A Certain Lack of Focus

Thursday, November 15, 2007

Asthma Devices

For some reason I was thinking of my asthma today. I was diagnosed when I was about eight and I was struck today with the sudden memory of the thing they gave me to control it.

Adult inhalers are pretty simple, and easily recognizable. Looking back I think at eight I probably would have been fine, but my pediatrician was a bit senile in those days and couldn't keep track of what sex I was (I had short hair) much less how old I was (I was also small for my age). So he gave me the kiddie model of inhaler which was a rather silly contraption.
spacerPlease forgive my drawing, I haven't had quite the standard in industrial design training (I think they spend three hours a day practicing drawing circles) which is entirely my own fault, but there you go. The inhalers were medical blue, you know the color, and in three parts. The actual medicine came just the same as it does today, in it's disposable plastic inhaler. You would take the metal piece out and install it into the plastic mouthpiece, which installed into a spacer. (I haven't drawn the locking mechanism so you'll have to take my word for it). As best I can remember, the medicine actually went through the mouthpiece so I'm not exactly sure how it went into the spacer rather than into my mouth. I think there was a grey rubber thing inside with an "x" cut through it so the air inside would only come when the child using it sucked on the mouth piece. The spacer itself was sort of a cross between a balloon and a trash can. It spiraled together to collapse on itself, then unwound into a blue cylinder. It made a noise that my friends claimed sounded like Darth Vader, but didn't really. It was a surprisingly loud plastic sound though.

inhalerThere were all sorts of design faults with this model. The main one was that the collapsible plastic was fairly thin so when a kid carried it around, treating it as carefully as kids will, it tended to get ripped apart pretty quickly. The newer models are quite a lot better, they have rigid plastic instead which can't be broken as easily. It still works in much the same way, only now you stick the full adult inhaler into one end and suck through the other. I'm pretty sure it uses the same rubber "x" to keep the air separate. Other models which I think are pretty clever, go over the child's nose and mouth. This is a much better design, because honestly the timing probably is less of an issue than the fact that it's hard for a kid to understand the difference between inhaling through one's mouth and inhaling through the nose. I think this design is intended only for very small children.

inhalerThis brings me to my main point, which is that I really never ought to have been on a spacer. Most kids over five are capable of learning the timing of a normal inhaler with a little work on their parents part and having the spacer is inconvenient and unnecessary. In my case it also made me assume that I was for some reason incapable of using a normal inhaler, so that I stuck with the stupid spacer until I was fifteen or so, long after they'd stopped producing the blue folding garbage cans. I've never had very severe asthma, I've never been hospitalized and I can count on both hands the number of "attacks" I've had. Nevertheless, asthma has affected me. When I try to think why, one of the main memories I have is of that stupid large pack of crap to carry with me everywhere.

basketball*Although I was never great at team sports, partially because of my asthma and partially because of my size, I continued doggedly with them because I enjoyed them. I remember when I was about twelve I had to stop in the middle of a basketball play because I couldn't breathe at all, but that was probably my first real attack in years. By the time I was a teenager I actually had "normal" lung strength, which my doctors always seemed to find surprising in an asthmatic. My first non-pediatrician doctor told me that if it weren't for situational symptoms, he wouldn't be able to even tell I had asthma. This made me absurdly proud, as though it were somehow my own doing, but I still carried around the niggling thought at the back of my mind that I was somehow disabled. Looking back I think this had less to do with the asthma itself and more to do with that damned spacer.

*Basketball picture from flickr. Children with inhalers from here and here.

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