Worn Out Lungs

Just about every asthmatic I’ve spoken to over the past couple of months agrees that this past year has been one of the worst.  My pulmonologist/immunologist corroborates that, and says that he’s seen far more urgent flareups this year than normal.

In a way, this is reassuring, because it means that I’m not alone in what appears to be this permanent flareup I’ve had since June.  On the other hand, it really doesn’t alleviate my symptoms.  I haven’t had a good strong breath for weeks, and I’m constantly coughing and wheezing.  I’m pretty fed up with it.  At least I can work from home so I haven’t had to use any sick time.

My doctor’s frustrated as well, because at this point I’m pretty much maxed out on therapeutic drugs.  I’ve got the maximum strength of Advair, I’m taking Singulair, plenty of Albuterol, and Aciphex (a drug used to treat GERD, because sometimes mild GERD can, even if no symptoms are reported, cause an asthmatic flareup).  And yet I’m continuing to wheeze.

There’s one more option on the horizon: Xolair, a relatively new drug developed by Genentech.  Xolair operates by going in and neutralizing Immunoglobulin-E (IGE), a protein which is associated with allergies.  IGE is almost always found in high levels in people suffering from allergies (though the presence of high levels of IGE does not necessarily mean you have severe allergies), and people with low levels of bloodstream IGE very rarely suffer from allergic symptoms (again, a high correlation, not a guarantee).  Despite plenty of research, no real purpose has been found for IGE in the immune system.  Early research indicated that IGE might be important in the body’s immunological response to parasitic infection, or in the early detection of certain kinds of cancer, but more recent research seems to contradict these results (in brief, people with allergies don’t have any lower incidence of cancer or parasitic infections than people without allergies).  My pulmonologist already has about a dozen people on Xolair, and it’s provided substantial improvement without any adverse side effects.  Said improvement is usually very quick, too.

The downside is that because it’s a new therapy, Xolair isn’t covered by many health insurance companies, is extremely expensive (about $15,000/year), and has to be delivered by subcutaneous injection.  Fortunately, my health insurance plan will cover it, provided that the patient has a sufficiently high level of IGE in the bloodstream (and my bloodtest shows a much, much higher level than most people; mine was about 350, while most people have less than 10 — and I’m afraid I have no idea what the unit of measurement is).  And I’m so used to shots that this won’t bother me at all (my mom sometimes jokes that I’ve had so many IV’s due to asthma that I’ve got track marks).

The manufacturer has already approved my taking the drug, so all that has to be done is for my doctor to send the necessary paperwork to my health insurance company.  If all goes well, approval should come within the next couple of days.

Here’s hoping that the Xolair really works.  I’m sick of being unable to breathe.  And I’m seriously worried that my asthma will prevent me from being able to go to Dragon*Con (or at least from having a good time while I’m there).

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