After reading about Julie's reactive airway and the new drug Xolair, which will help severe asthmatics by preventing an early step in the cascade of reactions that cause asthma (though at a $10k/yr price tag that may or may not get covered by all insurers), I had to reflect a little bit on my quarter century with asthma.

I have what I consider a fairly typical condition where asthma is concerned. It's triggered by the usual stressors (physical activity, extreme air temperatures, some allergens), causes a fair bit of wheezing, but rarely gets to the point where I couldn't ride out an attack (though there have been exceptions, such as the time I had a severe attack while walking in cold January air, forcing Shawn DeVeau to run and get my inhaler - thanks again, by the way).

I've often wondered why my asthma showed up when it did. You would think it'd be there all along, but I was pretty much unaffected until I was 8 or so. From that point on I've always been taking something to help me breathe.

This was a bit of a problem early on, given that the medications weren't all that effective. The first drug I was on that seemed to work reasonably well was Marax, though it tended to be of more use in reaction to an attack than in preventing them. I was on this for quite a while, to the chagrin of the first respiratory physician I saw, as it was well beyond being state of the art when I finally stopped taking it.

(Marax also contained ephedra, a banned substance for athletic competition. Rick DeMont lost an Olympic medal in 1972 because the USOC didn't make the connection when he listed it as a medication he took to control his asthma. Probably for the best that Massachusetts didn't do random urine testing during my football days).

From Marax I went on a pill and inhaler combo. As helpful as the pills were, the inhaler was the first medication that radically changed my life. Up to that point I still had to deal with attacks as they happened, which made me less interested in doing anything that would trigger one. With the inhaler, I could not only deal with attacks much faster, but could also take the medicine beforehand to head them off or make them less serious.

I thus entered a 10 or 15 year period where almost all of my asthma medications were administered by inhalers, as I wound up going off the pills and combined my fast-acting inhaler with inhaleable steroids. These worked much better than the systemic ones, delivering the steroids directly to the tissue that needed strengthening.

I have to admit to not being a very good inhaleable steroid user. Too easy to get off schedule, and more often than not they cost more than the simple co-pay that the fast-acting inhaler went for. I know, I shouldn't have put the money in front of my health, but as most of you probably know college is not a time where you have a lot of disposable income or the good sense to put what disposable income you do have towards something useful.

I lumbered along with the inhalers for some time, probably longer than I should have. It's easy to rely on them too much, ignoring management of the condition and focusing on just stopping attacks. I muddled through some medicine changes and a couple of doctor changes before the second life-changing prescription.

That came when my current doctor put me on Singulair, a once a day pill that's a leukotriene receptor antagonist, meaning that it blocks the receptors that the leukotrienes would normally bind to as a step in the development of an asthma attack (at least that's how I parse it from the physician's information, which is apparently written in Phrygian).

So while I don't understand the science behind it in anything more than a surface way, I do know that it keeps me from having attacks. I'm rarely even wheezy now, even when working out or doing things outside during allergy seasons that would previously have triggered things (Singulair is also used to combat hay fever).

I'm rarely one to gush about these sorts of things, and have some pretty deep suspicions about the pharmaceutical industry overall, but the change here is too dramatic to not go a little ga-ga over.

It does give me reason to pause, however, when thinking about the kid I was when all this started. What would have happened had Singulair been around back then? I was a pretty active and athletic kid; what if I was able to keep that up and develop like so many of today's elite athletes with asthma? There are a million things in a lifetime that have an impact on how you live your life, but I can't help but think that this particular "what if" would have resulted in me being a completely different person today.

Whether that's good or bad I don't know. Probably both.