That said: what is asthma control? That is the topic I delved into in this weeks post on my asthma blog at MyAsthmaCentral.com.
How To Tell If Your Asthma Is Controlled
by Rick Frea (From MyAsthmaCentral.com, Friday, September 04, 2009)
It's easy to think your asthma is controlled when it's not. We asthmatics like to forget we have asthma and go our merry way with our lives. It often gets to the point when we take our meds by habit, without even thinking about what we're doing. It's normal.
This is a worthy thing to think about from time to time, and to discuss with your physician, especially as newer asthma wisdom is learned, and better and safer medicines are invented that can help you gain better control of your asthma.
Is your asthma controlled? The answer is: It depends. For most asthmatics, needing your bronchodilator inhaler (often called a "rescue inhaler") no more than twice a week is considered controlled. However, some severe asthmatics still need to use their rescue inhalers a few times throughout the course of a day.
However, if you don't pay attention to your asthma, you cannot determine how well controlled it is. Likewise, if you don't admit your asthma is not well controlled, you will not gain control of it, and this may come back to cause you greater asthma problems down the road.
I'll use myself as an example of this. There was one time in my life where I thought my asthma was well controlled and it wasn't. In fact, I had been educated when I was a kid how to maintain good control of my asthma, and yet I somehow let this wisdom slip from my conscious memory -- for a while anyway. I went years without seeing my asthma doctor.
I was winded throughout the course of the day, and used my rescue inhaler at will. A friend approached me and told me I needed to see a doctor, and I refused. I said, "My asthma is well controlled." Like most people in denial, I didn't realize that I was in denial!
It wasn't until I a severe asthma attack landed me in the hospital that I started thinking differently. While there, my friend approached me again and said "Rick, you put yourself in here. You need to take better care of your asthma."
That was the day I decided I was going to become the model patient and work to manage my asthma (just like the Gallant asthmatic personality type!). It took a while, but by 2007 I had worked with my doctor and shed the hardluck asthma tag. Right about this time, I wrote on my RT Cave blog that my asthma is under control,and that I also use my rescue inhaler every day. An anonymous blogger responded to my post:
"Dude... You might want to rethink your answers on using albuterol... It should be as needed in asthmatics and generally if used more than twice a week (excluding EIA) your asthma is out of control and you are put into a bracket that is at a higher risk of death from asthma. Patients should always tell their doctors if [they are] using albuterol more than twice a week on a regular basis and their doctor should step them up on their maintenance medications. It's all in the asthma guidelines."
So, was I wrong? Was my asthma not controlled? Considering my past bad experience of being obstinate to the opinions of others, I decided to read these asthma guidelines. What I learned was that you cannot determine "control" in every asthmatic the same way. That anonymous blogger was unaware that I was a hardluck asthmatic even as recently as a few years ago, and that using my rescue inhaler "a few times a day" was a marked improvement for me.
However, generally speaking, he was right when we speak of a majority of asthmatics. Most of us can say our asthma is controlled if we rarely need our rescue medicine. And, for all of us, using your rescue inhaler more often is a sign of poorly controlled or worsening asthma (and that you need to call your doctor).
So, that said, how do you know if your asthma is controlled?
According to the Asthma Guidelines from the National Heart Lung and Blood Institute, regardless of asthma severity, the following are the most common markers for determining asthma control:
* Decreased symptoms or, better yet, prevented symptoms (such as coughing, breathlessness in daytime, night, or after exertion.)
* Decreased use of bronchodilators (rescue inhalers) for quick relief or, ideally, reduced use to less than two days a week.
* Fewer days or no days or school or work missed
* Ability to engage in normal daily activities or in desired activities
* Improved ability to exercise without having asthma symptoms
* Improvement in FEV1 in a pulmonary function test (PFT), or maintaining a normal pulmonary function.
* Reduction in exacerbation's
* Fewer emergency room visits and hospital stays for asthma
* Fewer nighttime awakenings due to asthma
* Optimal asthma meds with minimal adverse effects
* You're expectations are met or exceeded
* You're satisfied with your asthma care
In fact, the greatest marker for determining asthma control is a positive response to asthma therapy that allows an asthmatic to live a normal, active, satisfying life. After all, the goal of any asthmatic is to be "normal."
So, if after reading this you have decided your asthma is definitely well controlled, congratulations! Keep up the great work. If you suspect your asthma could be better controlled, then perhaps it's time you give your asthma doctor a call.