I was compensated by Med-IQ through an educational grant from Regeneron Pharmaceuticals, Inc and Sanofi Genzyme to write about asthma as a chronic disease and new treatments. All opinions are my own.
On a cold day in November in the early 1980s, I stood at the starting line in the freezing cold with my fourth-grade classmates for my elementary school’s annual Turkey Trot. Every year, the kids of the fourth grade would run a 1-mile loop around our school in hopes of winning, you guessed it, one of four turkeys provided by our local supermarket.
As I knelt down to re-tie the laces of my K-mart sneakers, I eyed the competition. I had bested most of the boys on the playground during recess and I was pretty sure that my brown corduroys and striped turtleneck would make me faster than a gazelle at the Olympics.
I wasn’t destined to be a fourth-grade nothing, thank you very much. I was going to run my giblets off for a turkey.
And that’s exactly what I did.
Barreling toward the finish line with my fourth grade class in my dust, I remember gulping the cold air and feeling a burning in my lungs. I couldn’t catch my breath and as I crossed the finish line, I could barely enjoy my victory because it felt like I was suffocating. But I had won a turkey!
It may have been the first time (and last, sadly) that I won a turkey but it was also the first time I experienced what I now know was my first asthma attack (not my last). A few weeks after the now infamous Turkey Trot of 1984 found me in a doctor’s office with a new diagnosis of asthma.
Back then, asthma was treated in a reactionary way: the doctor sent me on my way with an inhaler and instructions to “take a puff if you feel wheezy.” That’s it. That was the treatment plan, folks.
Asthma Blows…Literally. Here’s Why It Doesn’t Have to Suck So Much
Thus began my almost 40-year journey as a person with chronic asthma. And my desire to win swag at races but that’s another blog, ahem.
And, if you’ve hung around these parts long enough, you know that I’ve often written about what it’s like to live with a chronic illness, day-to-day. Case in point: https://www.instagram.com/p/ByWCsHTgIPb/.
Here are some asthma quick facts:
- Approximately 25 million Americans have asthma. This equals to about 1 in 13 Americans, including 8 percent of adults and 7 percent of children.
- About 20 million U.S. adults age 18 and over have asthma.
- Asthma is more common in adult women than adult men.
- It is the leading chronic disease in children. Currently, there are about 5.1 million children under the age of 18 with asthma.
- Asthma is more common in boys than girls.
Though I participated on my high school track team and exercised sporadically throughout my 20s, it wasn’t until my 30s that I dusted off my running shoes again. By that point, I was two kids in and had the mom bod to prove it. Through a local running club, I found five women who have pushed me out of my comfort zone over the last twelve years.
At first, we started off with group runs and the occasional 5K race on a Sunday morning. But, a few years into our friendship, we decided to attempt a half marathon. Yes, you read that correctly: 13.1 miles. In a row. On the same day. It’s as ridiculous as it sounds, trust me.
As we trained for the upcoming April race, I noticed that my asthma flare ups were becoming more frequent. The combination of cold air and the springtime allergens in the air found me gasping for air on some of my runs.
Here’s a picture of that beautiful spring day when we cheerfully toasted our half marathon completion. You see my smiling face, yes. But when I look at this picture, I can still remember the effort it took to try and catch my breath.
What I didn’t realize at the time was that my poorly managed asthma was about to put me on the sidelines for a good long time.
A few days after that race, I realized I was in real trouble with my breathing.
As I sat in my primary care doctor’s office, hunched over and trying not to panic from the inability to get a good deep breath, I started to cry when my doctor came in because I knew that this asthma flare up was sure to mean dreaded steroid prescriptions and around-the-clock nebulizer treatments. The diagnosis was worse than usual, too: not only was I having an acute asthma emergency but I had pneumonia on top of it all.
That was my asthma low point, friends.
Thankfully, I have access to a physician who not only understood my health concerns but who also respected the fact that I was not about to let asthma keep me from winning turkeys on race day. He knew we’d have to work together to get my asthma managed and my health back on track.
That day, I was grateful that my doctor said the words that forever changed the course of my asthma care, “It’s time that we do the work to get this under control. For real.” And we did.
While I was pretty sick during that visit, I quickly learned that 70% of patients can be treated by a primary care doctor. Most of my care has been handled through a regimen of daily maintenance meds and an ongoing dialogue with my family physician.
Asthma Requires a Plan…Literally
But, that’s not to say that things are always easy when it comes to an asthma treatment plan, which is a document that you and your healthcare provider can fill out together that gives clear directions on what to do if you are experiencing asthma symptoms. It can take the guesswork and anxiety out of trying to know what to do when your symptoms are severe. (Here’s an example.)
Once a patient starts having more persistent symptoms, meaning they need to use the inhaler more than a few times a week, it is recommended that they see a specialist. Poorly controlled asthma is considered such when a patient is using their medications as prescribed and still having asthma attacks. Patients with severe asthma rely on high doses of medications, both inhaled, oral and biologics to maintain control of asthma. The underlying cause of asthma is inflammation and the tightening of airways.
Let’s Climb the Ladder to Asthma Success
When I was working on creating my asthma treatment plan with my doctor, I learned that there is a ladder of treatment for patients with asthma and patients can move up the ladder of treatment options if their asthma is more severe and less controlled. Here are the steps:
The first step is determining when the asthma is severe and why they aren’t responding to treatment.
The second step up the ladder is to escalate the dosing of steroids and broncho-dilators.
The third step if the patient still has symptoms is to see a specialist – such as an allergist or a pulmonologist, as the specialists can then determine what type of asthma it is and potentially introduce new biologics to specifically target the pathways to help improve outcomes.
Barriers to Asthma Care Are an Unfortunate Reality
Now, before we continue with my story, it’s critically important to note that not everyone with asthma is given the same quality of care or the same access to care. Black and brown communities are overwhelmingly burdened by asthma due to elements of racism intertwined in medicine and in society and as a whole. There are also increased exposures based on where someone lives, with those living in urban, densely populated, and highly polluted areas at higher risk for asthma. Additionally, socio-economic factors can impact care and severity.
Asthma treatments can be expensive and access to doctor’s offices can present a barrier, though hopefully the rise in telemedicine from the pandemic can help eliminate this barrier for patients. There are also cultural barriers in terms of lack of trust in doctors and concern over side effects of medicine.
Living with asthma means that life that life isn’t harder, it just requires more planning when I want to run a marathon or hike the Appalachian Trail. Knowing my environmental triggers, keeping in touch with my doctor, and recognizing that my lungs have other plans once in a while means that asthma doesn’t suck nearly as much as it used to when I was eleven.
And when I hit a PR on my Peloton with nary a wheeze or difficulty breathing, I call a “fowl play” on the fact that that good people of Peloton have yet to reward my efforts with a turkey.
Now for the part where you can help asthma patients like me:
Med-IQ is conducting an anonymous survey and would appreciate your input. The survey will take less than 10 minutes to complete. Survey responses are shared only in aggregate. Your responses to these survey questions will provide Med-IQ with important information about the challenges you have experienced with asthma diagnosis and treatment, which will help us develop future educational initiatives. Once you’ve completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 6 $100 VISA gift cards. If you choose to enter, your email address will be used to randomly draw the winners and notify them of their prize.
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