Today 17 of June 2011 at 1330 was the time for my Mannitol asthma test. Because I got my asthma from working in a bus wash in the period of 2005-2007 I am to be granted long term damage payment from the socail security department NAV in Norway, and therefore they have ordered and demanded that I will have to do this test. Before I worked in the bus wash I was as healthy as can be.
Plan was to be able to film the whole thing. I asked them to allow me to do that but the nurse did not approve. But I took some photos instead just to show the machine and so on.
During the last three days I have not been allowed to take any medicine at all. So I was totally unprotected to any of the stuff I get sick from. It has been a hazzle to not be able to take any medicine, and I have gotten ill several times since Tuesday. I have solved this problem to not get sick by trying to avoid people I know smoke and use perfume, and I have used a protective mask to prevent to breathe in fumes I get ill from.
When I came to the hospital I was a bit unsure of where to go. It was a long time since I was at the lung clinic and needed advise where to go, so I knocked at the reception desk window in the main entrance to get help. The lady opened the window smiling. That was nice. But in the same second she opened the window perfume flew out the window in my direction, and I got ill and had an asthma attack all the way from there to the lung clinic and even through waiting to get in and also when I got in. I had managed to stay away from perfume for three days, and when I get to the hospital I get sick from it! : (
I complainted at the lung clinic and got informed that they are not allowed to use perfume there. But they did anyway and I got sick. : ( And I could not take any medicine because if I did I could not take the test, and also then 3 days of struggle without medicines would have been pointless and useless. I could not take any medicine because the medicines would make that the result come out wrong. To take the test I had to be unmedicated.
Well, luckily I came in almost at time after only have been waiting a little while.
I talked to the nurse about the last test I did 3-4 years ago and we came to the conclusion that it was a Metacholin asthma test I took back then. The Metacholin was rather straight forward, even though rather painful and hard. At the Metacholin test I first made a PEF measure to check the before test values of my breathing capability. And after the PEF test I breathed in Metacholin, and after that I took a new PEF breathing measure to get the after value of my breathing capability. During the Metacholin test I got all closed up lungs and could no breathe.
Today it was time to do the Mannitol asthma test of my lungs to state the long term damage. The Mannitol test is more complicated and more measurements are done.
First step of the Mannitol test is that I did a PEF measurement to get the before result of my breathing capability. After that I had to breathe in a gas from a hugh gas tank. I felt a small irritation in my lungs from that and started to cough. And after the gas I did another PEF measure.
Then it was time to do a surrogate test. I was to breathe in a surrogate to see the result of that. I even reacted a bit to the surrogate. And then another PEF measure.
After all that it was time for the real Mannitol test.
The nurse put some Mannitol capsuls in a piece that I put in my mouth and then sucked down my lungs. The test in all is in 9 such Mannitol intakes and the dozes is increased each time. For each increased doze of Mannitol the asthma attack get more severe.
I felt a small reaction on the first try with only one capsule. Then took a PEF measure for the after result. Then she gave me a higher dose on the second try, and then a new PEF measure to see the difference to the first. On the third go she gave me two capsules with an even higher dose and I got all tight in my lungs, and after that a new PEF measure to see the effect on my lungs and breathing ability. Fourth go with the Mannitol and even another increased dose in two capsules and another PEF measure after to see the difference. When I came to the fifth and increased dose of breathing in Mannitol it got really bad. It was really bad, I felt my lungs take a long pause and hold, and I could not breathe. After the fifth PEF measure the values was so bad that she said the rules obliged her to stop the test.
So what does that mean that I could not take all the nine Mannitol doses? It actually mean that my asthma is so bad that I could not take all the doses in the test. If my asthma would have ben less aggressive I would have been able to take all the nine doses of Mannitol. But with my asthma I could only take five doses.
After I got the fifth dose of Mannitol it was very hard to breath,and breathing even stopped. Serious stuff.
In the photo above the dark blue lines shows my lung function before the test. The green lines shows what measure would have been expected during the test if I were a person without asthma. And the red lines shows my lung function after the fifth breathing in of Mannitol. It is a big difference. It was so bad she actually stopped the test. If she would have gone further it could be dangerous for me.
And now I will tell the naked plain truth about asthma. This happens every time I or another person with asthma is subjected to any of what we get sick from either it is perfume, tobacco smoke, dust, hairspray, exhaust, or whatever it might be. It happens exactly as it does in the test, only in the test another substance is used to start the attack.
When she finished the test I got medicine. Ventoline in an Optichamber. And that was lovely! First medicine in three (almost 4 days) and being able to breathe again after the test was a blessing in itself.
And then it was time for the talk with the doctor. It was an interview about what my experiences is with what I react to and get sick from, and such things. Then I was done.
The doctor will write his notes and inform the social health security department the results.
Now I am going to take som medicine and enjoy it. :)
ps. If you are about to have an Mannitol or Metacholin test done on you I have two things to say. Yes, it can be a bit stressful, dramatic and maybe even scary. But you get medicine after so you will get better. The hours and the day after you can be a bit sore in your air-ways and you might also be a bit more sensitive then else to irritants and allergens. So try to stay away from that and take your medicines. Just relax and follow the nurse’s/doctor’s instructions and you will be fine.