Medication Dilemma

[Junglechicken]

Last year I was on a cocktail of asthma drugs. Around this time I was regularly hitting my PB. I began to feel uncomfortable taking so many drugs and decided that I wanted to try controlling my asthma with combo inhaler and salbutamol. For the last 6 months or so I’ve not been anywhere near the PB set during my consultant prescribed asthma plan. I’m still within acceptable levels on a good day around 85% and take my blue 2-3 times a week, which is a bit close to the limit.

I chatted to my GP and she has left it up to my own judgement whether I go back to my old regime and will support me what ever I decide. Although she does find the use of Azithromycin a little “unconventional” but bows to the expertise of the consultant.

I think going back to by old regime, (there’s no pred involved) which resulted in less blue use, is the way to go but I’m not sure. I understand that it is a very personal decision but I would welcome any thoughts. Thank you.

JC

[twinkly29]

I agree with Frazzle that you need to discuss this with your consultant. Your GP will say it's up to you because any medical decision is your choice and of course they don't have the expertise to advise you further, hence you seeing a specialist.

Were you put on the other asthma drugs by the private consultant you saw? It's not them being private that's the issue but trying to work out the timescale and whether they were added all at once or gradually. As you know I'm sure, asthma should be treated in step up step down way. It usually is in the UK but baffles me when (here or abroad) they throw all sorts of drugs at it at once - how is anyone, patient or medic, supposed to know which meds are working and which are actually needed (when it's done at a low level of asthma people end up way over medicated as well - not saying this is the case with you but happens very often when lots of meds are thrown at it early on in diagnosis).

That's quite a long roundabout way of saying that it's possible you don't need all the meds you were put on - because you are within your green zone without them. However, changing meds should always be done with medical involvement - it may not be dangerous immediately to change things but could well be in a less obvious way, eg underlying but almost unnoticed uncontrolled asthma.

No-one (well I would hope no-one 😅) wants to be on a raft of medication but sometimes that's needed. In many cases that's the answer - for you, for example, it gave you that control you'd not had before. Surely that's what one would want? It's also not to say that being on it all means that's forever - things change and, as I said above, being a step up step down thing, doctors and asthma nurses should look to reduce things when they're happy with a period of stability.

That said, some asthmatics have to be on a raft of medication - for some (like you) it will give the control and so give them their lives back - and so while not ideal to be taking the meds, needs must (a bit like other medical conditions - a diabetic doesn't want to have to be on insulin for example....but 🤷). At the other end of the scale of course, some people remain symptomatic despite everything and would give anything to have that control.

Of course the "ideal" is not to use one's blue inhaler more then twice a week (or whatever it is - I forget as I'm past that being a thing for my asthma). People should use it as needed and, if it's a sign that more control is needed, that should be put in place.

As someone with complicated severe asthma that's difficult to control despite loads of medication, the important thing to me is it not being my sole focus. If it becomes something to almost obsess over (which would be quite easy with symptom spotting, symptom tracking, which meds to take when, covid, peak flows, flares, admissions, appointments and so on) then that actually makes it worse - in terms of life impact compared to just taking the meds anyway.

Anyway back to you!

My advice would be to get in touch with your consultant (probably by phone at the moment of course), explain your concerns about too much medication and "good control but with niggles" and which of the discarded meds might be best to reinstate as a trial. At the end of the day, if one does need the medication to get the control and get our lives back then that's the way it is, despite it not being our preference. It does sound as if you probably don't now need all the drugs you were given - but please do it under medical supervision!

[ninelives]

Totally agree with the other posts on here.

Discuss with your respiratory team.

Be clear on what the plan is and very best of luck

[Junglechicken]

Thank you to everyone who has replied there are some great points that have been raised. I think I will call my consultant and get his take on the situation.