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Monday, July 12, 2010

Asthma control 101

One of the most common questions I get as an asthma expert is: "How do I gain control of my asthma?" Or, "How do I help my son or daughter gain control of the asthma beast?"

In the past several months I've published posts that provide some of the basic wisdom about asthma action plans, signs and symptoms of asthma, diagnosing asthma, asthma triggers and how to avoid them, and pulmonary function basics and peak flow monitoring.

The purpose of this post is to tie all this asthma wisdom together to provide and easy step by step answer to the question: "How to I gain control of my asthma?"

How to Gain Control of your asthma
By Rick Frea, May 6, 2010, @

You know you have asthma, or you suspect as much, and now your mission is to gain control of it so you can get your life back. Or perhaps you're a concerned parent of an asthmatic.

Here are ten tips to better asthma control.

1. Asthma doctor: You must find a good asthma doctor who will work with you on managing your asthma. Not only must you and your doctor be a good asthma control team (as I write here), you must be able to tell if your doctor is doing a good job (to learn how click here). So finding a good doctor is the key to managing your asthma, and a great place to start. (To learn more about the different types of asthma doctors click here).

2. Diagnosing asthma: For your doctor to treat your asthma, you must first get a proper diagnosis. There is no specific test that says, "You have asthma." However, there are a series of questions a doctor can ask you (like these), and tests he may perform, to help him make a definitive diagnosis.

To learn more about diagnosing asthma, click here.

3. Determining level of control: How controlled is your asthma? For most asthmatics, well-controlled asthma is determined by having symptoms or using your rescue inhaler two days a week or less, and being able to live a normal, active life. However, some asthmatics may have more severe asthma (like this guy), and therefore, may set their own goals for determining control.

To help you determine how well controlled your asthma is, check out this chart, and then take this quiz.

4. Determine severity: How severe is your asthma? Most asthmatics have mild or moderate asthma; their asthma is easy to control just by following the tips in this post. However, some asthmatics (around 10 percent) have hardluck asthma, and their asthma is difficult to control even if they are gallant asthmatics. If you have hard luck asthma, here are some tips to help you get your asthma under control. To determine how severe your asthma is, take this test.

5. Set goals: It's up to you to set goals that you want to achieve as far as your asthma is concerned. Do you want to run marathons? Do you want to be symptom free? A more reasonable goal may be to maintain your current quality of life. You'll need to work with your doctor on setting goals that are appropriate for you.

6. Asthma triggers: You must work with your doctor on finding out what exactly is triggering your asthma. If your asthma is seasonal, or if you suspect allergies, he might send you to an allergist to have allergy testing done. Once you know your triggers you can better deal with them, or avoid them altogether.

To learn more about asthma triggers click here and here. To learn how to avoid allergies, click here.

7. Asthma medicine: If avoiding your asthma triggers is not good enough, you'll want to work with your doctor on finding the right potions to help you manage your asthma. There are two types of asthma medicines:

  • Preventative meds: These medicines are taken every day even when you are feeling well and treat the chronic underlying inflammation to prevent acute asthma episodes. These actually make your lungs stronger and improve lung function, so your lungs are less sensitive to your asthma triggers, and acute asthma episodes are rare or less severe when they do occur.
  • Bronchodilators: These are medicines that can give you instant relief from acute asthma symptoms that occur as a result of exposure to your asthma triggers. It is highly recommended that all asthmatics carry a bronchodilator (like Albuterol) with them at all times, even if their asthma is under good control.

To learn more about what medicines work best for you, check out this link.

8. Proper medicine usage: Many respiratory medicines are inhaled directly into your lungs. This allows for the medicine to work quicker, better, and with fewer systemic side effects. There are many unique devices for taking in respiratory medicines, and you'll want to make sure you are using them correctly.

  • Metered dose inhaler (MDI): If you have a rescue inhaler like Albuterol, you'll want to make sure your doctor prescribes a spacer for you to take it with. Studies show an MDI used with a spacer works 70 percent better, and is equally as effective as a nebulizer. To learn more about how to use an inhaler with a spacer, click here.
  • Nebulizer: This is a device that is recommended if you have more severe asthma, or if you are having an asthma exacerbation and cannot inhale to get the MDI medicine into your lungs. Likewise, this is ideal for patients who have coordination problems with an MDI, such as little children and the elderly. For more information, click here.
  • Dry powder inhalers (DPI): These are inhalers where the asthmatic inhales the powder form of a medicine. These work equally well as MDI with a spacer, however you must be able to generate enough flow to actuate the device. Likewise, you'll want to make sure you read the directions, or work with your care provider, to make you're using your DPI correctly. For more information, click here.

To learn which device works best for you, inhaler or nebulizer, click here.

9. Compliance: It is highly recommended of all asthmatics that you take your medicine exactly as you and your physician work out in the doctor's office. The neat thing about asthma preventative meds is most of them only need to be taken twice a day. However, you have to make sure you have a plan so you don't forget to take them. Likewise, as with blood pressure medicine, you must never stop taking them without first getting the permission of your doctor. If you're an asthma mom or dad, you'll need to make sure your child is compliant.

10. Asthma action plan: This is a plan you work on with your doctor so that you know exactly what to do in case your asthma strikes. There are two ways to monitor your asthma, each of which is equally effective:

  • A peak flow meter: This helps you monitor your peak expiratory flow rates. You determine a personal best, and when this starts to drop you know you need to take action.
  • Symptom monitoring: This is where you learn and are observant to the signs of asthma that are unique to you. Then you act appropriately.

To learn how to start an asthma action plan, check out this link.

By working with your asthma doctor, and following the steps listed above, you should soon see that asthma really shouldn't stop you from doing anything.

For more tips, click here.

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