Specialist visit

An unexpected outcome indeed.

Today I dutifully went to the ear – nose – throat specialist my main doctor had referred me to. (Yes, in Norway they really are called “ear – nose – throat” specialists.  I don’t know what the corresponding specialists are called in English. You tell me.)

First we talked a bit about the symptoms, when they started, and what situations they arise. Then, after a couple minutes, the doctor jumps to the conclusion.  He has observed me speaking, and I am doing it wrong.  I speak too much on the last part of the breath; I don’t bring enough air through my vocal cords for the amount of sound I wish to make, so I have to use more effort in my throat to actually create the necessary sound. The problem is either that I have bad habits, or my lungs are not working as they should. Just to be sure, he looks quickly in my ear, nose and throat.  My vocal cords are a bit red, but there are no irregularities.  This is not his problem.

But as it happens, the neighboring office has a lung specialist, and she is willing to see me right away.  She writes a list of numbers on my arm with a ballpoint pen, adds a drop of liquid near each number, and pricks a small hole in my skin inside the drop.  Then she conducts an interview about my family history of allergies and asthma, which from the outset is her main suspect.  (Even though at this time she is not aware of my childhood asthma.) I also have to blow through some measuring tube that records my lung function.  She is not impressed.  I have to do this 3 times, while she tries to get me to just keep blowing.  But I already blow my lungs so empty I am afraid of not being able to breathe again.

My lungs function on 78% of the capacity expected by my age, gender, height and weight. This is not good.  (Really?  Almost 80% is not good?  There must be pretty low expectations then.  Most people make a good living with less than 78% of my brainpower, so you’d think I’d be able to earn my bread with 78% of their lung power, especially in an office job.)

The interview has pretty much concluded it already, but then the allergy tests all turn out negative.  I have no problem with any of the normal Norwegian pollen, dust mites, dogs or cats.  (I also seem to be more or less immune to needle pricks, as at first I was not sure whether she had actually pierced the skin.  My lack of reaction caused her to cut deeper in the final drops, something I can see now hours later. But still no allergy.)

What I have is exercise asthma.  (It seems to be called “exercise induced asthma” in English, if Google is not misleading me.)  It is evidently quite common, especially in people who had childhood asthma and grew out of it, like I did.  The unusual thing is that it is in such a “pure” form, without an obvious allergy component.

I already knew that I had exercise asthma, but since I am not doing sports, it has not bothered me.  I don’t need to have an athletic body since I am not doing manual labor or, more likely in this age, soliciting sexual intercourse.  My weight is already ideal (or was, before it started going down again.)  It never occurred to me that I would need to be near the optimal lung function for my age in order to answer telephones.

But never despair, Big Pharma is here to help you!  The lung specialist (shouldn’t that be “bronchies – lung – diaphragm” to fit the pattern?) was disturbingly quick to write prescription for two types of inhaled medication, one to take in case of symptoms, and one to take anyway, morning and evening. They both contain some kind of powder to inhale.  That cannot possibly be a good thing, inhaling powder.  Who came up with that in the first place?

The thing is, I did inhale one of those things after the first blow test, and after a while I did a second test, which showed no change.  And she still wanted – insisted, really – to prescribe both of them.  I felt as if I was sitting in front of not a doctor but a salesperson from Big Pharma.  The one I should take every day anyway (for the rest of my working career, I suppose) was a brand new product which could not possibly have side effects.  Isn’t that what they always say, until users die like flies and someone finally manages to launch an investigation that shows that they knew this from the start but it paid so well, they are still in the black even after losing in court?  That said, when Vioxx (the pain med) was withdrawn, I wished I had stocked up on it.  Of course, I don’t need that kind of low-level pain meds anymore now that I use meditation and brainwave entrainment.  For some reason, though, meditation has not improved my lung function.  Something must be done about that.

But what to do?  The obvious answer is to exercise more.  It should be possible to get closer to the trigger level (and thus breathe more deeply) without actually going far enough to trigger an attack.  This should improve lung capacity.  Perhaps I’ll do that starting tomorrow…

No, seriously, I did start exercising today (then again I do that every day after work, just a little) and found that my pulse was once again around 20 beats higher than normal.  Perhaps I am running an infection in the background, in which case the test today may not be accurate, at least if it is a respiratory infection.  Or perhaps this is a reaction to the powder I inhaled, or the extreme exhalation tests.  They really felt like an asthma attack at the very end there, when I had no air and could not breathe out more, and they did cause me to start coughing.  I kept coughing up mucus for a while after I returned to the city.  Whether that is good or bad, I cannot say, but I felt pretty much like I do in the hours after a light asthma attack.  (I have had severe attacks in my childhood.  The ones I have had from training have not been that bad, but then again I stopped immediately when I recognized them.)

I suppose my immune system may even have been mobilized from multiple breaks of the skin. Although they just look like small red dots, it is not something I experience every day.  If I were in charge of the immune system, I would probably ramp it up too after a day like today! So I exercised less strenuously than I had planned, and only for about 40 minutes.