I feel like I need to talk to others who understand about the anxiety of the decision about what to do in the upcoming month. I have adult- onset asthma. It hit me hard about two years ago and it took us a while to figure out that my triggers are viral (that’s the worst), air quality, smoke, mold and dust mites. I am on high doses of everything- dulera, spiriva respimat, montelukast, prednisone 15 mg. , and biologic Dupixent. I am still experiencing breathing symptoms -SOB, coughing and nighttime coughing and waking up and often needing my inhaler or nebulizer. I’ve been hospitalized twice for an asthma exacerbation- both were viral induced and had bad air quality on top. One was 9 days, the other 5 days.
I am a teacher. After the second hospitalization my pulmo said I should not go back to teaching. I cried. Teaching is what I do. I teach English to non- English speakers in elementary school. So, my anxiety is what will I do when my school asks or tells me we are returning back to our school building. If I say I need to do online work, then I lose my students. If I go to school, I could easily catch the virus and potentially have a very bad reaction. If I talk to my husband he starts to freak out. I am feeling alone in this worry. Anyone else have the going on?
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Shadowcat04
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I'm a teacher too and have had some concerns about returning to work in September. Some may not understand but I know mentally I feel better going to work and seeing my students. I think it's a case of risk assessment. Take the advice of your doctors and school but also weigh up how you feel? It's very easy for someone to say don't go back to teaching but you may end up feeling worse and stressed not doing it?
Ultimately it's your choice. Maybe chat it through with your gp or asthma nurse? I find them more helpful than family members as they tend to give more rounded advice! Remember, whatever you decide is not set in stone. We're all just taking this one step at a time!
I'm not working now but was teaching small people for many years. So many people said it was the children causing me to be I'll but, honestly, apart from one or two occasions I could pinpoint, I always felt I wasn't picking things up from the children - often they'd have runny noses, coughs etc, and I wouldn't get them. Yet a member of staff full of cold coughing all over the staff room and I would. Ok that's just me and on covid is unknown, but maybe there is something in children not spreading things as much as people think.
Yes we are vulnerable, some of us extremely vulnerable, and will still be in September. But.... infection rates (at the moment) are hugely lower so therefore the risk is lower not sure that'll stay the same now people will be congregating in pubs and so on but hey we'll see in 2-4 weeks time) and it may be that asthmatics aren't in future vulnerable groups anyway as asthma hasn't been as big an issue in terms of serious illness as they thought it might be.
As ReedB says, no-one really knows but it would be good if you could discuss your particular situation with your specialists - and work if you can.
Its definitely not an easy decision to make and something that has to be very personal. In terms of your asthma treatment generally - have you ever tried azithromycin or oral theophylline/aminophylline? (In case you haven't its something else you could ask about!).
If I remember correctly you're in the US right? So things will be a bit different to how they have been here in the UK. Here all asthmatics have been asked to be particularly careful with social distancing etc and those of us with severe asthma have generally been asked to "shield" (stay indoors essentially since March!) - which is starting to relax now.
Over here people who have been shielding can return to work from the start of August PROVIDED that the workplace have done risk assessments and steps have been taken to make it "COVID secure" - something that is obviously much more difficult in something like teaching!
The main thing I guess would be to keep an eye on the cases and hospitalisations in your state, talk to your specialist if you can and most importantly keep talking to your school. Ask them what measures they are putting in place, get them to do an individual risk assessment with you and essentially make a nuisance of yourself to get all the information you need about what would happen in different situations! Then that will at least give you more information to go on to make a decision - but again, remember that its totally personal.
For example, I'm still hospitalised with my asthma pretty much monthly and am on lots of steroids etc still to "try" to control it but I have decided to return to my medical school placements next week despite my city being on local lockdown. BUT that is only because I've had lots of discussions with occupational health, my medical school, infection control, hospital directors and placement organisers about it to make plans. I'm being given additional PPE well above the standard amount needed, have adjustments to my timetable so that I'm basically only seeing patients who have been shielding like me and am being kept in the loop about the infection rates coming into hospital. I also have online shopping deliveries sorted so don't need to leave the house for anything other than my placement.
So its only because of all of that that I feel happy to return, and am well aware that if things change in my local area I will probably have to step back, and that's fine.
I'm aware this has been pretty waffly but the main thing for me was getting all the information possible and having lots of discussions with others about what was best for me, taking all factors into account. And also the fact that my decision isn't set in stone - just because I've said I want to go back now doesn't mean I have to stay on placement if things worsen again.
Thank you. All your ideas and thoughts make me feel better and have given me some different things to think about. I will talk to my doctors about it, though I’m pretty sure I know my pulmo’s answer! I have other doctors to talk to.
Js 706, I did try a long round of antibiotics- didn’t seem to help at the time. I am currently being tested for low immunoglobulin levels. I had a test that showed low IgG. So, they had me do a pneumonia titer (they were not good), then do the pneumonia vaccine, wait 6 weeks, the. I do the titers again. If the titers are still low, they look at immunotherapy I think. If that could solve my ongoing symptoms,that would be great.
Yes, I am in the US. I am very jealous of you all in the UK. You have a national plan. They actually told you to shield. I am stuck with a president that doesn’t even believe we have a problem and won’t wear a mask. My state (Oregon) has done a pretty good job and the numbers are just now jumping. My husband has been doing almost all of the out of the house chores. My teenage kids have been doing most of the housework. I have been exhausted and on the couch. We are actually going backward from opening right now because our numbers of COVID infections are rising instead of falling. And, as you may be aware, the US is a mess and infections are rapidly rising and several states are in crisis. We, in Oregon, are not there, yet.
However, being on the rise, opening schools in 1-2 months seems crazy.
I have low IgG and am on immunoglobulin replacement for it so feel free to message me if you have any questions about the testing/treatment for that side of things
Did they do the vaccine while you were on maintenance steroids? My team wouldn’t do the test while on maintenance pred above 10mg as it affects the results (I just ended up on treatment because my IgG dropped so low that they said I probably wouldn’t respond to the vaccine regardless of the steroid dose and I had had 2 or 3 pneumonias requiring hospital treatment in 6 months)
Js706, your situation sounds very similar to mine. I was in the hospital Nov. 2019 and March 2019, both for viral illness, turned into bronchitis with bad air quality on top. It took about 8 weeks to recover from each. So, I had barely recovered from the last hospitalization when COVID came up. I wondered about further testing since I’m still on pred. 15, but they went ahead.
What is the immuno replacement like? Did you notice a difference? Were you able to stop other drugs? I’m not sure if my biologic-Dupixent is working or not. Have to ask doctor about that.
I guess at least if they knew you were on the pred then they will know it might affect the results. Have they put you on a regular antibiotic? As that's normally the first stage of treatment for low IgG regardless of the vaccine response. And how long till your retest?
I've always had lots of infections as long as I can remember (long standing problems with chronic sinusitis, catching every single winter virus etc!) and my IgG got picked up as part of my initial assessment at my severe asthma specialist. Although it was before I got stuck on pred I then got put on maintenance which delayed everything massively from the immunology side! Then as I said in my previous reply it got to the point where they had to give in and try for approval as things had got so bad with it as my IgG continued to drop and infections got more frequent and worse.
So I started subcutaneous (SC) replacement therapy last September. The other option is IV. IV is normally every 3 weeks or so and requires a day trip to hospital in most cases. SC is a smaller dose and done weekly at home after being trained. I infuse the drugs into the fat in my stomach for about an hour and a half every week via a couple of small needles, its a bit weird at first but fairly chilled out and easy!
It has honestly made such a difference to my life though. Things aren't perfect by any means and I still have severe asthma that is uncontrolled BUT from an infection point of view things are so much better. Since last September I've only had 4 or 5 courses of antibiotics and 2 "bad" viral infections (had a few more mild ones too but they haven't been a bother), whereas beforehand it was antibiotics every 4-6 weeks and pretty much constant viral symptoms. Pretty sure I've only had one, maybe two pneumonias as well, whereas I had 3 in the 6 months before starting!
I haven't been able to stop any other drugs but it has helped a lot with my general day to day fatigue symptoms and has given me some form of a life back! My admissions are now more like 5-7 days or so rather than the 2 weeks or so they were getting to beforehand as well, which is much more manageable.
Hi shadowcat. I’m a fellow American (though I live in France right now) and ESOL professional I’m no longer a teacher but I would completely have the same angst if I were in your situation. I have severe asthma and adrenal insufficiency and I had Covid for a month in April and I was ok just in case it’s helpful to hear a success story.
I can’t give you any advice other than to listen to your GP and your instinct.
I’m so sorry for how messy and angry and disorganized everything is in the states. It’s heartbreaking to watch from here.
Hi, I am a retired teacher with severe asthma so can feel your anguish and heartbreak. It sounds like you are quite ill just now and often, when ill, we don't make good decisions for ourselves. Perhaps you could try working online for a short while till you really feel better. Maybe your school could arrange for your students to talk to you online. Your husband will be thinking of your health .. I know how often mine wished I would just stay home when I was very unwell. Often now, I wish I had! Good luck with your choice. Try not to make it till you have to and remember your health. 💜
Thank you for your responses and ideas. Js706- I used to have tons of infections. When I turned 18, I started having strep throat-like infections, like 3-5 a year. It was horrible. Usually negative for strep, but cleared up immediately with antibiotics. I dealt with that and sinus infections mixed in until I was 30, when I finally had stable insurance because I started teaching in a classroom and had my tonsils out. I’ve never had strep since. Then after having kids (age 32 and 34), I started having other issues after the birth of my kids. I had severe anemia, requiring a surgery, blood transfusion and a lot of recovery. I had my first virus that led to uncontrollable coughing and bronchospasms and and ER visit for neb treatments. After that, I had sporadic viral infections that sometimes led to needing inhalers. At 47, I caught a viral cold that stuck with me and led to several ER visits and meds and doctors. Since then, I’ve had a few periods of control and my asthma has gone from “mild intermittent” to “moderate intermittent” to “moderate persistent” to “sever persistent uncontrolled”.
Thank you for the teacher responses. I am on the committee for my school giving suggestions to the district about how we might do school in September. I am in a pretty cautious state and my district has been pretty supportive of teachers with underlying conditions so far. I guess it’s the loss that I’m dealing with. I’ve worked for 12 years to make a strong ESOL program for my kinders through 6th graders. If I step out, it is likely that what I built will be gone. It brings me a lot of sorrow. You are right to wait and see what happens, though. Even though that is hard, it’s probably the right thing.
May 2019 my asthma was the worst it had ever been. I had zero quality of life, chronic sinus pain and earache. The symptoms were there all the time, pain was severe and I could do very little without severe SOB. I was off work alot. I was taking everything that I could to try and help. I asked to work from home. My boss said you are too unwell to work. All I could think about was how would I get by if I wasn't working. I talked it over with my family and they would all support me. While I struggled with the decision about work, everything was awful. Once I decided I had to be off for a while and accepted it, I was able to just rest, cope with my asthma and my brain was quieter. Another user said the decision is not carved in stone so you can change your mind at a later date. It's OK if you can't work for a while. I understand if it's not possible for everyone to do this but it might not be the worst you ever do. It's hard to cope with being as unwell as we are at times. I hope things get better for you.
Thank you, Hamscoul. It is definitely a hard choice to not work. After my first hospitalization, I thought I’d be ready to go back to work in a week or so. But, no, I could barely function and my pulmo informed me that maybe shouldn’t go back to school at all. We decided I should stay home at least 2 months. That was hard, but also a relief. I got to go back to school at the end of the school year. Then, it happened again at the end of October. I was in the hospital at the beginning of November and again on medical leave until January. I still don’t feel recovered. I’ve already had 2 long leaves of absence, Will the district get tired of that happening? I’m only 49, not ready to retire.
AND our insane president said today that all schools need to open fully in the fall. But, he says the virus is mostly gone and is 99% harmless, too. All of that is false. Sorry, no politics. It’s just that it can effect my health and even my life.
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