Monday, September 27, 2010

Surviving asthma

I’m one of the 12 million Filipinos that suffer from asthma. Although doctors say no one is born with this disease, some of my most vivid recollections of my childhood years in the 1950s were visits to hospitals after suffering from asthma attacks.

I remember having to endure painful injections of I don’t know what medicine to combat the disease. I remember the acrid and nauseating odor of emitted by a smoldering mound of “Dr. Schiffman's Asthmador,” a grayish powder made from a concoction of leaves whose smoke I had to inhale so I could again breathe freely.

I remember my delight when the tablet “Asmasolon”(theophylline) entered my world  in the 1960s. It meant I no longer had to rely almost exclusively on the pungent odor of burning “Asthmador” since this tiny tablet would do its work.

But Asmasolon tasted so bitter I had to swallow it with sugar and with my eyes closed. I remember that some of my most fervent prayers to the Lord were to free me from asthma, Asthmador and Asmasolon.

I also remember how asthma affected my fondness for sports. When I was Grade 5 at the University of Santo Tomas, our physical education was a choice between basketball and baseball.

Our PE instructor had a simple method of determining who would go on to play basketball: anyone who could run crosscourt while dribbling the ball and not pant at the end went on to play.

I remember dribbling that ball but at midcourt began to pant so heavily I had to stop. Baseball became my sport, which was also good since my dad also loved baseball. I still wish baseball were our national sport, however.

I still have the disease but do not suffer as intensely as I did in my youth. Modern medicine has had a lot to do with this.

I bless those scientists and doctors that invented “salbutamol (Ventolin),” the fastest and most effective cure I’ve taken that combats my asthma. The salbutamol inhaler is a life-saver and I never leave home without it.

Salbutamol nebules, however, have done more to increase my life expectancy than any other form of medication. I have a nebulizer at home and my greatest fear is having a severe attack and finding the nebulizer won’t work. That would be lights out for me. For sure.

And one thing that also made it easier for me to cope with asthma, which generally struck  at night, was Mercury Drug having some of its key branches open 24 hours. My dad used to rush off to Mercury's Quiapo branch when attacks found me without, or with insufficient Ventolin.

I did the same for my mother, an asthmatic like myself, and remember hurrying off to Quiapo after midnight one stormy night to buy nebules for my mother.

Defined by asthma
It seems my childhood years were defined by my battle against asthma. Doctors say it’s a battle I can’t win since there is no cure for asthma. Asthma will most likely kill me one of these days. At least, that’s what the statistics indicate.

I don’t fancy an asthma attack so severe it causes a massive heart attack that does me in. The painful fight for every life-giving breath will reach so terrible a stage in a severe attack that the body’s final defense is to give in and die.

I guess death is the only real cure for asthma, and I guess this is where I’m headed somewhere along the short road ahead.

But I don’t dwell on the inevitable. Patients with fourth stage cancer are forced to treasure every dawn that dawns.

Asthmatics are compelled to see life in the same light, but not with the same dreadful urgency. I do treasure each day and praise my Lord with each wonderful dawn.

My asthma is nocturnal and is caused by dirty linen (pillow cases, blankets and bed sheets). I used to think dirty meant dirty, as in dirty caused by dust and dirt.

Now, I know that dirty really means linen infested by dust mites and their feces carrying allergens that trigger asthma. So, I have to sleep in clean beds.

In my bachelor days, this meant I had to be very picky about where I (and my partner) slept. That usually meant going to first class digs known for their first class linen.

I guess few things are more embarrassing than having an asthma attack in the middle of you know what. Thanks goodness this never happened, although the fear remained at the back of my mind during those treasured moments.

Pollution and asthma
Now, in my middle age I find my asthma attacks are no longer purely nocturnal. I’ve had an increasing number of attacks while walking in a place far from the safety of my home and nebulizer.

I know air pollution from vehicle exhausts is the new allergen that triggers most of these away-from-home-attacks. But I have to travel to Makati City to do work for my clients, so my salbutamol inhaler becomes a life-saving device that always goes with me.

It’s also somewhat disconcerting to realize that some doctors view asthma as a “polygenic condition,” that is, a disease carried by genes and that can be inherited and passed on, and can be complicated by environmental factors such as pollution.

It’s also worrisome to learn that asthma and other allergic diseases have been on a significant rise for the last 50 years.

The Global Initiative for Asthma (GINA) project that disseminates information on asthma care and the results of scientific investigations said several studies indicate that multiple genes may be involved in the pathogenesis of asthma.

It also said asthma became more complex in the presence of environmental triggers such as pollution that cause an asthma attack.

A Filipino pediatric geneticist believes asthma afflicts 155 million persons worldwide and that asthma cases are increasing in the Philippines.

It is comforting to note that nobody is born with asthma. One, however, can be born with the gene (or “genotype”) that causes asthma. It is this genotype triggered by environmental factors that causes asthma.

In 2003, the Asthma Genetics Group from the University of Oxford in the United Kingdom reported an asthma susceptibility gene, PHF 11, which comes from chromosome 13. The gene appears to regulate the blood B cells that produce immunoglobulin E, the allergic antibody.

The study said there are some 10 genes that have a significant effect on a person's susceptibility to asthma.

What worries me about these findings is that they confirm asthma is an inherited disease. The last thing I wanted was for any of my six children to inherit the disease.

Unfortunately, one has inherited my asthma but the average interval in her attacks, thankfully, is measured in years, not days. Thankfully, our nebulizer stands ready to serve us when the need arises.

I can’t say with confidence that my asthma helped make me a better writer since it took much of any physical activity out of my life. But I can’t also say that I wouldn’t have stayed at home as much and read as much if I were a more physically fit man.

If I were a lot more physical, I’d probably have learned to love baseball; studied “kendo” and played NFL football with like-minded Pinoys (Are there any out there?). I’d also have probably run a marathon, which is a great ambition I realize I shall never accomplish. Especially now.

But I've learned to live with asthma. Life's still a beautiful work-in-progress, and I thank God profusely for every days that dawns.