Sunday, January 8, 2017

1970: The Beginning: Born with asthma genes

I was born on January 4, 1970. I was born with asthma genes. None of this was known at the time. In fact, not even scientists knew about asthma genes.

It wouldn't be until about 30 years later that the concept of asthma genes was even conceived.

I cannot guarantee this, but based on what I have read to this date, I can state with some degree of confidence that I was not born with asthma.

Does that make sense? I was born with asthma genes. In fact, i was born with a random assortment of the over 100 asthma genes. This meant that I had genes that were ready to tell my immune system to do something abnormal. However, this wasn't about to happen until these genes were exposed to some "environmental factor."

Environmental factors are substances around me, either in the air or inside me, that act as "keys" to turn genes on. Examples of environmental factors may include particles or chemicals in the air, such as those produced from wood or cigarette smoke. They may also include allergens, such as dust mites, pollen, mold spores, animal dander, cockroach urine, non-steroidal anti-inflammatory medicine (like Aspirin), an certain foods (like eggs, nuts, peanuts, etc.). Another example are respiratory infections, such as those caused by respiratory syncytial virus

So, I do not think people are born with it. Now, this is just my theory, but it's based on pretty good research. In fact, I think most asthma researchers would agree with me.

I know I was exposed to cigarette smoke from an early age. Mom didn't smoke, and dad didn't smoke in the house. In fact, I really don't have any memory of dad smoking in front of us kids. Whether or not he did when i was very little I would have no idea, and mom denies allowing him to smoke in the house. When we were at grandma ans grandpa Bottrell's house, though, I was exposed to smoke. I have some good memories of grandpa smoking. And, when we were over at their house, other people smoked too.

I was probably also exposed to viruses. But what I think caused my asthma, or turned on (activated) my asthma genes, were allergens. Mom says I was always sneezing, wheezing, and breathing heavy, and so I think I was exposed to allergens. I was exposed to dust mites particularly, and seasonal mold and pollen. Day after day exposure to these, perhaps coupled with smoke and viruses, caused me to develop allergies and asthma prior to the age of two.

My mom might have taken me to see the doctor. It was at the corner of U.S. 31 and 8th street. I can picture myself as a baby with a snotty nose and retractions. The doctor (was it Dr. Gunderson back then?) probably prescribed some over the counter medicine and sent me home with my mom. Considering both my memories and peer reviewed medical articles from the time, I highly doubt I was prescribed antihistamines, which I'm convinced would have helped.

There is some evidence that viruses (such as RSV, influenza and para influenza) may damage lower airway cells in such a way as to make a person susceptible to developing allergies. This would have caused me to develop a hyperactive immune response to allergens. And this response to allergens would have caused upper airway inflammation, which in turn caused the sniffles, wheezes and runny nose. it probably also caused rhinitis, which made my nose stuffy and caused me to breathe heavy.

Can you imagine how miserable this would have made me feel. And add into this the fact my older brother was annoyed with all the noises I made, particularly my heavy breathing. No matter he and I had issues getting along when we were growing up.

And I think the allergies, coupled probably with the virus induced asthma, probably ultimately lead to me developing lower airway inflammation, which made my lower airways hyperactive (twitchy) to asthma triggers, which included most of the allergens listed above and some.

There is evidence that allergies make colds more severe. So, every time I got a cold, every time i was exposed to allergens, I suffered from the gamut of symptoms: stuffy nose, runny nose, sneezes, wheezes, chest tightness. nasal irritation, scratchy throat, etc. I remember all these symptoms. I remember my eyes itching. I remember it all. No wonder I was a nerd as a kid. No wonder I had a low self esteem. No wonder why I became depressed in November of each year. No wonder I sat on the bench during school rather than participate in recess.

Of course, most of that would be later on. But, it all began with asthma genes. My genotype included asthma genes. My phenotype was allergic asthma. My endotype was a combination of cytokines, chemokines, histamine, and leukotrienes that were abnormally produced at increased levels by asthma genes and secreted by immune cells. Over time this got worse and worse, especially as I was increasingly exposed to my asthma triggers. And this lead to me developing severe allergic asthma at an early age.

Anyway, something turned on my asthma genes. Another theory is that it was allergies. Still, something had to turn on my allergy gene. So, perhaps a virus or chemicals turned on my asthma genes, and allergies turned on my asthma genes. Who knows. What is known is that I did develop asthma.

I talked to mom about this many times in my life. Her story has been consistent. She said I had a constant cold the first two years of my life (a virus, perhaps? Or was it allergies already?). She said I would stand up in the car and breathe heavy. My older brother Bobby hated the sound of my breathing, so I would have to stand in the front seat.

Okay, I know you are asking: "Why was he standing in the car?" That's just what we did. I have memories of standing in the car. I remember standing in the back seat. This was nice because then you could see. Back then, back in the 1970s and 1980s, kids were safe in cars; kids did not die in accidents. Nothing killed us. The idea of car seats was not even an idea.

So, mom says I got dibs on the front seat. I stood in the front seat, she said. I would often fall asleep, and breathe heavy. I breathed heavy even when I wasn't asleep.

As a side note hear. Seatbelts weren't worn then either. The only seatbelt for me was, when mom slammed on the brakes, her hand automatically went up, as though it would be strong enough to prevent me from shooting out the front window.

Okay, so mom was my seatbelt. Those things on the seat were just annoying knobs that you had to sit on. They were not used. Seatbelts were never used.

I'm sure there was medicine that would have helped a snotty kid who probably had retractions. his chest was being sucked in, but nothing was done. I'm speculating here. But, based on my experience as a respiratory therapist, I bet if I had a head cold all the time, I probably also showed some signs of asthma, and maybe even some severe signs of asthma. And it was all brushed off as a cold, even by my doctor. And so any medicine that would have helped me was no better than the seatbelts.

Not my parents fault here. Not my doctor's fault here either. It was just the way it was back then. They did not know I had asthma genes. The probably didn't know I had asthma. It was not uncommon for it to be brushed off as a cold.

So, I breathed heavy. I had a stuffy nose all the time. I was always coughing. I had snot on my nose. I was diagnosed with asthma when I was two-years-old.

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