How Do You Determine Your Treatment Priorities?
I was recently asked about what my treatment priorities are. It has been a long time since I have thought about treatment priorities. After spending a lot of time hearing from my medical team, that I had limited options, or that they have been exhausted I believe that I have become a bit immune to this topic. There was a time when I didn't feel that my doctors and I were on the same page regarding priorities. While I definitely want my inflammation to be controlled, it took me a while to wrap my head around the role of eosinophils in inflammation since I can't see them, it was difficult to understand why they are so important and why there was so much focus on the inflammation when I just wanted to focus on other needs that I had. Now that I have a much more in-depth understanding of inflammation and its overall role, I have changed my opinion on where inflammation sits on my lists of priorities.
My priorities have changed over time, as my initial treatment priorities were simply to be able to not be circling the drain and staying out of the hospital. The reality is that treatment priorities may shift over time and as your asthma improves and (hopefully) it will not decline. If I had to describe what my treatment priorities are now, they would be, to be off of prednisone, to improve my lung function (it looks like there are some new biologics on the horizon that are claiming to do just that). I will reserve judgment on that one till I know more/have tried one). I would like to have more effective control on my mucus secretion and if I could improve dyspnea control that would be great. I am pretty well controlled but if I would tweak this area, that would be awesome. Essentially, if I could never experience asthma symptoms. I know that this sounds a bit like a pie in the sky dream, however, it could happen one day and I believe that researchers are working towards these goals. In the interim, I will need to work in baby steps. I want to have generally good control and be the least affected as by symptoms as possible.
Priorities Guiding Research
I recently had the following written in a clinical note from a super specialist that I have recently seen.
"... the patient is currently optimized on available treatment. However, has unmet treatment needs."
This had me thinking a lot about how our priorities are guiding research and available treatment options. Like many of you may be aware, asthma is complex and heterogeneous. There are no perfect solutions that will suit everyone. I am hopeful that the closer that researchers get to learning more about phenotypes and endotypes, that we will have better targeted solutions and be able to adjust treatment priorities.
What are your treatment priorities? What makes you feel the most hopeful for asthma treatment? How do you decide what your priorities are? I would love to hear how you would tackle this question.
Have you experienced a collapsed lung?