A woman talking with her doctor with an inhaler in the air between them

Changing My Asthma Action Plan

Last updated: January 2023

My pulmonologist, aka The Good Doctor, and I came up with an asthma action plan many years ago. It’s fairly straightforward— if there’s an uptick in my symptoms and I start needing my inhaler more often, it’s time to start steroids and get in to see my doctor ASAP. And If I go downhill too quickly, go to the ER. Of course, there are some nuances, but that’s the gist. I’m guessing that your asthma action plan is very similar. For the longest time, I let my symptoms begin to intensify a bit, before jumping into my plan. I never wanted to start steroids too early and then nothing come of my symptoms, because avoiding steroids is the name of my game.

But when my symptoms started to flare a few weeks ago, I decided to opt for a different approach.

Treating migraines and what I learned

Along with asthma, I’ve suffered from severe migraines for the last decade. Horrible, debilitating migraines. I’ve worked with many specialists and I’m finally in a place where I feel like they are under control. In addition to controller medications, I also have rescue medications to take. The idea behind these rescue medications is to take them as soon as I notice a migraine coming on. The sooner I can treat a migraine, the easier it is to get rid of them.

It took me a few years to figure out the timing. Like with my asthma, I wanted to make sure my headache was turning into a migraine before I thought I should take my rescue medicine. But after years of fighting migraines, I came to the realization that I should treat the headache, or hint of a headache, long before it turns into anything significant. To put it simply, I’d rather treat the headache and assume it was going to turn into a migraine, rather than wait for the migraine to hit before starting to treat it.

It finally occurred to me that I should be treating my asthma the same way. Most of my asthma attacks start the same way. A tickle of the throat when I wake up and what I describe as a feeling of “junky lungs”. It’s a very distinctive feeling. And it almost always turns into an asthma attack. The key word is “almost”. And it’s that “almost” that I would hold out for before starting steroids. But it finally dawned on me that I should be treating the “almost” the same way I approach treating my migraines.

Changing my asthma action plan with my doctor

Here’s the theory. If I treat my junky lungs as soon as I can, perhaps hitting the symptoms with full force will eliminate the symptoms before they turn into anything worse. I’d rather treat the junky lung and assume it will turn into an asthma attack, rather than wait to “be sure”. If I can nip my symptoms in the bud, I can reduce the chance of a more severe attack, thus reducing the amount of time I’m on steroids.

I presented this idea to my pulmonologist the last time I had a check-up with him. After telling him my theory, he agreed that rushing to treat the symptoms just as soon as I notice them, might be the best approach for me. If I can overcome an exacerbation with a short four-day course of steroids, that’s much better than waiting a day or two and ending up on steroids for weeks or months.

Thus, my asthma action plan has effectively changed, and I think it’s for the better. As soon as I notice any change in my asthma symptoms, I have permission to do a short burst of steroids. I’m excited to have a new plan, as simple as it is. Hopefully, it will help reduce the number of attacks I have, and more importantly, reduce the time I'm on steroids.

Is your pulmonologist open to discussing changes in your asthma action plan? Has your plan changed recently? Let us know in the comments.

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