Personal Impact Paper
Bernard R. Bossert Jr.
NUR 427
October 4, 2014
Professor Beard

Personal Impact Paper
According to The Center for Managing Chronic Disease at the University of Michigan (2011) website, chronic disease can be defined as any medical condition in which the treatment expectation is one of control, rather than cure. The website further states that up to 70% (1.7 million) of deaths in the United States can be attributed to chronic disease. This statistic is not limited to the United States. The World Health Organization (2014) website states chronic disease accounts for 60% of all deaths worldwide, and half of those deaths occurred in people under the age of 70. The diagnosis of a chronic disease impacts a person in multiple ways, bringing with it new feelings, fears, questions, and lifestyle adjustments. This paper will explore some of these issues involving a person who is living with a chronic disease.
For this paper, I chose to explore the chronic disease of asthma and the impact it can have on a person. I chose asthma because I personally live with it every day and know firsthand the effects it can have on a person, thus I can examine how this disease has personally impacted myself. As an emergency department nurse, I have treated many patients with asthma and have seen how this same disease can affect different people in different ways. The conversations I have had with those that also suffer from asthma have opened my eyes to new ways to cope with the disease.
I have been living with asthma since I was 22 years old and I know exactly when and where the event was that was the catalyst for my developing this disease. I am a volunteer firefighter with Blair Township Emergency Services in Grawn, Michigan, and have been since I was 18 years old. I was involved in the cleanup and investigation of a house fire in 2003. We were in the basement sifting through the burnt remains of the house, looking for a point of origin of the fire. Like everyone else that was there, I was not wearing my self-contained breathing apparatus (SCBA), even though we should have. There are many excuses that one can give for not wearing the SCBA during the entire operation, including: “The fire is out”, “It’s heavy”, and “There’s no more smoke, so there are not any fumes”. This last excuse is the most concerning, as it has been proven false. According to Bolstad-Johnson, Burgess, Crutchfield & Storment (2000), “Removal of respiratory protection during fire overhaul could expose firefighters to a variety of toxic gases. A typical structure fire may involve destruction of plastics, foams, fabrics, carpets, asbestos-containing materials, and wood products. Gases, vapors, and airborne particulates are liberated when these materials are compromised by fire, and may remain in the overhaul environment for extended periods of time. In addition, organic vapors as well as halogenated compounds may use airborne respirable size particulates as a vehicle for entry into the firefighters' lungs.” Two days after this fire, I developed shortness of breath that lasted for about four days. It was not extreme and I did not seek medical treatment for it. Looking back, I believe I had developed pneumonia as two of the symptoms were chest heaviness with deep breathing and yellow sputum production. I recovered from this without any issues, or so I thought.
About two months later, I noticed that I would intermittently have mild wheezing when I would wake up in the morning or when I was around smoke. This worsened over several months until it reach a point that I could no longer ignore the symptoms. It was impacting my ability to function in my role as a firefighter and it was frankly annoying to be wheezing all the time. I scheduled an appointment with my physician. A chest radiograph was obtained, which was normal. I then participated in a spirometry test, which I promptly failed. It was then that the diagnosis of asthma was made by my physician. I was given a prescription for Symbicort and an albuterol inhaler. I was rather upset at first. I had always seen myself as a healthy person who could take on any challenge and succeed and now I had this disease that could potentially limit my ability to do physical tasks. I had been an EMT and phlebotomist for four years at this point. I had seen hospitalized patients with asthma and how it limited their lives. I was determined not to let this happen to me.
I began to do research on living with asthma. I started with the American Lung Association website. I read every page on it that had to do with asthma. It was there that I learned about a program called “Breathe Well, Live Well”. The American Lung Association (2014) website states that this is a program, aimed at adults, who want to better control their asthma. It involves a small workshop that teaches the participants how to get help from their physician, what asthma control medicines are available, how asthma and other conditions interact, what may trigger an attack, tracking symptoms, and developing healthy habits. I participated in one of these workshops and came away feeling much better about my condition. I met other people, young and old, who were also living with asthma. This allowed me to make new friends and connections with people who understood what I was experiencing.
I adopted certain habits that I felt would assist in preventing the asthma from worsening. I exercised on a daily basis in order to keep weight off. I also avoided known triggers for asthma, which included wearing my SCBa until all overhaul operations were completed. I also made sure to take the Symbicort twice a day, every day, as directed. I also started taking a daily loratidne tablet, as suggested by my physician, in order to block the action of histamine. I also made sure that I did not let myself believe that asthma was going to limit my lifestyle. I was determined not to end up like the patients I saw in the hospital. I feel blessed that I have good health insurance that allows me to obtain my inhalers at a nominal cost. I believe that being able to follow the treatment regimen of two daily inhalations of the Symbicort has been a large part in keeping the asthma under control. I have seen what happens when people cannot afford their medications. Many times they end up in the emergency department and need nebulizers, and in some extreme instance, intubation. I sincerely hope that this never happens to me.
The first theory of motivation and learning regarding asthma management that I would recommend would be self-efficacy. The Stanford University (n.d.) website states that this theory involves people developing personal control over their lives, and it uses mass media messages to get information out. This theory works well for those people that like a high level of control. Today’s society lives in a “Turned on” world, so a mass media message would be ideal. Another theory I would recommend is participatory simulations. The Stanford University (n.d.) website says this theory involves manipulation of objects that are involved with asthma, such as peak flow meters and models of lungs. This helps the participant to better understand how asthma works.
Asthma is a complex disease, but it does not have to rule a person’s life. Through self-education, proper medication usage, and group support, I have been able to effectively control the chronic condition known as asthma. I hope to be able to continue on this path for many years to come. I also share my thoughts in this with others when the opportunity arises. I feel that I am a good example of someone who can live with a chronic condition and still excel in life.

References
American Lung Association. (2014). Breathe Well, Live Well. Retrieved from http://www.lung.org/lung-disease/asthma/taking-control-of-asthma/participate-in-an-asthma-self-management-class/breathe-well-live-well/about-breathe-well-live-well.html Bolstad-Johnson, D. M., Burgess, J. L., Crutchfield, C. D., & Storment, S. (2000,
September/October). Characterization of firefighter exposures during fire overhaul.
AIHAJ, 61(5), 636-641.
The Center for Managing Chronic Disease at the University of Michigan. (2011). What is
Chronic Disease? Retrieved from http://cmcd.sph.umich.edu/what-is-chronic-disease.html
Stanford University. (n.d.). Theory. Retrieved from http://ldt.stanford.edu/~johnwong/ed229/asthma/theory.html World Health Organization. (2014). Chronic Disease and Health Promotion. Retrieved from
http://www.who.int/chp/en/