Hello, my name is Patches. I’m a thru-hiker and an asthmatic. It’s been 10 days since I last took a full, deep, lung and chest expanding breath and 3 hrs since I last used my emergency inhaler. I can already feel my lungs beginning to constrict again in an angry protest against my attempts to breath while climbing up this mountain and I’m counting the minutes until I can use my inhaler again.
Asthma is the reason why I quit my job and hiked the Appalachian Trail in 2013.. After I returned from my Appalachian Trail journey I checked in with my pulmonologist and I’d regained 100% normal lung function. I was incredibly excited… My plan had worked, hiking the Appalachian Trail had helped my asthma… 100% normal lung function!!! I hadn’t imagined that it would get that much better! Since my asthma had been occupational asthma and I no longer had that occupation, maybe my asthma would be gone for good?!
My continuing good health (and lack of asthma attacks) slowly reinforced the idea that my asthma wasn’t something that I needed to worry about anymore (as long as I took my maintenance meds). As I hiked through the desert sections of the PCT I felt strong and my lungs felt strong. I’d gone to Burning Man (a desert festival) twice, and both times the dust storms had aggravated my lungs leading to nasty bouts of asthmatic bronchitis followed by pneumonia, so I had been extremely nervous about desert dust storms on the PCT… But I’d gotten through the desert without any trouble with my asthma… During the first 700 miles of the PCT I’d only used my emergency inhaler once.
As I left the desert behind, I left my worries about asthma behind too… I even sent all but one of my emergency inhalers home (I’d been carrying 2 or 3 in case I lost one, or miscounted how many doses were left in them).
It came as a real shock to me when I entered the high Sierra and started routinely having breathing issues… I’d hiked over 700 miles, keeping pace with my peers, and my asthma hadn’t been a problem… Despite the daily maintenance meds I take for my asthma, I’d managed to completely forget that I was asthmatic.
At elevations above ~9000 feet, the second the trail started going uphill, I started slowing down, way down. At first I thought that the same thing was happening to everyone else too… “Aha,” I thought, “I can explain to people that being asthmatic is like constantly trying to hike uphill at high elevation.” I clearly remembered that this was exactly what it had felt like trying to climb the three flights of stairs up to my apartment when my asthma had been really bad… My body had shifted to moving very slowly and taking the fast shallow breaths that would keep my blood oxygen levels high, but that wouldn’t trigger an asthma attack, and I was taking frequent breaks… A break after every step or two.
It took me a couple of days before I realized that nobody else was responding to the altitude in quite the same way that I was… To realize that it wasn’t just one bad day… The people that I had easily outpaced in the desert and at lower elevations were all passing me. Everyone else seemed to be adapting to the altitude… But not me… My friends were all outpacing me… It wasn’t a choice… I just couldn’t keep up… And suddenly the thin veil of denial melted away…
I have asthma… It didn’t go away… Asthma doesn’t go away.
I would have taken a deep breath as I processed the realization, but I hadn’t been able to take a deep breath in days. I would have laughed at myself for being in such denial that I didn’t recognize that it was asthma until I actually had an asthma attack on top of Pinchot Pass, but laughing triggers my asthma attacks when my lungs are being cranky. Instead, I sighed… It seems like no matter how bad my asthma is I can always manage to sigh.
I have asthma. In the last year I had gotten so much better that I’d been able to forget what it was like to struggle to breath… I’d fallen back into denial (despite the pound and a half of maintenance meds I was carrying with me and taking everyday). Being at altitude wasn’t like having asthma, it was triggering my asthma, especially since the altitude was combined with lots of cold dry air.
My rescue inhaler which had been left largely unused throughout the latter portion of the AT and the beginning of the PCT was being used on a daily basis again… When I’d forced myself to keep working at the job that had triggered the asthma I remembered that after 2-3 hrs I’d start watching the clock to see if I could use my inhaler again… Here at the higher altitudes I found myself doing the same thing… Was it time yet? How about now? How about now?
I carefully monitored myself for signs of altitude sickness… Could I tell the difference between high altitude and cold temperatures triggering my asthma and HAPE (high altitude pulmonary edema)? I wasn’t 100% sure, but I did know that the inhaler helped for 2-3 hrs and that carefully controlling my pace meant that I could keep breathing at 8000ft, 9000ft, 10,000ft, 11,000ft, 12,000ft, 13,000ft and 14,000ft…
It felt like my asthma to me… and it wasn’t getting progressively worse or coupled with any other symptoms of altitude sickness… No nausea, no headaches. Just breathing issues and asthma attacks that frequent breaks and using my emergency inhaler seemed to keep at bay.
Though slowing down and having to stop to catch my breath more often meant having to hike alone, it also meant that I had more time to just watch and absorb all of the spectacular scenery around me… The high Sierra is breathtakingly beautiful!!
As I hiked through the snow-covered mountains and forded the icy streams of the Sierra I thought about how I hadn’t really believed that I had asthma until I was hospitalized for it. Why did I have so much trouble admitting, even to myself, that I have asthma?
Close your eyes and try to picture an asthmatic. When I did that, the first image that came to mind was that of a ten year old boy wearing a blue shirt and a red baseball cap staring longingly out of his bedroom window at his friends playing baseball… It’s an image from some tv show or movie from my childhood which lodged a stereotype in my head, “asthmatics don’t get to go outside and play.” But I love to go outside and play! I don’t want to be sick, weak, and trapped inside… With those images of asthma lodged in my head it’s no wonder that I didn’t want to accept that I have asthma.
Clearly I needed to exchange those old images of asthma and asthmatics for newer ones. I thought of myself standing on top of Mount Whitney at sunrise… Triumphant and strong… On top of the world… That’s the image of an asthmatic that I want to hold on to, that I want to come to mind first and foremost when I think about asthma. To get to the summit of Mount Whitney I needed to admit to myself that I had asthma, I needed to use my inhalers, I needed to respect my body, and I needed to go my own pace. I worked really hard to get there, but I did it, and it was absolutely amazing. My asthma didn’t prevent me from going outside and playing and living my dreams.
My name is Patches, I’m a thru-hiker, and I have asthma. My asthma is still there, I’m still hiking at high altitudes, I’m still going slowly, and I’m still out here living my dreams on the PCT in the high Sierra and loving it… Me, my backpack, the mountains, and my inhaler! :)
Patches Thru 