Very unpleasin' sneezin' & wheezin'
August 16, 2014 6:39 AM   Subscribe

At the ripe old age of 40 something, I have been diagnosed with adult onset asthma. Nope, I wasn't one of those wheezy kids, so this is a whole new world for me. And no, I've never smoked. I'm getting a handle on the medical side of things, but it's the everyday stuff that is proving a challenge.

For instance, I need to carry an inhaler, spacer and epipen. Toting it all to work in my regular bag, that holds my lunch and such is easy, but outside of that, I don't usually carry a purse, how do folks carry this stuff around, when out and about, or exercising? Do I have to rock the fanny pack, or is there a niftier alternative? I've seen pouches designed to carry an inhaler, but the spacer is a bit bulky and definitely won't fit those.

Also, I'm reacting badly to perfumes, air fresheners and the like. Riding the elevator at work in a high-rise office building can have quite unpleasant results if I'm stuck in there with someone marinating in perfume. Ditto with coworkers in my office. We also have a mad Lysol sprayer on staff. How do I deal with this without sounding like a jerk? Or do I just need to learn to hold my breath longer?

I've been told I can carry on with my normal life, but I enjoy many outdoor activities. Any advice from asthmatics who hike, camp, canoe, etc? Am I being paranoid wondering about the distance to the closest ER (not that I've needed that yet)?

Thanks, all!
posted by lawhound to Health & Fitness (17 answers total) 2 users marked this as a favorite
Can you talk to HR about getting a "no spraying perfume or Lysol in the office" policy for work? That might fall under "reasonable accommodation for a disability." And for all you know, there are other people who don't want to smell Lysol or Eau De Celebrity any more than you do. It won't help for the elevators, but it might give you room to breathe in the office.
posted by Rosie M. Banks at 6:50 AM on August 16, 2014 [3 favorites]

If you master the art of using the inhaler, you don't have to use a spacer - that would cut down on what you need to carry. The spacer just makes it easier for you to use the inhaler properly even if your technique isn't good. Is the epipen for other allergies?

You're certainly not paranoid for wondering about the distance to the closest ER, but if you've never needed one, you're not likely to have no warning and suddenly be desperate for one, so you probably don't need to be extremely close to one. The most common ER visit reason for mild asthmatics is that they either feel like they need to use their inhaler more frequently than every 4 hours, or have found themselves using it around the clock every 4 hours for one or more days (asthma exacerbation).
posted by treehorn+bunny at 6:56 AM on August 16, 2014

I don't have asthma or allergies severe enough to use an epipen but I have used an inhaler for YEARS. Once you get the hang of getting the medicine inhaled you shouldn't need the spacer anymore (I haven't had one in eons). I also make sure to puff before I do any exercise. Mine has gotten better over the years, and I have learned when to use the inhaler and when I just need to get some fresh air to overcome the effects of irritants (for me it is cigarette smoke). Of course, YMMV. But the longer you deal with it the more you learn.

If you have to have the epipen at all times and it won't go into a pocket while exercising (I make sure to buy larger shorts with pockets so I can keep my inhaler on me), you just may have to rock a fanny pack. Perhaps you can get a small one and get to the point where you can puff before you start to exercise then leave the spacer in the car.

Also, inhaled steroids and Singulair (pill) helps my TREMENDOUSLY when allergies are at their worst. Talk with your doc about whether or not either one of those will help keep your allergic reactions under control.
posted by MultiFaceted at 6:57 AM on August 16, 2014

I have asthma, and work with someone who is insane about the Lysol. I told my boss that Lysol aggravated my asthmal, and that I needed my coworker to reserve her Lysol fumes for times when I wasn't there. It was not a big deal. My coworker wasn't mad. This is a completely reasonable thing to ask. Actually, my boss was happy for an excuse to ask our coworker to tone down the Lysol stink bomb.

My asthma is pretty mild, but some of my favorite activities do set it off. Unfortunately, that does include outdoorsy stuff. If I go for a hike when it is very hot, very cold, or the pollen load is high - I will get wheezy eventually. It has yet to become an emergency, and I've not stopped doing those things. I think you will also figure out how to balance your asthma with your favorite fun stuff.

Oh, my acid reflux definitely exacerbates my asthma. Something to keep in mind if you have that issue, too.

My mom has much more severe asthma than I do, as a further note. She has other health issues that prevent her from hiking and etc, but her asthma is not usually what prevents her from engaging in daily life. She has a big, big problem with vehicle exhaust, though. Sitting in traffic is a nightmare for her. That might be something else to look out for.
posted by Coatlicue at 7:11 AM on August 16, 2014

Mine disappeared again after about four years when I moved offices. Legend had it that the air con in my old office was full of things, some alive, some no longer so. If there's any chance environmental factors are to blame, it's worth checking out.
posted by Segundus at 7:16 AM on August 16, 2014

I have a similar medical history. You might buy a mask with a charcoal filter from I Can Breathe. Wearing one was a quiet reminder to my co-workers of their need to be considerate of my health.
posted by Carol Anne at 7:31 AM on August 16, 2014

A few selected videos about asthma and diet: These videos might seem a bit "axe grind-ey" in the sense that they invariably advocate plant-based eating. But they are all based in actual research. See the "Sources Cited" section on each page for links to the papers.
posted by sarah_pdx at 7:45 AM on August 16, 2014

Definitely rule out environmental hazards. I thought I was getting asthma at one point – a mean hospital doctor refused to treat me unless I got rid of my cat. But it turned out to be my down futon. Every night I was sleeping under a thing that was making me sick. I have not had a single wheeze since I pitched the thing out.

However, animals can be the problem. My mother always had cats and was fine, but her last cat made her so sick that one doctor said her lungs were ruined and could never be rehabilitated. But when she was removed from the house with the cat she recovered completely. That cat even made me wheeze a little, and I've always had cats around with no issues – it can be one specific animal that affects you adversely.

Good luck!
posted by zadcat at 7:46 AM on August 16, 2014

I just throw my inhaler and epipen in my bag or car, and keep spares in my desk at work. Ask if you can have a second of each for this reason. Why do you need a spacer?
posted by rabbitrabbit at 9:16 AM on August 16, 2014

I have never had an epipen. Back when I had an inhaler and was a homemaker, I eventually just kept it at home and developed other solutions for when I left the house for usually relatively short periods. For example, for a time, I had a purse that was basically a wallet on a string (in other words: tiny little purse on a shoulder strap). I could fit a 70% cocoa chocolate bar in that tiny little purse. About half a bar of that was sufficient to address emergencies that would have otherwise been treated by an inhaler.

Later, when I worked at BigCo, if I was exposed to stuff at work, I washed my face (and, in extreme cases, rinsed my very short hair) at the bathroom sink and hit the breakroom for an extra diet coke (or cup of coffee) and chocolate bar. One of the side benefits of doing that was it didn't look medical to coworkers. It looked like I was just taking a break and having a snack. Since I spent basically ALL my breaks dealing with my medical issue, that helped me look a lot more normal -- which might not be an issue for you but it was an issue for me personally, for various reasons.

Caffeine is similar to the stimulant drugs that are typically used to open up the airways and, in a pinch, can be used to do that. It is readily available at lots of breakrooms, eateries, etc. in the form of coffee, cola drinks, chocolate, etc. I eventually noticed that on days when I was really struggling (because, say, the factory across the street from my office was spewing stuff that I was making me anaphylactic), my intake of sodas, coffee and chocolate just naturally went up without me necessarily consciously intending it.

Which isn't to say that you necessarily should leave your inhaler and epipen at home. It's more to say that there are a variety of ways to address an emergency "I can't breathe due to asthma/allergies" event and those ways can be as close to hand as your nearest breakroom, vending machine, fast food place or what not and doesn't necessarily require someone to dial 911 and get you whisked off in an ambulance. For me, that information was very freeing and empowering and helps me look/feel/live like "No, I don't have (serious respiratory condition). I just like good coffee!"

As for, say, getting stuck in the elevator with someone marinating in perfume, I personally would not hesitate to promptly get off at the next floor (as soon as I realized, oh, god, they are marinating and I can't breathe because of it) and walk up one flight of stairs and then get back on the elevator. I have found that doing something like walking up one flight of stairs to avoid something triggering a breathing problem for me puts a great deal less stress on me than enduring the exposure for however long it would take to "naturally" resolve. Also, walking is good for the lungs. Win/win! (I do a lot of walking these days and it has helped reduce my respiratory problems.)

I spend a lot of time outdoors. I encourage you to develop some awareness of what kinds of exposures trigger attacks and then try to avoid that in specific. It isn't necessarily all that hard. I mostly try to avoid dark, dank areas that are likely to be overrun with fungus of some sort. For example, if I am walking around an urban area and I have a choice between an overpass that takes me over the Interstate or an underpass that takes me under it, I prefer the overpass if it is not too out of my way. The underpass is likely to be a terrible environment and the fungal crap tends to cling long after I have walked back out into the sunlight. Whenever possible, avoiding exposure to stuff like that is just far superior in every way to trying to cope with the aftermath. And maybe walking under one underpass doesn't cause a crisis but do it two or three more times and maybe get coughed on by a passerby and all that adds up and then, suddenly, I am sick. So just avoiding, as much as possible, all of the little avoidable things that add up means I rarely have a breathing crisis these days, even though my respiratory condition is genetic and incurable.

Best of luck.
posted by Michele in California at 10:40 AM on August 16, 2014

Barring the spacer, would a travel type money belt work instead of a fanny pack? I have a passport holder with elastic bands that straps to my thigh and would hold an inhaler and epi pen (and my keys and a credit card) while I worked out. Check the travel stuff and runner's stuff at travel/sports stores.

Outdoors means knowing my triggers and pre-emptively treating my allergies... Spring=cedar pollen=3 Benadryl (and coffee!) and using my inhaler before I need it.

Nth that most cats are fine - I have two - but have been extremely allergic to individuals. Wtf, right?
posted by jrobin276 at 10:43 AM on August 16, 2014 [1 favorite]

My asthma (primarily cold-induced) was vastly improved when I gave up dairy for other reasons. So much so that I went a number of years without needing an inhaler. It's anecdata, but some percentage of people have a similar experience.

As far as carrying stuff, leave an inhaler and epipen at work, in the car if you have one, at home. When I wear clothes with no pockets, grumble, I wear a small purse with a cross-body strap for my phone, so you might consider something like that.
posted by theora55 at 10:48 AM on August 16, 2014

Is it an albuterol inhaler for acute attacks or a steroid inhaler for long-term treatment? If it's the latter I think you do need to keep using the spacer so you don't get an oral thrush situation. If it's just a regular inhaler, then I agree with everyone above that you will be able to stop bothering with the spacer after a little while.

As for office sprayers, I just throw away any cans of sprays that people are using and refuse to order more. There are enough sensitive people in my office that the sprayers and gallon-perfume-dousers have been peer shamed into cutting down significantly.

Definitely get as many sets as you can afford and leave one at work and another in your gym bag, if applicable. I have an inhaler in my bag, one by my bed, one in my desk drawer, and one in my gym bag. That way I always have one handy and can't forget it anywhere and panic in an emergency.
posted by elizardbits at 12:19 PM on August 16, 2014

Best answer: Fellow epipen and inhaler carrier.

Don't leave your epipens or inhalers in the car. Inhalers can explode if stored at over 50C, and epipens need to be kept between 15 and 25C to maintain optimal effectiveness, and a car can quickly exceed that temperature range. Epinephrine is not a super stable drug--when they say it lasts a year at optimal storage conditions, they mean it. (I found out the hard way. Don't be me.)

I'm also not wild about purses, but in this instance, it's one of those things that you're probably going to have to resign yourself to. I have a small bag that I carry basically any time I leave the house, and it pretty much just has an epipen and an inhaler. If you can embrace the look of cargo pants/shorts, you can often jam your stuff in a pocket, but then you've got a weirdly bulgy pocket, which may or may not be a thing you can deal with.

My personal metric with the ER is that I end up there about once or twice a year, and any time I go anywhere, I first check where the nearest ER is and how I can get there. Vacation, friend's house, whatever--I know where the ER is. If you're hiking, etc, I'd stick (at least at first) to places where you have cell service and where emergency services could reach you. Once you get more accustomed to your limitations and how to manage them, you can probably be a little more relaxed about it.

Re: Office stuff: Some offices are great about this, and some are not. I've worked in an office that had an explicit no-scents policy and purchased unscented cleaners, etc, and I've worked in one that Scentsy "parties" every month. My advice is to speak to HR, not your coworkers directly, and resign yourself to the fact that work is always going to be a potential hazard--even if your office is scent free, there are going to be some assholes who have to push the limits, and there are visitors, sales reps, delivery people, etc, who won't know. At some point you're going to share an elevator with them. People get remarkably tetchy about being told that their gross body products are making you ill--all, "oh, it's just a little [brand], it shouldn't bother anyone!", or "that's my SCENT! I've worn it for YEARS!" You would think that shipping someone off to the hospital would be enough to convince them that their ~scent~ isn't actually awesome for everyone, but you would be wrong.

Finally, use this no-copay coupon that Metafilter found for me a while back. You can use it as many times as you want, and my experience is that they're putting out a new one every year. Keep the pens everywhere, and replace them every year.
posted by MeghanC at 12:33 PM on August 16, 2014 [1 favorite]

Fwiw I use both steroidal and non-steroidal inhalers without a spacer and have for my entire life. I asked my doc about it and he said that if you're not getting thrush then you're fine to ditch the spacer. He also said I could rinse my mouth with water after taking a hit if I was worried about it.
posted by Aizkolari at 7:15 PM on August 16, 2014

Response by poster: Thanks everyone for your input!

It's a rescue inhaler, and my doc is telling me I need to use the spacer (at least for now), so I'm stuck with carrying it. With the frequency I'm using it, I'm suspecting that I may be switching to different meds. I'll be starting allergy shots soon, and I'll have to carry the epipen on the days I get shots, but with my memory, it will have to be part of my daily gear, or I risk running out of the house in the morning without it.

I guess it's time for bag shopping. has some stuff that looks interesting, and might work and I'll check out some travel stores as well.

I have noticed coffee does help, but too much gives me other problems. :( I'm thinking about how to approach HR. I know there have been other complaints about the lysol and air freshener spraying, but it hasn't seemed to have stopped.

I'm putting it all in a dry bag today and going for a (non-wilderness) paddle. I'm hope getting into the outdoors will help de-stress about this whole situation.
posted by lawhound at 3:34 AM on August 17, 2014

I've always been pretty outdoorsy and active. I got adult-onset asthma at 40-something, and it hasn't slowed me down much in nearly 20 years. I camp and hike at altitude (and BTW, dry air is good for asthmatics. Humidity is not your friend).

I've had to cut back on the extreme uphill hiking although I can easily walk on level surfaces for miles and miles. As soon as there is some elevation gain, I have to whip out the inhaler. It makes other hikers nervous to see me wheezing and sucking on the inhaler on my way up to a waterfall in RMNP, but I still do it.

I keep one rescue inhaler in my purse (it will fit in a pocket if I have one) and another on the bedside table. When hiking or riding my bike, I take one in my pack. The non-rescue (flovent, as opposed to albuterol) inhaler only goes with me when I am away overnight. I find that inhaler fits nicely inside the spacer. If I'm packing light, I can live without the spacer.

Asthma also makes people who don't know it's asthma nervous - if cold air is one of your triggers, you may feel that you should explain that your wheezing and coughing is not contagious, it's just asthma.

If you ever show up at the emergency room with an asthma attack (this happened to me when I was poor and ran out of meds) you will be seen right away, because it is considered life-threatening. They'll take you right in and give you a nebulizer. Don't delay - if you're having an attack and your emergency inhaler isn't helping, go to the ER. But don't let this stop you from living your life - my only serious attack was triggered by cleaning house, never from breathing campfire smoke or hiking uphill.
posted by caryatid at 8:13 AM on August 19, 2014 [1 favorite]

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