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Could we exhale, my children and I?

Pam Kress-Dunn
Patient
December 24, 2013
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When he was five, my son Daniel went through a rough patch with his asthma. Both he and his sister Allison had been diagnosed the year before, when we were living in Colorado. I never knew if it was the fault of the pollution that too often smeared our view of the mountains, or my then-husband’s two-pack-daily cigarette habit. Or was it the unspoken shriek of anxiety?

After I divorced my husband, we all moved back to Iowa — me, with my kids, to take a job close to my hometown, my ex to live with his parents while sporadically looking for work. More than just the asthma made the journey with us. Memories of that marriage — scorched by the years of cigarettes, the alcohol, the yelling, my bruises, the police calls, the gun — surely didn’t make for good health.

I found the children a good doctor who mapped out a strategy. When their symptoms would escalate, so would our response. I kept the plan taped to the bathroom wall, so I wouldn’t have to waste time thinking when Dan — it was usually Dan, not Allison — began wheezing.

Our first line of defense was the pills that they took daily. These came in sprinkles, tiny multicolored balls I would release from their capsules into a spoonful of pancake syrup (the children’s choice) to be licked clean. We made sure every sprinkle went down.

At the first sign of a cold or other respiratory distress, we ramped up the response. Both kids were aces at using their inhalers, and at this point I would hand out prednisone as well. They learned to ask, “Back? Or front?” since a hard tablet went down better with the head tipped back, while a lightweight capsule floated on the sip of water, so was best swallowed with the head tipped forward. (The things that go on in other people’s houses … Their friends had no idea.)

Often, this was enough. But sometimes it was not. Now was one of those times. So I called the doctor and was instructed to bring Dan to the ER for a breathing treatment. (Later on, we’d invest in our own nebulizer and do it ourselves at home.)

Fifteen minutes after the mask was on, Dan was both jazzed up from the drugs and beginning to nod off. (Did I mention it was past his bedtime?) Luckily, his sister was at camp. So we went home, my mind echoing with the doctor’s warning: “If it comes back, we’ll have to admit him.”

It did come back. So back we went, Dan strapped into his booster seat as I drove, staring straight ahead and worrying about losing my son.

I was trying not to think about the “twitchy tubes” a pulmonologist had described, and how, as a fellow asthma parent put it, at some point there’s really no way to bypass an asthma attack. They just give them the same drug different ways — by pill, by vapor, by injection, intravenously.

What did I know? I hyperventilated every time my kids had a breathing test. The nurses said all the moms did that, as they shouted, “Breathe! Breathe breathe breathe breathe breathe!”

He was a brave boy, changing into the hospital gown, letting them take his blood, submitting to the insertion of the IV. When his bronchioles finally relaxed a bit from this new onslaught of pharmaceuticals, he was sent up to pediatrics, and we settled in for the night, him in the bed, me on the recliner.

He was there two nights, three days. When Allison returned from camp, a neighbor took her in. Impressed by her brother’s adventure, she talked with him on the phone.

On the second evening of our stay, I knew we’d turned the corner when I began to fret about Dan’s dirty fingernails.

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On the morning of what turned out to be his last day there, they let him out of bed to go to the playroom. The telltale allergic shiners were finally starting to fade from beneath his eyes.

Grudgingly, I called my ex-husband, who now lived just over one hour away and occasionally acted like he cared. He showed up later that day, and I, desperate for a trip home, kissed my son and walked out into the hospital parking lot.

Passing the yellow Chevette that had once been mine, I saw it: a bumper sticker jeering, “Ex-wife in trunk.” I found my own vehicle and drove home, telling myself all the way, “Calm down. At least he came. And you’re not married to him anymore.”

Back home, I took a shower, put on new clothes, ran a quick inspection of the house, grabbed the mail, then drove back to where I belonged.

I parked, got out, saw the bumper sticker once more. Stopped, walked back, looked again.

It came off so easily. I stuffed it into my pocket. No need to wave it in his face.

I took the elevator back up to the third floor, found my boy and said goodbye to his father.

It wasn’t until then that I sensed just how shallow my own breath had become, during all those years when an honest comment, an accidental lowering of my guard, could let all the air out of the room, or a punch knock me literally breathless.

Could I inhale now? I could. Could we exhale, my children and I? Yes, finally.

The next day, we were discharged. Sprung.

Dan and I walked out into the sunny spring day, full of promise, full of threat. Together, we breathed deeply, then let it out.

Pam Kress-Dunn is a medical librarian. This piece was originally published in Pulse — voices from the heart of medicine, and is reprinted with permission. 

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