A common theme in asthma and waterfalls – creeping normality

A few interesting things happened in July – there were opportunities to showcase ADAMM, the list of potential uses for ADAMM grew longer and there were lots more great articles on asthma and ADAMM. Of all the interesting stuff that happened, some of them were tied together in our mind. First, our co-founder Jared Dwarika gave a very well-received speech at the WT | Wearables Technologies Conference in San Francisco. Then, we read this profound article by Henry Ehrlich at www.AsthmaAllergiesChildren.com about being asthma prepared; and, seemingly unrelated, a couple of us visited Taughannock Falls in Ithaca, NY. Seems like a fairly random set of occurrences, but we really thought they had a recurring theme.

At 215 feet, Taughannock Falls is the highest single-drop waterfall in the North East of the US, 33 feet higher than even Niagara. For many of us, in our lifetime we’ll see this and take it for granted. However, the size, shape and depth of the gorge has gradually eroded over time – changing the baseline for good, until each “new” baseline is accepted as our reality. Etched on the walls of the gorge are hundreds of new baselines – each one meaning that the falls got “taller” and it became harder to go up river.

The article by Henry Ehrlich draws attention to the differences between anaphylactic reactions and asthmatic control – the former is immediate, loss of asthmatic control happens gradually over time. As Henry Ehrlich points out: “frequent resort to albuterol [rescue meds] is a sign that asthmatic inflammation is not controlled, but people think that as long as the inhaler stops the wheezing it is [controlled]”. Conditions that are far from being in control eventually get accepted as being in control – we gradually get accustomed to a new baseline.

During his speech, Jared referred to the concept of ‘creeping normality’ and applied it to respiratory conditions, and specifically, asthma. According to simplicable.com, creeping normality is an objectionable change that is accepted because it occurs slowly. Or, as Wikipedia.com puts it, creeping normality refers to the way a major change can be accepted as the normal situation if it happens slowly, in unnoticed increments, when it would be regarded as objectionable if it took place in a single step or short period. In the case of loss of control in asthma, there can be gradual loss of control, or acceptance of a changing baseline for symptoms, until one trigger pushes you over the edge into a life threatening attack.

That’s the key to successful asthma management – don’t accept that creeping normality! Don’t give in to the thinking that it’s ok to keep using rescue meds at an increasing frequency, even if it happened over a period of days or weeks. Keep track of your symptoms and meds and learn the signs of inadequate control. Those are the fundamentals of an asthma management plan. Intelligent Asthma ManagementTM goes beyond these fundamentals and adds the ability to independently recognize pre-cursor symptoms – yes, symptoms even before you’re self-aware.

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