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Tuesday, March 1, 2011

Why You Need to Take Asthma Medicine, Even if You Feel Fine (1)

Carolyn M. Kercsmar, MD, the director of the asthma center at Cincinnati Children’s Hospital Medical Center, recently had a 10-year-old patient who decided, on his own, to stop taking his asthma medicine—crucial maintenance steroids he was supposed to take regularly.

His reasoning: He felt fine and hadn’t had any asthma attacks for a while, so why bother? Dr. Kercsmar performed a series of tests, and it was clear his lung function was compromised, even though he didn’t have any coughing, wheezing, shortness of breath, or other signs of asthma. She made sure he knew that he needed to start his asthma medication again.

“We were to come into pollen season, which could have triggered his asthma symptoms, possibly leading to an emergency room visit or hospitalization,” she says.

Generally, asthma can be categorized into two classes: intermittent asthma, in which symptoms occur less than three times a week, and chronic asthma.

People with intermittent asthma can often get by using only a short-acting or “rescue” inhaler when symptoms develop. Those with more chronic asthma and more frequent flare-ups (like Dr. Kercsmar’s 10-year-old patient) need to take a maintenance medication to reduce inflammation between attacks. “The goal of asthma treatment is to prevent, prevent, prevent,” Dr. Kercsmar says.

Unfortunately, patients failing to take their maintenance medication is an all-too-common scenario. People may take medication incorrectly, in an erratic stop-and-start fashion, or just flat out skip it. It’s not that people with asthma are trying to dupe their doc. Asthma can be a sneaky foe. Most people feel perfectly fine, until they very quickly don’t. All it takes is a rise in pollen counts, a common cold, a chance encounter with a cat, a change in temperature, or a bout of exercise to send a patient into the danger zone. The problem? It’s hard to predict when that will happen.

“It can be hours, days, weeks, or months, so it’s pretty easy for patients to be lulled into a false sense of security,” says Dr. Kercsmar. “It’s an incredibly variable disease that can be punctuated by flare-ups, but the time between flare-ups can be variable.”

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