Asthma: Learning to Control Your Symptoms

What is asthma?

Asthma is a disease of the lungs. The airways of people with asthma are extra sensitive to the things they're allergic to (called allergens) and to other irritating things in the air (called irritants).

Asthma symptoms start when allergens or other irritants cause the lining of the airways to swell (become inflamed) and narrow. The muscles around the airways can then spasm, (contract rapidly), causing the airways to narrow even more. When the lining of the airways is inflamed, it produces more mucus. The mucus clogs the airways and further blocks the flow of air. This is called an "asthma attack."

How do I control my asthma symptoms?

Treatment of your symptoms involves avoiding things that cause asthma attacks, keeping track of your symptoms and taking medicine.

How can I avoid allergens and irritants?

If pollen and mold cause your symptoms, use your air-conditioner and try to keep the windows of your home and car closed. Change the filter on your heating and cooling system frequently.

To keep mold down, clean and air out bathrooms, kitchens and basements often. Keep the level of humidity under 50%. You can do this with an air conditioner or a dehumidifier.

People who are allergic to dust are actually allergic to the droppings of dust mites. To reduce dust mites in your home, wash bedsheets weekly in hot water (above 130°F). Cover mattresses and pillows in airtight covers and remove carpets and drapes. If you must have carpet, you can treat it with chemicals to help reduce dust mites. Try to avoid stuffed animals, dried flowers and other things that catch dust.

Pets can cause problems if you're allergic to them. If you have a pet, keep it out of your bedroom.

Don't allow smoking in your house or car. Tobacco smoke can make your asthma worse.

Things that can trigger an asthma attack

Air pollution
Dust
Mold
Pollen
Tobacco smoke
Pet dander
Exercise
Changes in temperature
Some foods
Sulfite (food preservative in red wine, beer, salad bars, dehydrated soups and other foods)
Aspirin, or ibuprofen (brand names: Advil, Motrin, Nuprin)
Heartburn
Sinus infections
Strong emotions
Perfume
Spray-on deodorants
Viruses

What is a peak flow meter?

A peak flow meter is a hand-held device that measures your peak expiratory flow rate (PEFR), or how fast you can blow air out of your lungs. Measuring your peak flow regularly can help you tell whether your asthma is getting worse.

To use a peak flow meter, you will first need to find out your "personal best" peak flow. Take a deep breath and blow as hard as you can into the mouthpiece. Your personal best is the highest reading you get on the meter over a 2-week period when your asthma is under good control.

What medicines are used to treat asthma?

Warning signs of an asthma attack

Peak flow less than 50% of your personal best
Coughing or wheezing
Shortness of breath
Tightness in chest

Asthma medicines can generally be divided into two groups: medicines to prevent attacks, (controller medicines), and medicines to treat attacks (sometimes called rescue medicines).

Your doctor will talk to you about these medicines and what to do if you have an asthma attack.

How do controller medicines work?

Controller medicines help reduce the swelling in your airways to prevent asthma attacks.

Controller medicines include inhaled corticosteroids (some brand names: Azmacort, AeroBid, Flovent, etc.), cromolyn (one brand name: Intal) and nedocromil (brand name: Tilade).

Newer medicines, called anti-leukotrienes, are also used to prevent asthma attacks. These include montelukast (brand name: Singulair), zafirlukast (brand name: Accolate) and zileuton (brand name: Zyflo).

Controller medicines must be taken on a regular basis--whether or not you're having symptoms. They take hours or days to start to help and don't work well unless you take them regularly.

How do rescue medicines work?

Rescue medicines provide quick relief during an asthma attack by helping the muscles around your airways relax, which allows your airways to open.

Inhaled bronchodilators are rescue medicines (some brand names: Brethine, Proventil, Tornalate, etc.). They can be used on a regular basis or only when they are needed to quickly reduce symptoms.

How do I use an inhaler?

Some asthma medicines are taken with a metered-dose inhaler. Your doctor will show you how to use an inhaler. Here are the basic steps:

Remove the cap and hold the inhaler upright.
Shake the canister.
Tilt your head back and breathe out.
Put the inhaler 1 to 2 inches away from your mouth. Or, if you're using a spacer, put the end of it in your mouth and seal your lips around it. (A spacer is a tube that you attach to your inhaler. It makes using an inhaler easier.)
Press down on the inhaler to release the medicine as you slowly breathe in for 3 to 5 seconds. (If you use inhaled dry powder capsules, close your mouth tightly around the mouthpiece of the inhaler and inhale rapidly.)
Hold your breath for 10 seconds so the medicine can get into your lungs.
Repeat as many times as your doctor suggests. Wait 1 minute between puffs.

How can I tell if my asthma is getting worse?

Signs that your asthma is getting worse include having symptoms at night, a drop in your peak flow and the need to use your rescue medicine more often. Talk to your doctor if you think that your asthma is getting worse.

Get help right away if:

Your rescue medicine doesn't relieve your symptoms.
Your peak flow keeps dropping after treatment or falls below 50% of your best.
Your fingernails or lips turn gray or blue.
You have trouble walking or talking.
You have extreme difficulty breathing.
Your neck, chest or ribs are pulled in with each breath.
Your nostrils flare when you breathe.