Conquering Asthma: breathing through my nose

I'm excited to share that I'm making significant progress on my asthma problem.

How do I know? Did I go to the doctor? (No, I don't even have insurance right now, so that's out of the question.) How do I know I'm getting better?

I ran my entire 12 mile long run on Sunday while breathing through my nose. That's right--no open mouth breathing, no gasping, no out-of-breath feelings. I ran 12 miles straight and didn't lose my breath. Not even going up (several) hills.

This is HUGE! I've been trying to breathe through my nose more as I run to help filter the air I take in (something useful when pollen and allergens are nature's confetti), but this was the first real run I did with NO mouth breathing.

I'm delighted.

I still take my rescue inhaler with me (better safe than sorry), and I still take my asthma medications every day (though getting them at a reasonable cost soon may be difficult if I don't find a way to get health insurance). But I feel so FREE when I don't need to THINK about breathing. Free! Free, at last!

This is a milestone for me. My body is strong enough to run the distance and my lungs can now keep up. I feel incredible.

Running Education: A Coach and a Team

In the throes of illness last week, I missed the informational session for the Training Academy run by Elite Runners and Walkers (Robinson Twp and Monroeville, PA), but my friend Eleanor hooked me up with the details and the contagious energy of the group while we drove to and from Columbus this past weekend. I was excited about the prospects of learning about running so I could be good at it. But I wasn't *quite* sold.

Last night was our first meet. After driving around the local high school's enormous campus searching for the track (which I had incorrectly assumed would be lit), I finally found my friend's car and parked next to it. Each of us in the small group is training for either the Pittsburgh Marathon or the Pittsburgh Half Marathon. It was hard to stand still because it was pretty chilly and kind of windy.

Our coach arrived. We talked about the program and how it worked, and then made our way to the exceptionally dark track. Somehow it seemed that the darkness got a little darker there. We walked quickly to warm up, and I found a few small patches of ice. That made me nervous... Coach taught us some really excellent stretches, most of which I had never even seen before. Then we ran around a few times. I was being extra cautious and I'm not fueled by lightning, so I was trailing behind the pack. We decided it was too dangerous to do any timed running there and made our way back to one of the myriads of parking lots.

Then the goal seemed simple. Run for ten minutes. I ran behind the group until we returned to the starting point and had to stop. Passing a half dozen idling diesel school buses in addition to running in the cold air sent my lungs reeling and I couldn't catch my breath. That was a little upsetting. But at least I'm being honest with myself. I want the coach to know where I am. Really. And to help me develop a plan to improve from that point. So while I was a little down about my performance, I was at least feeling okay about being real with both myself and the coach.

After everyone finished, we discussed lots of other aspects of the program and I began to see the merits of being involved in something so well organized. I get a coach, a training plan, education, and personal interaction. Not bad for such a decent price. Definitely cheaper than a semester of college (which is about how long the program runs).

I'm treating this as my investment in my future. My education as a runner. I'm hoping to learn enough and improve enough that I can take these lessons with me for the rest of my life (even if I end up going back to the program again and again, which is what they say many people end up doing).

Elusive asthma triggers: no allergies

Yesterday's trip to the allergist to talk about my asthma was rather uneventful.

I saw things going differently in my mind: I would walk in and talk with the doctor, get poked and prodded, and--voila!--we would find what I'm allergic to and develop a plan to treat it. I would walk out of the office feeling great that finally my asthma was going to be under my control (instead of it controlling me).

In reality, it went more like this: I walked in and talked with the doctor, he explained that I might not be allergic to anything but, instead, sensitive to environmental allergens. I was poked and prodded (oww!) and I didn't have a single reaction. (Good thing: I'm not allergic to my dog!) Since I didn't react to the allergens he tested, it seemed likely the environmental things--things like smoke, dust, pollens, or molds, things he can't possibly test me for since there are hundreds of pollens and molds--and that I would have to do some hard work.

First, we decided to switch up my daily inhaler. It's an inhaled steroid to help keep my bronchioles happy, open, and not irritated. I had previously tried the inhaler he switched me to, but I hadn't tried it with a spacer...

Let's talk about spacers. I had seen these before and always associated their use with really asthmatic people (I don't have a definition of that outside of the thought of them needing to use a spacer, this extra apparatus, with their inhalers). A spacer is a plastic tube with a rubber end where you plug in your inhaler and a mouthpiece end to, well, put your mouth on. The idea is that, with typical puffer inhalers, when you spray the medication into your mouth, most of the medication ends up in your mouth or throat, instead of being successfully inhaled into the lungs. With the spacer, you spray the medication into this tube where it is suspended in the air, just waiting for you to breathe it in. You get more medication in your lungs because you're breathing in medicated air.

So the doctor's thought was that I had tried this inhaler before and not seen results... but I hadn't tried it with a spacer! Trying the medication with the spacer will get more of each spray into my lungs, putting the medicine to work and (hopefully) showing results.

I've got this new inhaler and a spacer to use with ALL of my inhalers. (Yes, "all" of them; I have three--one everyday inhaler, one to use prior to exercise, and one rescue inhaler.) Sounds like enough to try to change the game plan, right?

Wrong. He also wants me to remove any perfumey things from my life. This is not going to be easy. I love scented lotions, body sprays, and air fresheners (right now I'm using "fall leaves" from Bath & Body Works... it's the best!).

He wants me to reconfigure my bedroom so there is less surface area for dust to settle. Meaning I should remove my bookshelf, my books, and my nightstand.

He also wants me to get a dust mite cover for my mattress and box spring. (Not cheap... but it's super icky to think about dust mites. I hate those enlarged photos they show you to prove that they exist. Microscopic bugs are still bugs and they still freak me out.)

He also wants my dog to not sleep in my bedroom. (She has her own puppy bed on the floor; she's not allowed on the bed, but now he wants her out of the room. I think this has a 0% chance of happening because my little dog won't sleep anywhere else if I'm home.)

He also wants me to thoroughly clean my house every week to keep dust to a minimum. (I'm gonna need a smaller house or a maid. I do not have time to do this... I clean my bathroom twice a week and change my sheets once a week, but outside of that I'm lucky if I get any laundry done in my spare time.)

He mentioned getting rid of carpeting, but then I said that I rent (I do) and that it's not my choice. He suggested vacuuming more often (and to have someone else do it since the dust is likely to bother me when it's stirred up).

At this point, the most do-able thing out of all of these is to use the darn inhaler with a spacer. Getting my environment under control is going to take some work. And that still doesn't address any environmental allergens/irritants OUTSIDE of my house. Pollen? Grass? Leaves? Oh, geez, who even knows. Hopefully (HOPEFULLY) in time I will feel better with the new inhaler and my new found control over my environment.

Asthma: you've met your match.

Resilience and my first ever group run

Yesterday I enjoyed my very first group run. I have always trained solo and ran races with hundreds of strangers. This was a wonderful change from my ordinary routine.

Because I’m signed up as part of the Animal Rescue Leagueteam for the Pittsburgh Marathon (5K, Half, Relay, and Marathon), I have the opportunity to attend informational training sessions along with the rest of the ARL team. Yesterday we learned about the way to build yourself up to run the half or the full marathon. The lady who spoke gave us a great calendar that included suggested mileage (for beginner and advanced), cross training days, and rest days. I was so happy to have this because I didn’t really know how to go about preparing and I wasn’t sure what advice to trust since the Internet is filled with resources for runners. 

After the info session, we gathered into groups setting out to run different distances—one 3.5 mile group, one 5 mile group, and one 8.3 mile group. My friend and I chose to go for 5 miles.

It was a gorgeous fall day—sunshine, blue skies, warm air, and cool breezes. We took off and the group settled into a line that obviously outlined our pace comfort zone. I know right now that I run about 11 minute miles regularly. I’m proud of this, considering I’ve only got one year of running under my belt, but I’m always looking to improve. I just know that speed isn’t going to come overnight…!

After about a mile and a half, I couldn’t get a deep breath. I started to feel drained as my breathing got worse. I’ve noticed that in the past few weeks that running outside has been really tough. Sadly, I think this has a lot to do with the leaves on the ground. They smell wonderful! It’s an irresistible autumn aroma that I look forward to every year, which now seems to be irritating my lungs. 

I had to slow down. Walk. My friend stayed with me and she jogged as I speed walked along the path. I don’t normally run in the city, so I think it’s possible that exhaust fumes irritated my lungs even more. I stopped to use my rescue inhaler. I was sad that I had to stop. I was ready to run! Why can’t I just run? My breathing was shallow and I gasped for air as we walked along. It took a while for my inhaler to work. I feel like I walked at least two of the five miles, unfortunately. 

I began jogging again when I felt that I could breathe, but each time I began to transition to running I found my cough worse, my throat itchy, and my fingers tingly. The tingle in my fingers is a bad sign—I usually experience that right before I get dizzy and need to sit down or I will blackout. It’s scary. I stopped again and sat down on the side of the road. I took some time to catch my breath, but I caught it nonetheless. When we crested that last hill, I did my best to keep my legs moving at a pace my lungs could handle, but ultimately I walked back to the community center where the rest of the group was waiting. 

My asthma was the worst it’s been in years yesterday. I’m disappointed that it’s bothering me so much. I’m going to meet with an allergist on Wednesday, and I’m hoping he will be able to help me figure out the other triggers for my asthma and what I can do about them. I realize that I might not be able to do anything about some of the triggers, which is frustrating. At the same time, I find myself getting angry about pollution, smoking, and exhaust filling the air that fills my lungs. 

The group run was still fun, despite my minor medical emergency, and I plan to do it again next month. I’ll begin my half marathon training in December like the training program suggests, but in the meantime I’ve pretty much racing every weekend from now till the middle of December. I will work my way through this asthma and I will continue running. No matter what.

What makes the difference in day to day air quality?

Yesterday and today are nearly identical end-of-summer days in Pittsburgh. In terms of weather, temperature, and wind, they were cut from the same mold. Yet the air quality index is significantly different from yesterday to today. Neither day is as awful as the orange action days from last week... What makes the difference?

It rained last evening. It was intensely foggy this morning. It is a Tuesday and therefore traffic patterns and weight might vary. But scientifically, what makes the difference?

Tuesday, August 28

Monday, August 27

I wish I knew.

Unfortunately, it's not as simple as looking at the numbers and doing simple math--a particulate matter pollution rate at 58 today (8/28) from a nice low 23 yesterday (8/27) means little to us non-scientist types except that the EPA has done the math and assigned a ranking to the level of pollution present in the air (seeing today as more hazardous because of a higher rate of PM). The National Ambient Air Quality Standards (NAAQS) lists primary and secondary standards--primary for sensitive populations and secondary for the general public welfare.

There's some serious atmospheric science involved with these calculations and the regulations that apply, and I hope to understand more as I continue to read about them, but for now I'll take the AQI for what it's worth and adjust accordingly.

The effects of air quality warnings

Today is one of those "action days" in Pittsburgh. You know, when the weather person mentions that people with lung illnesses or the elderly should probably stay indoors. Then there's those numbers--particulates and ozone. What do they mean? And how do those numbers affect us?

Particulates are bits of solid matter or liquid pollution in the air. (Also known as particulate matter.) Sounds great, doesn't it? So today's a yellow day for particulate matter. Not fantastic, but not awful. Overall, though, Pittsburgh is ranked #6 for long term particulate matter pollution.

The ranking system (Air Quality Index, or AQI) goes from green (0-50) to maroon (301-500). If red is bad and purple is worse, I think maroon probably means that you're inhaling a pile of ash or maybe just straight acid fumes.

But ozone--something we've heard about in the news for years--is also dangerous to breathe. It's a little more complicated to explain than particulate matter, though. Ozone is the result of a chemical reaction between oxides of nitrogen and volatile organic compounds (VOCs) in the presence of sunlight.

 Either one--particulate matter or ozone--is not really good for us to be breathing in. It's worse for people like me with asthma (it's also bad for people with other pulmonary diseases).

 Air quality alerts are issued to warn people about the quality of the air outside and its potential to harm them or make them sick. Even healthy people (without asthma or other respiratory problems) can be affected by the air quality.

To me, the AQI suggests that I ought to keep my air conditioner on so I can breathe, not run outside, and try to not do anything strenuous outside. I keep my rescue inhaler with me all of the time. I've had to use it a lot lately, even on decent air quality days, so I'm working with my doctor to try to get my asthma under control. It's tough, but I'm hopeful we'll find something that works. In the meantime, paying attention to how I feel with whatever the AQI is for the day helps me prepare for days in the future with similar AQI ratings.

Ultimately, we need to cut down pollution to improve the AQI nationally and internationally, but perhaps more people will be convinced of that when they learn how ozone and particulate matter affect the people in their lives and the ones they love...