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Thursday, June 18, 2009

A better way to determine asthma severity

I think it was last week I wrote a post (click here) about how according to the Asthma Guidelines my asthma is severe. I personally don't think my asthma is severe at all, but the guidelines say so, so severe my asthma is.

Today, however, as I was perusing this book called "Allergy & Asthma: Practical Diagnosis and Management," I came across criteria for determining if a person has severe asthma I think is fair. It goes like this (I'll quote this right out of the book):

The following defines severe asthma

  1. Treatment with continuous or near continuous oral corticosteroids (more than 50% of the year).
  2. Requirement of high-dose inhaled corticosteroids to achieve control of mild to moderate persistent asthma.
That to me looks much better. Going by this determination, my asthma isn't even close to severe, because I haven't been on oral corticosteroids in over ten years, and the inhaled corticosteroid I use is the medium and most commonly used dose of Advair (250/50).

Likewise, while I do have mild asthma symptoms occasionally throughout any given day, my peak flows are above normal for me. So I think the Advair does a pretty good job of keeping down the chronic inflammation in my lungs.

Granted, however, the asthma guidelines do say that the best way of determining severity of asthma is "before" starting a patient on inhaled corticosteroids. And, absent the Advair, I'm pretty certain my asthma would be severe.

So, we'll have to conclude this post by saying the asthma guidelines for determining severity are fair pre-corticosteroids, and the chart listed above is best for once a patient is on inhaled corticosteroids.

By my own determination, I now consider that my asthma is mild persistent. Yet not to be treated any less serious than if it were considered severe, because all asthmatics (no matter how severe) can have a severe, life threatening attack.

It's true with all asthmatics (mild, moderate or severe) that asthma should be re-evaluated regularly. The new recommendation is that all asthmatics see their doctor twice yearly.

Any questions or comments please inquire within.

1 comment:

Kerri said...

Now THAT makes sense!!