Tuesday, February 21, 2012

Just Breathe

When I was twenty-four, I was diagnosed with asthma in the traditional way: at a dinner party at a doctor’s house. I had gone from the dining room (warm) to the porch where people were having canapés and cocktails (cold) and commenced to cough. Since I was in day nine of Quinn’s Annual Bronchial Plague, I thought nothing of it and sequestered myself by the tomato plant in the corner to have a satisfying half-hour hack. Nearly everyone inched away from me, but my feelings weren't hurt in the least. My bronchial opera isn't pleasant to be around. I have been known to break blood-vessels in my throat, such is my coughing. Once, I found myself in an ER waiting room sitting across from a person holding a dirty rag against what appeared to be a stab-wound. He  watched me cough a few minutes and said I could go ahead of him. So you can imagine my surprise when the host actually sought out my company.

“Where’s your inhaler?” he asked.

I waved my arms around in a way I thought would convey Thank you for your concern, but this isn’t asthma as much as the tail-end of a bronchial Cthulhu and it will abate somewhere between now and next month.

“I don’t know why anyone hasn’t told you this, but you have asthma,” he said firmly. “Now come in the house and let me see if I have something for you.”

Always accept dinner-party invitations at a doctor’s house. A few minutes later I was no longer coughing. One specialist's appointment later, I had an official diagnosis: asthma. I had the type most usually aggravated by a previous illness, which explained why my November cold usually left me hacking and wheezing until April. I was given two inhalers -- one for crisis situations and one for every day use -- and told to take care of myself. Since “take care of myself” meant “stay away from people who are smoking and work out regularly,” I can honestly say asthma may be the best thing which ever happened to my health. Of course, I’m great in a crisis but kind of a disaster when is comes to mundane tasks. Some days, I’d carry my inhalers; most weeks, I wouldn’t. Hey, I’d think. I’m fine! When I’m not fine, I’ll carry my inhaler! Come to think of it, I haven’t had an attack in months. Perhaps I’ve outgrown asthma! And sometimes I’d forget to get a new inhaler when the old one ran low but, Hey, asthma hasn’t happened in months!

About six years later, I got sick. Because I’m all about timing, my illness ramped up and required antibiotics late one night, on what turned out to be  the coldest night of the year. Consort offered to make the run to the all-night pharmacy but I got weirdly stubborn and insisted I could take care of it myself. He drove. When we arrived at the pharmacy, I got out of the car (warm), and since I couldn’t breathe through my nose, I sucked in a blast of nearly freezing air through my mouth. My bronchi closed with the finality of a bank-vault and I started to cough. Coughing pushed whatever air was left in my lungs out, but when I attempted to breathe back in, I couldn’t. And then I’d cough again. The force of it caused me first to lean against the car and then eventually sit cross-legged on the ground, coughing and pawing through my purse looking for my inhaler which was safely and ineffectively back home. Consort was next to me, looking down and saying calmly, “We have to go to the emergency room now, you’re not breathing, let’s get you into the car” and I’m coughing and waving my hands at him in the It’s really not that big a deal, just give me a quick tracheotomy and we’ll be on our way manner, but I was clearly hypoxic and I rarely make my best decisions hypoxic. And all the while some part of my brain is thinking This can’t be the way I die. It’s too stupid.

We found an inhaler in the glove-compartment. I have no recollection of putting one there. I think the universe looks out for me but is well within its rights to roll its eyes every now and again.

I thought of that incident this week when Anthony Shadid died. Mr. Shadid was, by any measurement, an extraordinary journalist. This is from Wikipedia:
  • From 2003 to 2009 he was a staff writer for The Washington Post where he was an Islamic affairs correspondent based in the Middle East. Before The Washington Post, Shadid worked as Middle East correspondent for the Associated Press based in Cairo and as news editor of the AP bureau in Los Angeles. He spent two years covering diplomacy and the State Department for The Boston Globe before joining the Post's foreign desk.
  • In 2002, he was shot in the shoulder by an Israeli sniper in Ramallah while reporting for the Boston Globe in the West Bank.
  • On 16 March, 2011, Shadid and three colleagues were reported missing in Eastern Libya, having gone there to report on the uprising against the dictatorship of Col. Muammar Al-Ghaddafi. On 18 March 2011, The New York Times reported that Libya agreed to free him and three colleagues: Stephen Farrell, Lynsey Addario and Tyler Hicks.The Libyan government released the four journalists on 21 March 2011.
  • Shadid twice won the Pulitzer Prize for International Reporting, in 2004 and 2010, for his coverage of the Iraq War. His experiences in Iraq were the subject for his 2005 book Night Draws Near, an empathetic look at how the war has impacted the Iraqi people beyond liberation and insurgency. Night Draws Near won the Ridenhour Book Prize for 2006. He won the 2004 Michael Kelly Award, as well as journalism prizes from the Overseas Press Club and the American Society of Newspaper Editors. Shadid was a 2011 recipient of an honorary Doctorate of Humane Letters from the American University of Beirut. He won the George Polk Award for Foreign Reporting in 2003 and in 2012 for his work in 2011.
This guy was the real deal. He spent his career making a fascinating and dangerous part of the world comprehensible to civilians like me. Last week, Mr. Shadid died in Syria, not from a bullet or an explosive device, but from asthma. He was trying to leave Syria on horseback and suffered an asthma attack. Reports were he was especially allergic to horses. He probably wouldn’t have chosen to leave Syria that way but it’s a war zone and he took a chance, as he had so many times before while reporting from that part of the world. Maybe he had his inhaler with him. Maybe he didn’t. Maybe this was avoidable. Maybe this wasn’t -- some asthma attacks are not going to turn around even with an inhaler. Maybe he had a moment of thinking "This can’t be the way I die. It’s too stupid."

Mr. Shadid left a legacy of award-winning journalism and great writing.

Mr. Shadid also left a wife and two small children.

And Mr. Shadid left a chilling reminder to all of us who live with asthma; can kill you. If you’re reading this and you have asthma, please stop reading right now and check to make sure you have a working inhaler and that it's with you at all times. Make sure it’s not expired. If it is, get it replaced. You’ve never gotten me a birthday present, so consider it an early gift to me.
Rest in Peace, Mr. Shadid.


Blogger Hen Jen said...

oh wow, I didn't know this was how he died.

3 of my kids have cough variant asthma, brought on by virus/colds and by out-door mold...they have gotten much better, we prefer the nebulizer machine to the inhaler. I did try to have an inhaler with me, but did you know they just went up to $40?? Our prescription plan changed this summer and the steroid inhaler went up to $105...our nebulizer broke last year- Ca legislature has made it impossible for me to order a fast/compact one from discount retailers...as a mother, sometimes I want to scream! We are currently using my MIL's 1960 nebulizer, until my Dr. family member mails us a new/used one...

your story was scary, thanks for reminding me to carry at least one with me...

5:25 PM  
Anonymous Robin Raven said...

Wow, such a tragedy. Thanks for your beautiful blog entry.

Oh, and this might sound a little odd, but your mentioning birthdays (when mine is almost here haha) got me to thinking, "When is Quinn's birthday," and the ever-helpful Wikipedia told me. I'd never picture you as a Leo. (Not that I believe in astrology at all, but learned about it when getting into the role of Sarah in a play of "The Accused." haha)

Anyway, just wanted to say great blog entry, and here I am a-rambling. Cheers for your great writing!

6:42 PM  
Blogger Sara J. Henry said...

And if you're ever around someone starting to wheeze and they don't have an inhaler and the emergency room isn't a viable option - immediately make hot tea or coffee and have them drink it: caffeine is an effective bronchodilater. I did this with a friend who was just starting to wheeze, and it worked astoundingly well. (I sent her home with a spare tea bag and a stern admonition to carry her inhaler. Sounds like a cola drink would work as well, but I'd go for the hot beverage.

7:10 PM  
Blogger Twisted Susan said...

My mom has been sending inhalers to my alcoholically charming brother for twenty years. A few months back he finally got scared enough to quit smoking.

8:44 PM  
Blogger knit one, knit two said...

Thank you for the wake up call. I was dx'd with asthma last year after a bout with H1N1 left me with a lingering cough (plus years of bronchitis/pneumonia/wash rinse repeat did a number on my lungs.) I felt ashamed to admit I had asthma, hoping it would go away too. Thank you for showing me it's not shameful to have this disease.

3:56 AM  
Anonymous NY Nancy said...

Oh, Quinn, back in 1991 my best friend died from an asthma attack. She was in her home, had access to her inhaler as well as a machine, but couldn't get relief. She was unable to call 911 and died alone, trying to breathe. Your post struck a strong chord in me and hopefully others. Best of health to all.

7:03 AM  
Blogger MomQueenBee said...

My dear friend Margaret made it through two years of Peace Corps safely but three years later didn't want to take her asthma medicine because she was breastfeeding and thought it might harm her baby. That baby was nine months old when his mother died, and he'll never know what a feisty, funny, smart woman she was. I will miss Margaret and hate asthma forever.

7:06 AM  
Anonymous NancySongbird said...

EXP DEC 2011 :-(
Thanks for the sobering reminder, from someone who has at times been guilty of both arm waving and weird stubbornness. It's not something to mess with. Point gratefully taken.

11:59 AM  
Anonymous Anonymous said...

Thank you for this post. My daughter, who is 20, was diagnosed when she was about 5 with this type of asthma. I always thought asthma was all about the wheezing, but luckily our pediatrician was well versed in all types. Hers is triggered by illness, allergies and cold air. Her doctor always said the time you will need your medication will be when you don't have it with you! She is pretty vigilant, but I'm going to forward your post to her at college. You just can't remind people too much!(even though I will probably hear "mooom, I knowwww" !)


4:05 PM  
Blogger Claire said...

My older son had pneumonia at the age of almost 5 and for years he had what was dx as Reactive Airway Disorder. He only would have problems after a virus or cold. Probably going from warm to cold wasn't an issue for him only because we live in Florida where it is mostly warm, warmer, and hot (with a few cold fronts moving through in the winter).

So we used nebulizer treatments at the first sign of coughing with an illness for years. He is almost 12 and appears to have mostly grown out of it but I still keep an eye out for the obvious RAD cough.

He has allergies but they don't appear to set it off and never have.

4:24 PM  
Anonymous Anonymous said...

Thank you! I have had asthma since I was 2- I have had physical education teachers tell me running would cure me and it was all in my head. I manage it well enough that most people don't know I'm even asthmatic and I'm so sad this wonderful gentleman died such a tragic death. Thank you again for spotlighting the seriousness of a disease people don't understand and even mock. How many times have we seen the nerd in the movie or TV show pull out his or her inhaler to the laughter of the audience? People don't get it

5:46 PM  
Anonymous Anonymous said...

Oh and did you realize that the only non-prescription (read "affordable") inhaler was pulled off the market on January 1 because of minor environmental issues? I wonder how many uninsured or people who just need an over-the-counter inhaler in the middle of the night will suffer needlessly or tragically?

5:51 PM  
Anonymous Lisa said...

My daughter was diagnosed with asthma when she was 2 years old. It is triggered by respiratory illness, allergies and her emotions (which is tough because she is a hot tempered kid). Just when I start to think that maybe she doesn't have asthma anymore because she hasn't had an attack in eons, I get surprised by a new asthma attack. Thank you for the important reminder to never let your guard down when it comes to asthma and always have your rescue inhalers.

11:32 AM  
Anonymous Riin said...

I've been carrying around an inhaler that expired over a year ago, figuring it probably still kind of works, but I guess it's time to get a new one.

12:09 PM  
Anonymous Anonymous said...

My daughter was just diagnosed this past fall (at age 18). An important reminder to me to take it seriously (and to nag her). Thanks for the PSA!

Chris in NY

9:57 AM  
Anonymous Anonymous said...

Oh, my. I got the chills reading your blog and the comments. I cannot imagine how scary, if not downright terrifying, it must be to not be able to breathe, something most of us take for granted.

I was heartbroken to hear of Mr. Shahid's death. Thank you for the lovely tribute.

1:57 PM  
Blogger Girl From Nowhere said...

Oh my God- I think I have asthma. No, I'm not kidding or trying to be a smart-butt. Several years ago, an Allergist diagnosed me with asthma. Having never had what even resembled an asthma attack, I poo-pooed her and carried on. In the past 2 years, however, I've noticed some breathing...issues. I've never even thought such a thing as a sudden temperature change would cause an asthma attack, but I have experienced similar problems to what you are describing, although to a lesser degree. Additionally, I was recently sick, and my cough has never fully gone away, leaving me with a constant feeling of not being able to quite get enough air. I was also woken up in the middle of the night with a coughing fit and proceeded to have what I can only describe as the closest thing I can imagine to an actual asthma attack. I think I may need another visit to my Dr...

3:07 PM  

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