What to Know to Breathe Easier, Even with Asthma
Asthma is a complex lung disorder that affects 25 million Americans. Although the chronic condition is often manageable, 10 people die from asthma each day. Many people who have asthma do not know how to avoid flare ups or do not heed advice on avoiding triggers.
With May as National Asthma and Allergies Month, this is an ideal time to learn about asthma, and its symptoms as well as how to treat and manage the disease.
What Is Asthma?
Asthma is a respiratory condition that causes inflammation in your lungs’ airways. The inflammation narrows those airways and makes it hard to move air in and out. If you get short of breath, feel tightness in your chest when you breathe or hear a whistling or wheezy sound when you breathe, you may have asthma.
A person with asthma may have variable and recurring symptoms, and may be sensitive to certain triggers that can cause a reaction (sometimes called an asthma attack).
Those triggers include:
- Outdoor allergens, such as pollen
- Indoor allergens from pets, dust mites and mold
- Irritants in the air, including smoke and strong odors
- Illnesses such as cold and flu
- Weather conditions, including windy or cold weather
A visit to your doctor can help determine if your symptoms are caused by a trigger, if the airflow obstruction is at least partially reversible and if there is any other diagnosis that could explain the condition. Although many people with asthma have known triggers, for some, an allergic trigger may not be identified.
Your doctor may use a spirometry test to determine your lung capacity. This is a non-invasive test where you inhale deeply and blow out forcefully into the spirometer. This test can help set the baseline of airflow capacity and obstruction.
Asthma may be classified to help physicians determine the appropriate medications and interventions. Severity describes the intensity of the disease. This is done at the time of diagnosis through a combination of the spirometry results, description of recent symptoms and any history of asthma attacks that required medication in the past year.
- How frequently do you cough, have shortness of breath or wheeze?
- Do you often wake at night because of these symptoms?
- How often do you use your rescue inhaler to treat your symptoms?
- Do your symptoms limit your ability to engage in normal or desired activities?
- Have you had any attacks that required oral systemic corticosteroids, emergency room visits or hospitalizations?
Based on your answers to these questions, your physician can determine if your asthma is intermittent, mild persistent, moderate persistent or severe persistent.
Once the appropriate treatment is started, therapy can be adjusted depending on how your symptoms respond to treatment. Asthma may be well controlled, not well controlled or very poorly controlled.
Treatment of Asthma
Managing asthma is a long-term approach, with the overall goal being control of the symptoms. It's important to remember that asthma has no cure. Even if you feel find, you still have the disease, and a flare-up or attack can occur at any time.
A treatment plan for asthma includes four steps, with medicines and combinations changing as needed to control the symptoms:
- First, a short-acting beta agonist is used. Often referred to as an inhaler, this medicine relaxes the muscles around the airways that may tighten during an attack.
- The second step introduces a low-dose inhaled corticosteroid to suppress inflammation.
- The third step involves adding a low-dose inhaled corticosteroid plus a long-acting beta agonist or a medium-dose inhaled corticosteroid.
- The fourth step is a medium-dose inhaled corticosteroid with a long-acting beta agonist and a referral to a pulmonologist.
Once symptoms are well controlled, step-down therapy is recommended , under your doctor's guidance.
One of the best ways to limit asthma attacks is to avoid triggers.
- If the trigger is an animal allergen, remove the irritant by keeping pets out of the bedroom and bathing them weekly.
- If the trigger is caused by dust mites, encase your mattress and pillow, wash pillows and sheets each week, and vacuum carpets once or twice a week to decrease house dust.
- For fungal triggers, control dampness and consider investing in a dehumidifier.
- For pollens, stay inside during peak pollen season, keep windows closed with the air conditioning running and take care of outside tasks in the morning.
- For air pollutants, avoid exercising when pollutant levels are high.
Health conditions such as GERD, obesity, obstructive sleep apnea, rhinitis, sinusitis, stress and depression can make asthma worse.
Factors that carry a higher risk of death from asthma include:
- A previous ICU admission or intubation
- Two hospitalizations within the year
- Three ER visits in any year
- Hospitalization or ER visit within a month
- Using more than two canisters of rescue inhaler per month
- Illicit drug use or psychiatric history
- Difficulty recognizing asthma symptoms
- Cardiovascular disease, chronic lung disease or chronic psychiatric disease
Asthma is a serious disease, but with a solid understanding of it and a strong collaboration with your doctor, you can recognize symptoms early and manage your condition, giving you the best chance to breathe easier.
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