Living with Asthma

Patients who understand environmental triggers are better able to avoid asthma attacks.

What is Asthma?

Asthma is a disease affecting your lungs. Asthma causes wheezing, short- ness of breath, chest pain, and coughing. In many instances, these symptoms appear mostly at night or early morning. Some people with asthma have these symptoms daily. People with asthma often have asthma attacks. An asthma attack occurs when something bothers your lungs. Airways become swollen and inflamed which makes it hard to breathe. These attacks can be mild, moderate, or severe. Even though you may feel fine, an asthma attack can occur anytime.^1,2

Asthma affects 25 million people in the United States, including 7 million children. Many children outgrow their asthma. For others, it becomes a lifelong condition. Most children develop symptoms before the age of 5. More boys have asthma than girls. In adults, there is no difference between men and women.²

What Causes Asthma?

We don’t know the exact cause of asthma. Researchers believe it results from several factors. Genes appear to be involved. For example, children of parents who have asthma are more likely to have asthma than children of parents who don’t have asthma. Environmental factors also play a role. These factors are called “triggers.” An asthma attack occurs when you come in contact with these triggers. Most people with asthma have allergies, which are also triggers.³

Not all people have the same triggers. To help you identify your triggers, you should keep a diary and write down what you were doing before your symptoms got worse. If your asthma gets worse when you come in contact with a particular agent, then that agent is a trigger. Along with the triggers listed in the Table, many other things can make asthma worse. These include exercise, food additives, food preservatives, fragrances, medicines, and emotions. Knowing and avoiding your triggers will help keep your asthma under control.

How Is Asthma Treated?

Asthma is treated with 2 types of medicines—a long-term medication and a quick relief medication. The quick relief medicine is also called a “rescue” medication. The long-term medication helps reduce airway inflammation. This medication reduces or even eliminates asthma symptoms. Most patients are given inhaled corticosteroids for long-term use. Quick relief medication is used when an asthma attack occurs or when symptoms suddenly get worse. You need to carry your quick relief medication with you at all times because an asthma attack can occur without warning.

Your treatment depends on the severity of your symptoms. Once you begin taking medication, your doctor will ask about your symptoms. He will also ask about any side effects that you may be experiencing. If symptoms are not under control, your doctor will adjust your dose or try another medication. The goal is to achieve maximum control with the least amount of medication.²

What Is an Asthma Action Plan?

You and your doctor will create an asthma action plan. This plan describes your daily treatments and the time you should take your medication. It will also tell you which triggers to avoid. Your asthma action plan helps you identify if your asthma is getting worse. The plan gives you instructions as to when you should call the doctor or 911.

Your asthma action plan also tells you how to measure and record your peak air flow. You will be given a small handheld device along with instructions on how to use it. The device will measure how well air is coming out of your lungs. If your peak air flow measures at 80% or higher, your asthma is considered to be under control. If your peak air flow is between 50% and 79%, it means your asthma is not under control. If your peak air flow is less than 50%, you need to call your doctor or an ambulance.

Dr. Zanni is a psychologist and health systems consultant based in Alexandria, Virginia.

References:

• Centers for Disease Control and Prevention. Asthma. www.cdc.gov/asthma/faqs.htm. Accessed March 13, 2013.
• National Heart, Lung, and Blood Institute. What is asthma? www.nhlbi.nih.gov/health/health-topics/topics/asthma/. Accessed March 13, 2013.
• Morris M. Asthma: practice essentials. http://emedicine.medscape.com/article/296301-overview. Accessed March 15, 2013.