At the ripe age of 21, I joined the more than 20 million adults in America who live with asthma.

My first asthma attack happened just before my 21st birthday. I was training for my first half marathon and lived in Arizona at the time.

As someone who had to deal with allergies my entire life, I anticipated Arizona would be a respite. I thought the air would be cleaner and the desert plants wouldn’t cause the same issues as tree pollen or grass. Hindsight is 20/20.

As a young college student, my days consisted of class, part-time work, naps, spending time with friends, and running anywhere from three to five miles a day. I loved being active. I had played on an intramural soccer team in college, and participated in track, cross country, and soccer in high school.

Running was a beautiful escape for someone like me who had a tendency to overthink everything. It was where I could clear my head and solve all of life’s silly problems between an easy pattern of step, step, breathe.

My symptoms

It was late winter in 2012 and I had just returned from a spontaneous weekend trip to visit my grandmother in Chicago.

I had a chest cold that wasn’t going away. I also struggled to complete my simple workouts. After a day of constant coughing, a sharp pain in my ribs, and difficulty breathing, I scheduled an appointment at an urgent care clinic.

By the time I was in the waiting room, I could hear myself wheeze with every breath. Was it really that bad? I figured I’d walk out of there with a round of antibiotics and within two days I’d be back on the trails and catching up on mileage.

After the doctor examined my lungs with a stethoscope, the concern in their voice is something I’ll never forget. They ran a quick spirometry test on me, and I almost passed out from being so lightheaded.

We had to run the test twice because I was so short of breath that I could barely complete it. They poked around my ribcage and I felt the same sharp pain I had when getting out of bed, twisting to one side, and bending over. I groaned.

They asked about my running, their faces twisted with judgment and disbelief. I insisted that I had been running, and that this cold was really getting in the way of my training.

At this point, I couldn’t tell if the anxiety was causing my lungs to tighten, or if it was something worse. Deep breaths were uncomfortable, but I was doing everything I could to keep my breathing at a steady pace, even though I was still wheezing a bit.

The doctor decided to perform chest X-rays to determine if there was any fluid in my lungs or an issue with my ribs. I rejoined the doctor after my X-rays, and they started to explain the bad news. My lung capacity and overall function was severely reduced.

They were shocked that I hadn’t come in sooner. They noted that if I’d waited longer, I would’ve ended up in a hospital bed.

In my head, I couldn’t help but think about whether I would be able to run or not. The marathon was still a few months away. Taking a few weeks off wouldn’t ruin my training.

What if it was more than that? What if I wasn’t able to run again? What if I couldn’t exercise the way I was used to? That was the one way I would de-stress. How could I handle this?

My diagnosis

I walked out of that clinic with a diagnosis of bronchitis, a cracked rib, and adult-onset asthma.

I had no idea where to begin. My first step was picking up the inhaler and antibiotics from the pharmacy, but the endless Googling began the second I got home. Is there a risk of lung cancer associated with asthma? Can you run with asthma? Can asthma kill you?

I’ve had several asthma attacks since that day, and each time I try to think about what I could have done differently. Did I remember to take my medication? Was I pushing myself too hard? Am I around any triggers?

It’s impossible to achieve perfection when you live with a chronic disease, especially one like asthma. There’s always going to be some element of the condition that you can’t control. Even in the midst of an attack, I’ll find myself repeating my running mantra: step, step, breathe.

Some days, that’s all you can do.