Navigating the Tough Choices in Asthma Treatment

I have always found that my asthma never presented easy answers; however, I was surprised to be facing asthma treatment decisions after finding what I thought was a sweet spot.

Tracking symptoms to make informed therapy changes

I recently had an adjustment in my treatment regimen and found myself with a few asthma treatment-related symptoms. I usually pride myself on taking good notes on symptom changes and so forth; however, I cannot recall whether this was a new feeling.

This had me thinking about the threshold I had once established for asthma treatment side effects that I was able to tolerate and accept. When I first started my journey with biologics, I was quite unwell, uncontrolled, and pretty much willing to accept anything. It all seemed better than the brutal side effects of oral corticosteroids.

Weighing the side effects of asthma treatments

It is important to identify whether these side effects were truly from my asthma treatment or if they were related to other things that may have been occurring at the same time. With some symptoms, it is hard to know whether they are from the lasting effects of oral corticosteroid treatment or something else.

I resumed symptom tracking to get a better idea of what I was dealing with. I shared my data with my care team, and they used it, along with other diagnostics, to determine that at least some of these symptoms were related to treatment. I was relieved to have confirmation, but it also raised decisions I may need to make.

Making asthma treatment-related decisions

I made a list of asthma medication side effects that I was less willing to live with. My list included weight gain, vision changes, sustained increases in blood pressure, and, rounding it out, constant hives. I knew that I was not willing to be on antihistamines long-term. They make me incredibly sleepy and affect my quality of life.

The last time I had to make big treatment decisions, I made decision trees and spreadsheets with rationales. I don't feel this decision is quite that intense, but I do feel conflicted. In discussions with my care team, it was “up to me” to decide what level of control I am willing to accept.

Knowing when to make asthma treatment changes

Now that I have been on this asthma treatment regimen for some time, I am changing my threshold. I have drawn the line at eye issues. We only have 2 eyes; they are already subject to the age-related issues that come with life, and some biologics have eye-related symptoms.

There must have been a part of me that thought if I had not had these symptoms before, then I would not get them now. I have been on some of these treatments for years. In my case, this was not exactly true; in discussion with my specialist, I learned that some asthma medication side effects can develop over time. It is important to understand that they can be treated, and everyone will have a different tolerance for side effects.

The right decision isn't always obvious

I felt conflicted about what the best decision would be: should I take a break from this treatment to see if things resolved, or was this a side effect that warranted immediate discontinuation? What symptoms was I willing to live with long-term?

I decided that I needed to do a test by holding some of the medication for a short time to see if it made a difference. I did this under medical supervision and in consultation with my care team. Once we understood its role, I could make a more informed decision. I have been able to tweak some of my regimens, and I hope to be back in the sweet spot soon.

What has your experience with asthma treatment decisions been like?

Have you decided to discontinue medication? What was your rationale and threshold? How did you know you were making the right decisions? Did you feel that there was a trade-off, or were you perfectly content with your decision? I would love to know about your experiences.