Wednesday, May 11, 2016

ASC Conference

Mike and I went to the Asthma Society of Canada Conference  in Toronto last weekend. Here is the link for a video of each talk plus the accompanying slides.

I thought the most interesting presentations were by Mark Fitzgerald and Param Nair. Dr. Fitzgerald talked about the difference between uncontrolled asthma and severe asthma.

Uncontrolled asthma occurs when people are not taking the appropriate medications. It can become very serious and patients can end up in hospital. Why would patients not take the right medications?
  • The patient doesn't have a GP or never thought their asthma was serious - so never had a diagnosis and hence no medication was prescribed
  • The doctor didn't do enough analysis and prescribed the wrong medication
  • The patient couldn't afford the medication (we need universal pharmacare so everyone can get the medication they need)
  • The patient didn't realize that they had to take their medication even when they were feeling fine
  • The patient simply quit taking the medication to see what would happen - this is more common than you would think and can have frightening results. 
Severe asthma is when a patient is properly diagnosed, taking all their medications and still having exacerbations and needing prednisone. Some people need predniosne every day - other people need it in short bursts to end an exacerbation.  I have severe asthma. This is why I had an exacerbation in March after catching a cold - despite taking Xolair, teva trimel, floconazole, symbicort, spiriva, and pulmicort. But, because I am 100% compliant, the symptoms cleared up with prednisone and azithromycin without ever getting completely out of control. At least that is how I understand it.

Dr. Nair's was given an award by the Asthma Society for his break through work. His talk was very important - but  seemed to be aimed at people who already knew a lot - ie doctors. I The main thing I, as a severe asthma patient, understood was that when our body is under attack, our bone marrow produces different kinds of white blood cells to fight the invader.  In a person with asthma these white cells appear in the sputum. Eosinophils in the sputum are a sign of an allergic reaction and can be treated with corticosteroids and prednisone. Neutrophils in the sputum are a sign of infection and can be treated with antibiotics.  There is a fairly simple test that any lab should be able to perform to determine what is in the sputum. Most doctors do not do this test and they should. Otherwise they will prescribe unnecessary medication or ineffective medication. Lucky for me, my specialist does all this and I think he is as cutting edge as Dr. Nair.  I am trying to get a better understanding of this scientific approach and will post again when I know a bit more.

I was on a patient/doctor panel which was intended to give the audience an understanding of doctors' and patients' different perspectives on the disease. It was very rushed and I don't think it actually worked. However, preparing for it - which I did for hours and hours - did give me insights into my own story. Now I just need to figure out the white blood cell thing and I think I will know a lot more.

The last session at the conference was a panel on the need for fair pharmacare. I will write up my thoughts on that at a future time. It is a tough subject with many emotional, economic, business, societal and  political implications - not to mentions society's view of the purpose of taxation, who should be getting this healthcare movement going (the bean counters or the visionary politicians),  plus the actual impact on individual patients who do not get better because they cannot afford their medication.

Last bit of totally good news - my peak flow hit 500 on Monday! This must be good news.

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