Asthma and How To Control It
Asthma is a common and chronic (long-term) condition. Asthma causes the airways in the lungs to become inflamed and to constrict, making it difficult to breathe. Its impact may be mild, moderate or severe.
How do I know if I have asthma?
The most common symptoms of asthma include cough, wheezing, chest tightness, and shortness of breath. Diagnosis begins with a thorough review of your medical history and symptoms by a health care provider. The provider will perform a physical exam and order pulmonary tests, such as spirometry, pulmonary function, and methacholine challenge tests. Testing is important to make a diagnosis of asthma and to determine your baseline respiratory function and the severity of your condition.
What can trigger asthma symptoms?
Asthma symptoms can be triggered by many things. These include, but are not limited to:
- temperature changes
- environmental factors
- allergens
- stress
- exposure to tobacco smoke or perfumes
- viruses, such as the common cold
These “triggers” cause the airways to react, resulting in constriction and inflammation. In asthmatics, the airway is what we call hyper-reactive, meaning more easily irritated. This hyper-reactiveness is what causes the symptoms associated with asthma, such as cough and difficulty breathing.
How is asthma treated?
The first step in the plan of care to help you manage your asthma is education. It’s important for you to understand:
- how asthma affects the body
- what triggers constriction and inflammation in your airways
- which medications are safe and effective
You will be prescribed a quick relief inhaler to help relieve immediate symptoms. Your provider will work with you to identify triggers that cause the onset of symptoms and identify ways to control these triggers. Your provider may order allergy testing as well.
It is important to follow the plan of care and track the pattern of your symptoms. Your provider will want to know if you get sick or notice an increase in your symptoms, but also remember to see your provider for regular follow-up appointments even if you feel well. Follow-up appointments are important so that your asthma control can be assessed and changes to your treatment plan made if needed. Successful treatment and control of your asthma is truly a partnership between you and your provider.
Controlling Your Asthma
Once diagnosed with asthma, will I always have it?
Yes. You will always have asthma, but it can be well-controlled. Managing your condition well can result in minimal symptoms and thus minimal interruption to your daily life.
What defines “well-controlled” asthma?
Well-controlled asthma means you are having minimal or no symptoms and you do not require your quick relief inhaler (Albuterol) more than twice a week. It also means that you are not waking up from sleep in the middle of the night with asthma symptoms more than twice a month.
How can you limit your triggers?
Limiting your exposure to those things that trigger your symptoms is key to managing your asthma. That includes:
- Getting a flu shot. Over 10,000 people in the United States died of the flu last year. It is recommended that everyone get a flu shot every year, ideally between the months of September and December. In addition, once you are diagnosed with asthma, you should receive the pneumonia vaccine, called Pneumovax 23 and then another pneumonia vaccine at age 65, called Prevnar 13.
- Care in cold weather. If cold weather is a trigger for you, wear a scarf over your nose and mouth when outside.
- Hand hygiene. It is always a best practice to wash your hands well and frequently, especially during a pandemic. It is always best to avoid being around others who are sick.
- Taking antihistamines for allergies. Spring allergies may be a trigger for some, causing itchy eyes, ears, nose and throat. Taking allergy medications, called antihistamines, can help your symptoms and may prevent allergies from triggering your asthma.
Benefits of Shared Medical Appointments
A shared medical appointment (SMA) is an exciting and new model of care that increases the amount of time that a provider has with you. The SMA involves meeting with a provider in a comfortable and friendly group setting with other patients who have a similar health condition. This team approach allows us to provide you with a better understanding of how to take care of your health and answer your specific questions. For our asthma patients, it offers help and support to one another by sharing experiences.
What to expect:
The SMA provides the asthma management team with 90-minutes to educate patients. Topics include:
- A discussion of the different levels of asthma severity.
- An explanation of the most common features of this chronic illness and why this condition has dormant phases as well as exacerbations.
- Examples of triggers in our outside environment and right in our own homes. Recognizing triggers and learning how to avoid them is critical to managing asthma.
- A demonstration of the different types of inhalers and inhaler devices. We have found that many patients who have difficulty with managing their asthma are not using their inhaler(s) properly.
In addition, each patient will receive a peak flow meter, a device to help to monitor asthma at home. Written materials are always provided as well.
Let us help you learn to better manage your asthma. Learn more about our program here.
About the Author:
Kathy Rebeiro, ANP-BC, AE-C
Kathy Rebeiro, ANP-BC, AE-C, is a nurse practitioner in women’s primary care and the asthma clinic at the Women’s Medicine Collaborative. She has an extensive clinical background in primary care, managing a wide array of acute, chronic, and complex problems, as well as preventive and routine medical care. Her clinical and research interests include women’s health issues, asthma education and patient advocacy.
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