Shayna R

Shayna R., WA

I was diagnosed with asthma when I was in my mid-20s. Every year I would get this horrible cough for months and there weren't any real answers as to why. Then at 25 years old, the coughs were paired with being out of breath and I was diagnosed with adult-onset asthma. I'm 38 now. Over the last 13 years, the amount of times I've had to go to urgent care or the emergency room for breathing treatments was less than a dozen. My asthma was well-controlled with a daily inhaler that I used twice a day, and I had my rescue inhaler and albuterol on hand. I would get flare ups, but it was well-managed.

Last fall, Washington state was hit hard with wild fire smoke. I've always been mindful of the smoke and if it got bad, I would stay inside, and if I had to go outside I would have a high-quality mask. This year it was different; the air quality was the worst I'd ever seen, and it lasted so long. At one point we had the worst air quality in the entire world! There was no way for me to avoid it completely, but I still took precautions. I was using my inhalers and had even used my nebulizer, and it wasn't getting better. I went to urgent care on Oct. 20th, and they prescribed me the standard breathing treatments and started steroids. Two days later, on the 22nd, I went to the local emergency room. They were on the fence with admitting me and told me that what they would do at the hospital is typical to what I could do at home, so I opted to be able to go home. They increased my steroids. I actually thought things were getting a bit better on Sunday and Monday, but on Tuesday the 25th it started to get way worse. I had scheduled an appointment with pulmonology after the first urgent care visit, so I went to my appt at 3pm. The PA was very clear that if things got worse--even just a tiny bit--I needed to go straight to the hospital. He was clear that I was not to call him, not to go to urgent care, and to immediately go to the emergency room. He gave me a different solution for my nebulizer and extended my steroid dose.

I went home that day and we went through our typical routine. While eating dinner, my chest started to feel heavier. I felt like I couldn't take any breath--my chest just wouldn't even move. I told my husband he needed to take me to the emergency room and he could tell by my voice not to ask me any questions. We live 5 minutes from the hospital but during that short time, by ability to breath got even worse. When we walked through those doors and went to the check-in desk they immediately took my back to triage. They checked my O2 levels, did a ECG, gave me breathing treatments, a shot of steroids, and monitored me. Unfortunately, I didn't respond well to any of it and they moved me back to a bed. I was on non-stop breathing treatments and they finally made a call to use non-invasive ventilation with a BiPap machine. The second they put that machine on me I felt like it was the first time I'd been able to breath for hours, but I still couldn't get enough air. The respiratory therapist was worried to turn up the machine anymore, for fear that my lungs might pop, as they were rock hard. I was still in crisis, I wasn't breathing well, and I laid there while they discussed the possibility of intubating me. Everything reached peak crisis, I was moved up to the ICU, given sedatives, and I don't really remember much of the next few days. I remember being on BiPaP and constant breathing treatments and IVs with steroids. The sedative continued because without it, the panic of not being able to breath made the asthma attack even worse. After a few days, I was able to move out of the ICU and into the regular part of the hospital. I was discharged Saturday, with the instruction that recovery would take a while from something as significant as this, and I needed to be under my doctors' close watch. Later that day I returned to the ER when I became head-to-toe covered in hives, which we later found out to be related to an allergy to prednisone. They got it under control and sent me home. Less than 10 hours later I was back again, covered in hives again and also covered in mysterious bruising. Bruises on my hands and forearms were popping up in a matter of minutes. Ultimately it was thought that was also tied to the prednisone allergy.

I thought my recovery after that would be quick-- I WAS WRONG. I felt like I could barely walk, and I was so tired. I was on decadron now, replacing the prednisone, and any time over  the next month that they tried to drop me down, my ability to breathe was severely impacted. I was still doing breathing treatments every four hours and was on 23 different medications a day.

Eventually, the prolonged exposure to steroids took a toll on my body. Over a month later, on December 5th, my entire body ballooned nearly 25 pounds. My body felt so heavy. I was still struggling to breath well and started to have horrific panic attacks. I was then diagnosed with Cushing's syndrome, which was causing these continuing health issues, the heaviness, and the psychological side effects. We had to make an immediate plan to taper off steroids. Fortunately, I started Nucala injections around that same time, and saw an immediate improvement in my lungs. By Jan 6th I was all the way off steroids and while my asthma was better, the rest of my body would take until April to get back to "normal." I'm still not all the way there, but I'm close.

The wildfire smoke set this all in motion. My doctor explained to me that wildfire smoke isn't like any other type of smoke. It hits your mucus and turns to acid. People with no asthma issues can struggle to breath, and for me...I ended up almost dying. I have flashbacks all the time about laying there thinking I was going to suffocate when I was on that Bipap machine. My daughter died at that same hospital, just down the hall, 7 years prior. She was just 10.5 months old and the hospital already carried incredibly heartbreaking memories, despite my unwavering support for the staff there. When I was in the worst of it, I kept thinking that I was going to die right where my daughter was pronounced dead, and my husband and mom would have to just sit and watch it happen.

Thankfully I am okay, but the effects of the wildfire smoke weren't just physical for me. The PTSD and triggering events from that week continue to be something I have to manage. This sounds alarmist, but I think things might cause me to die all the time. I now, still, randomly break out in hives two to three times a week, which we're sure the anxiety and stress contributes to. I often fall asleep with the hives and think, "Here's hoping I don't suffocate in my sleep."

My youngest daughter is afraid if I am gone from home too long. She wouldn't leave my side for a month after I got home, but brings it up constantly. My husband silently watches to make sure I'm okay every day. My mom struggles to talk about it.

We need clean air. I need cleaner air. My lungs, my heart, my family...we can't wake anything less.