It was late at night and Aanika Valbh was headed to shower before finishing some schoolwork at Penn State University. She was tired. It was cold. She figured the warm water would feel good and be a nice respite from the grind of school and a counter to the cold autumn evening.
She had her robe. Shampoo. A pink luffa. Moisturizers. She put her room key and phone near the shower. The water ran. The steam filled the bathroom. Nothing but the sound of the water hitting the gray-blue tiles.
Within several minutes, however, she began to notice something. Her chest tightened. Her breathing felt forced. With each attempt to breathe deeper and less air coming in, her brain began to panic at the rebellion by her lungs.
Breathe. (I can't)
Breathe! (I can't!)
BREATHE!
Gasping, she collapsed to the floor. Her vision began to tunnel and sense of direction began to fail. Dizzy, she stumbled, staggered and eventually crawled to her dorm room. She couldn't see anymore. Somewhere in the blur, she heard her roommate's voice.
Aanika's sole focus was to get that inhaler she'd picked up a few weeks prior when she noticed she'd had shortness of breath walking across the large campus in Happy Valley.
Her roommate quickly retrieved the inhaler. Multiple puffs. She lay there as her breathing became easier and her panic began to subside. Her lungs filled with air as her mind began to fill with terrifying questions: What was that? What if I didn't have the inhaler?
"I was really scared," she said. "I had no family in Pennsylvania and this was the first emergency I had to handle independently. My heart was beating out of control, I was scared, and I kept thinking: Why is this happening?
Aanika Valbh developed asthma while attending Penn State University as a freshman. She said she had never experienced anything like it up until that point in her life. Photo: Nation of Artists for Amgen.
Asthma Affects Millions
Aanika was diagnosed at 18 with asthma, a condition that affects about 25 million Americans and about 262 million people worldwide.
An asthma attack happens when the airways in your lungs suddenly become inflamed, swollen, and narrow. During an attack, muscles around the airways tighten (called bronchoconstriction), and the lining inside the airways swells up.
The body is also simultaneously creating extra mucus, which clogs the already-narrowed passages, making it harder to breathe. Wheezing, chest tightness, coughing, and shortness of breath. Triggers for asthma can include dust, pollen, smoke or exercise and attacks can range in severity. It can be passed genetically, but it also can come about amid the environment within which a person lives.
But Aanika's asthma seemed to come out of nowhere. She said she'd never had any previous history of it. Her parents said she'd always been healthy growing up and rarely got sick. And as the asthma attacks continued, the uncertainty worsened.
"I didn't know what was happening. Nobody told me that this is what an asthma attack felt like," she said. "I didn't know. It felt like your chest is imploding and exploding at the same time. I thought I was having a heart attack."
Aanika's experience is a powerful reminder of how unpredictable asthma can be, and how important it is to understand your own triggers and what asthma control looks like for you.
Aanika Valbh and her mother, Tina Valbh (right), cooking together. While Aanika was struggling with asthma away at college, her mother was battling cancer. It was a difficult time for the family, but it also pulled them closer together. Photo: Nation of Artists for Amgen.
An Added Fear
Tina Valbh, her mother, had a deep understanding of the health care system in the United States, working as a pharmacist and interacting with doctors and health care professionals for years. She was worried about her daughter being more than 1,000 miles away from home. The tight-knit family had never lived apart before.
Still, Tina didn't know the full extent of the asthma attacks and trips to the emergency room or the fear that gripped Aanika sometimes when faced with doing basic things like walking across the campus.
"She was really trying not to tell me a lot," Tina said.
That's because Valbh knew her mother was battling Stage 3 breast cancer. And she didn't want to burden her mother with another worry when Tina was in the fight for her own life.
Her father, Sandip Valbh, said the combination of both health situations simultaneously put a strain on everyone.
He said the day Tina had surgery scheduled for her double mastectomy was also the day his daughter was rushed to the emergency room because of a severe asthma attack. Sandip found himself on the phone with Aanika's friend, talking him through his daughter's progress while at the same time praying and waiting for his wife to emerge from surgery.
"It was a tough, difficult period," he said. "But Aanika is resilient and an old soul. She doesn't need help through anything. I think all of this made Aanika grow up quicker, but she was already a mature person."
The surgery was successful and Tina has been cancer-free for the past two years. But she still is haunted by the time her daughter was still struggling to figure out how to live a life with severe asthma.
Tina said, as her mom, she was often in a fog with "chemo brain" and the battle against cancer was taking a lot out of her. She wanted to help her daughter through the red tape of getting medicine or seeing doctors and filing insurance claims, but it was hard when she wasn't at even close to full strength.
"I could barely put together words. I couldn't recall or understand how the medications worked. I was scared to death to advise my daughter, which was very disappointing to me as I was a pharmacist and knew how medications worked," Tina said. "It was pure disappointment. And guilt."
But her daughter remembers it a little bit differently. She remembered helping take care of her mother and her mother taking care of her – with her father as the glue holding them together.
In her memory, they all worked together to help each emerge on the other side.
"I couldn't have done it without my mom and dad," Aanika said.
Aanika Valbh went through a series of tests before being diagnosed with asthma. Photo: Nation of Artists for Amgen.
Getting Help
Growing up in Florida, Aanika was always an active person; she played tennis and ran track in high school. She loved to ski and hike.
She said it never occurred to her that her body might rebel against her spirit and that things she loved to do might suddenly be inaccessible to her.
But as she continued at Penn State, even accomplishing basic things began to come with additional challenges. She had to plan ahead for walking to class and managing around her triggers, like cold weather. At night, asthma attacks interrupted her sleep and she'd awaken with chest pain. Going to a Nittany Lions football game with friends required a check to make sure inhalers and nebulizers were handy.
Keeping up made her feel more like she was falling behind in life.
She remembered walking into the doctor's office while home in Florida for the Thanksgiving break in 2022.
"It almost felt like doomsday approaching as I'm walking into the doctor's office," she said. "Like what is wrong with me? What are we going to find out today?"
The doctor performed a spirometry test. They had to do it three times because her breathing output was too low to register a result. On the third try, it captured a low result and the doctor asked her if she had asthma and borderline COPD.
She felt confused. Uncertain about what it meant for her future. After came a series of prescriptions, inhaled medications and oral corticosteroids to try and combat the asthma. For a full year, nothing worked. The side effects – dizzy spells, stomach pains, exhaustion – made her tired and she said she was "getting more side effects than results."
Eventually, Aanika was prescribed a biologic in addition to her other asthma medicines to help treat her severe asthma, and she began notice an improvement.
Aanika Valbh has always been an active person. She also achieved her dream of swimming with dolphins. Photo courtesy of Aanika Valbh.
There are still some precautions, however. Aanika transferred to the University of Virginia to study to be a pharmacist to be a little closer to her parents, who still live in Florida, just in case she is needed or her parents need her. She also said her aunt lives just about 90 minutes away, which provided everyone with extra peace of mind.
Sandip said that through his daughter's battle with severe asthma and his wife's fight with cancer, it's given the entire family a new perspective on life.
He said before the asthma and before the cancer, they – and especially him – could "sweat the small stuff." Now, he said, it's reframed what living means.
"I don't think we take anything for granted anymore," Sandip her father said. "Going through something like this makes you realize what's important. It reset everything in our approach to life."
One breath at a time.
The Valbh Family (from left to right): Aniya, Sandip, Tina and Aanika in 2024. Photo courtesy of The Valbh Family.
Aanika has been compensated by Amgen for her time. This is her experience and may not be the same for every patient.
