What Happens When Asthma is Not Controlled?
When I was first diagnosed, there were was a lot of discussion about the fact that my asthma was uncontrolled. The reality is that it was a bit more complicated than that but when you are starting at the beginning, I barely knew that I had asthma, let alone understanding what uncontrolled asthma was or its impacts.
In a nutshell, uncontrolled asthma is asthma that is not current adequately controlled. It differs from severe asthma that remains uncontrolled despite all available therapies. They are closely related and proper diagnosis is essential to distinguish between them.1
Unfortunately, more research is needed on how to determine the best treatment in patients who have inadequately controlled asthma, in addition to high dose, ICS, LABA. The role of biologics is changing this, however, more research is still needed in regard to best next steps. The current standards of treatment are the GINA guidelines and to follow the stepwise approach.2 Everyone will have individual experiences. In my experience, I needed a biologic and it took a long time to get there, this is before there were as many options on the market as there are now. I know that I felt a bit desperate to get my asthma under control and gain some semblance of a normal life. It did take some experimentation and working on different parts of my asthma, one by one. Inflammation took a front seat, then working on my "twitchy" airways. There are still very limited options for my mucous issues but will be having better control in the other areas. I have been able to enjoy better asthma control.
The risks of uncontrolled asthma that is severe
Severe asthma that remains uncontrolled is at a high risk for exacerbations, hospitalizations and reduced quality of life.1 This can include increased risk of developing stress, depression, and anxiety. Research is currently establishing the links between achieving adequate asthma control and reducing these risk factors.
Dealing with uncontrolled asthma can be frustrating
I know from my experience that it can be an incredibly frustrating experience dealing with uncontrolled asthma. It can feel like a never-ending saga of trying medications, brief moments of a good stretch, and then a return to moments of uncontrolled asthma. Unfortunately, there are no magical fixes but I personally found that going through an extensive diagnosis period and phenotyping was especially helpful for me. I encourage you to hang in there, speak to your care team, seek out second or third opinions, if necessary, and of course, be an active participant in your own asthma management. This may be trying different medications or getting a handle on comorbidities. Things can improve and you will be on your way to feeling better.
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