rain

they dont actually explain what was happening, but they showed definitively that i was having trouble breathing. and that i had high neutrophils when i didnt a month ago, and that could be an indicator of neutrophilic asthma which would fucking explain why steroids arent working to control it, that's a known problem. and that my temperature and blood pressure actually went up significantly while i was in the ER. i have actual evidence now beyond trusting that a provider knows that you cannot "force yourself wheeze" in your lungs. my body was acting like i was having a hard time breathing because I fucking was.

at least they didnt label it as anxiety, i know they do that a lot, but i'm so used to medical bullshit that i dont actually freak out about it. which may be why the first doctor claimed "no chest pain" even though the chest pain on the right side of my body when I breathed deeply was the reason I went to the ER, because that was new and abnormal and my rescue inhaler didn't do anything. it didnt sound like i was in distress bc i wasn't talking a lot, because i was focused on breathing so i don't get fucking brain damage from hypoxia, and you didn't ask me if my chest hurt. the whole reason i was there was because it hurt to breathe at all and i had to manually force my lungs to expel all the air. i'm not going to mention every symptom I have unprompted when I have to time my breathing to be able to talk. when every other provider that interacted with me went "oh i hear it" about the wheezing when I wasn't taking deep breaths and you didn't, I think that just means you're not a great doctor.

btw this blood draw was AFTER I'd already started feeling some improvement and then it got worse again. I still had the chest pain. they discharged me without retesting to see if the levels were normal or without any additional intervention beyond the nebulizers and prednisone, with a methlyprednisone prescription, after an extensive discussion with the doctor who very clearly was like "yeah idk what else we could even do for you here aside from more nebulizers" after i expressed concerns about it getting worse again once i left. pulse oximetry never dropped below 95% while they were drawing blood for this - the lowest I saw it get the whole time I was in the ER was 89%, while I was talking to the first doctor and hadnt gotten any medication yet. and yet clearly the venous oxygen levels showed something weird and abnormal was happening.

so why the hell didn't they do more testing?

when someone dies because this ER sent them home without doing basic due diligence, i will not be surprised. your reaction to someone very clearly in some amount of medical distress because their body is consuming more oxygen than they can adequately supply should not be "welp, we gave a bronchiodilator and steroids, that's all we can do!" it should be FUCKING FIGURING OUT THE CAUSE. They didn't test my sputum to see if it was neutrophilic asthma, which should have been the obvious next step! i don't have a medical degree and i could figure that out from basic googling of what high neutrophils mean during an asthma attack! I had to ask them to run swabs for COVID, RSV, and influenza because that was the first thing they did in my previous ER asthma visits and no one ever swabbed me when I came in on Tuesday!

The whole reason I had to go to the ER, I would venture, is because their hospital system doesn't have a fucking asthma specialist! When i was referred to their outpatient pulmonology clinic because my asthma is still getting worse despite my PCP's best efforts, I got sent to a doctor who primarily treats COPD patients. She told me that since I was already on high dose inhaled steroids and didn't otherwise qualify for biologics (would need to be prednisone dependent for 6 months), she didn't know how to help me. This is literally the only hospital system in the county and they don't have a doctor who knows how to treat what is, on paper, uncontrolled moderate asthma? come on.

they dont actually explain what was happening, but they showed definitively that i was having trouble breathing. and that i had high neutrophils when i didnt a month ago, and that could be an indicator of neutrophilic asthma which would fucking explain why steroids arent working to control it, that's a known problem. and that my temperature and blood pressure actually went up significantly while i was in the ER. i have actual evidence now beyond trusting that a provider knows that you cannot "force yourself wheeze" in your lungs. my body was acting like i was having a hard time breathing because I fucking was.

at least they didnt label it as anxiety, i know they do that a lot, but i'm so used to medical bullshit that i dont actually freak out about it. which may be why the first doctor claimed "no chest pain" even though the chest pain on the right side of my body when I breathed deeply was the reason I went to the ER, because that was new and abnormal and my rescue inhaler didn't do anything. it didnt sound like i was in distress bc i wasn't talking a lot, because i was focused on breathing so i don't get fucking brain damage from hypoxia, and you didn't ask me if my chest hurt. the whole reason i was there was because it hurt to breathe at all and i had to manually force my lungs to expel all the air. i'm not going to mention every symptom I have unprompted when I have to time my breathing to be able to talk. when every other provider that interacted with me went "oh i hear it" about the wheezing when I wasn't taking deep breaths and you didn't, I think that just means you're not a great doctor.

btw this blood draw was AFTER I'd already started feeling some improvement and then it got worse again. I still had the chest pain. they discharged me without retesting to see if the levels were normal or without any additional intervention beyond the nebulizers and prednisone, with a methlyprednisone prescription, after an extensive discussion with the doctor who very clearly was like "yeah idk what else we could even do for you here aside from more nebulizers" after i expressed concerns about it getting worse again once i left. pulse oximetry never dropped below 95% while they were drawing blood for this - the lowest I saw it get the whole time I was in the ER was 89%, while I was talking to the first doctor and hadnt gotten any medication yet. and yet clearly the venous oxygen levels showed something weird and abnormal was happening.

so why the hell didn't they do more testing?

when someone dies because this ER sent them home without doing basic due diligence, i will not be surprised. your reaction to someone very clearly in some amount of medical distress because their body is consuming more oxygen than they can adequately supply should not be "welp, we gave a bronchiodilator and steroids, that's all we can do!" it should be FUCKING FIGURING OUT THE CAUSE. They didn't test my sputum to see if it was neutrophilic asthma, which should have been the obvious next step! i don't have a medical degree and i could figure that out from basic googling of what high neutrophils mean during an asthma attack! I had to ask them to run swabs for COVID, RSV, and influenza because that was the first thing they did in my previous ER asthma visits and no one ever swabbed me when I came in on Tuesday!

The whole reason I had to go to the ER, I would venture, is because their hospital system doesn't have a fucking asthma specialist! When i was referred to their outpatient pulmonology clinic because my asthma is still getting worse despite my PCP's best efforts, I got sent to a doctor who primarily treats COPD patients. She told me that since I was already on high dose inhaled steroids and didn't otherwise qualify for biologics (would need to be prednisone dependent for 6 months), she didn't know how to help me. This is literally the only hospital system in the county and they don't have a doctor who knows how to treat what is, on paper, uncontrolled moderate asthma? come on.

Hot tips:

Read your insurance handbook

Laugh at it for the audacity

Read the secret employee policies you can find via google because security is shit, and highlight keywords needed for approval

Research "how to get X thing approved" both general and your specific medication/service

Look up templates that people used to get approved with

Show to doctor as well as explain each step that will be required

???

Profit

Ancient disabled wisdom: There is no Can there is only How

the physical muscle movement required to speak

staying awake

reading and writing emails

standing to perform basic self care tasks like eating, using the bathroom, and getting water

eating and digesting things

standing and walking places

etc. i can barely keep myself alive much less have energy to do the things I need to to keep my body functional enough to do things like arguing with an insurance company.... like retrieving the meds i already have coverage for so i'm in a healthy enough physical state to even make a phone call.