Ahahahaaaa another click-bait headline. Hah. Haha. *sobs*
Actually, this isn’t a tale of woe, filled with the dark downsides of being the not-so-feminine counterpart to the so-called Alpha Male, but is in fact part three of the tale of my faulty lungs. The reason for the title will become clear shortly (so I can at least offer you pun-fulfilment if nothing else), although I have yet to find a good reason for why my brain associated a female gorilla with the idea of an Alpha Female, nor why I decided that one of her squishing Johnny Bravo was the best of what Google Images had to offer.
If you’ve not already read the preceding two posts about this story, I suggest you do so now, otherwise this post will lack context:
Part 1 – Breathing More Easily
Part 2 – The On-going Saga of My Faulty Lungs
So where I left off, I’ve been diagnosed with COPD. Chronic Obstructive Pulmonary Disorder. That’s the umbrella term for a collection of diseases and conditions related to lungs, including chronic bronchitis, emphysema and chronic obstructive airways disease.
It is the emphysema that’s my problem. The damage to the air sacs in the lungs cause air to get trapped. Whereas a normal person doing intense exercise would struggle to get air in, I struggle to get it out. This manifests itself as wheezing on the out-breath which gets worse the harder I push myself. It sounds like breathing’s hard work, and dammit it is!
Your lungs’ alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.
When you exhale, the damaged alveoli don’t work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can’t reverse the damage.
(From the Mayo Clinic site)
So, I’m 36 with emphysema, the end-point of which could see me being one of those old people who can’t go anywhere without a big can of oxygen, attached to their face a via tube up their nose, being dragged along on a trolley behind them. I actually have no idea whether (or when) this could happen, as it’s too early on to have any idea of the trajectory it could take, which is somewhat disconcerting.
Now you’re probably all like “what the actual fuck, Fi! How the hell did that happen?”… and yeah – that’s a good question…
The cause is a genetic mutation that means that my body doesn’t produce an anti-inflammatory which protects the lungs (and liver, although that bit doesn’t affect me so far, if indeed it ever will). The condition is called Alpha 1 Antitrypsin Deficiciency, A1AT being a protein which would protect tissues from enzymes of inflammatory cells.
Quick biology lesson: you may (I hope!) know that women have two X chromosomes (XX) and men and X and a Y (XY). This is what determines their sex (yeah, this is a little simplistic, but bear with me…). It is the same in Alpha 1 – you have two versions of a gene called SERPINA1, and which ones you have determines how much A1AT your body makes.
The types are:
- M: The normal type which most people have, and results in a normal level of A1AT
- S: Produces moderately low levels of A1AT
- Z: Produces very little alpha-1 antitrypsin.
Now when your Mummy and Daddy love each other very much… they end up giving you one of these alleles each. So the options are:
MM, MS, SS, MZ, SZ, ZZ
MM is normal, MS and SS not so bad – they generally produce enough A1AT to protect their body, MZ can suffer in some ways – low levels of A1AT can contribute to quite a wide range of problems (not enough time, space nor inclination to go into them here), SZ generally has lung problems, and ZZ is serious, often affecting lungs and livers from a very young age, resulting in massively reduced quality of life and often an early death.
I’m an SZ. So it could be worse, but it could be better. My A1AT levels are very low and there is no doubt that this is the cause of my breathing problems. There is no cure for emphysema, nor any of the other conditions that are referred to as COPD, but what I can say is that I am doing everything in my power to slow the progression and not expose my lungs to further damage. This means regular cardio exercise (yup, I’ve no choice but to be a runner now), healthy eating (foods that aren’t inflammatory, so minimal sugar and crappy quality fats, lots of fresh veg), living a low-stress lifestyle, and also minimising my exposure to pollutants.
This is the tricky bit, and has resulted in me hatching a five year plan to get out of London. It also has resulted in a very much enhanced sensitivity to pollution (although, weirdly, I’ve always had this, and done odd things like covered my mouth with a jumper when I went stock car racing, and constantly move around a camp fires to avoid smoke), and I now also endeavour to leave London for my longer runs, or at least not do them in zones 1 and 2, lovely as some of the parks – and pavements – are. In fact the avoidance of pollution has become one of the biggest steps I’ve taken since I’ve been diagnosed, as it’s one of the few areas I can control in order to prevent a worsening of the condition.
I think it’s worried my parents deeply, especially the element of the unknown. One of my sisters thinks I’m being attention-seeking, I think because of the fact I described myself as “an alpha” (this is the de-facto term for people with the condition – a small glimmer of LOLZ in what is, for some, a pretty bleak future), and if you’ve made it this far just to get to the route of the punny headline, you can stop reading now if you like. Neither of my sisters have got their genes tested, but my parents are an MZ and MS, which is pretty damn awesome as it means that neither of my siblings could be ZZ. And in terms of probability, they’ll probably be better off than me. So that’s a definite plus.
When telling fiends, some people have been slightly horrified – somehow my calm demeanour makes them unsure how to react, or perhaps think that I’ve blown it out of proportion because I couldn’t possibly be so calm yet have something so potentially serious.
But you know what? My quality of life is excellent. It might become worse, but that’s a might. In my family I have three members that are Type 1 diabetic, including my niece. Every day they have to inject themselves with insulin, watch what they eat and risk being affected by a range of health problems from limb amputation to blindness (one cousin is already quite far down this road). Another cousin recently had pregnancy complications and now can’t have any more kids. Another tried to commit suicide last year and has been in a mental hospital ever since. My dad had a knee replacement op and hasn’t been able to walk more than a few hundred metres for coming on four months now, and since I started writing this post has been admitted to hospital with pneumonia. And that’s just my family – there are innumerable people out there with much more serious things wrong with them, and I’m fucked if I’m going to mope around thinking about what might happen to me.
In the future it means annual check-ups, mainly in the form of spirometry to test my lung function, but also liver scans to make sure there’s nothing unusual going on there (it also means that becoming an alcoholic wouldn’t be a wise move). But unless they uncover anything, there won’t be much change to my life. Oh, except for one thing: I have an inhaler. When I went to see the specialist (there is a reasonably funny story about this which I may tell you face-to-face, if you ask…) they asked if I wanted any medication. I explained about the running and the wheezing and asked if I could try a bronchiodilator. They gave me a Spiriva inhaler and said that if I feel better running and that it improved my peak flow score (which it did, from 350 to 370!) to keep using it. And that’s pretty awesome – it’s pushed the point at which I feel really uncomfortable up just enough to allow me to go faster for longer, which has obviously helped my training. I don’t take it every day, but if I have a race or fast running session planned I take it for a week beforehand, just to make sure my lungs feel nice and clear.
Since I’m stuck doing cardio and I quite enjoy running through the countryside, I’ve also been putting some effort into making my body robust enough to enable me to do it without risk of pain or injury. So all those boring strength exercises that no one ever does (until they’re injured)…? Yeah, I do them all. And I watch videos on YouTube about form and technique and go and try and replicate it. And (which you’ll be reading about on another post) I had gait analysis done yesterday so I can get right to the bottom of what’s going on when my somewhat un-coorinated limbs plod along this mighty earth.
So yeah. That’s it really. Dodge smokers, keep running, move to the countryside in a few years and eat healthy food. And hopefully stop having those pesky dreams in which I wake up thinking I’ve got drunk and had a fag.