The Cycle That Follows My Asthma Attacks

I am recuperating from on overnight admission to the hospital after an asthma attack. I am recognizing a cycle I have experienced before.

It is 10 days since I came home from the hospital. It was the second hospital visit this year. I am much better at recognizing that my asthma is severe enough to need to go to the hospital now.

I have adult onset asthma and have had this for just three years. Getting diagnosed took nine months, nine months of not being able to breathe at all well, plus the indignation of being told my problems were stress-related.

I take four different puffers twice a day and one tablet. I am on the maximum dose of preventer medication, a steroid. And still, my asthma wouldn’t be described as “controlled.”

On day 10, I am feeling absolutely exhausted. I am back to needing to sleep every afternoon!

In the hospital I started to feel relaxed. I felt safe. Help was available with people who knew and understood asthma. The nebulizer and the high doses of reliever and the steroid were doing their jobs. There seems to be a cycle that follows an attack.

1. Terror. The midst of an attack is terrifying. Not only is breathing impossible, but your brain may cease to be rational. Being deprived of oxygen can cause distorted thinking. You need to slow your breathing and take deep breaths – while all I could do was cough and gasp for air!

2. Relief. Getting to the hospital means help. A nebulizer is available and this is much easier to use to deliver the drugs than a spacer. Oxygen too helps to put oxygen into your blood stream. It takes a minimum of six hours before you are considered to be responding appropriately.

3. Hyped up. Once the twice-hourly 12 doses of salbutamol and the 50-mg. of steroid start to kick in, I start to feel very hyped up. I can’t sleep, I am extremely hungry from the steroid, I am shaking and knocking things over, dropping things and am an emotional wreck.

4. Freedom. I am well enough to go home. It feels so good to be in my own home. I have medications and another seven days of steroids and follow up letters for doctors. But, I am tired and very emotional. The emotional see-saw comes from the steroid use. So does a ravenous hunger. I have little energy. I feel like I am a blob!

5. Relaxed. After a few days at home I am starting to want to do a few things but my breathing still isn’t in the “OK” range so I have to be “cautious.” I am still on steroids so I am very moody and hungry. I am still taking a fair amount of relievers so I am pretty clumsy. I am tired. I am also tired of being unwell. My ability to concentrate is nonexistent. There is some frustration creeping in.

6. Tension. I have nearly finished the steroid but still am not back to my usual breathing nor back to my usual medication levels. This worries me a bit. It’s taking much like longer than usual. Lots of doubts surface here. What if it gets worse? I am finding I am coughing a lot more. It is very common for asthmatics to have a repeat attack within the first two weeks of an attack. Is this starting to happen? So I am feeling a bit tense.

7. Exhaustion. It is day 10. I have finished the steroids. I have gained weight again. No surprise there. That’s one side effect of the steroids! I am still needing extra relievers during the day. I still can’t resume my usual daily activities. Today, I washed up and then went to the shops with my husband. I sat in the car. That was too much! Not enough energy! My peak flow is still mainly in the caution zone. I feel totally depleted and flat. I have come down from the steroid, but I am still hungry. The exhaustion is extreme. The exhaustion is overwhelming! This exhaustion seems almost unbearable!

8. Hope. I hope the next part of the cycle is the gradual ability to resume my usual activities. I hope my peak flow gets back to OK. I hope my oxygen saturation will stay above 95 percent for a whole 24 hours! I hope I can get the reliever usage down. I hope I don’t push my tired old body to recuperate too fast and slip backwards again.

My asthma is chronic. I know it won’t ever go away and all I can really hope for is that I can manage it.

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Thinkstock photo via artant.