Watch your Step![down]: Part 2

Fast forward about 3 years since we last left off in my medication step down journey. The world continues to spin, I continue to dispose of half full rescue inhalers when they go out of date. Yes, I have occasional asthma challenges. I have stayed off oral steroids and out of the hospital without a Long Acting Bronchodilator. Is my control perfect, No. I am however satisfied with the minor limits asthma puts on my life. Whether it is correlation or causation I lost about 10% of my body weight since I switched from combination to steroid only inhaler.

Fingers crossed for my annual checkup

On a chilly December day I head out to the asthma doctor for my annual checkup. I cross my fingers that there won't be any surprises. This is especially true since I was without a car. I biked the mile or so from the bus to the doctor's office with an air temperature around -12 degrees. (10*F to my fellow Americans who haven't metricated). This was a short downhill ride, so I made it to the doctor with no asthma difficulties. I check in and get called back to a room for vitals check. I take the asthma control test. My doctor comes to do our annual state of the allergies and asthma discussion.

We discuss how my year has gone (well!) and where we could go with treatment for the upcoming year. My doctor suggests that if spirometry comes out at baseline we can reduce my controllers. Time for me to blow out the birthday candles and see what my lungs have to say about this plan. I am holding consistently at my baseline still per the spirometry results. The treatment plans we settle on is that I will drop my oral leukotriene inhibitor. If that goes well, next step is to lower my inhaled steroid dose.

Getting used to less medication

I go home that evening and for the first time in - I can't remember how many years - I have no evening pills to take. I sleep through the night and the next. A week and then two passes. My life and lungs continue at their usual pace. Currently, I have succeeded in eliminating the Leukotriene inhibitor. I am nervous to call this a complete success as winter is generally my best season. I hope the success I am seeing now will continue into the spring and summer. With some luck I'll see my asthma doctor as the instructed: "Return in 1 year." and no sooner!

As outlined in the plan we agreed upon I am going to step down the steroid dose in the coming weeks. Reducing my medications hinges on continued asthma stability. If I lose control I will go back to these medications and talk to my medical team about the appropriate next steps. I can feel the trepidation welling up inside of me as I stare down less and less asthma medications. Here's hoping the light at the end of the tunnel is not a train headed straight for me. Either way I will take it one day at a time. Have you stepped down treatment recently?

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