Reducing Your Asthma Medication Safely

**Escape from Asthma Episode #13 Reducing Asthma Medications Safely

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Hi, welcome to episode thirteen of Escape from Asthma that is about reducing your asthma medication safely. Since we know every medication carries some adverse side effects that vary from minor to potentially very serious, so it makes sense to try to manage with as little medication as possible while maintaining good control of your asthma.

Side Effects of Reliever medications: reliever medications can cause tremors or nervousness in children with a 20% risk and over 10% risk of insomnia in young children, all users may experience nausea, fever, bronchospasm, vomiting, headaches and increased heart rate. A smaller percentage may suffer dizziness, coughs, allergic reactions, earache, nose bleeds, and a range of other symptoms.

Warnings are given for any who have severe hypersensitivity to milk proteins. Patients are advised to use with caution if they suffer from cardiovascular disease, asthma, glaucoma, diabetes, hyperthyroidism, or seizures. Excessive use may be fatal; do not exceed recommended dose; serious adverse effects occur when administered dose exceeds recommended dose. They may exacerbate heart failure in patients with reduced ejection fraction and may produce significant hypokalemia, possibly through intracellular shunting, which potentially produces adverse cardiovascular effects.

Preventer medications (Steroid): although life-saving and an essential part of many asthma patient’s treatment do have far more serious adverse side effects when used long-term or in excess. Corticosteroids carry a risk of side effects, some of which can cause serious health problems. When you know what side effects are possible, you can take steps to control their impact.

Side effects of oral corticosteroids

Because oral corticosteroids affect your entire body instead of just a particular area, this route of administration is the most likely to cause significant side effects. Side effects depend on the dose of medication you receive and may include:

• Elevated pressure in the eyes (glaucoma)

• Fluid retention, causing swelling in your lower legs

• High blood pressure

• Problems with mood swings, memory and behavior and other psychological effects, such as confusion or delirium

• Weight gain, with fat deposits in your abdomen, face and the back of your neck

When taking oral corticosteroids longer term, you may experience:

• Clouding of the lens in one or both eyes (cataracts)

• High blood sugar, which can trigger or worsen diabetes

• Increased risk of infections, especially with common bacterial, viral and fungal microorganisms

• Thinning bones (osteoporosis) and fractures

• Suppressed adrenal gland hormone production, which may result in a variety of signs and symptoms, including severe fatigue, loss of appetite, nausea and muscle weakness

• Thin skin, bruising and slower wound healing

Side effects of inhaled corticosteroids

When using inhaled corticosteroids, some of the drug may deposit in your mouth and throat instead of making it to your lungs. This can cause:

• Fungal infection in the mouth (oral thrush)

• Hoarseness

If you gargle and rinse your mouth with water — don't swallow — after each puff on your corticosteroid inhaler, you may be able to avoid mouth and throat irritation. Some researchers have speculated that inhaled corticosteroid drugs may slow growth rates in children who use them for asthma.

So with these potential adverse side effects you will probably agree it makes sense to limit their use as much as safely possible, this is where your breath training provides a way forward.

By this stage of the course I would hope you have increased your Control Pause to over thirty seconds and that you have found you hardly ever feel the need to use your reliever puffer. If you are still in the twenty to thirty second control pause range you will be feeling the benefits but not yet able to manage without your reliever medication from time to time. Don’t worry with more practice you will get there, it can take a little time to change a lifetime’s bad breathing habits.

Remember how you can use an extended breath pause plus a few minutes of reduced breathing instead of your reliever when you have improved your everyday breathing enough. Usually this is when you are achieving a morning control pause of over thirty.

Remember you must continue using your preventer medication, your corticosteroid puffer regularly as prescribed by your doctor. DO NOT DISCONTINUE ITS USE SUDDENLY BUT ONLY WITH GUIDANCE FROM YOUR DOCTOR.

When you have been symptom free and have not used any reliever medication for six weeks you may then approach your doctor to agree on a safe protocol for reducing the preventer medication.

The Buteyko Method suggests that you start by reducing your morning dose first as this is when your natural supply of corticosteroids is highest. If you were on two puffs in the morning and two puffs at night, you will now start a week of one puff in the morning and two at night. Keep a regular check on your control pause during this period and ensure it stays over thirty five seconds. If your control pause goes down then return to your two puffs in the morning again.

Assuming your control pause stays high and you have no symptoms the second week eliminate one puff at night, so now you are taking one puff in the morning and one at night. Once again keep a close check on your control pause to ensure it stays above thirty-five seconds and if it falls go back to two puffs at night.

The third week you can reduce your preventer to just one puff at night and as before maintain a close check on your control pause. If you have no symptoms and your control pause stays high, continue routinely checking your control pause every day especially in the morning. It is generally advisable to keep a check of the morning control pause for a year or more, it literally only takes less than a minute and it is your protection against the return of your asthma.

Don’t try to reduce your preventer medication at a bad time of the year or during a period of stress. Remember it can take some people up to two years to come off all steroids as your adrenal glands need time to rehabilitate to normal functioning.

**IF IN DOUBT ALWAYS CHECK WITH YOUR DOCTOR **

The next episode will discuss stopping taping and Buteyko Exercises and offer more helpful advice on restoring you to full health.