Asthma ER Tales Part I: How I Went to Paris and Ended Up in the ER

I did not expect to be hospitalized last week. I expected to be poo-pooed like the last time I went to the ER over 4 years ago after a vacation in Europe. For some reason, that episode, the initial ER visit was great. The doc was great, but I needed antibiotics and more nebulizer treatments and didn't get them.

Not that particular ER doc's fault. He was actually really good and asked me how I thought I was doing after the nebulizer treatment--he knew I knew my disease. I was so happy to be able to breathe, I ignored the fact that I was still wheezing quite a bit with a lot of gunk in the lungs. "I'm great," I trilled almost manic with glee at how much easier it was to inflate my lungs. "I'll be fiiiiiine."

Famous last words.

Sure enough,I was back at the same ER the next day after unsuccessfully trying to get in to see a pulmonologist or my primary care doctor. Fighting for every breath. Fighting for control.

The pulse ox registered 88 before they turned it so I couldn't see.

The ER doc on duty that day asked me in a very condescending tone of voice "So you...came back?" As if I was retarded.

Then he left the room. Shut the door. I was left in the dark for several hours (for some reason they turned the lights off). Struggling so hard to breathe that I could not function well enough to open the door and ask for help. I was too sick to advocate for myself and it was terrifying. I ended up using my rescue inhaler... in the ER.

I wondered if anyone was going to help me. I wondered how it was that the day before I had been treated so well at the same ER, yet now seemed to be more sub-human than the stereotypical drug seeker all ER staff love to hate. It was a horrible experience.

I was a medical orphan at that time. An asthmatic without a pulmonologist...going on seven years. My fantastic pulmonologist had moved to another state and I didn't like her replacement so I never went back. My primary care doctor was prescribing my meds. My asthma was really stable and well controlled (remember for 7 years!), I figured I was good. But I went to Paris and caught a bad bug and ended up in the ER.

(By the way,I call Paris the vacation that tried to kill me, because asthma wasn't the only thing I brought home with me. More on that some other time.)

In the end, they offered to hospitalize me but I refused. I felt so ignored. So discounted and uncared for that I didn't trust them. I asked for an albuterol solution prescription (the one med I hadn't kept filled the last 7 years) and left hoping I could deal with the asthma on my own.

Luckily, I did eventually get in to see a pulmonologist who figured out I needed antibiotics. Within hours of the first dose, I started feeling SO much better.

So anyway, I recently caught another bug. My toddler has been sick almost continuously since January. She's had 5 or 6 infections including bronchiolitis that caused wheezing and necessitated her first nebulizer treatment. I caught one of her bugs and it was hardcore virulent.

The fastest I've ever gotten sick. By day three I called my pulmonologist (the same one from the post-Europe ER experience) and begged for prednisone. I never ever beg for prednisone. I hate prednisone, but I knew I needed it. More importantly, I did not want to go to the ER.

I was afraid of the ER.

So I did 5 days x 60mg of prednisone. 6 days of round the clock nebulizer treatments. Slept sitting up for 10 days. Coughed until I puked. Coughed until I peed my pants (oh the joys of the postpartum body). My pulmonologist suggested a chest x-ray and maybe some antibiotics.

"No, it's viral. Classic virus," I said. "I'll be fiiiiiiine." Afterall, I had prednisone and nebulizer solution, surely they would patch me up?

I'm beginning to think any time I start chirping "I'll be fiiiiine" I should just go directly to the ER. The sicker I am, the more I say I'm fiiiiine. I don't think it's denial so much as 'faking it until I make it'. I so desperately want to be better, I pretend I am as a coping mechanism.

I spent the weekend regretting my decision not to do the x-ray. I white knuckled it through the weekend. Too miserable to sleep. My lungs weren't just wheezing, they creaked. Monday I called the pulmonologist to arrange the chest xray and promptly realized 3 things:

1.My pulmonologist was busy and it was going to be difficult for us to coordinate anything given that I was an unplanned problem trying to crash her already beyond full schedule.

2.There was no way I could drive or breathe well enough to physically navigate the medical building.

3.I needed to go to the ER and should've gone to the ER days earlier.

I was not "fiiiiiine."

Part 2 will be forthcoming. As a side note, the picture of me with my daughter that I use up in the blog sidebar is from the most recent asthma exacerbation and hospitalization. The picture in this post is from Paris 2006--the vacation that tried to kill me.

Edited to add: As you will learn in Part III, I was right to never go back to pulmonologist's replacement. She was a passive-aggressive sociopath who caused me all sorts of grief when I ran into her last year.