From My Perspective

OK so another thing I get asked a lot is what is an asthma attack like? How do you know when you're having one and how do you deal with it. I haven't really ever gotten completely in to this before as it's a really difficult thing to discuss or describe to anyone whose never experienced it. Maybe a part of me finds it hard to think about things like that as, to tell you the truth, it's not a fun thing to go through and it's certainly not something that I, or anyone who has seen it for themselves, take lightly. I'll tackle my own insight to it by stages, because that seems to be a logical approach. But I'm warning you, this isn't something that is incredibly hard and I've never really talked about the whole process in much detail. To be totally honest its not easy to put in to words and it's taken me this long to really think about how it happens and when we know enough is enough. It's difficult with severe asthma as you're pretty much having what some consider an attack most days. It shouldn't ever be that way, but it is.

Please don't take this as medical advice or instruction, asthma attacks can be different from person to person. This is purely me explaining as best I can about my own experiences. If you are experiencing problems with your asthma, don't delay getting help if it's bad and follow your treatment plan.

Stage 1:

So, at the first points where I'm starting to think "OK, this is my asthma" and where the process begins. Sometimes there's a definite trigger (cigarette smoke, dust, stress and many other things). Sometimes it just kind of happens out of nowhere. Usually with me, it starts with my chest feeling uncomfortable and I could be coughing more or wheezing a bit. Generally it makes you feel quite ill and when it starts with me, I can be a little bit grumpy or just want to be on my own (no one around me means no one to snap at, that's more my own desire to not upset people). I also become quite flitty and struggle to stay focused on anything for too long. At this point it's not bad, just the beginning of things and I tend to try and get it under control. Sometimes it works. Sometimes, not so much.

Stage 2:

It's at this stage that I'm more than sure that it's my asthma and time to use my nebuliser. I tend to use my nebuliser every 4 hours for maintenance nebs (morning and evening with my steroid preventer nebuliser, budesonide) of salbutamol and ipratropium. For attacks, I can have 1-2 extra salbutamol but at this stage we tend to be a bit more on our guard. For the uninitiated, a nebuliser is a machine that pushes air through a chamber where a liquid medication is. The result is a fine mist which I can inhale. The dose is much higher than the standard dose of an inhaler. The thing with nebulisers though is that there is debate among patients and doctors that a standard inhaler, used with a spacer, can be sufficient for most asthmatics but there are some patients who respond better with nebulisers. Just depends on the person. Usually by this point, there's an obvious wheeze and I cough like a 20-a-day smoker (I don't smoke, never have and never will). 

The next part is a bit complicated so bear with me. 

Stage 3. A.

This part depends on what happens with the nebulisers. Obviously it can have one of 2 outcomes. This is what happens if the nebuliser does the trick. I'll sound a lot less wheezy and my breathing kind of settles. The protocol in this case is to take 20mg prednisolone and rest. The full effect of an asthma attack actually takes an awful lot out of you and you feel it most in your chest muscles. Asthma can make breathing really laborious and it is like running a marathon. Imagine your chest feeling like something has enclosed around it but you have to keep breathing, you're going to get really tired, really fast. Often I tend to sleep for a bit, turn oxygen up if my sats say I need to and generally take it easier. If it flares up again then we go straight to the other part of this stage.

Stage 3. B.

So, what do we do when the nebs don't work or I flare up again after treatment? Unfortunately this is the stage where we know we can't beat this ourselves and know we need professional medical assistance. This is when we call 999 and get an ambulance. Over the years  I've built up a strong rapport with local paramedics, they know me and (importantly) they know how bad I get and how rapidly. They know that when they arrive, chances are, I'll be sleepy and probably unable to say much. After a check and they take over with any more nebs or oxygen (sometimes IVs) and we go straight to hospital. It's not that scary after the amount of times its happened and the local A&E are amazing too. Usually the priority is to get me stable and find out if there's (and usually there is) anything underlying like an infection. Usually by now, all I want to do is sleep but at the same time, I get anxious about being by myself. 

Never really understood that. When you're having an attack and it kicks your ass, you are both so exhausted and in so much pain you want to just sleep but at the same time, you just kind of want someone there to get you past the inevitable crash you'll feel afterwards. Unfortunately though, thy usually decide to keep me in for a few days to either get my strength back or start getting over having any infection. 

Stage 4:

The aftermath. This starts with the urge to sleep. And after an attack, I've been known to sleep for most of the day afterwards. It's like my body is saying "thank frick that's over..." and I just want to sleep and start recovering. The only problem is that as I tend to get admitted, I have to do this on a busy hospital ward. Between being in a room with 5 strangers and being visited by doctors and nurses it can be tricky to settle down and get some rest. The routine in hospital is a lot different to being at home. At home I'm able to manage when I take meds, have meals and sleep. It's hard to readjust when you get home but usually after a few days I find my groove again.

So I hope this was informative and interesting for you guys. It was actually kind of cathartic for me as I do tend to keep things quiet unless it's a big thing that's going on. I hope too that giving you an insight to my world a little bit, it will help you understand a bit more.

Til all are one!

Wendy xx