I am recovering from perhaps my biggest personal maintenance fail ever.
(Don't worry Mom and Dad! I'm fine. And I don't think the recent trip to Arizona has anything to do with this story- the timing is coincidental.)
About a month ago, I noticed that the maintenance inhaler I use to keep my asthma under control was empty. It took me a few days, but I eventually dug up the box with the prescription number on it and went to call in my refill. But then I noticed that the prescription had expired in June. This meant two things: (1) either I had been inhaling nothing for several weeks or I had been missing doses (or both!) and (2) I'd have to call my doctor to get her to call in a new prescription.
It took me at least two weeks to get around to calling my doctor. I did it on a Monday. The prescription was called in for me that day and was ready by Tuesday, but I didn't pick it up until the weekend- I just couldn't make the time to get to the store. (Or so I told myself.) I had at least made a doctor's appointment for myself when I called for the prescription- but in the time that I went without making this call, I'd called and made doctor's appointments for both my kids, called and made an eye doctor appointment for myself (I wear disposable contacts and they are running low), and sorted out a billing error made by a doctor I hadn't seen in roughly 7 years (I was charged for someone else's urine test). So clearly, I had time to deal with my prescription. I just didn't prioritize it.
I have mild asthma, so what happened next crept up on me. My asthma had been slowly getting worse, but I'd blamed it on the colds I kept getting from Petunia, or the fact that I'd gone near a cat (one of my biggest triggers), or... nothing, really. I just didn't take it seriously.
Then, on Saturday, when I was sitting on the plane on my way to a much-awaited visit to my family in Arizona (I know! What kind of nut goes to Arizona in August? But the visit was worth the heat) I noticed that my asthma was actually pretty bad. I don't get the stereotypical asthmatic wheeze, at least not loud enough for anyone to hear without a stethoscope. I get a dry cough- which I'd had for weeks at this point- and my back muscles get sore, presumably because I'm working harder to breathe. If I am particularly dense, I might get a panicky feeling before I realize I'm not breathing well. This time, it was the sore back muscles and increasingly frequent cough that clued me in. I dug my rescue inhaler out of my carry on and used it, and expected that would be that.
But it wasn't. My asthma stayed noticeable for most of the visit to Arizona. I used my rescue inhaler once or twice every day. We flew home Tuesday evening, and by the time I went to bed, it was so bad that I ended up getting a second pillow so that I could sleep in a more upright position. I struggled through the day on Wednesday, using the rescue inhaler more than I can ever remember doing in the past. When I got home, I knew I couldn't wait until my doctor's appointment for help- it isn't until late August. I called the doctor's office to see if anyone could see me sooner. The earliest I could get an appointment was Friday. I knew that was too late. So I made my first really good decision in this entire story: I called my husband and informed him that as soon as he got home, I'd be going to urgent care. And then I made dinner.
Traffic was bad, and my husband got home late, just as the kids and I were finishing our dinners. I kissed the kids good-bye, grabbed my purse and my Kindle, and headed off to urgent care. I got incredibly lucky and there was almost no wait, so I was able to get a breathing treatment (not much fun- those meds made my heart race, and that is apparently normal), get a chest X-ray to rule out pneumonia, and drop by the pharmacy to pick up a prescription for a five-day course of prednisone, all before Petunia went to bed. I definitely got off lucky, timewise. As I walked out of urgent care, the waiting room was full. If I'd arrived then instead of two hours earlier, I think my visit could easily have taken 4-5 hours. Still, urgent care is far better than emergency care for this sort of thing, so I'm glad I decided to go while my situation was still urgent, and not emergent. Also, that meant I could drive myself and didn't have to drag the whole family along or call my sister or neighbor to come watch the kids.
I've had exactly one day of prednisone, and I already know that I never want to take it again. But I also know that I can breather freely for the first time in over a month. I've still got the cough, though. I suspect my doctor will adjust my maintenance meds when I see her in a couple of weeks- I'm on a less-favored inhaled steroid because it is OK to take while pregnant or nursing, and I haven't been back to my doctor since Petunia weaned back in February. I suspect she'll also lecture me about taking better care of myself, and she'll be right.
Obviously, the biggest lesson from this whole experience is that I need to take my asthma more seriously. I am used to thinking of it as a mild, no big deal condition- because it has been for me. But that can change, and one sure way to make that change is to let it get out of control. Asthma is a "cascading" illness, meaning that a flare-up can essentially feed on itself and get worse and worse rather than getting better, unless you step in and interrupt the cascade. It is also a disease that can cause damage that makes it get worse and worse. I need to stop the next cascade sooner, so that I don't allow damage to occur that makes future cascades worse.
The next big lesson is that my husband and I need to get a better handle on our non-work lives. We've both been very busy at work, and we've also not been communicating well about chores- and I include the organizational "master planner" type tasks like remembering to make doctor's appointments and the like in "chores." Traditionally, I've done most of the "home project management" work, because I am (usually) better at it. It is, after all, what I do for a living. But I've clearly maxed out my mental load again, so we need to rebalance. During the period of time in which I was failing to refill my prescription, my husband revamped our picture-sharing system and researched and bought a new voice over IP phone. The picture system work is something he convinced himself needed to be done before he could post pictures for our families to see and the new phone was prompted by the fact that our old handset stopped working, and will also save us a lot of money. But. Neither of these things are as important as making doctor's appointments for the kids (Petunia needs shots at her next visit, Pumpkin needs a form filled out for school). And they certainly aren't as important as making sure I had my asthma meds. To be fair, I did some less important thins, too. I took some dry cleaning in (and forgot about it until last night- oops). I wrote a bunch of blog posts- always after the hours in which I could call my doctor, but I could have done some work instead to free up time during the day to call. And so on.
I'm not sure how to improve this. I need to wait until I'm feeling better to discuss it with my husband. He rarely gets sick and isn't the most empathetic person when it comes to illness, and he really doesn't understand chronic things like asthma. I am relatively freaked out that I had to go to urgent care, and I am really annoyed about the prednisone. A conversation now is unlikely to go well, so we'll delay it, but have one soon. I'd like to figure out a way to outsource more around the house, but he is resistant to that, for some good reasons, some cultural reasons, and some silly reasons. He's gotten almost comically careful about spending money- arguing with me tonight about whether I should get a cell phone plan that costs $40/month when I could have one that cost $30, for instance. I understand that this difference is important for some people, but it is absolutely in the financial noise for us. Still, the expense will probably be a source of resistance to any extra outsourcing. I will point out that I spent almost $100 last night by the time I'd paid my copay and paid for the new prescriptions. So doing nothing has a cost, too.
I'm also planning to let technology help me more. My medical group has an online communication option, which will make scheduling appointments easier once I get it set up. I can switch to mail order prescriptions for my maintenance meds, so I can order those online and have them delivered to my house. I will finally get a smartphone, sync the calendar app with my Google calendar, and start using that to remind me about things like when I should get my prescriptions refilled and the like. This, in fact, is why we were discussing cell phone plans tonight. And yes, I'll get whatever plan I want!
My final lesson is less for me, and more for people who don't have chronic illnesses and often wonder about why those of us who do have them don't manage them better. I hear this most about people with mental illnesses and diabetes. I am a grown woman working in a very flexible workplace. I am well-educated about my illness- heck, I can draw you some of the pathways that go haywire when I'm having an asthma attack. I fully understand how serious the disease can be, and I know what the meds I take do, down to the molecular level. There is no stigma associated with my disease, and no one thinks it is "in my head." I have plenty of support and plenty of money, both of which make it relatively easy for me to make healthy choices. Furthermore, the healthy choices I need to make to manage my asthma are easy ones- no yummy foods to avoid, for instance.
And still, sometimes, I fail. The symptoms of chronic illnesses can sneak up on you slowly, so that you don't notice them until you're in a full blown acute attack. I don't notice that I'm struggling to do something as essential as breathing. I can only imagine how much harder it is to recognize the symptoms when the symptoms themselves interfere with your ability to process what is happening, as is the case in many mental illnesses. I can also imagine how much harder it is to call your doctor for an appointment if you have scheduled breaks instead of flexible ones. So, cut us some slack, healthy people! Yes, some people do stubbornly refuse to take ownership of their own health. But I suspect that far more people have stories like mine, where a series of seemingly minor suboptimal decisions land them in urgent care or the ER. I will make changes to minimize the chances that it will happen again, but I can't guarantee that it won't. No one can.