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Asthma is a long-term disease that leads to inflammation and narrowing of the airways in the lungs. During an asthma flare (exacerbation or attack), the lung airways become so inflamed and narrow that it becomes difficult to move air in and out of the lungs. As a result persons experience symptoms of shortness of breath, chest tightness, cough and wheezing. Wheezing is a whistling sound heard when breathing and chest tightness may feel like something is pressing down on the chest. The shortness of breath feels like it is difficult to exhale or breath air out of the lungs and the coughing usually occurs at nights or early mornings. Your doctor will diagnose asthma based on your medical history, a physical exam, and “Lung Function” test results.
The following are Factors that may trigger or worsen asthma symptoms (especially when asthma is uncontrolled):
The cause of asthma is still unknown, and there is no cure. It affects roughly 300 million persons worldwide (according to WHO). It affects persons of all ages, but most often starts during childhood. Asthma flares can be fatal, so it is very important to follow your “ asthma action plan”. Below are some tips to help reduce asthma flares and help keep the disease under control. CONTROL Tip#1: The goal of asthma treatment is to control the disease, which will prevent asthma attacks, help you maintain good lung function and let you maintain your normal activity and sleep at nights. MEDICATION Tip#2: Asthma medicines are usually taken using a device called an inhaler, which allows the medicine to go directly to the lungs. (Some medicines for asthma are taken in tablet form as well.) Tip#3: Quick Relief Inhalers Every person with asthma should have a quick relief inhaler. Use these whenever you feel symptoms (chest tightness, wheeze, shortness of breath, cough). The medicines in these inhalers are short acting beta2 agonists e.g. salbutamol/albuterol/Ventolin. They are bronchodilators, which relax the tight muscles around the airways in the lungs; this allows the airways to open up to allow better airflow. Your Reliever Inhaler should be taken with you everywhere you go in case you do begin to feel symptoms. Tip#4: Controller (Prevent-er) Inhalers Most persons with asthma have to use a controller inhaler. These inhalers contain medicines called Inhaled Corticosteroids, which offer long-term control of asthma. Some examples include beclometasone, budesonide and fluticasone. These work by reducing the inflammation of the airways in the lung. They prevent symptoms from starting, but DO NOT OFFER QUICK RELIEF OF SYMPTOMS. These inhalers should be used daily and can reduce the severity of symptoms and how often they occur. Inhaled corticosteroids usually are safe, but can have side effects, the most common being oral thrush (a mouth infection). Rinsing your mouth with water after using your controller inhaler can lower your chance of getting thrush. Another option is to use a SPACER to prevent the medicine from landing in your mouth or throat (see below). Tip#5: For persons with severe asthma, other types of medicines may be used to help control symptoms. These include long acting beta2 agonists with inhaled corticosteroids (inhaler), leukotriene modifiers, theophylline and oral corticosteroids that are all in pill form. Tip#6: How to use a Metered-dose Inhaler (MDI) A metered-dose inhaler is a device that sprays a pre-set amount of medicine through the mouth to the lungs. It is important to use it as prescribed by your doctor. The steps below indicate how to use your inhaler correctly. 1st- Take off the cap of the inhaler and shake it about 10 times. 2nd- Take a deep breath in and then blow out the air completely. 3rd- Hold the inhaler upright and place it in your mouth, make a tight seal. 4th- Press down firmly on the canister once to release 1 puff, while taking a slow breath. 5th- Hold your breath for about 5 to 10 seconds, then exhale slowly. 6th- Wait for about 30 seconds before taking another puff. Tip#7: How to use an inhaler with a Spacer SPACERS are large tubes, usually plastic, that are used with inhalers to deliver medicine to the lungs. They are easy to use, and deliver more medicine to the lungs than inhalers alone. One end has an opening to attach the inhaler and the other end has an opening for the mouth (a face mask can also be attached here). Children benefit more from spacers with face mask. 1st- Take off the cap of the inhaler and shake it about 10 times. 2nd- Attach it to the spacer in an upright position. 3rd- Put the other end of the spacer in your mouth, (or attach a face mask and put it over the mouth and nose). Ensure a tight seal. 4th- Press down firmly on the canister once to release 1 puff, while taking a slow breath. 5th- Hold your breath for about 5 to 10 seconds, then exhale slowly. 6th- Wait for about 30 seconds before taking another puff. See videos in the link below that demonstrate proper techniques on using inhalers and spacers. https://www.cdc.gov/asthma/inhaler_video/default.htm Tip#8: AVOIDING TRIGGERS One of the important methods to control asthma is to avoid its triggers. Avoiding some allergens such as dust and smoke may be easy, and keeping the home clean may be possible. However other triggers such as stress and viral infections may not be as simple. It is important to stop smoking, as this could significantly improve symptoms. One trigger that must not be avoided is EXERCISE because of the overall health benefits that it provides. Talk with your doctor about how to manage exercise-induced asthma. Tip#9: EXERCISE-INDUCED ASTHMA Some persons’ asthma is triggered by increased physical activity. If you have exercise-induced asthma, you may benefit from using a controller medicine or using a reliever inhaler before exercising. Some types of exercises are less likely to induce symptoms than others; these include walking, hiking, biking and swimming. Sports such as football, basketball and long distance running require longer activity and are more like to provoke asthma symptoms. Tip#10: Asthma Diary Keeping an asthma diary can help your doctor identify how controlled your symptoms have been since you were last reviewed. Note the date you had symptoms and what kind of symptoms they were and how severe. Also note when you used your reliever inhaler.. If you know how to take your own peak flow readings, you can record them as well. An asthma diary is beneficial to persons who have symptoms often (several times a year). Tip#11: ASTHMA ACTION PLAN An action plan is written up by your doctor/nurse. There are 3 main sections: green, yellow and red, which correspond to ‘doing well’, ‘warning symptoms’ and ‘emergency’. Each zone describes the symptoms you are experiencing and tells you what and how much medication you should take, and whether or not you should go to a doctor/hospital. Your action plan may change slightly depending on how controlled your symptoms are. Persons that follow their action plan are 4 times less likely to end up in the hospital. Tip#12: Emergency!! The following are signs/symptoms of an asthma attack that requires that you or anyone with these signs/symptoms be taken to the emergency department.
If you/anyone having an asthma attack experience any of these symptoms and have/ has a RELIEVER INHALER, take 4 puffs every 4 minutes until symptoms subside or until you/they have arrived to the hospital or an ambulance has arrived. I hope the tips on ASTHMA were helpful, REMEMBER, YOUR HEALTH IS INVALUABLE. By Dr. Lawarna Matthew
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AuthorDr. J. Lawarna Matthew Archives
January 2021
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