I've had this cough/wheezing thing going on for the better part of five weeks now. It was bronchitis, I thought it was still straggling. I went to different minute clinics and medchecks and received breathing treatments and xrays -- just kept being told that I needed to take Mucinex and Albuterol to both open up my lungs and then get the crap out of them. So that's what I did. And the cough/wheezing kept getting worse.
This past weekend I was so bad I couldn't put sentences together without panting, I began to vomit up everything I ate from the severity of my coughing, I had this signing sound (honestly sounded like a whale) whenever I breathed. Sunday night/Monday morning around 3am I woke up coughing - which again led to vomiting - which led to coughing/vomiting up blood - which led to me finally being freaked out enough to head to the ER.
That's the first time I realized that I have severe asthma and was going through a very severe and prolonged asthma attack. I didn't even register on the peakflow spectrum - I have no idea what my pulse ox was because everything was happening so quickly. I had three different breathing treatments (the last two each were over an hour long) along with a steroid IV, magnesium IV, more xrays, yadda. They decided to admit me to the hospital for prolonged IV steroid and nebulizer treatments as well as observation, and I've just been discharged today - my 29th birthday.
The honest to God truth - the part of me that I don't want anyone to see - is that I'm feeling very mopey and sorry for myself right now. I wanted bells and whistles, streamers and possibly a clown, to line the halls of the hospital as I left in celebration of my birth and recovery. I wanted dinner plans, or an exciting package at my doorstep, or some sort of huge bash of a finish to celebrate my ability to breathe and the beginning of the end of my 20's.
But people have lives. And the ones who might be able to hang tonight are so far away that it isn't on the radar. The ones who are closer either have plans or lives of their own - and I feel like it'd be the worst guilt trip in the world to ring up someone I'm acquaintances with and say "Hey remember me? The one on your facebook who was just in the hospital for four days and was born at this moment 29 years ago?? Wanna get some chips and cheese?" No obligatory dinner for me - it just isn't my style.
Apparently though sulking and pouting are exactly my style. I called Amanda to bitch and she said "Maybe you should be glad you're seeing 29."
This is the tough love stuff I hate, but always has the biggest impact on me.
The truth is, I have had some major medical issues this year - and every one of them are in some way affiliated with my weight. I feel like a kid with cancer who won't do the chemo. I mean I'm bummed because I can't go eat Mexican tonight - what kind of delusion bs is that? I should be jonesing for, like, carrots and humus.
:( Boo to that.
My pulmonologist gave me this article to read that discussed the connection between obesity and asthma. Here are some excerpts:
In addition to the asthma epidemic, there is an obesity epidemic in the United States. One-third of all 16-year-old children in the United States are overweight, and 15% are obese. Cross-sectional studies indicate an increased prevalence of asthma in the obese (4–7). Although it is possible that this association is the result of reduced exercise by subjects with asthma leading to obesity, longitudinal studies (8–10), which indicate that obesity antedates asthma, suggest that this is not the case. An important aspect of these epidemiologic data is that the impact of obesity on asthma is much stronger in females than males. For example, the incidence of asthma after the age of 11 years is five- to sevenfold higher in female children who become obese versus those who remain lean, whereas no such relationship exists for males (8). (Weiss, S. 2003) (And shoot me if I have the citation incorrect - I do indeed have my MBA).
In obese individuals, airway smooth muscles are likely to be unloaded (have less tension) in part because obese individuals have a decreased FRC and in part because obese individuals assume a breathing pattern with higher frequencies and lower Vt that lean control individuals. Decreased FRC shortens muscle length and hence decreases tension. Tidal stretch of airway smooth muscle is an extremely potent bronchodilator: stretch of airway smooth muscle detaches cross bridges, leading to reduced force generation and reduced shortening (39). The reduction in cross bridges also makes the muscle less stiff. Thus, in the obese individual with a reduced FRC and a decreased Vt, it is easy to create a downward spiral, wherein less stretch leads to greater stiffness making the muscle even harder to stretch and resulting in increased airway shortening and airway hyperresponsiveness.
Leptin is a hormone produced by adipocytes that acts in the hypothalamus to signal satiety and to increase basal metabolic rate. Serum leptin is increased in obesity (18). In addition to its effects on immune cell function, leptin also has effects on inflammation such as promotion of the release of tumor necrosis factor-α and IL-6 from endotoxin-treated macrophages and lymphocytes. Consistent with these effects, leptin enhances ozone-induced airway hyperresponsiveness and increases ozone-induced neutrophil influx and eotaxin release into bronchoalveolar lavage fluid in mice (27). In contrast, fasting, which reduces serum leptin, attenuates ozone-induced inflammation. Finally, obesity per se is associated with systemic inflammation including elevations in peripheral blood leukocytes, which causes an increase in serum levels of C-reactive protein, proinflammatory cytokines, such as tumor necrosis factor-α and IL-6, and cell adhesion markers, and markers of lipid peroxidation (28–31). Whether there is also resistance to the effects of leptin in the lung or on immune function is unknown, but such resistance might be expected to polarize to a Th2 response and to reduce lung size in developing children, conditions that could be expected to impact the development of asthma (Weiss).Okay enough of the research report. I'm including all of that so I don't feel like I'm throwing myself a total pity party. There are three researched connections between obesity and asthma right there - even coming down to the chemicals my body secretes because I am overweight.
So yeah, Heidi has asthma. You love me - I have no doubt of that - and are glad I'm out of the hospital and know more about the cause behind my recent illness. But all that said, I still feel misunderstood - even by myself - and especially by the way I anticipate others will feel when trying to relate to this struggle of mine. Why is it still difficult for me to get on board with weight loss when I couldn't say my name without taking a breath? I have horrible bruises on my stomach from blood-clot reducing medication - I had to use oxygen b/c room air wasn't enough for 2.5 days. I had breathing treatments every 4-6 hours, steroid injections twice a day, severe pain in my back and chest from all of my coughing, edema in my ankles and shins.
Though I am discharged, I still have to take more medications now than I ever have had to in my life, I have a sleep study scheduled for possible sleep apnea next Monday night, and my Dr. has referred me to the Community Hospital Bariatric Center so that I can get into a controlled and monitored weightloss program.
And this is just the most recent medical "event" of the year.
I have already lost hope, and I dread saying that honestly. I know the encouraging words, I've pulled out and dusted off my Bible, I've had the pep talk four or five times just today - but I know myself.
Heidi just doesn't lose weight. I don't stick with it, I don't decide - somewhere deep down where it matters - that now is the time. There has to be a reason I don't - am I so irreverent to life? I think not - I struggle with the concept of death nearly as much as I do the concept of making life changes to lose weight. I get all the gear around, sure, set myself up for a plan, throw some money at it and smile for the camera. But I don't follow through - the results disappear - and here I am again in the hospital for some NEW thing that - surprise surprise - is connected to my weight.
I'll dive more into that at some point - and I'll try to get the courage up to write some of the "whys" or barriers here for you to see. For tonight, I'm going to focus on getting dressed, getting my prescriptions ordered and my insurance called, and finding something to eat.
It's my party and I'll cry if I want to, right? I think a high school female barbershop acapella version of this is fitting.
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