10 May 2014

A Different Kind of Awareness

May is Asthma Awareness Month, and the Centers for Disease Control wants you to know that "you can control your asthma."
The page acknowledges that "we don't know what causes asthma, and we don't know how to cure it." But if "you" are "living with" asthma, it's your responsibility to keep it under control.
There's more:
Although asthma cannot be cured, it is possible to manage asthma successfully to reduce and prevent asthma attacks, also called episodes. Successful asthma management includes knowing the warning signs of an attack, avoiding things that may trigger an attack, and following the advice of your healthcare provider.
This bothers me for so many reasons, I barely know where to start. 

An "episode" sounds like something you watch on tv.  An "attack" sounds significantly more sinister. 

The grammatical construction of "your asthma" suggests that the person owns the illness, but the construction of all the ideas on the page suggests that the asthma owns the person.

I might live with asthma, I might have asthma, but it's not "my" asthma. And I am not "my asthma."

"You," the person with asthma, are admonished to stay away from anything that "may trigger" an attack.

"May" (why not "will"?) suggests multiple possibilities, and by extension the impossibility of avoiding everything that could trigger, let's call it an "exacerbation," which directly contradicts the insistence that "you can control your asthma." If "we" don't know what causes asthma, how are "we" who "live with" the disease supposed to recognize and be able to avoid all, or any, possible triggers?

My list of triggers includes several foods and additives; airborne things like smoke, dust, mold, and chemicals; various animals; upper respiratory infections; and exercise.

Yes, exercise. I exercise anyway, because it helps to reduce the severity of the disease on a day-to-day level as well as during "attacks," but I have to be careful.

Most of the things that trigger my "episodes" are pretty common.  I don't know if it's usual for people to have such a long list, though.

I cringe when I hear someone sneezing or coughing near me. There are plenty of respectful smokers, but others stand right under the no-smoking sign and light up, or walk down the street waving a lit cigarette, and I don't always see them until after I've inhaled what they're trailing. Eating in restaurants is your basic crap-shoot.

The problem with the admonition to "avoid triggers" is that it lays all the responsibility on the indidivual rather than calling for the community to mitigate potential toxins as much as possible.

The claim that "you can control your asthma" is made twice, alongside the exhortation to "learn to control your asthma." Maybe it's meant to be encouraging: "you" don't need to live with symptoms. But it also implies that a person who has an attack is at fault for failing to avoid the triggers. If you "can" control your asthma, then if you have an "episode," it must be because "you" screwed up.

Reality: asthma is poorly understood; there is no cure; it can't always be effectively controlled. We live with it every day. And we go on living.