Asthma is a condition in which your airways narrow and swell and may produce
extra mucus. This can make breathing difficult and trigger coughing, a
whistling sound (wheezing) when you breathe out and shortness of breath.
For some people, asthma is a minor nuisance. For others, it can be a major
problem that interferes with daily activities and may lead to a life-threatening
asthma attack.
Asthma is a long-term disease that can’t be cured—but it can
be treated. With proper treatment, you can enjoy doing the things you
want to do.
Asthma is present, even when you have mild or no symptoms. That’s
why it’s important to do all you can to prevent symptoms before
they appear.
What does asthma feel like?
The main symptoms of asthma are:
Coughing—with or without mucus
Wheezing—a whistling noise when you breathe
Chest tightness—a feeling that something is squeezing or sitting
on your chest
Shortness of breath—not being able to catch your breath
For some people, asthma signs and symptoms flare up in certain situations:
Exercise-induced asthma, which may be worse when the air is cold and dry
Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach
waste, or particles of skin and dried saliva shed by pets (pet dander)
What happens when you have asthma symptoms?
Three things happen when you have asthma symptoms:
Swelled up: The lining of the airways are swollen.
Plugged up: An asthma trigger then makes the airway space fill with mucus.
Squeezed up: An asthma trigger causes the muscle around the airway to squeeze, making
the airway even smaller and further limiting airflow.
Diagnosis
To diagnose asthma, your doctor will discuss your medical history with
you and perform a physical exam. You may need a lung function test and
maybe other tests, such as a chest or sinus X-ray.
Personal and medical history
Your doctor will ask you questions to understand your symptoms and their
causes. Bring notes to help jog your memory. Be ready to answer questions
about your family history, the medicines you take and your lifestyle.
This includes any current physical problems. A history of allergies or
eczema increases your chance of asthma. A family history of asthma, allergies
or eczema increases your chance of having asthma, too.
Tell your doctor about any home or work exposure to environmental factors
that can worsen asthma. For example, these might include pet dander, pollen,
dust mites and tobacco smoke. The doctor may also ask if you get chest
symptoms when you get a head cold.
Physical exam
If your doctor thinks you have asthma, they will do a physical exam. They
will look at your ears, eyes, nose, throat, skin, chest and lungs. This
exam may include a lung function test to detect how well you exhale air
from your lungs. You may also need an X-ray of your lungs or sinuses.
A physical exam then allows your doctor to review your health.
Lung function tests
To confirm asthma, your doctor may have you take one or more breathing
tests known as lung function tests. These tests measure your breathing.
Lung function tests are often done before and after inhaling a medicine
known as a bronchodilator, which opens your airways. If your lung function
improves a lot with use of a bronchodilator, you probably have asthma.
Your doctor may also prescribe a trial with asthma medicine to see if it helps.
Treatment
There are many effective medicines to treat asthma. Most people with asthma
need two kinds: quick-relief medicines and long-term control medicines.
Immunotherapy (allergy shots) can also be helpful.
Quick-relief medicines are taken at the first sign of symptoms for immediate relief:
Short-acting inhaled beta2-agonists
Anticholinergics
Both types of drugs are bronchodilators, meaning that they expand the passageways
into the lungs (the bronchi), allowing more air in and out and improving
breathing. They also help to clear mucus from the lungs by enabling the
mucus to move more freely and get coughed out more easily.
If you have exercise-induced bronchoconstriction (EIB), also known as exercise-induced
asthma, your doctor may recommend that you use these medicines before
exercise or other strenuous physical activity.
Quick-relief medicines can stop asthma symptoms, but they do not control
the airway inflammation that causes the symptoms. If you find that you
need your quick-relief medicine to treat asthma symptoms more than twice
a week, or two or more nights a month, then your asthma is not well controlled.
Long-term control medicines are taken every day to prevent symptoms and attacks:
Antileukotrienes or leukotriene modifiers
Cromolyn sodium
Inhaled corticosteroids
Long-acting inhaled beta2-agonists (always administered with another asthma-related drug)
Methylxanthines
Oral corticosteroids
Immunomodulators
These medicines are taken every day, even if you do not have symptoms.
The most effective long-term control medicines reduce airway inflammation
and help improve asthma control.
Asthma Biologics
There is a group of injectable prescription medications that treat severe
asthma in patients whose symptoms are not well controlled by inhaled medications.
These specialized medications target cells and pathways that cause airway
inflammation.
These injections can be given at home or in the clinic; as often as every
two weeks or up to every 8 weeks depending on the medication of choice.
You doctor my order blood tests or breathing test to see if you qualify
for an injectable asthma treatment.
Patients do not stop using inhalers when taking these medications, but
can hopefully reduce or avoid the use of oral corticosteroids which can
cause adverse effects if used long term.
The goal of biologic asthma treatment is to reduce asthma exacerbations
and hospitalizations due to asthma by optimizing a patient's ability to
breath easier.
Asthma Triggers
Pay attention to things that seem to make your asthma worse—these
are called triggers. Avoid these triggers if you can. Talk with your healthcare
provider if you have any questions about your asthma or your triggers.
Asthma triggers include:
Smoke. If you smoke, get help to quit. Don’t allow smoking in the house
or car. Make sure wood-burning stoves and fireplaces are well ventilated,
or avoid use, if possible.
Dust Mites. Keep mattresses and pillows in dust mite–proof covers. Wash your
sheets and blankets each week. Use very hot water. Remove stuffed toys
from the bedroom, or wash them weekly in hot water. Vacuuming may stir
up dust. Stay out of rooms that are being vacuumed . Take rugs and carpets
out of the bedroom.
Cockroaches. Don’t keep food in your bedroom. Keep food and trash sealed.
Pollen. Stay inside and keep windows closed when pollen levels are high.
Exercise. Ask your doctor if you should take asthma medicine before you exercise.
Warm up before you exercise.
Strong Odors. Avoid perfume, powders, aerosol sprays like hair spray or insect spray,
and strong-smelling cleaning products.
Weather. On cold days, cover your nose and mouth with a scarf to avoid breathing
in cold air.
Pets. Keep pets with fur or feathers out of your bedroom, or home, if possible.
Give your pets a bath to reduce dander.
Mold. Fix leaky faucets and pipes. Clean moldy areas, including shower curtains.
Keep basement areas dry.
Cold. Avoid people with colds . Get plenty of rest. Drink plenty of fluids.
Stress.Try to stay calm and breathe slowly. Focus on things that keep you calm or happy.
Outpatient Asthma Education Program
The outpatient asthma education program provides a personalized, face-to-face
encounter with a certified asthma educator who provides support for patients
and their caregivers to help them breathe better.
Asthma education includes the basics about asthma, how to avoid triggers,
what medications are available, how to properly use an inhaler, and a
personalized asthma action plan.
Patients are
not required to be established with a pulmonologist to enroll.
Asthma education visits last 30-45 minutes and are held on the Ashland
campus in the Lung Center, Suite G10.
Any provider, inside or outside of King's Daughters, may refer patients
to the program.
