Asthma

Understanding asthma

Asthma causes inflammation of the air passages and makes it difficult to breathe.

What is asthma?

Asthma is a chronic, or lifelong, lung disease that makes your lungs more sensitive than other people's. Sensitive airways are more likely to react to irritants and other triggers. Once asthma is "triggered," the lining of the airways gets inflamed or swollen and the muscles around the airways tighten, making breathing difficult.

What are the symptoms?

Not all people with asthma have the same symptoms, but the most common ones are:

• Shortness of breath
• Chest tightness
• Wheezing (noisy breathing)
• Persistent coughing, especially at night or after exercise

How is it diagnosed?

To diagnose asthma, your doctor will hear your history of symptoms, listen to your lungs with a stethoscope (to detect wheezing), and perform a peak flow test which shows how quickly you can blow out air in a single breath.

Sometimes an X-ray may be ordered to rule out other causes of coughing or wheezing, like pneumonia.

What is an asthma attack?

An asthma attack happens when your symptoms worsen. The symptoms can be mild or severe. Anyone can have a severe attack, even a person with mild asthma. The attack can start suddenly or slowly. Attacks usually need to be treated immediately with an inhaler, because they can be very dangerous — even fatal — when severe and left untreated.

If you're having so much difficulty breathing that you can't speak more than a few words, or you're using your chest muscles to help you breathe and your regular medicines are not helping, get medical help immediately.

Types of asthma

Your treatment plan and the types of doctors you need to see depends on which type of asthma you have.

• Some people with asthma have symptoms every once in awhile, such as only during exercise or only when they've had a cold for several days. Regular medicine is usually not necessary. This is known as intermittent asthma.
• Others have symptoms more than once a week and/or have nighttime symptoms more than twice a month. Doctors refer to this as mild asthma.
• If you have daytime symptoms every day, and nighttime symptoms at least once a week, then you have moderate-to-severe asthma.

Finding the right care

Start by seeing your primary care doctor at least once a year.

If you have asthma, plan to see your primary care doctor at least once a year for checkups and preventive care.

Your primary care doctor can recommend a tailored asthma treatment plan and make sure you get annual vaccines like a flu shot and pneumonia shot. These are especially important since people with asthma are at high risk of complications from these illnesses.

If your asthma is triggered by allergies, you may benefit from seeing an allergist/immunologist. This is a doctor who specializes in the diagnosis and treatment of asthma, helping people identify the factors that trigger asthma and teaching them how to prevent asthma attacks.

If you have mild or moderate-severe asthma, you should also see a pulmonologist, a doctor who specializes in lung diseases, once or twice a year for more specialized care, medications, and to check how well your lungs are functioning.

Choosing a treatment plan

Control your asthma so it won't control you.

1. Work with your doctor to create an asthma action plan

An asthma action plan is a written plan that tells you and the people who care about you to take care of asthma symptoms. This includes what to do every day to prevent symptoms and also what to do if symptoms are very bad or severe.

2. Know your triggers and how to avoid them

Your doctor may recommend you keep a journal to track your asthma symptoms and identify your triggers. When you know what triggers your asthma, you can take steps to avoid or minimize them.

Common asthma triggers include:

• Allergens like pollen, dust mites, mold, animal dander, and cockroach droppings
• Irritants like cigarette smoke, air pollution, or strong odors
• Exercise
• Respiratory illnesses like cold, flu, and sinus infections
• Changes in weather, or particular kinds of weather
• Strong emotions, anxiety, or stress
• Some types of medications like aspirin or non-steroid anti-inflammatory drugs (e.g., Ibuprofen)

3. Take your asthma medicines at the right times, and take the right amount

There are two main types of asthma medications with different uses. Your doctor may recommend one or both types, depending on what type of asthma you have.

1. Short-acting “rescue” inhalers for use during an asthma attack. Sometimes called “bronchodilators,” they relax the area around the lungs. People with asthma often need to keep this type of medication with them at all times.
2. Long-acting “controller” medication taken on a daily basis to prevent attacks from happening.

4. Monitor your symptoms

About once each year (more often depending on the severity of your asthma) your doctor may perform a pulmonary function test to measure how well your lungs are working, A quick, painless office test that measures the volume and speed of air that a person can inhale and exhale.

Your doctor may have you take regular breathing tests at home using a peak flow meter. A peak flow meter is a small, handheld device that measures the speed at which you exhale.

Living with asthma

You don't have to let asthma keep you from living an active life.

Don't let asthma keep you on the couch

People with asthma can and should get regular exercise. Your doctor can help you determine how to use medications to keep symptoms under control when you're exercising. Walking, biking, yoga, and swimming are all a good fit for people with asthma.

Exercise is also good for your overall health and controlling your weight. This is especially important since obesity is associated with more severe asthma symptoms.

Asthma and your emotional wellbeing

Asthma doesn’t just take a toll on your physical health, it affects your emotional health as well.

Difficulty breathing is a frightening experience. Asthma attacks cause anxiety and fear of future attacks. Asthma attacks are also unpredictable. The feeling that an attack can happen at any time can make people with asthma feel like they’re always in danger.

So it's not surprising that almost half of all people with asthma also have anxiety or depression. Besides taking an emotional toll, this fact can make it difficult to stay on track with your asthma action plan.

If you have asthma and think you may have symptoms of depression, you are not alone. Talk to your doctor about these feelings so you can get the support you need for your physical and emotional health.