More Than a Minor Inconvenience
My son has always struggled with being able to breathe fully. When he was only 4 months old, he was in the hospital for three days with respiratory syncytial virus (RSV). At age 2, he was in the hospital for nearly a week with pneumonia. And all during his preschool and elementary school years, he had asthma brought on by colds and bronchitis.
As parents, we got quite good at administering his albuterol breathing treatments through the nebulizer. At times, I even had to leave work to go to his daycare to give it to him, as the facility refused to give him his much-needed medication. It was time-consuming, and he hated it. We hated it, too.
Throughout all of this, doctors said told there was a good chance he would outgrow it. At age 21, he still has mild asthma, and there are no signs of it going away.
The early years
There were definitely times we packed away the machine, despite doctor orders that we should start breathing treatments at the first sign of him getting sick. My upbringing was of the “if you ain’t bleeding, you are fine” motto. Consequently, doctors did scold me once for waiting too long to start each round of treatments. My son just didn’t seem that bad to me. I learned quickly to just follow doctor’s orders and be proactive.
In second grade, he had another bad bout of breathing. We took him to see an allergy and asthma specialist. The doctor switched his nebulizer for an inhaler. Wow! They were so expensive, even with insurance.
My son also had a pulmonary function test, which was inconclusive because my son had a very difficult time following the precise instructions. He just couldn’t empty his lungs fast enough and hard enough to get a good reading. As the doctor explained, my son could get the air in but had a hard time getting it back out. In the end, the doctor was not concerned, so we weren’t either.
Basically, the thought up until now was that he had asthma and he would just have to deal with it. What was termed as a “minor inconvenience” didn’t really affect my son’s daily life. So, we didn’t stress over it. He could play tee-ball, soccer, ride his bike, and chase after his friends with little trouble when he was healthy. His asthma was definitely manageable.
But in the fourth grade, things took a turn for the worse. He ended up in the emergency room twice due to severe, unexplained chest pain. He was already diagnosed with psoriasis and psoriatic arthritis for four years, and we braced ourselves for even more bad news.
Everything at that time pointed to heart problems, and this scared us a lot. My husband and I spent many sleepless nights while doctors tried to figure out exactly what was going on. My son had two echocardiograms to check his heart. He was a human pin cushion from the number of blood tests. He had x-rays. Everything came back normal.
The intersection of asthma and psoriatic arthritis
The doctors couldn’t find anything wrong with his heart and concluded it must be psoriatic arthritis inflammation in his rib cage that was causing all of the pain. This diagnosis made even more sense when this pain subsided after increasing his medication. It was a rough few months, but we got a good treatment plan and his psoriatic arthritis finally got quiet. His breathing and chest pain were better, too.
Over the years, my son continued his mild asthma treatments. Every time he would get sick, he would pull out the inhalers. Sure, it was inconvenient, but it didn’t affect his daily life too much. Fast forward to adulthood, and about a year ago, my son started having coughing fits. They would come every few weeks and sometimes last months at a time.
One doctor, who didn’t take his health history of psoriasis and psoriatic arthritis into consideration, diagnosed him with allergies and told him to take an over-the-counter antihistamine. It didn’t help. He went to another doctor who told him he had sinus drainage and told him to take a different kind of over-the-counter medication. It didn’t help either.
My son works in the audiology field and often has close contact with patients. You can imagine the looks he would get when seeing the patients. He explained to his clients that he wasn’t contagious, and they seemed satisfied.
He dismissed these coughing fits as another “minor inconvenience,” and put off seeing another doctor get to the bottom of the symptoms. But we all thought deep down it was something more serious. We were right.
Connecting asthma to psoriatic arthritis
When the fits lasted longer, started consuming his days, and left him physically exhausted, my son finally gave in and saw a new doctor. After a chest x-ray, breathing test, and physical exam, he diagnosed my son with asthma that was caused by psoriatic arthritis inflammation in his chest.
The inflammation kept the air from getting in and out correctly. After an inhaler and an increase in NSAIDs, the cough got better, and so did his inflammation.
His asthma is not life-threatening. His asthma is mild, but that doesn’t mean it is ok. He must stay on his inhalers and take the necessary medications for his psoriatic arthritis to make sure his asthma doesn’t get worse. Why live with a chronic cough and fight for breath if it is something you don’t have to? Had my son mentioned this to his rheumatologist, not an urgent clinic doctor, he might have gotten relief sooner.
Have you ever gotten "moon face" as a side effect of prednisone?