It seems like familiar symptoms always rear their ugly head at the worst possible time.
This week I was leading a work webinar when I began to cough. I had been having an increase in symptoms over the last few days, a combination of the humid weather and the usual end of the half-life of my biologic. I thought that taking a bit of salbutamol was going to help my airways stay open, at least for the length of the webinar that I was hosting. I was following my action plan, I had water standing by and I thought I was good to go.
What I had not anticipated was just before the start of my webinar I wound have a run-in with all sorts of allergens. A neighbor was cutting down trees and mowing their lawn--ugh! I quickly tried to close our windows to prevent allergens from coming inside, however, it may have been a little bit too late.
Airway hyperresponsiveness is considered to be one of the signatures of asthma.1 This is something that I sometimes have an ongoing battle with. It was an allergen-induced hyperresponsiveness response that was going to be an issue for me.
What is airway hyperresponsiveness?
Airway hyperresponsiveness in response to environmental allergens creates a series of physiological responses. This begins with the initiation of dendritic cells and Th2 pathway activation.1 I have been told by my specialist that this Th2 activation is one of the reasons for some of my symptoms.
The other important factor is the role of late asthmatic response (LAR) and inflammation which can be factored in sustained asthma symptoms from allergens. These responses typically occur 2-6 hours after you have been exposed to an allergen.2 This falls right in line with when my response occurred.
In the middle of the webinar, I had that sensation that I needed to clear my throat which turned into a coughing fit. I was lucky that a colleague was presenting at that time and my video was off. Our course during the panel that I was hosting my voice seemed to be going and I felt that familiar tickle. Why does sputum always attack at the worst possible time?
I tried having some water and doing some discrete mucus clearing. This just seemed to get my sputum going. I had to turn off my video and step away. I was lucky that I was able to defer to a colleague to present the next section of the presentation so I could leave to cough up a bunch of sputum. I had to be quick. Luckily not many people noticed.
However, this could have led to a coughing fit, captured on video, or much worse. I may not have been able or predict that this was going to happen. I am glad I was at least able to resolve it quickly after I was able to clear the sputum. I was at least able to finish the webinar without another incident.
Have you ever had a sudden onset of symptoms during the most inopportune time? How were you able to resolve your symptoms or discretely excuse yourself?
Have you ever gotten "moon face" as a side effect of prednisone?