How to Manage Your Asthma !!!
Asthma Symptoms typically include cough, chest tightness, wheezing and phlegm production. Symptoms vary over time, intensity and worsen at night or early morning. They may be triggered by weather changes, emotions, infections, car and exhaust fumes, smoke, strong smells odors, pet fur etc.
Asthma diagnosis requires detailed history, thorough clinical examination and demonstration of variable airflow limitation by means of a test called as Lung Function/Pulmonary Function Tests (Spirometry).
If symptoms are not typical, then other diagnosis needs consideration and evaluation. Multiple other diseases of lungs, vocal cord, and heart and Gastrointestinal tract can also lead to chronic cough and chest symptoms.
Asthma control is best achieved by directed inhalation medications. Depending on several factors, asthma may be labeled well –controlled, partially controlled and poorly controlled. These factors include daytime symptoms, night time awakenings, use of emergency medications (such as Asthalin/ventorlin) and spirometry values.
(image courtesy Wikipedia)
Another domain of asthma control includes risk factor control, frequency of flare ups, side effects of medication and complications. Other risk factors even in patients with fewer symptoms include hospitalizations or past history of intensive care (ICU requirement), psychological problems and worsening lung functions.
Patients require treating medications for an extended duration of time (sometime months) for gradual step down/step up of treatment. Depending on patient’s response, the minimum treatment that produces maximum control with least side effects is usually decided. Some patients may have intermittent asthma and may not require lifelong/ yearlong medications. Treatment of acute episodes in such patients may bring lasting control of the disease.
As a part of routine monitoring, Lung Function Testing should be always performed at the time of diagnosis, 3-6 months after treatment and periodically thereafter. The goal of treatment is symptom control and risk reduction. Spirometry (Lung Function Testing) usually measures the airflow versus lung volumes. Spirometry parameters above 80 % of predicted for age, height, weight and ethnic ranges is usually considered as normal.
Patients with asthma should be reviewed by doctors on basis of initial level of control, response to treatment and patients’ self-management skills. In general see your doctor after 1-3 months of starting treatment then every 3-12 months, except pregnant females who should be reviewed every 4-6 weeks during treatment.
Asthma can be adequately controlled and worsening prevented by proper treatment. However, presence of asthma cannot be totally eliminated by any medical treatment. Patients may remain asymptomatic and healthy for many years without any treatment if properly managed and trained for Self-Monitoring.
Take an Easy Test to Assess Your Asthma Control: Know your Score
1. In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home?
1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
2. During the past 4 weeks, how often have you had shortness of breath?
1. More than once a day
2. Once a day
3. 3 to 6 times a week
4. Once or twice a week
5. Not at all
3. During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness, or pain) wake you up at night or earlier than usual in the morning?
1. 4 or more nights a week
2. 2 to 3 nights a week
3. Once a week
4. Once or Twice
5. Not at all
4. During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as Albuterol, Ventolin®, Proventil®, Maxair®, or Primatene® Mist)?
1. 3 or more times per day
2. 1 or 2 times per day
3. 2 or 3 times per week
4. Once a week or less
5. Not at all
5. How would you rate your asthma control during the past 4 weeks?
1. Not Controlled at all
2. Poorly Controlled
3. Somewhat Controlled
4. Well Controlled
5. Completely Controlled
If your score is 19 or less, your asthma may not be controlled as well as it could be. Talk to your doctor or book an appointment with Dr Anshum Aneja Arora