Jennifer Van Syckle  0:00  
Many people think asthma is just some childhood illness, you take a few puffs of the inhaler, you get better you get over it. But that's not the case. And today's guest Rachel is going to share the journey of her daughter being diagnosed with asthma. And hang on, because this is one heck of a story. Thank you for joining us for this episode of talking health in the 406 where we're one community under the big sky. I'm your host, Jennifer Van Syckle, longtime health care worker turned health educator.

You kind of been touched in your life with asthma. Do you have a family history of asthma? Like parents, grandparents or anything?

Rachel Anderson  0:47  
I don't. My kids dad does. Okay. So kind of you that sign that he has asthma.

Jennifer Van Syckle  0:56  
When your kiddos were young? Were they would you have considered them healthy? Active? Take us back. How was life back then?

Rachel Anderson  1:05  
Yeah, absolutely. Healthy Kids, no issues at all. They did sports. Just no major health issues whatsoever.

Jennifer Van Syckle  1:18  
And one of your girls developed some issues with asthma. And so what what did that look like? How, how did that first surface? Or what first caught your attention with that?

Rachel Anderson  1:31  
Yeah. So Mia was in sixth grade, she was playing basketball. And she started having some breathing issues during games where she would get very out of breath, and have trouble recovering and coming out of that. So took her to the doctor. And she got diagnosed with exercise induced asthma. And I remember being really surprised and shocked. I thought, No, this can't be right. She doesn't have asthma. She's fine. She's a healthy kid. So she got prescribed an inhaler if she only had to use it during games.

Jennifer Van Syckle  2:15  
So did she would she take it before the game even started just as like a preventative? Or was it just when she started having symptoms?

Rachel Anderson  2:22  
At first, just when she started having symptoms and getting out of breath, and then eventually that evolved into the prevention of taking it. Okay.

Jennifer Van Syckle  2:34  
Okay, and so she would have been about probably like, 12 or so. And that's interesting that it was just being out of breath. And you guys were able to tell, you know, it's not just oh, you're out of shape. You need to run more in the offseason. It was something a little different. It kind of presented itself a little differently.

Rachel Anderson  2:52  
Yes, she was always an active kid. She did lots of different sports. At one point she did softball and soccer at the same time. Never had any issues. Okay. basketball season,

Jennifer Van Syckle  3:12  
till that year. And so then how did it go from there? Did she seem to plateau? And did it did the inhaler work? Or what happened?

Rachel Anderson  3:22  
Next? Yeah, everything worked fine. No issues just went along. And then when she got to be a sophomore in high school, that's when things started going downhill again. And at that point, she was having asthma attacks, just walking up the stairs, in the school. And then she would start having asthma attacks, just sitting in class doing nothing at all just sitting. The inhaler still worked. At that point, it was just getting very frequent. And so back to the doctor again, found out her iron level was very low. So she she was anemic. And iron carries oxygen through the blood. So the doctor explained that when she's anemic, the oxygens not getting carried to her lungs as efficiently. So that was part of the issue.

Jennifer Van Syckle  4:26  
And I wouldn't I would never pay a sophomore for being anemic. Did they ever figure out what the anemia was from? Was it just from like monthly cycles? Or?

Rachel Anderson  4:36  
Yeah, wow. Yep. Oh my gosh, absolutely. Because she, so I'm a dietitian. I'm a nutritionist. I know she her eating was good. She didn't have wasn't doing any of the things with her eating that would cause anemia, like kids that drink excess amounts of milk can become anemic, or kids that don't want to eat meat, for example, but she wasn't doing any of that. So it was definitely the monthly cycles were bad. She was losing too much iron every

Jennifer Van Syckle  5:18  
month. So one issue compounded by another issue. Yeah. Which would have taken you down to completely different specialty paths of care, and pads of care that don't tend to overlap too frequently between respiratory health and gynecological health. Yeah, that's interesting. And so during all that had, you guys received, you know, any extra additional education on like asthma triggers? Or, you know, here's the best way to use your inhaler, or was it just kind of like, Here, try this Med, and walk out the door? Or how do you in hindsight, you know, do you guys feel like you were fighting that asthma? The best you could? Or

Rachel Anderson  6:02  
how do you look back on that? Looking back on it, we definitely weren't, but at the time, with the knowledge that we had, we were doing the best we could. She did go see an allergy and asthma specialist. She had allergies, also seasonal allergies, that would trigger the asthma. So so we did, we did see a specialist, we were taught all of the, you know, inhaler techniques and how to I can't remember the name of it now, but it was a something that she would breathe into that would determine her lung capacity.

Jennifer Van Syckle  6:48  
Okay. Yep. And were the asthma attacks. You know, at that point, were they debilitating? Or were they kind of like, Hold on, I gotta, I gotta stop before I get to my next class and take some puffs of my inhaler. Or were they you know, had you guys ended up in the emergency room at that point in time?

Rachel Anderson  7:07  
No, no, no emergency room it was. It was manageable. She did miss a little more school than than normal. Because of the asthma especially when she would get sick. She got sick. That's that would also trigger more asthma attacks. Okay, so other than missing some school, it wasn't too debilitating.

Jennifer Van Syckle  7:35  
I think a lot of people are, are at that stage and they live with asthma. You know, about we have stats about 16% of Montanans have had to miss work or, or school due to asthma. You know, and 35% of people in Montana that have asthma have had an asthma attack in the last 12 months. And so I think anybody that's getting an asthma attack probably feels like they're in good company. And it's pretty easy to find somebody around them that's in a similar boat. And so then, what, how was the next steps in life? So in high school, she was having more and more asthma attacks. And then can you take us through what happened after that?

Rachel Anderson  8:18  
Once we got the anemia under control, it seemed like things improved. So it was mostly sophomore year, that was the tough time. And then after that, after, after the anemia was under control, and she got on some allergy medication too, to reduce that trigger. It seemed like life just moved on. And she was doing fine. All through the rest of high school. And then really up until so she graduated from high school in 2015. And then in about 2018-19 is when she started having more issues again. And not sure why exactly

Jennifer Van Syckle  9:17  
Okay. And what what does an asthma attack look like? Rach just for our you know, general population what, what, what was your daughter going through when she had those

Rachel Anderson  9:30  
ah, panic is a big, she would get very panicked when you can't breathe. She couldn't talk when she was having an attack. So, but just I just remember that fear that that fear in her eyes, like I can't breathe.

Jennifer Van Syckle  9:58  
And then take inhale or, and, you know, was it seconds after the inhale? She was able to get to her medicine that it would stop? Or are we talking like, you know, I need to sit here for about another five or 10 minutes? And how long? How long

Rachel Anderson  10:13  
was it? Yeah, it wasn't. It didn't stop immediately. And that's the part that kept getting progressively worse, it would take longer for her to recover. So she would have to take several puffs from the inhaler. And then sometimes just rest the rest of the day. Wow.

Jennifer Van Syckle  10:41  
That's that sounds debilitating. That sounds like you know, qualifying for disability, you know? Yeah. And, and so she graduated from high school. Did she continue to live at home? Or did she move away and go off to college, or,

Rachel Anderson  10:58  
yeah, she went off to college in Bozeman didn't really have issues, everything seemed pretty okay. She eventually moved back to Billings and went to college at MSUB. And it really wasn't until probably partway through maybe halfway through 2018 that she started having more issues. Okay. And what,

Jennifer Van Syckle  11:29  
what did those issues looked like? Was it just more frequent asthma attacks? Or was she starting to struggle with her iron again, or

Rachel Anderson  11:36  
just more frequent asthma attacks? They just kept getting more frequent and more severe. Okay.

Jennifer Van Syckle  11:48  
And so was she able to work and go to school? Or was it did she end up having to drop out of that? Could she still function with life?

Rachel Anderson  11:55  
She, she was going to school and working still. She would miss some work and classes sometimes. But But yeah, she was still still going along. She's a she's a fighter. Yeah, yeah. Yeah.

Jennifer Van Syckle  12:15  
She was what 21 By that time? 22. So

Rachel Anderson  12:20  
let's see. So, yeah, 20-21 Okay.

Jennifer Van Syckle  12:27  
So she was just going along, still, with life and asthma attacks were getting more frequent and worse. And, you know, was she just kind of coping with them in the usual way? Or was she having to, you know, travel to see no more specialists trying to get on top of it? Or how, you know, how was that part with trying to cope with it?

Rachel Anderson  12:49  
She she had a primary doctor that she mainly went to, she wasn't seeing a specialist at that point. She she lived on her own. So she wasn't in my house. I and this is one of those things where you look back, you know, the what ifs are sometimes hard. So I didn't know the extent of how bad it was because she lived on her own. And she, she's one of those, you know, I can handle it. Kind of people. It was April of 2019. It was getting really bad. She she had gone to the doctor three times and 10 days, having issues she was going to walk in. Because it's hard to get into. It was hard to get in to your primary doctor. So she would go to walk in. They would give her a nebulizer treatment and she got steroids, five days of steroids. And then then she would be back again. A few days later, still still struggling. On her last visit, to walk in. The provider prescribed her a maintenance inhaler. So up until this point she had only ever used albuterol which is a rescue inhaler.

Jennifer Van Syckle  14:32  
Okay, so like I'm having an attack here. This is what's going to pull me out of it.

Rachel Anderson  14:36  
Yeah, so up until this point, she had never used a maintenance inhaler. She went to the pharmacy to get it. The pharmacy said it had to be pre approved by the insurance first. So she could have gotten it but it would have cost her $400 Oh my gosh out of pocket. So she decided to wait and wait for insurance to know the approval to go through to get. So the very next morning, she ended up in the ER she actually drove herself to the ER that time. Because again, she's, I'm tough and I can, I can handle this and I don't want to worry anybody. But she did she she called me when she got to the ER so I went and met her there. She got several nebulizer treatments in the ER that day. And then they discharged her and, and she went home, we got the maintenance inhaler. So she she started using that. And then it was probably less than a week. I think it was maybe I want to say it was about three days from the first ER visit. Three days later, my niece called me and told me Mia's on her way to the ER in an ambulance. She stopped breathing. And my niece did CPR and got her breathing again. The paramedics were amazing, they got there within minutes. So so she was, you know, in the ER again, this time, they decided to admit her to ICU. And so we're in the ICU, I decided to spend the night with her. And we were laughing and joking. And she seemed good. And I thought, well, she'll get discharged tomorrow and life will go on. So it was about four in the morning. She said mom, I feel Wheezy. And I went and grabbed one of the nurses. And within five minutes, they were intubating. her, she she stopped breathing again. And this is happening in front of me. And it's it's not like in the movies where they get you out of the room and you don't witness anything. It's they are so focused on her. And they they put her in a medically induced coma so that her lungs could heal. And at that point it if she would have not been in the ICU when that happened. She probably wouldn't have survived that, because it happened so quickly. And so, so she's in a medically induced coma. But her oxygen levels were dropping still. So her her lungs could not oxygenate her blood, like like they are supposed to. So she had an amazing pulmonologist that I credit with saving her life at that time, just very compassionate and intelligent doctor and she told us Mia needs to be put on ECMO. So ECMO is a machine that takes all of the blood out of her body oxygenates it and puts it back in so the machine is doing the oxygenating instead of her lungs. And it was this was basically a last resort. If this didn't work, there was nothing else. So so she went into surgery, and she had two large tubes put into the artery in her in her neck. And those were the tubes that took the blood in and and took it out and and put it back in. So so she was getting so that went well. And then her oxygen levels were good. They did have to go in and suction mucus out of her lungs pretty regularly so that the next hurdle was she could only stay in in Billings at the hospital for 72 hours. So they were going to have to send her to Salt Lake and part of the part of the reason for that is when, when a patient's on ECMO, they have one nurse that takes care of them the entire time. And that nurse does nothing else has no other patients. It's just her. And it's a very specialized thing. And there weren't enough nurses to take keep taking care of her. And she had amazing nurses and they even volunteered to work 16 hour shifts, so that she could stay. But there's a hospital policy also in place with that, so so we had to, had to go to Salt Lake. So a team from Salt Lake flew to Billings to get her a lifeflight team of six people came to get her and I couldn't go on the plane with her, because there's all this medical equipment, the medical staff, there's just not room, you know. So at that point, she was not completely stable, it was still pretty iffy. And so I didn't know, you know, saying goodbye, if I would see her again. So she went, she went on the Life Flight. And her dad and I had to drive to Salt Lake. So, so she was going to get there before us. And thankfully, my my sister lives in Idaho Falls. So she drove to Salt Lake and was there when Mia got there. So I was really thankful for that. So we drove all night to Salt Lake, Mia's Dad and I and, and my other daughter came with us as well. And we got there at probably four in the morning or so. And I was able to go see her. And the neurologists came in and said, We're going to wake her up, we're going to we're going to take her out of the of the coma. And I guess they told they said on the flight, she kind of made a a turnaround during the flight there. So for whatever reason, she started to improve to the point where they're gonna take her off of the, you know, out of the coma. So that's what they did. And she she was still intubated for a while, but she was awake and when she when she came out of the coma she was she was making these motions with her hands. And the rest of us weren't smart enough to figure out what she was doing. But she was using sign language. We eventually figured it out. And it was so crazy, because she she took a sign language class when she was in grade school, probably third or fourth grade and hadn't done anything with it since then. But for whatever reason she she remembered. And she was trying to communicate to us with sign language because she was still intubated. She couldn't talk. Oh, wow.

Jennifer Van Syckle  23:53  
That's impressive.

Rachel Anderson  23:54  
Yeah. Yeah. So once we figured that out, of course, the rest of us don't know any sign language. So we still didn't know what she was saying. But we the nurses got her a whiteboard. So she could she could write it down. So she was in Salt Lake for about a week. And she came out of it. She she had some damage to her vocal cords and anybody that knows Mia That was terrible because she is a performer she she loves theater. She would direct plays. Acting was her passion. So to have damaged vocal cords was wasn't the best news. But luckily, they her vocal cords did recover and she was loud as ever. She was actually when all of this happened. She was about to have a performance and she was She had a lead role in this play and then this all happen and she couldn't she couldn't do it because her vocal cords were damaged. So she had to, she had to also do some physical therapy, because this, at this point had been over 10 days of being in a hospital bed. So she was pretty weak.

Jennifer Van Syckle  25:25  
So did they discharge her back to Billings? Like she had to stay back in a billings hospital? Or was it like, straight home from Salt Lake City, straight home, Okay.

Rachel Anderson  25:35  
Hmm. straight home. So at that point, she moved back in with me, because she couldn't. She couldn't work for a while. She, she had to, she had to recover. So and but eventually she she started working again. And we figured out some of her triggers. So before this all happened, she was she loves animals, absolutely loves animals. And so she was working as a groomer. And so we figured out that the chemicals and the all of the animal hair and all of that, that she was around all the time was probably a trigger. And then after she was able to go back to work again, after the ICU, she went to work at Starbucks, where she had worked there before, but this time, the cleaners all that the chemicals and the cleaners that that she had to use would trigger so she she couldn't do it. It was very triggering and and just too risky. For the audience's triggers

Jennifer Van Syckle  26:49  
are what caused an asthma attack basically, right? They kind of just, yeah, they caused the lungs to get inflamed and yeah, oh, gosh.

Rachel Anderson  26:59  
Yeah. So so she got a desk job. And, and that going. Everything was gone pretty well. And then, and then COVID hit. And I was so scared. I thought if she gets COVID, she might not survive it.

Jennifer Van Syckle  27:25  
Thank you so much to Rachel for sharing this story with us. Rachel returns for our next podcast, she's going to share some important messages about asthma, as well as her daughter's heartbreaking battle with that disease. If you would like more information on asthma or anything else you heard on today's podcast, please visit our website at Talkighealthinthe406.mt.gov and until next time, take care.

Transcribed by https://otter.ai