Spring Break 2009

(Note: the assignment to produce this particular blog entry has been delegated to the husband...)

Spring break for BYU-Idaho was the week after Easter this year. The plan was for me to take one or two days and finish up all of my grading and other end of semester goodies, and then we would spend a few days (well, afternoons at least, since the kids were in school that week) having some fun outdoor family activities. Then again, even the best of plans....

While some of the devoted followers of this blog may already know a little about my health history, I'll give just a few details for the benefit of those who may not. About five years ago, having no history of the disorder previously, I was diagnosed with exercise-induced asthma. About a year later I had noticed other things would also trigger the occasional bronchospasm, like a good shot of household dust or, more frequently, any type of upper respiratory illness. However, the symptoms were always relatively mild, and the spasms were quickly dispelled by the use of an albuterol inhaler. For about eight or nine months after my sinus surgery in December 2007, the asthma had gone away almost completely, but once the cold season started up the following year, it began to return.

About mid-March I had contracted a cold, which, as is usual with me, turned into a sinus infection (number four since the beginning of the year). The day I decided it was time to go and pester the doctor for yet another antibiotic, I felt the infection start to move down into my lungs. The doctor expressed some concern when he saw me, primarily because he couldn't really hear anything with the stethoscope due to the wheezing. He suggested that I rent (or purchase) a nebulizer and run through a vial of albuterol every six hours for the next several days to get my airways opened up. So, a trip to the medical supply store and five prescriptions later, I was back at home. The illness had cleared up (or at least so I thought) after three or four days, though I still found myself using the nebulizer about once a day.

Fast forward three weeks to the end of the semester. The afternoon after graduation (April 11) I felt that all too familiar tickle at the back of my throat, and knew I was in for yet another cold/sinus infection. It took its usual course over the weekend, though by Sunday evening it felt like it was on its way out. We ate Easter dinner with my parents that night (thanks Mom and Dad), and the next morning I was back at work grading that end of term stack of papers.

On Monday night I was feeling a little wheezy and stuffy, and to avoid keeping Kim awake I decided to sack out for the night in the recliner, but not before a breathing treatment with the nebulizer. Around 1:00 in the morning I woke up wheezing again. This was an entirely new experience for me. Every time previous to this the albuterol would do the trick and keep my asthma down for at least 12 hours. It had only been three.

I was pretty tired at this point, so I just pulled out my inhaler and took a few puffs. Still the bronchospasm only lightened up a little - not enough to let me get back to sleep. This went on for the next several hours, eventually reaching the point where I could hardly walk. At this point I was pretty sure I would need to see the doctor the next day. The thought had crossed my mind as well that perhaps this was something that needed more immediate attention. However, our copay for the emergency room is five times higher than the copay for the physician's office, so I quickly dismissed that idea. But things kept getting worse, eventually to the point where I could use the albuterol and be right back to wheezing hard only 15 minutes or so later.

Finally, around 5:00 or so I woke Kim up and suggested that I get to the ER. (To give you an idea of what my condition was at this point, I was completely winded after walking the 20 or so feet from the recliner to the bedroom.) She calmly got up, got dressed, instructed the children on how to contact us should they need anything before Grandpa arrived (thank goodness they live relatively close), and drove me to the hospital.

I figured that I would go to the ER, they would give me a shot or two of corticosteroids and a breathing treatment, and within a few hours everything would be back to normal. This was sometime around 6:00 am.

At about 1:00 pm, after four courses of steroids, three shots of epinephrine, and I don't even know how many breathing treatments, I was still showing no sign of improvement. My oxygen saturation was only holding in the low 90's with the oxygen on, and my pulse would not drop below about 120 bpm. I had already been in for a chest X-ray, and when it came back not exactly normal was sent back in for a CT scan. The ER doctor was getting pretty concerned at this point, and was starting to wonder whether I should be transferred to a pulmonary specialist in Salt Lake City. My Dad and our Bishop showed up around 1:30 and gave me a blessing. By 2:30 I was starting to slip even further. Now, granted, I had been awake for the last 13 hours with my pulse racing and working hard for every breath. Things get a little hazy to me for the next few hours. I remember slipping in and out of sleep, and hearing some sort of conversation as to whether I should be moved into the ICU.

Now, I must say, when a person gets into that type of condition, certain thoughts start to run through their mind. For a short period of time I wondered if I was eventually going to pull through or not. And if I didn't, would Kim and the kids be OK? Needless to say, I think I learned a thing or two from that experience.

As the evening drew on I was eventually moved out of the ER and admitted into the hospital. Things must have began to turn around while I was in and out of sleep, because they wheeled me into a regular hospital room, and not the ICU. I spent the next two and a half days in that room, receiving breathing treatments every four hours, steroids every eight hours, and antibiotics two or three times a day. I was released on Friday morning.



Thanks to a borrowed laptop and an open wireless network at the hospital, I was still able to get my grades in on time :).

So, spring break this year did not turn out quite as planned.

Since my release, I have been in for a few follow up visits. The otorhinolaryngologist (or ENT, though I suspect they prefer the technical name) discovered that, even after a week of antibiotics, I still had an infection brewing in my sinuses. He took a culture and prescribed another 12 day course of steroids and a four week course of antibiotics. I'll learn about the results on that culture in about a week. He also found that my sinuses were for the most part still fairly good, the only exception being widespread inflammation and thickening of the mucosa and a few polyps. The plan right now is to see if we can just shrink those up with the steroids, and hopefully avoid any additional surgical procedures.

Anyhow, the moral of the story, I suppose, is as follows. If you or your loved ones are treating asthma with an inhaled beta agonist more frequently than twice a week, see your doctor and get it under control. After all, you would probably rather spend your spring break watching trout rise for your blue wing olive than eating bland hospital food.