In Which I Try to Explain Asthma to Liver Surgeons

I've had something like 12+ doctors appointments since landing in the ER this past October. Each time, I disclosed my medications and health history.

Same for the presurgical consult.

I thought when I said things like, "I have asthma. I'm on Symbicort daily and pulmicort, pro air, albuterol solution and prednisone as needed' that they understood I had asthma.

Not Kim Kardashian asthma that expresses as a cute little cough and comes with a custom inhaler cover to match your purse and shoes.

No, I don't have that asthma. I have jihadist, kamikaze asthma that has declared me an enemy who must die.

My asthma, when activated, does not play.

The blessing and the curse is that moooost of the time, the asthma is controlled. So everyone gets complacent and tends to dismiss my intense interest in staying on top of it.  (Except my pulmo because she's seen it in action.)

But you don't get a never ending prescription for prednisone 5 day bursts because you can breathe just fine, you know?

So after the liver resection, my lung partially collapsed and the asthma came out to play and I didn't see good O2 sats for days. Unfortunately, no one really noticed. On Day 2 I woke up enough to go 'gee, I'm undermedicated for this' and started demanding meds in an effort to find relief.

(They were treating me with oxygen and one puff of Advair and nothing else.)

The 'we are bros, bro' residents told me they were going to discharge me with shit breathing and that I couldn't take any steroids for my lungs.

And I freaked.

Seriously? You are going to discharge me with O2 in the 80s and tell me I can't use my 'asthma action plan'?

What?

I kept asking them about it. Trying to get them to make the connection that maaaaaybe it's not the smartest thing to ditch a patient at home when they aren't breathing so great. Maaaaybe the bro code could include figuring something out so I don't bounce right back into the hospital.

However, I was in a lot of pain, my O2 was not great and talking was very difficult. Meaning, my ability to express myself was not at 100%. I don't think I was very effective and the bro residents really were not interested.

FINALLY, my family got one of the halfway decent residents in my room and I tried to explain again.

"If I can't breathe now, what do I do if it gets worse when I go home?"

They had no answer. I brought up prednisone.

"No. No. No prednisone. We're not giving you any steroids."

"I don't need you to give me steroids. I have prednisone at home."

You should have seen the look on the resident's face. Like, he was shocked. Utterly shocked to learn I had steroids to use at my discretion.

Somehow that translated. The light bulb went off. "Ooooh you have asthma." I don't get why this was such a shock to any of them, but there it is.

I then pushed for a pulmo consult, which was too late in the game to help me much. I'd already gotten the meds they could have prescribed and lined up the RTs for nebulizer treatments.

I resent that I had to work that hard on my care. I was exhausted, in pain, and struggling to breathe, and I had to argue and argue and OMG argue for care. I can't believe they didn't pull in pulmo when the lung collapsed, but apparently that is just not done. It was very disappointing.

Ultimately, nothing was settled. I was sent home with no plan for my breathing and was left to manage it on my own. I don't know why a surgeon would bother to cut a patient if they weren't going to ensure something else didn't ruin their work down the line, but here we are.