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Premeditating Premedication

I messaged Kerri and Dia quite a bit in the week before a conference in Philadelphia. In this exchange, auto-correct decided that I should share my musings on “premeditation”. The computer has yet to learn that I always mean premedication not premeditation.

Does one pre-medicate while stepping down treatment?

The genesis of this chat topic is that I am in the midst of a step-down plan. As much as I put on a strong happy face, there is a voice somewhere inside of me that says maybe it won’t work”. Most days I ignore that voice. I continue with the lower dose treatment. Yet, spring is starting to show up after a winter with a rollercoaster of weather. They are forecasting snow tomorrow, April 1, here.

Last year, at this same conference in Philadelphia I came home with a bit of flare. This trip to would test the limits of my lungs on the step-down treatment plan. On the other hand, the only thing worse than flaring is flaring out of town. I was nervous to throw away months with barely a blip on the asthma radar.

The anxious voice inside me said not to throw years of good control away for a few days out of town. My rational side knows that there is no shame in taking the medications I need to be well. I’m not a failure if I never make it below the “step” I’m currently on. Even if I need to “step up” my treatment, that should not reflect on my character or worth as a person.

I’d love to say I was able to quiet that anxious inner voice. Over here in real life, I went ahead and pre-medicated. I decided for my own peace of mind, I would go ahead and switch back to twice a day inhaled steroids. This was a following the spirit rather than the letter of my Asthma Action Plan.

Taking a step back up to my previous treatment gave me some reassurance as I headed off to the East Coast. Who knows if I would have had the same or different wellness without this change. I was well enough to have a meaningful experience at the Connexion conference. Unfortunately, I was not having as good of breathing time as I’d hope. Some part of the blame for this definitely falls to me. I walked many miles of Philadelphia on breaks to see some of the sites. Perhaps, I would not have needed as much Ventolin if I had sat still. I don’t normally pre-medicate for walks, but I also don’t regularly walk long distances. I tend to cover longer distances by bicycle.

I’ve been home a few days and am nearly back to baseline. I continue my maintenance inhaler twice a day. If I can’t get myself titrated back down to the lower step, I will reach out to my asthma doctor. We’ll see where this leads. If this is all the better my asthma gets I’m satisfied. I’ll take it if becoming a “blue puffer” only asthmatic is in the cards. Time will tell if this is a realistic expectation. Does your treatment plan change when you travel?

Disclaimer: These views and opinions expressed in this article are that of the writer. Please contact your doctor and medical team before making changes to your treatment and asthma management.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • John Bottrell, RRT moderator
    1 year ago

    Hi. Kat. Thanks for sharing this story. Like Leon, I never heard the term “blue puffer” before. How could I be one for so long and not heard the term earlier? Anyway, I have been known to premedicate myself before certain vacations. With allergic asthma, I premedicate before going to places I’m allergic to, but “have to” attend — like hunting camp ( It’s what allows us asthmatics to be a semblance of normal, or what helps us in our attempt to live normal — to not let asthma get in the way of enjoying life. John. Site Moderator.

  • Leon Lebowitz, RRT moderator
    1 year ago

    Hi Kat and thanks for your article. I’ve heard of ‘blue bloaters’ when it comes to COPD, but the term you used, “blue puffer” is a new one for me. Would you be good enough to provide an explanation and clarification for our membership?
    Thanks so much,
    Leon (site moderator)

  • Kat Tynan author
    1 year ago

    Blue puffer being an albuterol or quick-relief inhaler. I most of mine have been blue over the years 🙂 I’m not sure where I first heard mild intermittent asthma called that but the term stuck in my head as the finish line.

  • Leon Lebowitz, RRT moderator
    1 year ago

    Hi again, Kat, and thanks for the prompt reply – that makes perfect sense to me!!
    Leon (site moderator)

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