My First Urgent Care Visit for Asthma(-ish)

Figuring out when to seek professional assistance is one of those conundrums of chronic illnesses like asthma. After increasing shortness of breath last weekend, I started prednisone on Monday evening of a long weekend after a bit of conferring with John. The reality was, I knew what I needed to do after 2-plus days of regular albuterol by inhaler and nebulizer, I just didn’t want to do it.

A long time since a severe asthma exacerbation

It’s been 7 years since I was last on prednisone—a pretty good run, but simultaneously not long enough. As I could tell my exacerbation was not getting better after the usual 48 hours of scheduled albuterol, and that albuterol was barely helping anyways, I reluctantly threw back the prednisone and saw my doctor the next morning (which proved unnecessary but hey, she had wanted me to!). The pred was pretty easy on me this time. Surprisingly, I was hungry, but otherwise not too affected by the side effects.

However, by Thursday I was still feeling relatively the same breathing-wise. Based on past experience, I’d felt like with 3 doses of steroids on board and so much albuterol, I should have been at least marginally improving. After a nebulizer treatment again had less than stellar effect on my peak flow, I opted to go to urgent care.

Visiting urgent care

In more than a decade with asthma, I’ve always felt able to handle things without heading to urgent care or emergency. This time was somewhat the same and somewhat different. I knew what I needed to be doing and was doing it, but what if I was missing something? It was time for that second opinion, but from a place that could do more comprehensive tests than my doctor’s office could.

The waiting room

After 45 minutes I was finally triaged and began the wait. While I spent a total of 2 hours in the waiting room, I was still the second or third called in among those waiting (and I think those two may have been better suited going to emergency than urgent care!), making me feel better about my decision to go in.

Seeing the doctor

I explained to the doctor how I'd been treating this severe asthma exacerbation, when I started prednisone, and tried to give him the lowdown on my experience. They kept monitoring my vitals and he of course commented on my lack of wheeze; I never wheeze, and this was not helping me feel more justified in getting care!

However, the doctor decided it would be good to rule out pulmonary embolism as cause for my dyspnea, given some risk factors. (I'd been on a plane 3+ weeks prior, but I also take hormonal birth control for my fibroids.) So in came the phlebotomist, very apologetic that she was going to bruise me and my tiny, tiny veins. I also had an EKG by the nicest EKG tech I’ve ever met! When the blood test came back negative for a blood clot, I headed off to x-ray.

The x-ray

At some point, my previously normal temperature jumped up enough for the nurse to check it twice. I’ve got history of not realizing I have a fever, so I wasn’t terribly surprised (and thought to myself, “Hmm… my doctor did not check my temperature on Tuesday”). After that, I got sent for a chest x-ray. In all of it, I know the doctor commented on my x-ray but I can’t remember exactly what he said—like if it was unremarkable or only slightly interesting.

What caused my severe asthma exacerbation?

Based mainly on the fever developing (and maybe a bit on the x-ray?), they determined the source of my problems was a lung infection. Along with my instructions to keep doing what I was doing, I left with a prescription for azithromycin for 5 days and to finish my last two days of steroids. I’m 3 days into the antibiotics and, while I don’t know if they’re helping or I’m just starting to recover, I am beginning to feel a bit better (in fact, though I’ve taken my inhaler a few times, it’s 2:12 PM on Sunday and I’ve not taken a breathing treatment yet!).

Based on all of the above—being seen relatively quickly, having tests done to rule out other causes for my symptoms, and being kept long enough for observation and finding the problem—I feel like I did the right thing by going to urgent care, and even more so when I was told to come back if I got worse or wasn’t improving. I just didn’t want to have gone in for nothing—the common plight of the bad asthmatic.

Of course, two days after me being in urgent care, my dad came down with a cold. So, even though Saturday I may have finally felt like sort of leaving my room, I am staying in relative isolation, because a cold is the last thing I need!

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