I like those odds

Some days I really think that if I wasn't Mormon I would play the lottery. One in a million odds seem to be my specialty. I can give a great example. Yesterday I had a methacholine challenge test. If you're scratching your head wondering what that is don't feel bad. I'd never heard of it either until my allergist mentioned it. It's to confirm or rule out a diagnosis of asthma. It's important to know if you're dealing with asthma and allergies or asthma-like symptoms and allergies.

The premise of the test is that a pulmonary function test (pft) is performed to get a baseline. Then you breathe in a saline solution. Another pft is performed. Finally in stages you breathe in methacholine and take another pft after each stage. In theory what should happen in someone with asthma is the following: the lungs should react and there may be mild upper airway constriction. It causes a very distinct and noticeable drop in pulmonary function. If they see this drop in pulmonary functions then it's considered a positive test result which is an absolute indicator of asthma. Now it should be noted that a negative test result doesn't necessarily completely rule out asthma it just argues against asthma.

In theory no one should have an allergic reaction to methacholine. That should have been our first clue. The test has been around since the '40s so it's considered very safe.  Well you're looking at one of the very few people to manage to buck that trend. The test was going fine which should have been the first sign something was bound to go wrong. I'd had the first dose of methacholine administered to me and the pft done. While I waited for the next dose I started coughing. Now that isn't at all surprising I'd been coughing already for two days from being off most of my medications. Also methacholine is known to cause cough in some people. The problem is that methacholine should respond almost immediately to albuterol.

When I started to flush the respiratory tech, Micheal, started to get a little panicky. I can't blame him, if you've ever seen my list of allergies you might panic too. Then I asked the question that really made him panic, it is normal to feel itchy? That was the big red flag that something was going wrong during this test. So he started a nebulizer treatment but my coughing got worse. This was the point he switched to oxygen and paged the doctor. I managed to get two doctors and another tech in the room. Benadryl, oxygen, and a little bit of time later I was back to stable again. I did manage to give them quite the scare though with my heart rate. It was bouncing all over the place from 105bpm up to 140 bpm and everywhere in between.On a positive note the pulse oximeter didn't register a drop in O2 saturation so that was good.

So the moral of the story is that it is unlikely that I have asthma. The evidence just doesn't support it. Do I have something that looks and acts remarably like asthma, yep. Is it actually asthma? Probably not. Also they were able to draw blood to check a particular level in my blood. It's called a serum tryptase level. For several of the diseases they are considering an elevated level is a clear indicator. The other moral of the story is that I run the odds and well. If there is a one in a million chance of it happening you might want to plan on it with me.