The Air Out There
{ August 7th, 2009 }
If you’ve never experienced an asthma attack, it feels sort of like the aftermath of a really vigorous run. The type of an exhaustion a first time marathoner experiences, or the first time you ever ran more than a mile. Now imagine if you aren’t running any more, you’re resting, you’re pacing, you’re breathing deeply, you gasp… But nothing works. No matter what you do, you can’t catch your breath.
An asthma attack is like going immediately to that stage of breathlessness, often while doing nothing at all.
About a month or two ago, I had what was the scariest moment of my life. Sarah and I had gone out with some friends and a few couchsurfers and had wonderful evening. It started around 2pm at a coffee shop and conversation over cookies, coffee and the roaring laughter of fifteen or odd people who had just met and instantly bonded. Then someone suggested we go to a concert featuring a number of touring francophone bands and musicians. By now it was well into the evening and we headed to a local Korean restaurant for a hearty meal.
I remember having a mild attack during the course of this. I measure the severity of my asthma attacks like so: light (eventually goes away, without medication), mild (goes away with the help of medication), heavy (medication followed by rest and a lot of deep breaths) and critical. Until, this night, a ‘critical asthma attack’ was unknown territory for me. After all, although I was born asthmatic it didn’t really manifest until I was around four or five. And by high school it was completely gone. Whatever allergen or cause (the doctors told me dust and pollen were to blame) triggered the attacks, I guess my body built up an immunity to them. Growing up among the lush florals of a south Georgia farm and the thick hazy smog of Atlanta, I suppose those extreme conditions forced me to.
I haven’t considered myself an asthmatic since I was maybe 16, that’s the last time I can remember having an attack. Although much like alcoholics, asthmatics are never cured, we’re just in lifelong recovery. Apparently over a decade later I would relapse.
The relapse happened the day I set foot in Uganda. Maybe not THE day but for someone who assumed that the days of sitting out P.E. and consulting a doctor before exercise were behind him, it was pretty clear right away that something wast right. Whether it was the dust in the air (a thin coat of red dust covers almost everything in Africa), the dense pollution, or the particles in the air here previously alien to my body, I was not prepared for the air here. If not the first day, it was only a matter of days before I needed to purchase an inhaler. The first that I’d bought in ten years. That last inhaler I bought, followed me around for six years (just in case) before I eventually threw it away in a move.
Going back to that night, although I drank a lot and had a splitting headache, there was nothing particularly wrong with me by the time Sarah and I made it home for bed. I was tired from the long day, and the two of us sank into the fake IKEA bed like we do every night.
Just past midnight I woke up with a start. My body was not in the best shape. I assumed it was the rumblings of too much Ugandan beer, which has this substance in it called sorghum, but a few trips to the bathroom didn’t help. My chest felt tight, I keep an inhaler by the bed for mild attacks during the night. I took a puff and went back to sleep. At this stage the attack was light,
Again, I woke up. My chest was tighter. I’d moved to mild. When you’re in bed and you feel like this, you start to toss and turn. You can’t breathe ob your back, side, stomach, sitting-up…but you still feel like you need to do something. Your body wants you to find a comfortable position so you can breathe. I took more puffs from the inhaler and drifted off back to sleep.
Around 4am I felt awful. This wasn’t a hangover, my stomach was convulsing and my head was swimming. This also didn’t feel like asthma but I could breathe. I made a number of trips to the bathroom and rushed over to find an inhaler (we keep several around the house in case we can’t find one when I need it). I took a puff of the inhaler. Nothing. I took another puff. Nothing. Odd. Usually two puffs from the inhaler and I’m immediately feeling better. Something was wrong.
I stumbled back to the bed, still feeling bad. At this point Sarah had woken up from all the commotion. I didn’t want to unnecessarily alarm her, so I told her I was fine and sat on the edge of the bed trying to will the attack away. There are some things that you instinctively know about a situation. I have an asthma attack, I reach for an inhaler. Even after such a long absence from my life, this is the reaction because this is what works. The inhaler was my survival so this was like drowning at sea, and reaching for a rope that’s not attached to anything. So, when I sat on the edge of our bed and tried three separate inhalers, only to have none of them do what they had always done. I was lost.
The inhalers stop the asthma.
The inhalers stop the asthma.
That’s what they do. They stop the asthma.
The asthma isn’t stopping.
That thought ran through my mind, maybe a hundred times in only a few seconds. I was panicking which is the thing all doctors try to get asthma patients NOT to do, because it only makes everything worse. But what does a doctor do when a treatment, the only thing way they know and have studied, doesn’t work? I can only assume they panic a bit too. By now I had broken into a cold sweat. The attack was getting worse and the inhalers weren’t working. The only solution I knew of in the world for a heavy attack was useless….this meant I was critical. This meant it could be fatal.
Well that realization is not one you want to come to when your objective is NOT to panic. Not at all.
Sarah rushed to my side, still awake and sensing trouble. It was time to put my pride aside, I couldn’t breath. I needed to breath.
I could barely speak but I managed to gasp, “They aren’t working.” I think she realized what this meant more immediately than I did.
I stumbled out onto our porch that over looks, Kampala. This time of morning everything was quiet. All I could hear was my own wheezing and the faint sounds of human traffic miles away. The sun was barely over the horizon. I’d gone out there because I thought fresh air would help. But that didn’t work either. I was confused and at this point I was breathing so little oxygen that I could feel myself threatening to blackout. My heart was pounding. My head was pounding. I was fully drenched in sweat. I’m convinced that, in a time before modern medical invention (long before most of us were born) this was how people died from asthma. Not wanting anything more than one final full, glorious breath of crisp air. I was petrified.
By now Sarah had rushed out of bed into some clothes…or maybe pajamas (I don’t remember)….and had called a taxi. The taxi driver usually stages at the bottom of the hill but it was barely 5 a.m. Where would he be? What would he be doing? Would it be a long wait? Were there ambulances in Kampala? Those thoughts raced through both of our minds as we waited.
Needless to say, the taxi driver arrived swifter than we imagined he would at that hour. He could tell by looking at me that there was no time for the normal pleasantries. “The surgery!” Sarah urged him. We went racing off towards the only 24 medical facility in Kampala that I know of. The rest is a blur, I know Sarah was urging me to relax, trying to soothe my breathing while the driver navigated early morning traffic. When we arrived at the Surgery I was rushed in and after explaining that it was severe asthma attack, I was put on some type of oxygen tank. I don’t know the name of the medicine (Beclomatsone?) but Sarah later told me it was a steroid but I was told to breath from it for several minutes. Eventually, I could feel the color coming back to my face, and with it an easing of my lungs. The treatment was working, I could breathe.
There are people in the world with worse asthma that I have. There are people here in Uganda with asthma and NO inhaler…their families can’t afford them. I don’t know the numbers, or have the research to back it up. But one day, provided I’m able to acquire the resources and the contacts, I will work on improving the air in Africa. Whether it’s natural triggers like dust and pollen, or artificial one’s like pollution, I assume that there’s little focus on such a big problem. I doubt the any of cars here would pass the same emissions tests that we have in the U.S. As annoying as it is, those tests were started for a reason.
Never in my life have I had an attack like that and I haven’t had one since. However, it was enough of a shock to me that I realize as long as I’m here I face quite a bit of risk. It’s not my motivation to leave, it’s even more motivation to improve conditions here for others.
