How To Identify and Manage Changes in Asthma Control

I was feeling unsure about my recent asthma control. This was a new experience for me. So much of my asthma control has focused on feeling "good enough."

This changed once I found a treatment regimen that allowed me to thrive. The challenge is that this stretch of controlled asthma has come with a few very bothersome side effects. I can usually navigate most side effects, even when I have wanted to throw in the towel; however, I have been struggling with this latest zigzag. I have been trying to determine what my next steps should be, or if I could learn to live with this change in asthma control.

What is well-controlled asthma?

This had me thinking about what I truly considered “well-controlled asthma,” and what it looked like for me while navigating bothersome side effects from asthma medication. Let’s recap how well-controlled asthma can be defined.

The American Lung Association defines well-controlled as when "you experience very few symptoms throughout the day and night, and you can perform daily activities without shortness of breath, chest tightness, coughing, or wheezing."¹

I believe I have lowered my threshold for how I define well-controlled asthma to the point where I was perhaps slipping from my well-controlled status. This issue felt two-fold:

1. Not wanting to acknowledge that my asthma control has changed.
2. Feeling like I had very few options outside of accepting these side effects.

Identifying recent changes in my asthma control

I decided it was time for me to take a closer look at the symptoms and side effects I was experiencing. I have been known to be a "poor perceiver," so this was my way of making sure I could quantify what I was experiencing.

I started by tracking everything. I went back to my early diagnosis days and did comprehensive medication tracking, activity tracking, and symptom tracking, along with a section for all things related to my biologics. One day, I will transcribe my notes into a spreadsheet, but for now, they are in their most accessible place: a journal.

What I discovered was that there wasn't much to track at the beginning. I had a few symptoms, and they were mild at first. They felt almost “normal,” but over time, I began to identify some patterns. I noticed that I had some symptom flare-ups that could be connected to trigger exposure, while in other cases, there was no real reason at all. These subtle shifts were my first real changes in asthma control.

How I managed changes in asthma control

In consultation with my respirologist, we made some adjustments to see if we could minimize side effects. It was interesting to see documented downward trends. The proof is in the pudding, as they say. It was a good experiment, but unfortunately, it also emphasized that I was not going to be able to adjust the specific medication that produced the bothersome side effects I was experiencing.

I was disappointed that the overall result meant I was going to have to "suck up" my side effect symptoms and treat them as best as possible in order to preserve lung function and keep my asthma truly controlled. However, having data to map out these changes in asthma control has helped me stay motivated with my asthma treatment and makes me feel like I am in more control of my health.

Have you ever felt at a crossroads with your asthma? What methods have you used to help you gain a new perspective and stay motivated despite bothersome treatment side effects?