What My Twitter Followers Want to Know about Asthma

Sometimes writer's block leads to great experiments. Tonight, staring at a blank Evernote window after scrolling Google News for inspiration, I tweeted the following:

Twitter, i’m trying to write a blog post about asthma and my brain is failing me.
Let’s have a Q&A. Ask me #asthma Qs and I will answer (or find answers) in an article.
And… go.

— kerri wears a mask 😷 🇨🇦 (@kerriYWG)

1.5 minutes later, I had a reply. Then another. Then a follow-up. Then another.

My followers’ asthma questions, answered

So, here’s the thing. I didn’t really specify what kind of questions I wanted. So, it was a free-for-all. And that’s cool as long as nobody thinks I am a medical professional which I am clearly not (and provided a disclaimer as such). So, here we go.

Q1. "Why did I outgrow mine 100% minus cats 🐱??”

What Putty is asking is why did he outgrow his asthma, except where it comes to symptoms triggered by cats? He was diagnosed with asthma when he was 3 and required treatment in hospital, and outgrew lots of other allergies… but not his cat allergy.

He’s not been able to get a great explanation for this, and I think that’s possibly just due to the inherent randomness of atopic symptoms—like allergies and asthma—that are caught somewhere between genetics and environment/exposure.

However, one theory could be that he had greater low-level exposure to the other substances that he was allergic to and developed tolerance to the allergens without knowing it throughout his childhood—which would be potentially more likely with pollens, molds, and perhaps even dust, for example—but less (or no) significant exposure to cats, not desensitizing him to this specific allergen.1

Q2. "how old was your first attack? did you end up in hospital? (sic)”

I experienced asthma symptoms for the first time when I was 16 (according to TimeAndDate.com, I was 16 years, 8 months, and 24 days old). Interestingly, my symptoms weren’t what I’d ever imagined could be described as an "asthma attack." However, despite that, my friend Tanya figured it out almost immediately and offered me her inhaler, which I didn’t take.

It took the doctors another 74 days to figure out no, I didn’t have bronchitis for 2.5 months and it was actually asthma, and I finally got an inhaler. So thankfully, no hospital since my symptoms were not too bad—though they may have accurately diagnosed me faster? But maybe not.

Q3. "Was it rough back in the days when everyone smoked everywhere? Do you appreciate that we're pretty much smoke free?"

Thankfully, being diagnosed with asthma in 2008, indoor secondhand smoke wasn’t a huge issue for me to deal with—walking down sidewalks downtown on the other hand, a bit more of a challenge! With that said, I’ve had some less than fun experiences going into a casino in Edmonton that allowed smoking (on a reserve)—which hadn’t even crossed my mind as a possibility because I’d never experienced indoor secondhand smoke here!

I’m thankful that smoking laws are generally as they are, as the few times I’ve encountered smoking indoors in public (be it tobacco in the casino, or people illegally smoking weed inside a concert) it’s been less than great for me—including having to leave the concert early, which sucked! So I can only presume how miserable folks with asthma might have been just a few decades ago (or even more recently depending where they live)!

Q4. "How bad is it that I take my singulair (sic)every day and am horrible about remembering my maintenance inhaler? like, every few days bad. 😂" 1/2 "Caveat, I may or may not have actual asthma - might just be funky lung muscle tone. But since singulair (sic) legit changed my life, I won’t argue with whatever.” 2/2

So, in the interest of the greater good, of course, always take your medications as prescribed. However, sometimes it also comes down to what works for you, as long as your doctor is in the know and cool with that. I’ve been known to take Singulair in an inconsistent way that sometimes works, with the full knowledge of my doctors. So, while you may not get the full benefit of the inhaled medications taking them this way, it’s also possible that—so long as your doctors give it the green light—that this is a strategy that works for you.

There’s some research pointing to the fact that people who are so-called “non-compliant” are actually taking medication in the way that is most appropriate for them, and are on an adequate dose for what they need, but not more--which also folds into the more emerging applicability of [S]MART--maintenance and reliever--therapy, enabling inhaled steroid doses to be titered to (potential) actual need.2

And of course, add in the fact that your breathing issues may or may not be related to asthma, if it works and your doctors are cool with it, it works.

Q5. What is your phenotype? Why would this information be helpful?

This, my friends, is fellow Asthma.net contributor Dia trolling.

For the answer to “What is my phenotype?” please refer to this Asthma.net article. There are other ways to break down phenotype beyond severity. My specialist has described my asthma several times as severe, as well as that I am mildly atopic (allergic)—but there can be a lot more to a phenotype than that, such as what substances (ie. eosinophils or neutrophils) are at the root of your asthma symptoms.3

Finding out the nitty-gritty details in terms of phenotypes mostly matters in terms of making the most appropriate choice when it comes to using biologics, but may also have other implications, too. I think as time goes on with asthma, and treatment becomes more targeted, we’ll see more ready testing and identification of phenotypes across the board, including outside of major research centers. But what do I know?

Anyways, because this question was brought to you by fellow contributor Dia, please stay posted for her upcoming article on asthma phenotypes.

Questions about asthma?

Questions about asthma are, of course, best directed to your doctor, nurse, or asthma educator. But, sometimes when you just have a curiosity and aren’t seeking actual medical advice, doing your own research can be interesting, too—as long as you don’t make any changes to your care without talking to a pro first. Finding accurate information can be challenging, and this guide may help you in ensuring the sources of health information you’re reading are high quality.

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