend.

While sick, I’ve been playing an online scrabble analogue called Words With Friends, beating nearly everyone. I’m “drlizardo” on there, if you want to get your ass kicked. It helps to keep my mind off of the pain and discomfort and anything that makes me think rationally is great — very helpful to avoid freaking out. I also read a bunch of books:

Imperial San Francisco by Grey Brechin. This is not very readable unless you’re a super-history-wonk. But it does tie together quite a lot of information about San Francisco and the military industrial complex of mining and empire. It mentions so many interesting things that it’s a great book to read with Wikipedia on hand. And it’s very scholarly with great footnotes & sources.

Gulag by Anne Applebaum. If you are sick in bed, warm and well fed, but still very miserable and whiny, reading about millions of people sent to freezing cold prison camps and gnawing on tiny hunks of moldy bread to survive is strangely cheering. I had no idea the Soviet prison camps were so huge, and so essential to the economy.

Priceless: The Myth of Fair Value by William Poundstone. This was a good quick read, a little bit fluffy, with descriptions of a lot of different experiments in economics and psychology. One of its central points was “anchoring” — if you are exposed to an initial “anchor” number, even if it has nothing to do with a following question in which you have to come up with a price or a number or evaluation of any kind, the anchor’s value will influence your answers. So the idea that someone, somewhere, might pay 2 million dollars for a jeweled handbag, makes people more willing to pay an unreasonably high price for some other piece of crap or car or whatever else.

I’m in the middle of The Net Delusion by Evgeny Morozov, Dark Sun by Richard Rhodes, and Among Others by Jo Walton. I’d like to write in detail soon about The Net Delusion, which I highly recommend!

Time for some soup and another nap. I see the doctor again on Friday. Cross your fingers for my lungs to get less inflamed and for me to develop magical patience with this bullshit, or to obtain my cyborg body very soon. Asthma can take anyone out, as can bronchitis. I feel extra overwhelmed as I *already* am on the edge of being able to deal with life, working pretty hard to cope with disability. This illness took me down hard. I don’t know how other people manage, honestly. I think the worst part is not being able to take care of my child very well. I’m very lucky to have an understanding workplace, good medical care, an incredibly helpful partner, and a lot of friends who bring me things and give me amazing emotional support.