Apparently, the hospital has one. After Thursday night's smaller attack, they decided to keep me through Friday, as expected. I had no more major exacerbations on Friday, successfully took a few short walks, and thoroughly enjoyed a visit from my babies (who were happy to see me for about thirty seconds before becoming too interested in the hospital room). We decided to release me on Saturday morning, and by 11:30, I was on my way home.
I hadn't made it much farther than the front door before I became noticeably winded. I thought, well, it's just a lot more than I've been doing, and went into the bedroom and lay down on the bed to rest. When the breathlessness didn't abate, I hit the rescue inhaler and waited. When it grew worse, I tried to calm myself down and wait it out, but ultimately it became obvious that it was time to give up and go back.
Unfortunately, because it was Saturday afternoon, I couldn't just go back to my regular pulmonologist and let him decide to admit me. Instead, we had to go to the ER, which turned out to be a horrible experience. I'd been controlling the fear okay all the way to the hospital, but when I got to the ER, I was hyperventilating to some degree, and it had caused my hands to spasm and lock up. They put me in a room, shut the door, and left me alone while G went to go park the car, and at that point, it just got too much for me, and I got a little hysterical.
It took them hours to decide it wasn't just a panic attack -- for some reason, they kept insisting that I'd been released from the hospital two days previously, not two hours, and therefore it must not be a repeat attack, and I didn't have the breath to make them understand. Further adding to the confusion, I don't wheeze, haven't throughout this whole process, just simply don't take in as much air as I should. I wasn't doing terribly bad, once I got the panic under control -- I was moving enough air to have okay oxygen levels, but still not as much as I should have been.
Next, they decided I must have a pulmonary embolism, and that I needed a chest CT scan. Now, this is not an unrealistic thing to rule out, considering that I've been treated quite aggressively for asthma of late and still am far from well. The problem is that not only does this involve x-ray radiation, but also radioactive contrast dye. I kept trying to explain to them, again without much breath, that I might be pregnant, and that if I were it still wouldn't show on betas or HPTs. The ER resident tried to argue with me about it, asking why I didn't believe the HPT, until I asked *her* how many days past ovulation she would expect to see a detectable amount of HCG. She said 10 was about the minimum, and I said, well, there you are, and refused to have the CT scan done. The chances of this actually being a PE are not non-existent, but they're also not very high, and I can wait a couple more days to get this one done.
Eventually, they got me on enough albuterol to really start opening up my lungs again. I'm worried about how much albuterol this seems to take, at least two back-to-back treatments to start having a noticeable effect. There are some very confusing things happening here, and this is one of them. Anyway, two hours of continuous nebulizer had me able to breathe and speak normally again, and at 3 AM, just over 12 hours after arrival, they kicked me upstairs for an overnight stay.
I've had more breathing treatments this morning, including two back-to-back ones, which did seem to help me a good deal. I got up to have a much-needed shower, though, and I haven't really been able to catch my breath afterwards, so I think another one is in my near future. I'm back on the IV steroids, and the plan is to keep me on the steroids and nebulizer overnight, and then do pulmonary function testing tomorrow and let my own doctor make the call.
I am trying very hard not to think about how upsetting this all is. I've been in the hospital for all but a few of the last 96 hours, and we don't have much in the way of answers. The underlying inflammation of the asthma should have responded by now to the steroids, and I shouldn't be needing so much albuterol just to have breath enough to speak. Yet I'm not heavily de-satting, so objectively, I'm not in all that terrible a shape... as long as I stay very, very still. Getting up and moving around doesn't do me any favors.
Hopefully we will have some better answers by tomorrow.