Asthma is a chronic lung disease. This means that it cannot be cured. For most patients it can be controlled. Asthma causes the airways to be very sensitive. Airways become inflamed and narrow. Breathing becomes difficult. The inflammation leads to edema or swelling of the airways. Edema causes cells in the airways to break down. This breakdown of cells releases chemicals into the airways that lead to more edema and inflammation. Increased inflammation, swelling, and mucus block the flow of air, making it difficult for you to breathe. Certain “triggers” can cause asthma episodes.
The typical symptoms of asthma include:
Shortness of breath
Wheezing
Chest tightness
Coughing
Asthma treatment is different for infants, children, and adults. Treatment varies and is based on your asthma symptoms, and how often you have these symptoms.
Talk to your doctor about your personal treatment goals. The general goals of asthma treatment should include:
Be free from severe symptoms day and night, allowing you to sleep through the night
Have the best possible lung function
Be able to participate fully in any activities of your choice
Not miss work or school because of asthma symptoms
Need few or no urgent care visits or hospital stays for asthma
Use medicines to control asthma with as few side effects as possible
Be satisfied with your asthma care
To reach these goals, your personal asthma treatment plan may include:
Avoiding triggers (staying away from things that bother your airways)
Medicines (know how they work and how to take them)
Monitoring your symptoms
Seeing your doctor regularly
Knowing when to get medical and emergency help
Peak flow, which is a measurement of air flow, monitoring
Every person with asthma has different triggers that can bring on an asthma attack. Controlling your environment by reducing or stopping exposure to your triggers is an important part of treatment. Here are some typical triggers and ways to control them:
Animal dander: Animal dander comes from the skin, hair, or feathers of all warm-blooded pets including dogs, cats, birds, and rodents. If you have asthma, it is recommended that you don’t have a pet. If you must have a pet, it should never be allowed in your bedroom. Wash your pet weekly. If you have forced-air heating, filter or seal the air ducts that go to the bedroom. You should also avoid products made with feathers (such as pillows). Use a vacuum fitted with a HEPA filter.
Dust mites: Dust mites are microscopic insects found in the home. Many people are allergic to them. Put your mattress and pillows in airtight covers. Wash all bed linens, clothing, and stuffed toys weekly in hot water to kill dust mites. The water temperature should be 130 F. The use of an air conditioner or dehumidifier may decrease the amount of dust mites.
Cockroaches: Cockroaches and their droppings cause allergic reactions in many people. Use poisoned bait or traps to control cockroaches. Cockroaches are attracted by water and food debris. Do not leave food or garbage exposed. Permit eating only in the kitchen or dining room. Keep food in the refrigerator or in sealed containers. Keep your kitchen counters clean. Remove garbage daily. Vacuum and mop floors regularly. Repair leaky faucets.
Pollens: Pollens are some of the most common allergens. To minimize your exposure, stay inside with your windows closed as much as possible during the high-pollen season. Stay inside especially during the afternoon when the pollen count is high.
Cockroaches: Cockroaches and their droppings cause allergic reactions in many people. Use poisoned bait or traps to control cockroaches. Cockroaches are attracted by water and food debris. Do not leave food or garbage exposed. Permit eating only in the kitchen or dining room. Keep food in the refrigerator or in sealed containers. Keep your kitchen counters clean. Remove garbage daily. Vacuum and mop floors regularly. Repair leaky faucets.
Pollens: Pollens are some of the most common allergens. To minimize your exposure, stay inside with your windows closed as much as possible during the high-pollen season. Stay inside especially during the afternoon when the pollen count is high.
Indoor molds: Mold is caused by damp conditions. It puts off tiny spores, which can cause allergic reactions when breathed in. Fix all leaks and eliminate water sources associated with mold growth. Clean your bathroom, kitchen, and basement regularly. Use dehumidifiers with the setting placed between 25 and 50 percent in damp basement areas. Avoid sources of mold, such as wet leaves, garden debris, and stacked wood. Avoid standing water or areas of poor drainage.
Tobacco smoke: If you have asthma, you should not smoke. No one should smoke in your home. Choose no smoking areas in restaurants, hotels and other public places.
Cold air: Breathing very cold air can irritate your airways and lead to an asthma attack. Cover your mouth and nose with a scarf in the winter.
Infections: Lung infections, like bronchitis and pneumonia, can be dangerous for people with asthma. Increased mucus and inflammation in the airways make it very hard to breathe. Stay away from people with colds or the flu. Talk to your doctor about over-the-counter cold medicine before taking any of them yourself. Get a flu shot each year and ask your physician if you should get a pneumonia vaccine.
Exercise: You do not have to avoid exercise because of your asthma. In fact, exercise is strongly encouraged. Talk to your doctor about developing a safe exercise plan and how to use your medicine before you exercise. Always warm up and cool down. Avoid exercising outside in the afternoon and evening when pollen, mold, or ozone counts are high. Avoid exercising when your asthma is not well controlled or your peak flow results are low.
More irritants: Strong odours from painting or cooking, scented products, strong emotional expression (such as crying or laughing hard), and stress can also be asthma triggers.
Other triggers:
Medicines (Some medicines can make asthma worse and even life-threatening. Make sure you tell all doctors that you have asthma and what medicines you take for it.)
Sulphites in food, such as dried fruit or beverages (wine)
A condition called GERD (gastroesophageal reflux disease), which can cause heartburn and make asthma symptoms worse, especially at night
Exposures to irritants or allergens at work
Your doctor will create a personalized plan for you so that you know what to do in case of an asthma attack. Asthma is a chronic condition. This means it can be treated, but it cannot be cured.
You need to follow your treatment plan carefully to help control your asthma. Signs that your asthma is not controlled include
Waking at night with an attack
Increased use of bronchodilators
Decreased activity level
A peak flow reading in the yellow or red zone
Premedicating means using your inhaler before you have symptoms. You can premedicate before you exercise or before you come in contact with known triggers. This can help reduce or prevent symptoms. Talk to your doctor about premedicating.
Asthma can be life-threatening. If you experience any of the following signs, go to a hospital emergency department:
- Your wheeze, cough, or shortness of breath gets worse, even after you have taken your medicine and it has had time to work.
- Breathing becomes difficult.
- You have trouble walking or talking.
- You stop playing or working and cannot start again.
- Your lips or fingernails are blue or grey. If this happens, go to hospital.
Your doctor will evaluate you on a regular basis to see how well your treatment plan is working. It’s very important to stick to your treatment plan, even when you feel well.
Many people stop taking their medication when they are symptom-free. Remember: asthma is a chronic condition. It doesn’t just go away. You will have good and bad periods.
