■ no or few asthma symptoms, even at night or after exercise
■ prevention of all or most asthma attacks
■ participation in all activities, including exercise
■ no emergency room visits or hospital stays
■ less need for quick-relief medicines
■ no or few side effects from medicines
Keep Asthma Symptoms in Check
Many of the 22 million Americans who have asthma limit their activities and miss work or school. The disease also can kill. Almost 4,000 people die from asthma each year and most of these deaths are preventable. Uncontrolled asthma and asthma deaths happen when the disease is not treated correctly or sometimes because people do not know they have asthma.
Effective asthma treatment begins with the right diagnosis early in the disease. Delays can lead to permanent lung damage.
Your doctor first decides how to treat your asthma by looking at what your symptoms are now and what they have been in the past. The doctor also will try to determine your risk for future attacks. This information will help you and your doctor develop a plan to manage your disease and keep your asthma under control. If you just started treatment or have frequent symptoms, your doctor may want to see you every two to six weeks. Once treatment is under way, doctor visits may be every one to six months to check asthma control, even when you have no symptoms.
During your visits, the doctor will review your symptoms, activities and medicines. Between visits, it is important for you to monitor your asthma by keeping an asthma diary to track your symptoms or using a peak flow meter to measure the air fl ow from your lungs.
With either method, you also should keep track of your medication use. This information will help you and your doctor decide if any changes in your treatment plan are needed.
Partner with Your Doctor
Your doctor is your partner in learning about and managing your asthma. Together, you and your doctor should:
- talk about your treatment goals and how you can reach them
- develop a written asthma action plan that explains the treatment you need every day and what to do if your symptoms become worse
- review your asthma medicines so that you understand the purpose of each
- practice how to take your medicine
- discuss how to keep track of your symptoms and make decisions about how much medicine to take
- review the things that make your asthma worse - your 'asthma triggers' - and discuss tips on how to avoid them
The more you learn about your asthma and your medicines that treat it, the more you can keep your disease in control.
Avoid Asthma Triggers
Often the best way to control asthma symptoms is to stay away from whatever causes or “triggers” them.
Asthma triggers frequently include
■ things to which you are allergic (allergens) such as pollen, dust mites, cockroaches, molds and animal danders
■ tobacco smoke, air pollution, formaldehyde and other volatile organic substances
■ medicines such as aspirin and acetaminophen
■ cold air
■ exercise
Some health problems also can trigger or make asthma symptoms worse. These include obesity, obstructive sleep apnea, acid refl ux, the common cold, sinus infections, stress and depression. Let your doctor know if you have one of these conditions so you can discuss the best approach to control both your health problem and your asthma symptoms.
Use Proper Asthma Medication
Today, there are many effective medicines to treat asthma. Most people with asthma need two kinds.
■ Quick-relief medicines — taken at the first sign of any asthma symptoms for immediate relief:
Short-acting inhaled beta2-agonists
Anticholinergics
Your doctor also may recommend you use these medicines before exercise. Quick-relief medicines can stop asthma symptoms, but they do not control airway inflammation that causes the symptoms. If you fi nd that you need your quick-relief medicine to treat asthma symptoms more than twice a week, or two or more nights a month, then your asthma is not well controlled. Be sure to tell you doctor.
■ Long-term control medicines — taken every day to prevent symptoms and attacks:
Antileukotrienes or leukotriene modifiers
Cromolyn sodium and nedocromil
Inhaled corticosteroids
Long-acting inhaled beta2-agonists (never taken alone)
Methylxanthines
Oral corticosteroids
Immunomodulators
These medicines are taken every day even if you do not have symptoms. The most effective long-term control medicines reduce airway infl ammation and help improve asthma control.
Your doctor will work with you to fi nd the right medicine, or combination of medicines, to manage your asthma, and will adjust the type and amount based on your symptoms and control. The goal is to have you feel your best with the least amount of medicine.
Consider Allergy Shots
If you cannot avoid an allergic asthma trigger and you have symptoms three days a week and more than two nights a month, you should consider allergy shots. Also known as immunotherapy, the shots are especially helpful when symptoms occur year-round or are not easily controlled by medicine.
See an Allergist, an Asthma Specialist
An allergist can help you learn more about your asthma and develop a treatment plan that works for you.
The Guidelines say that you should see an asthma specialist if you:
■ have asthma symptoms every day and often at night that cause you to limit your activity
■ have had a life-threatening asthma attack
■ do not meet the goals of your asthma treatment after three to six months, or your doctor believes you are not responding to current treatment
■ have symptoms that are unusual or hard to diagnose
■ have conditions such as severe hay fever or sinusitis that complicate your asthma or your diagnosis
■ need more tests to fi nd out more about your asthma and the causes of your symptoms
■ need more help and instruction on your treatment plan, medicines or asthma triggers
■ might be helped by allergy shots
■ need oral corticosteroid therapy or high-dose inhaled corticosteroids
■ have taken oral corticosteroids more than twice in one year
■ have stayed in a hospital because of your asthma
■ need help to identify your asthma triggers
An asthma specialist is recommended for children ages 0-4 who have asthma symptoms every day and three to four nights or more a month, and should be considered for children who have symptoms three days or more a week and one to two nights a month.
Source: American College of Allergy, Asthma & Immunology