Clinical Significance?

Wed, Feb 27, 2002 10:43PM -0600

I guess sometimes great historical events turn on simple medical facts. Would Franklin Delano Roosevelt have been the man of character he was during World War II if he hadn't had polio? Would the 1980s have been the decade of decadence and greed it was if Ronald Reagan hadn't been demented? Would the U.S. still be a British colony if George III hadn't had acute intermittent porphyria? Maybe Henry VIII could've gotten Catherine of Aragon pregnant if he hadn't had syphillis, and then maybe the Church of England would never have split off. Maybe Constantinople wouldn't have fallen if it hadn't already been ravaged by plague. Or maybe the white man might have failed to establish himself in the New World if the natives had been immune to their diseases.

Such were the thoughts that ran through my head as I ran on the treadmill today. Ah, the simple pleasures of physical activity, I suppose. And the benefits of higher education as well. Now that I know a little more about pathology, I realize that I've never really "outgrown" my asthma. As a child, I used to have a lot of episodes where I couldn't breathe, complicated by recurrent infections. My parents thought it was mostly because of my tonsils, so I had them removed when I was 6 (back in the day when you still had to be admitted to the hospital for tonsillectomies.) Apparently that did solve some of the problem, since afterwards I didn't get sick as often. But perhaps they never considered an underlying cause.

It wasn't until last year when I noticed that if I exercised, I'd start wheezing. I assumed that it was only because I was terribly out of shape. Then I recalled a six month episode my junior year in college when I was constantly coughing without any mucus production, to the point that my parents recommended I get a chest X-ray (negative of course.) The cough eventually just spontaneously resolved. And then I was introduced to pharmacology this year, specifically beta-agonists and phosphodiesterase inhibitors (one of the more popular ones being caffeine), solving my wheezing during exercise. Ah-ha! I think I've got exercise-induced asthma.

Of course, yes I know, I'm not a doctor yet, and no doctor has ever been good a diagnosing themself anyway, but as far as I can tell, it works. Some Primatene, maybe even just a can of Diet Coke, seems to do the trick. (WARNING: This is the kind of thing that can give you strokes and heart attacks too. As I said, IANAD. If anything you read on this site somehow kills you, I didn't tell you to do it. It's not my fault. And if you sued me, I'm not sure what I could give you, since I will soon have a debt of a quarter million dollars.)

So I remember all those times in high school when I had to run half a mile on the track, and how much I dreaded it because I'd get tired really easily, and how much better it might have been if I had known why, and how different my life might have been, but I suppose that that's the way things are. The only good use for "what-ifs" are science-fiction and fantasy.

e-mail: aswang@earthlink.net

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