an anxious woman sits on the bottom step of a flight of stairs

Step-Down Failure?!?!

When I last talked about my journey stepping down from asthma treatment, my doctor had me headed toward no daily controller medications. The challenge for my care team is always that I enjoy being active outdoors. For me, the thing that motivates medication compliance is the ability to go on hikes, ride my bicycle, and generally enjoy the outdoors. Of course, I want to stay out of the hospital and prevent any long term problems like airway remodeling.

Failing to step down my asthma treatment

Since my asthma has been fairly stable for years, I only have one asthma doctor check-up a year. I can call and get in when I’m having a flare. I have proven to my care team that I can be trusted to be fairly compliant with treatment plans.

Thus I walked into my annual check-up having spent a month or so down to the lowest step on the previous year's plan. In my month on the lowest dose, I found myself using my quick-acting inhaler nearly every time I did anything active.

Stepping up my asthma treatment again

Going outside to “play” is one of my favorite ways to spend my time. So I followed the instructions from my doctor and went back to 2 puffs of my controller medication twice a day. This is the right decision for the kind of lifestyle I want to lead.

In this case, the proof isn't in the pudding, rather the spirometry. On this controller medication, annual lung function tests were minimally better year over year. Holding rock steady on numbers with no impact on my quality of life is an awesome place to be.

Yet, this place is bittersweet to me. I “failed” at stepping down my asthma treatment. I am stuck with daily medications to control my asthma. I want to be the person who is happy that I am controllable. Guess what--I’m not!

Will I ever be able to step down completely?

I want to have it all. Just a rescue inhaler that I use rarely, not daily medications that bookend my day. I’m not that asthmatic that gets to dodge daily medication--and I may never be. I am finding ways to make peace with this. However, walking out of the doctor's office that day on 2 puffs twice a day... I felt defeated.

My asthma doctor feels strongly that it is important for me to do the outdoors things I love. He’s right; we weighed the pros and cons. The slightly higher dose of daily medications is the right choice for me to have a life I enjoy: biking, hiking, and camping.

I long for the day when we try again to change up the medications in hopes of something lower dose or less often. Whether or not that day will come is debatable. I doubt another trial at stepping down from my asthma treatment will come in the next year or two. A girl can hope! Life is a twisting, winding road full of unexpected events after all.

Meanwhile, I have got a standing date with my controller inhaler and so many places to explore! Maybe I’ll see you on my adventures. Do you also have a bittersweet relationship with your medication?

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