Saturday, December 19, 2015

The Confounding Asthma Information Packet

I just got this package in the mail from my health insurance called, "Welcome to our Asthma Program."  It came complete with tips on managing my asthma symptoms, what triggers to be aware of, and the importance of avoiding triggers, It also comes with tips on how asthma is treated, and a 
copy of my very own Asthma Action Plan I can work on with my doctor.  

I don't know what to think when I get this kind of stuff.  I mean, a part of me thinks it's good, considering most asthmatics could benefit from this kind of wisdom.  But a part of me, the part that took over when I received the pamphlet, wanted to make fun of it.  And, of course, this is what I did. I mean, this is just public relations junk as far as I'm concerned.  Allow me to explain. 

1.  Avoiding Triggers.  Here I'm encouraged to work with my doctor to learn my triggers, and then to avoid them.  Yeah, it's easier said than done.  Here they say if I'm allergic to dust mites I'm supposed to allergy proof my home.  Well, this would be fine and dandy if they'd be willing to pay for the things they suggest, like air conditioning.  I'd love to have it.  Maybe they'd like to come and remodel my basement to to get rid of the dust mite infestation down there.  I should stay indoors when the pollen counts are high, they say.  So, what do they want me to do, live in a bubble in the spring, summer and fall.  Fat chance that's going to happen.  

2  Signs your asthma could be better controlled.  
  • Do you have nighttime symptoms more than twice a month
  • Do you need quick-relief medicine more than two times a week? 
  • Do you need more than two canisters of quick-relief medication a year?
Yes, yes, and yes!  Those are my answers.  So they recommend: "If you answered 'yes' to any of these questions, your asthma may not be as well controlled as it could be.  Talk to your health care team about bla bla bla. 

You see why I hate this stuff.  I hate the criteria that you have poorly controlled asthma based on how often you have symptoms and how often you use your inhaler.  I'm already on all the best controller medicines in the world, I already try to avoid my triggers, but, for the sake of God I HAVE SEVERE ALLERGIC ASTHMA. MY ASTHMA CANNOT BE TREATED THE SAME WAY TYPICAL ASTHMATICS ARE TREATED, AND CONTROL FOR ME IS WHAT THEY SAY IT SHOULDN'T. 

I think the whole notion of asthma guidelines are going to change very soon.  I think gone are the days -- or leaving are the days -- when all asthmatica are treated the same.  I think asthma subtypes are going to be further defined, and asthma guidelines created for each subtype.  For instance, my subtype is Severe Allergic Asthma. 

Truly, the only medicine I'm not taking that might benefit me is Xolair, and my doctor has never even suggested I try it.  Still, I'm not even sure my health insurance, the same one that is so concerned about me that it sends me this generic asthma information packet, would put out the $3,000 needed to cover each dose. I mean, they already don't want to pay for Advair and Breo. So, I suppose they care so long as they don't have to pay for it. 

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