After a record number of admissions to the intensive care unit this year, (5 so far), it was pretty evident that my current asthma action wasn’t working anymore. So, at last weeks pulmonary clinic follow-up visit, we (they) came up with a new asthma action plan that will hopefully reduce that high number of ICU admissions.
For those of you who don’t know what I’m talking about; an asthma action plan is basically a set of instructions agreed upon by the patient (me) and the physician (my lung docs), on how to best manage one’s asthma on a daily basis. It includes such things as, how to interpret peak flow readings, when to increase or take certain medicines, what to do if your symptoms get worse, when to contact the your doctor…that sort of thing. The goal for most people of course, is to keep your asthma under control so that it will never escalate to the point where you have a crisis and need to seek emergency medical care.
Well, with very brittle asthmatics, things are a little trickier. The primary goal of the action plan often becomes not one of avoiding the ER, but rather, of going to the ER right away.
The way it worked before, was at the first sign of increased symptoms (ie. my yellow zone) , I would take a loading dose of prednisone (60-80mg) and then wait at least 24 hours for the steroids to take effect. If after that period I felt better…fine. If not , I would call my doctor for further instructions or go to the ER for treatment depending how I felt.
This new action plan eliminates that 24 hour waiting period altogether.
Now , they want me to go to the emergency room immediately after taking the first dose of prednisone and regardless of whether I think it’s necessary or how I feel.
In other words, no more waiting to see if things will get better.
The rationale for all this is ? In their words (not mine):
#1 ) I’m a poor judge when it comes to recognizing the severity of my own symptoms.
#2) Sometime I like to push the envelop.
# 3) It’s better and much safer for someone like me to spend maybe one day in the emergency room, than to spend a week in the intensive care unit….or worse.
Let’s hope I don’t have to put this new plan to the test for a long..long time.
I have a marathon to train for, and even a single day in the hospital is going to screw things up.