from MedisoftIndia 

Understanding Asthma

Tips for better control of asthma

Sometimes, despite the best efforts of you and your doctor to treat your asthma, you end up back in the doctor's office or the emergency room, wheezing and coughing.

About 10% of all people with asthma have very severe asthma. They don't get as much help from their treatment as they would like. A careful review of the situation can help most people with asthma reduce their symptoms. This will improve their lung function and allow them to perform normally at work, at home and at work.

Role of environment in triggering asthmatic attack

About half of all adults and 80% of children with asthma are allergic to something in their environment. Your environment can be your home, your school, your workplace, or any place you spend a lot of time e.g. the cleaning job you did recently.

Until you figure out if something in your environment causes your asthma, medicine might not help you much. Getting rid of the things you are allergic to in your environment can help your medicine work better. Taking 3 or 4 medicines while you are living with asthma allergens is like riding a bike with the brakes on--you don't get far!

It isn't too hard to find out if something in the environment causes your asthma. Some asthma triggers are cobwebs, pollen, mold, house dust mites, cockroaches or pet dander. Your doctor can find out by using skin tests or blood tests.

It's been proved that avoiding allergy triggers makes the symptoms of asthma get better. Avoiding asthma triggers can also make your lungs work better. It might even reduce the amount of medicine you have to take. Talk with your doctor about ways to remove asthma triggers from your home.

Role of workplace in triggering asthma attacks:

About 15% of people who start getting asthma symptoms when they are adults are sensitive to something in their workplace. For example, more than 200 workplace chemicals are known to cause asthma.

You might suspect that a chemical at work causes your asthma if some of your co-workers also have asthma symptoms. Another clue is if your asthma symptoms get better on weekends or vacations. Your doctor can help find out if a workplace chemical is responsible for your symptoms. When you find out what the chemical is, you have to stay away from it.

 Inhalers are better than tablets. How?
  • Inhalers directly deliver the drug to the lungs (site of air flow obstruction) in the  inhaled air so that it does not get wasted in the rest of the body (as happens with tablets). As the blood level of the medicine is very low, there are fewer side effects. Tremors, palpitation, insomnia occur less often compared to tablets.
  • The required dose is very low -in micrograms unlike tablets which need to be given in milligrams for the same effect.
  • Inhalers act fast -in minutes, compared to tablets which may take up to an hour to start working. 
  • Inhalers do not cause addiction or habit formation. They are safe enough to be used continuously for years under medical supervision. If you only use them now and then, they can't help you. 
 Role of medications in triggering asthma attacks:

Some asthma medicines, such as steroid sprays, take days or weeks to start working. If you only use them now and then, they can't help you. About 40% of people with asthma don't follow their doctor's advice about taking their asthma medicine. Many trips to the hospital and most asthma deaths could be prevented if patients would take their medicines carefully and REGULARLY.

Something as simple as always taking your medicines the way the doctor tells you can make the difference between feeling good and ending up in the emergency room.

 You need to  know enough about asthma:

Learning how to manage your disease is very important. If you have asthma, it's good to feel comfortable talking about it with your doctor. Ask your doctor questions if you don't understand something. Your doctor can help you learn to control your symptoms. It may also reduce the cost of your medicine, and make it less likely that you will miss time at work or school. Ask your doctor to suggest things you can read to learn more about asthma. Tell him exactly how long you have been suffering and when (mornings, nights, after work) you get your attacks most. And how and when to reduce your dose. You also need to know about your regular maintenance dose, as 60% of patients do need that.

How bad is your asthma?

It's hard to believe, but most people with chronic asthma don't know how bad their asthma is.

An inexpensive device called a mini-peak flow meter may help you. This is a plastic tube that you blow into several times a day. It measures the amount of air you can blow out of your lungs. You can use the peak flow meter every day at home. Keeping track of how much air you blow out lets you know when you need to take extra medicine or call your doctor. Your doctor can teach you how to use a peak flow meter and what to do when your asthma gets worse.

Are you using using your inhaler the right way?

Asthma inhalers can be hard to use. Many people with asthma don't use them the right way. If you aren't using the inhaler the right way, you aren't getting as much medicine into your lungs as you need.

A device called a spacer makes the inhaler easier to use. The spacer helps more of the medicine get deeper into your lungs, where it's needed. Ask your doctor about getting a spacer for your inhaler, and have your doctor show you how to use the inhaler the right way. It is particularly needed for children and elderly who do not know how to inhale, and those who have severe attack and cannot breath well.

Change of medicines:

There are a lot of medicines to use for asthma. Each one has different strengths. If the medicine you take now doesn't seem to be helping, another medicine might work better.

Some people whose asthma is triggered by allergies might get help from allergy shots (also called immunotherapy). Ask your doctor about this treatment.

Is it really asthma?

Other illnesses can act like asthma. If your asthma treatments haven't helped you, maybe you don't really have asthma. Your doctor may want to give you another exam to be sure. 

This is a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information, talk to your doctor.

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