Diagnosis: Asthma

I was right.  Kinda hard not to be when the symptoms match so closely, especially after I'm symptomatic now after being a good bit better after someone smoked near me.  It may or may not end after this year; it may be temporary lung damage from whooping cough and it may be permanent. That much will be a wait and see.  I'm guessing though that my lungs took a hefty hit with the whooping cough because my voice is still not back to normal.  From what I've read it may never be quite the same; right now I have no idea as asthma flairs make it worse as does the time of day, how much I've talked, etc.  The exhaustion is probably from waking up coughing and I'm on another med that should be my main med for this which will hopefully help at night (Singulair). I'm also continuing Spiriva for another 10 days then will determine if I still need it or not.
 
The trick is that these are the only 2 asthma meds I can take.  I was afraid of that, and actually let him know about 10 days ago that I was developing reasons to believe this was asthma and that I realized treating it was going to challenge him.  I did not ask the obvious question of what happens if these don't work.  I pretty much know.  If I continue in an acute fashion as I have been for so long and continue just being sick I will have to do steroids.  If this continues long-term and these meds don't work then I assume several things happen:  we get creative, I see a specialist (probably at the big-deal hospital where Dr. Brain works), and compromises will be made.  Whether this is breathing treaments again (presumably with the slower than molasses stuff as I have few options for those as well), use of Xopenex which is contraindicated with MAOIs but may not be horribly contraindicated meaning we may be able to try it with me monitoring my blood pressure closely (but this also left me feeling a bit agitated when I took the couple doses I did take), or hospitalization to get everything under control with steroids and try to go from there.  I suspect that is the one that happens most readily, partly just to get it controlled enough to see if we start from controlled if I can maintain that with the wimpier meds I can use, rather than trying to make the inflammation go away without using anything very strong at doing that.

When I was in college I had this thing (ok, it was a learned behavior from childhood) where I did not take pills.  Period.  I made it from freshman year of college (1995) until 2002 with no antibiotics for illness, although I did have a round in grad school for an infected toe.  I occasionally took something for a headache. That was it.  I did take allergy meds in the summer, but hay free and camp counselor is not a good combination, and that was usually only 6 weeks and then maybe a few in the fall. That is why I delayed antidepressants for over a year of really needing them:  I hated the thought of meds that I would rely on, even if it would only be 6 months or so.  Since I never believed I was sick that pretty much made medications pointless.

I did have a point about meds.  As thankful as I am for the meds that have saved my life and that we finally have found a combination that works well and is adjustable for me, it is still also true that since the day that I was told by Dr. Guru that yes, I had bipolar disorder and due to how rapidly I cycled, the severity of my symptoms, and a few other factors that there was no way that any one medication available at that time (or now) would ever work for me and in fact he suggested starting with a 3 med cocktail in a clinical trial that I fit the criteria for perfectly (ie people with severe rapid cycling who had not gotten any control with other med trials).  That was 8.5 years ago ago and I have been on many, many cocktails since then.  And over time as the intensity of the meds changed I started adding on more and more other meds to counteract side effects and damage caused by these (granted the damage really was caused by lithium toxicity, NOT just from taking meds, but lithium toxicity added a thyroid pill, an acid reducer thanks to my ulcers from vomiting constantly, 2 pills (only b/c they don't make the dose I need of a medication to make my kidneys function correctly).  Antipsychotics caused me to add Provigil, which morphed into a new version called Nuvigil, to allow me to get to work something like on time.  Seroquel added all sorts of different meds for constipation; at one point I was taking 8 pills and a dose or 2 of powdered med daily for constipation alone.  Now I just take 1-2 pills for that.

Asthma meds are novel in that they aren't caused by psychotropic use.  Yet it's weird to think that without bipolar I would just now be taking 1 pill and 1 inhaler dose daily and instead I take something like 17 pills, 1 patch, and 1 inhaler dose daily.  This is the first "big" (size is very relative; as long as these meds work I'll have pretty mild, controlled asthma) problem I've had besides bipolar and all the consequences of treatment for that.

Anyway I have some more sewing I want to get done tonight.  I am pushing the edges of time to finish things, even though I finished a big pile today.  That's ok, we'll make it somehow.