Controlling Asthma Your Asthma Can Be Controlled: Expect Nothing Less

"Almost all asthma patients can become free of symptoms with proper treatment. Patients and their families should expect nothing less."

This is a common and true statement made by many who treat asthma patients.

This booklet will help you work with your doctor to become free of symptoms. How? By helping you learn what questions to ask and what information to share with your doctor. This is basic information all people with asthma can use. Read on to learn:

What to expect from asthma treatment

How you and your doctor can control your asthma

How to work with your doctor

Patients and their families can control asthma.

What to Expect From Your Asthma Treatment–The Goals

No symptoms or minor symptoms of asthma (symptoms include wheezing, coughing, shortness of breath, and chest tightness)

Sleeping through the night without asthma symptoms

No time off from school or work due to asthma

Full participation in physical activities

No emergency room visits or stays in the hospital

Little or no side effects from asthma medicine

Do not accept having symptoms as normal.
Goal: Full participation in physical activities. Are You Meeting the Asthma Treatment Goals?

Go to the worksheet, print it out, and put a checkmark next to each goal that you are meeting. Tell your doctor which goals you are meeting and which you are not. Do this at every visit.

All these goals can be met with long-term treatment. You need to work with your doctor to achieve every goal.

If you are not meeting a goal, your treatment may simply need to be changed. Your doctor may ask for help from a specialist to achieve your goals. Ask about this.

Goal: No time off from work or school due to asthma.

How Your Asthma Can Be Controlled

Asthma is a chronic disease. It can be controlled with proper, long-term treatment. But it cannot be cured. People with asthma have —

Airways that react to certain things called triggers — things like smoke or dust

Airways that sometimes become narrow and blocked. This causes wheezing, coughing, or trouble breathing

Airways that become inflamed and swollen.

Each of these features of asthma can be prevented or treated by:

Staying away from your triggers or controlling them

Taking medicine that opens your airways

Getting treatment for the inflammation

Treating inflammation is very important in the control of moderate to severe asthma. This may mean the daily use of such medicines as cromolyn sodium or inhaled steroids. Both of these medicines are safe to take.

Treating inflammation is the advice given in the 1991 National Asthma Education Program’s Guidelines for the Diagnosis and Management of Asthma.

Three Actions to Help You Gain Control of Your Asthma

Learn what things start or prompt your asthma symptoms. Then avoid or control them.

Respond quickly to warning signs of an asthma episode.

Make two treatment plans with your doctor: one for daily treatment and one for emergencies.

What follows will help you talk about each of the above issues with your doctor.

Take your medicine at the first warning sign of an asthma episode.

Learn What Things Start Your Asthma Symptoms and Control Them

Most asthma symptoms start when your airways are bothered by something. These things are called triggers. Your symptoms will be reduced when you stay away from or control your triggers. Your asthma will be more controlled!

Go to the worksheet, print it out, and check the things that trigger your asthma symptoms:

Dogs, cats, or other animals

Colds or flu

Pollen from trees, grasses, and weeds

Dust or mold

Strong odors from perfumes, paints, sprays, or other items

Smoke from cigarettes or from burning wood, paper, or other items

Weather changes or very cold air

Air pollution

Crying, laughing, or yelling

Exercising, what type of exercise?

Aspirin or other medicine

Other

Peak flow meters can help you find out what your triggers are. Peak flow meters measure how well you are breathing. The peak flow meter is simple and small. It can be used at home or at work. Talk to your doctor about this.

Tell your doctor what your triggers are.

Ask your doctor how to control your triggers.

Make a plan with your doctor to take your medicines when you cannot avoid a trigger.

Write your plan of action for staying away from or controlling your asthma triggers:

Respond Quickly to Your Warning Signs of an Asthma Episode

Most asthma episodes or attacks start slowly. Most people can tell when an asthma episode is coming.

"I learned that when my chest started getting tight, my asthma was going to act up. Now I take my asthma medicine when my chest starts to feel tight. I have prevented many asthma episodes this way. Once I learned this, I felt more in control."

Deborah, asthma patient

You can often stop an asthma episode when you catch it early and take your medicine. If you fail to do this, your symptoms may get worse. Learn what your warning signs are. Make a plan with your doctor or nurse about what to do when you notice your warning signs.

Go to the worksheet, print it out, and check the warning signs that you have before an asthma episode.

Drop in peak flow rate

Coughing

Shortness of breath

Tightness in your chest

Wheezing

Faster breathing

Itchy or sore throat

Other

Talk with your doctor about your warning signs.

Tell your doctor your warning signs.

Plan what you should do when your warning signs occur. Follow the plan you and your doctor make. This often means taking your medicine and resting. By knowing what to do when you notice early warning signs, you will feel more in control.

Ask about other times when you should take your medicine. This may be the first sign of a cold or flu. It may be before you exercise. Or it may be before you come into contact with something you’re allergic to.

Ask your doctor about using a peak flow meter.

A peak flow meter can tell you when an asthma episode is coming — even before you feel symptoms. Taking medicine before you feel symptoms can stop the episode. People over age 4 with moderate or severe asthma should use a peak flow meter at least daily.

Write down what your doctor wants you to do when you feel a warning sign:

Make Your Treatment Plan With Your Doctor and Follow It

Talk with your doctor about your different asthma medicines. Some medicines need to be taken daily to prevent asthma symptoms (inhaled steroids and cromolyn sodium). Other medicine can relieve your symptoms once your symptoms begin (medicine that opens your airways).

Complete the "My Asthma Medicine" forms with your doctor (see below or go to the worksheet and print it out). Be sure to tell your doctor if you do not want to take a medicine. Also, call your doctor if you have any problems taking a medicine. Your doctor can often find something else for your asthma.

Ask your doctor to show you how to use an inhaler. Then at each visit, show your doctor how you use your inhaler. Ask if you are using it the correct way. If you have trouble using an inhaler, ask about a spacer or holding chamber.

Remind yourself to take your medicines. Here are some ways to do this.

Take your medicine at the same time as one of your daily routines. Take it at meals, when you brush your teeth, or some other time you choose.

Put a sign on the bathroom mirror or the refrigerator to remind yourself.

Ask your family members to remind you.

Always carry your inhaler that contains the medicine to open your airways. Always have it within reach.

My Asthma Medicines

Ask your doctor the questions below. Write down what your doctor says for each medicine prescribed to you.

Name of medicine

When and how much you should take

How long to take it

What does the medicine do and when will you feel it working

What to do if you forget to take it

Side effects and what to do about them

When to call the doctor

Summing Up: Write a Plan for Controlling Your Asthma

Prepare a plan to manage your asthma with your doctor by going to the worksheet and printing it, and filling it out. Include how you will avoid triggers, respond to early warning signs of an episode, and take your medicine. Work with your doctor to make the use of a peak flow meter part of your routine. Lastly, learn the best way to reach your doctor for routine questions and urgent care.

Write your plan for an asthma emergency.

Ask your doctor what you should do in an emergency. Write the answers below.

What are the signs that tell you to seek care quickly?

What should you do if your medicines do not seem to be working?

Where should you go to get care quickly?

Should you call your doctor first or go to the emergency room?

What do you do if you have an asthma emergency very late at night?

When you call, what information will your doctor want (your symptoms, what medicines you have taken, when you took them, and your peak flow rate)?

How to Work With Your Doctor to Get the Best Care

Ask questions.
Write down all your questions before each visit. Review this booklet to help you decide what to ask your doctor. Take this list with you when you see your doctor. Then ask your questions.

Give information.
Tell your doctor what your symptoms have been since your last visit. Be honest. Provide peak flow meter readings, if you have them. Talk about how and when you take your medicines. Talk about problems or concerns you have about your medicines. Use the checklist of treatment goals given in the first part of this booklet. Talk with your doctor about the goals being met and those not being met.

State what you expect at each visit.
Tell your doctor what you want from the visit. You may simply want some questions answered. Or you might want a change in your medicine.

Follow directions.
Write down what you are supposed to do. Repeat back what you think your doctor wants you to do. This helps you to be sure that you know what you are supposed to do. Take your medicine as your doctor tells you. Tell your doctor when you have trouble doing what he or she asks.

Keep your appointments.
Have a way to remind yourself to keep your appointments. Put a note on the refrigerator, your dresser, or some other place. If you cannot keep your appointment, call and change it. With time, you and your doctor will find the care that works best for you.

You’ll be in control of your asthma!

Ask questions. Follow directions.
Remind yourself to keep your appointments.

On the worksheet, write your questions for your next doctor’s visit.

Other Helpful Phone Numbers For You
These groups provide information and materials.

American Academy of Allergy, Asthma, and Immunology 1-800-822-2762 American College of Allergy, Asthma, and Immunology (for pamphlets or a list of board-certified doctors in your area) 1-800-842-7777 American Lung Association Call your local Lung Association Asthma and Allergy Foundation of America 1-800-727-8462 National Allergy and Asthma Network/Mothers of Asthmatics 1-800-878-4403 National Jewish Medical and Research Center Information Service (Lung Line) 1-800-222-5864

For further information, contact National Asthma Education and Prevention Program 1-301-251-1222

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service – National Institutes of Health

NIH Publication No. 91-2664


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