Passive smoking……what does it mean???

apart from death?

I cannot count the number of posts I have done about smoking, passive smoking, the smoking ban and how it effects my lungs and the lungs of many others like me.

It really hit me the other day after parking my car in the carpark at work and walking the 200m to get into the hospital how many people I had to pass firstly at the pedestrian crossing, then the pavement to get to the narrow walkway to get inside the doors and then the narrow walkway itself and the doors was just like running a gauntlet and taking your life into your hands.

24….thats how many people (patients) I had to pass who were smoking on the short 200m walk. It is sickening to have so many people.

Im not sure those who are smoking really understand just what the effect is on other people as there is no way to liken it to anything else. I can never explain the mental and physical negative effects that it has on me (and Im sure I am not alone in those thoughts).

The fear I have is unreal. I am terrified that this is what may happen AGAIN

Both these photos are from the effects of passive smoke which hit me when I was no expecting it. The first photo was just before going to ICU after spending about 8 hours in resus, getting stable, moved to assessment unit to then get bad and need ICU. The second was taken in ICU after someone smoking below my open window and me having an asthma attack.

The fear of having asthma attacks is like no other. There are theories that you can make someone run up stairs with a close peg on their nose and breathe through a skinny straw to simulate what it is like to not be able to breathe but they can always take the peg off and open their mouth.

In the photos above I was so tired I just wanted to give up and stop fighting but you cant. If you give up you risk being intubated or dying. This is the reality. So many people die from asthma attacks that come from triggers that are out with their control. It feels like you are being punished for something you didnt do. It is more than just the attack itself but the consequences that go with it- being off work, missing holidays, medication that causes side effects, family being so worried about you, family needing to look after you to name a few.

Before the ban on smoking there were visible smoking shelters and it never used to be a risk to just get from your car into a building. I am not saying that everyone used the smoking shelter but a majority did and the risk was greatly reduced which matters so much.

My biggest fear in life is having an asthma attack, so imagine being faced with your biggest fear on a daily basis multiple times. It seriously makes me wonder if working is really worth the risk. I don’t know who to speak to about it. I blogged about it, tweeted about it, spoken to my union and will just about tell anyone who will listen. I love my job but it is getting to the point of weighing up risk and reward especially with being on a new treatment. Can I really justify the expense this new treatment will cost the NHS vs exposing myself to a major trigger everyday and risk attacks which could jeopardise the success of the trial.

Anyone who can suggest or make a difference to the smoking obstacle course I face please let me know (I have tried using other entrances but this is an issue at other ones too). as I am desperate now.

 

Itching, burning and needed advice.

Just to say before getting into this post, I attempted to get advice and help for the situation I was in but hit a brick wall. All is semi ok now thank goodness and all is safe.

In previous posts I have talked about allergic reactions and allergies, which of late (last 6 months or so) have been getting worse, more difficult to manage and coming out of the blue. I have had various allergies for a long time, followed a salicylate free diet and always reacted badly to insect bites etc, but nothing quite like this.

Something Im not really that familiar with about myself is really quite scary. I think it is because I just can’t get a hold of them and don’t know what it is that is triggering these reactions.

So anyway the other night I had a fairly bad reaction, I was home alone, it was the evening, I had maxed out on anti histamines and was not sure what else I should do short of scratch my skin off.  My face looked like this despite having 14mg pred, 12mg chlorophenamine, 180mg fexofenadine, 10mg citirizine on board!

IMG_1384

I went red and blotchy all over to so thought I had better call NHS24 just to check out if there was anything else I should be doing or if I should take some extra steroids to help.

So phoning through I spoke to a call handler and explained what has gone on and she asked about various allergies I have and if I could identify what caused this reaction. I wasn’t able to tell what caused it. She tried to get through to a nurse but couldn’t so said I should expect a call back within the next 3 hours from a nurse. So I just waited and with 10 minutes before the 3 hour time I got a call back from a call handler who ran through various questions which included if the reaction had changed or got worse which by this time it had spread all over my body, my face particularly my eye and ear on the left side were quite swollen and I had hives developing too. She must have been relaying this information to a nurse as she came back saying not to do anything different and see how it goes. I asked if I should take some more prednisilone or more antihistamine to help to which she relayed to the nurse and was told no. I was then told that if it didnt get better to call my GP in the morning and take it from there. I was also told to have a cold shower and they went. That was the end of the conversation.

I felt really upset and scared after this. I just wanted some reassurance about what I should be doing and what I shouldn’t do, what to expect etc whereas I was basically told to sit tight and if in 11 hours time (8am GP opening time) things were still the same or worse I should call them. I came off the phone feeling like an idiot. The first call I told them how I had had previous reactions and the last hospital admission I had an allergic reaction that sent me to high dependancy unit.

I thought to myself, clam down and just think what is the logical thing to do. I knew I could take more chlorophenamine soon and would be taking my ranitidine soon too which has antihistamine properties in it, I also had my inhalers to take and various nebulisers so my breathing was going to get a boost but I was still worried so I decided to take some more steroids. Even though they told me not to from previous reactions I have always been given steroids so I thought I should take them. I knew I wouldn’t be overdosing myself or anything by taking a dose and weighed up that it was safer to than not to take them. I got cool flannels to try and cool the hives down and stop my face burning. It was a long process but it eventually settled down about 4am or so. I did not get much sleep that night- infant my fitbit which was on me recorded no sleep that night at all.

I do feel now looking back, why did I bother to call NHS24 when they did nothing to reassure me or offer any advice. They left me feeling scared and vulnerable. I guess I am lucky on two fronts one that I have had reactions before and have had some experience at dealing with them and that I am a nurse so have some knowledge but if I hadn’t had either of those 2 things Im not sure what I would have done. The next step I guess would be to go to A&E but really is that needed for an allergic reaction. I suppose yes as they can be life threatening especially delayed reaction which I sometimes get.

From this I have learnt some good lessons.

  1. you know your own body
  2. im glad i have steroids to increase dose if needed
  3. im a nurse
  4. not to rely on NHS24 and go with my gut

I know my condition is quite complex and maybe I did over react but when you have lungs that are on a knife edge anyway you don’t want to do anything which might just cause them to tip and go overboard- because that is just too much hard work to deal with and a fight I really don’t have the energy for!!

I will be going to the GP and have immunology soon to so things are moving forward with finding out what is going on and if it is just that my body is not as strong so thats why I am having worse allergic reactions than I was before.