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[personal profile] marydell
I've been increasingly fatigued lately, and just chalked it up to generic tiredness--lack of sleep, too much work stress.  I have always had the habit of leaning on nearby furniture when standing up for a long time, but in the past three weeks I've taken to also sidling up to walls so I can lean against them.  This is much harder to do in a casual way than leaning against a desk, particularly in an open-plan office, so I've had to explain that I'm tired a couple of times to people.

Then a couple of days ago I was playing trains on the floor with Charlie, which involves sitting on the rug and pushing a train on a track and saying "choo choo."  He supplies all the enthusiasm and I don't need to budge from the same spot while playing, so it's hardly a taxing endeavor.  But I found myself feeling exhausted and also very bored--like, really wanting to get up, move around, put on laundry, and do some other kinetic things.  That seemed strange to me, because my internal "I'm lazy" narrative would suggest that sitting on the floor would be my preferred activity when I'm tired.

So I checked my breathing with my peak flow meter and found myself in the yellow zone - that is, the zone that says it's time to use an inhaler.  No coughing, no wheezing, no symptoms that I've ever recognized as asthma symptoms.  Damn it!  And looking back I see a pattern of increasing tiredness for the past two months--basically, starting a month after I went off my inhaled steroid.  Google tells me that atypical asthma symptoms include sighing, anxiety attacks, fatigue, lack of concentration...I've spent a couple of months wondering if I'm depressed, but since my mood has been fine it's been very puzzling. Until now.  

So it seems that I may have this low-level constant pre-attack thing happening. I'm seeing my doctor tomorrow night to ask if I can go back on my steroid, and I'm taking a dose tonight because I'm pretty sure she's gonna say yes.

Normally I try not to be irritated with loved ones for unknowingly harming me, but I have to admit I'm irritated right now with all five of the smoking family members I shared a home with as a child. Grumble grumble passive smoke grumble.

Date: 2011-06-30 04:57 am (UTC)
From: [identity profile]
Ohh this is very familiar. *hugs & sympathy*
Wish I'd been able to do the mystery-diagnosis for you like you did with me. Missed it if you talked about it though :/

Date: 2011-06-30 11:22 am (UTC)
From: [identity profile]
Oh, but you did! You're the reason I've been paying more attention to my fatigue symptoms, and why I started to think my asthma might be presenting with a wider range of symptoms than just cough/wheeze. So thank you very much for talking openly about your health, because it's helped me a lot to undertand my own asthma and Charlie's not-asthma. :)

I do have two questions for you (I wasn't going to pester you just now, but since you're here, I'll ask, if you don't mind!). 1. For you, does the fatigue you get from being under-oxygenated feel the same as the fatigue you get from not having enough cortisol? I haven't taken enough steroids to have serious withdrawal problems, I *think,* but I don't know if this sort of fatigue is a normal asthma thing or possibly a different thing. It's different than the fatigue I would get when my endometriosis was active though--this seems to involve more dizziness and restlessness, along with mental fog instead of the calm inertia I had back then. 2. Is it possible to have sort of low-level not-quite-an-attack o2 deprivation going on for days or weeks, without actually having an attack? Because it sort of feels like that's what's happening, but I don't know if asthma works that way or if I've got some other pulmonary foo going on.

I'm also asking my good-asthma-doctor these questions tonight, too, so don't worry about needing to have answers. :) I'm glad to hear this sounds familiar, though, since I'd rather it was asthma-related than, yakknow, heart-related or something.

Date: 2011-06-30 04:05 pm (UTC)
From: [identity profile]
Oh I'm glad that helped!

1) The cortisol-deficiency fatigue is not like this, it's (in extreme case) lying there not having any ability to move, and in milder cases more like calm inertia. Restless/foggy fatigue sounds to me more like the asthma fatigue (which I hadn't thought of as fatigue before just tiredness, so thankyou for pointing that out!)

Dizziness also - though I'd mostly get that on standing up? so mine might be cortisol-related low blood pressure. Though maybe not, now, and I still get that sometimes.

2) That's my normal manifestation; I very seldom have attacks.
My understanding, which is doubtless oversimplified, is that the severe attacks are more brought on by constriction and the chronic low-level stuff more by inflammation/mucus; so feeling the itchy/sore lungs and /or drowning-sense, more than the tight-catch of the severe attacks. And in my case at least I can get my peak flow reading well into the green even when I'm having the low-level stuff.

Speaking of which, your post on this got me to realize that, yes, the low-level stuff has been worse for me since I tapered the cortisol, even though peak flow still looks good (getting 400s rather than 430s mostly, but my green starts at 350. Which... may be outdated. So I hadn't realized till I read your post that I should mention this to the doctor.)

And yay for asking the good-asthma-doctor! All else aside, I certainly don't want to say it's definitely asthma and not heart-related! All I know is that what you describe sounds familiar, after all :)

Date: 2011-06-30 04:48 pm (UTC)
From: [identity profile]
Thank you, that's very helpful! And it sounds a lot like I'm having the low-level version of things. I suspect that going on prevacid, which has eliminated my reflux, has made it so I'm not triggering actual attacks any more, so I'm almost never taking any albuterol and maybe things are building up because of that.

I had lots of fun getting my heart checked very thoroughly a couple of years ago because of a random chest pain (that turned out to be digestive, not circulatory), so I'm not very worried about it, but I keep it in the back of my mind as a possibility.

Do you have a pulse oximeter, or just a peak flow meter? I don't know if the home versions of the finger oximeter things are any good, but it sure would be nice to have an objective measurement of what's going on.

Date: 2011-06-30 04:58 pm (UTC)
From: [identity profile]
I don't have a pulse oximeter. Might be something to talk to the dismissive-asthma-doc about if I have to go talk to him anyway.

Date: 2011-06-30 05:26 pm (UTC)
From: [identity profile]
I just ordered myself one for $30 from amazon...we'll see if it's any good. The ones all the reviews use as a point of comparison are Nonin brand, which are $100 and up, but the cheap ones are as low as $22. (The negative reviews are like "don't get this, spend more for a Nonin!" and the positive ones are "I like this almost as much as my Nonin!") It seems like a lot of people use them...I'll be interested to see if the $30 is at all useful. I'm hoping it can provide a second opinion when my peak flow meter says I'm in the green despite me leaning on things and heaving sighs.

Date: 2011-06-30 05:26 pm (UTC)
From: [identity profile]
p.s. I hate your dismissive asthma doc! Grr.

Date: 2011-06-30 05:35 pm (UTC)
From: [identity profile]
On my end, there's not much point in getting the extra datapoint unless the doctors will pay attention to it, since I have no real reason to think the headfuzz etc are caused by other-than-asthma when I can feel the lung-ow.

I meant to say!

Date: 2011-06-30 05:38 pm (UTC)
From: [identity profile]
It could be other pulmonary foo; I've never been officially diagnosed with anything other than asthma/hayfever/COPD, but haven't seriously tried to clarify it further, really.

Re: I meant to say!

Date: 2011-07-01 02:11 am (UTC)
From: [identity profile]
The treatments for all sorts of pulmonary foo seem to be remarkably similar.

I saw the doc and she told me to go back on alvesco 2x a day for 3 weeks, then 1x a day after that, in perpetuity. She also dismissed my awesome peak flow reading, because I had to take albuterol 40 minutes prior to the appointment. She's like "yeah, that's why your peak flow is good, go back on the steroid immediately." Woo.

Date: 2011-06-30 05:32 pm (UTC)
From: [identity profile]
*emails you oxygen*

Date: 2011-07-01 02:11 am (UTC)
From: [identity profile]
*inhales gratefully*

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