Asthma is a disease of the airways in the lungs. In asthma the lungs are more sensitive than other people’s. When someone with asthma is exposed to a trigger (a substance or event-such as cigarette smoke, dust, animals or pollen that causes a reaction) the airways think the trigger is an ‘invader’. In attempt to get rid of the ‘invader’ the following changes take place in the airways.

Swelling:
The airways become swollen & red. This redness & swelling is normally referred to as ‘inflammation’.

Tightening:
The muscles around the tubes tighten & make the lumen of the airways narrow. This tightening of the airways is called as ‘bronchoconstriction’.

Clogging:
The airways start to make a lot of mucus which clogs the airways.
Together these three things swelling, tightening & clogging reduce the room inside the airways for the air to flow through. This makes breathing difficult.

Symptoms  of Asthma
“What’s your first clue that you may be experiencing or having an asthma attack?

The Whistling wheeze?

A tight grip around your chest?

People with asthma have different warning signs, so it’s important to tune in to your own red flags. Most of them have one or more of these classic symptoms:

Wheezing
Either a low or a loud whistle that’s usually heard when you breathe out.

Coughing
A mid cough that won’t quit, and often occurs at night.

Chest tightness
Feels like rubber bands are strapped around your chest or like a burning sensation.

Shortness of Breath
Feels like you’re trying to breathe through a straw—or worse, like you can’t catch your breath. Breathing out is especially tough.”

Types of Asthma Medication

Most people with asthma need two types of medications. A quick relief medicine & a preventive medicine.

Preventive medicines work slowly to decrease or prevent the inflammation or the airways. They thus protect the airways & prevent asthma attacks from starting. Preventive medicines help to control asthma. They are non-addictive & are safe to use every day even if you use them for many years.

Very often, asthma patients think that quick relief medicines are more effective than preventive medicines. It’s obvious one feels so, as quick relief medicines give relief immediately. But a word of caution here. Using too much of the quick relief medicine can really hurt you. Though they make you feel good immediately, they do not reduce the swelling in the airways. The airways get more & more swollen & you are in danger of having a very bad attack.

So be smart. Use your preventive medicines regularly. They are good for you. At the same time always carry your quick relief medicine with you so that you are prepared for any kind of emergencies.

Use Inhalers

Don’t shy away from inhalers. World over inhalers are seen as a better way to administer asthma medicines. Let’s take an example. If our eyes are red & itchy we use an eye drop, if our nose is stuffy we breathe the medicine through our nose (e.g. to clear a blocked nose we inhale Vicks). So if our asthma is in the lungs the best way to take asthma medication is to inhale it. When the medicine is inhaled it goes right to the airways where it is needed. That’s how logical it is. So the next time the doctor prescribes an inhaler for you. Go ahead & use it. Remember, inhalers are good for you.

Inhalers V/S Oral medicines

1.      Inhalers act directly on the airways where it is needed the most. 1.      Oral medicines go to the stomach from where a small fraction of the amount reaches the lungs.
1.      Act faster as the medicine directly reaches the lungs. 2.      Take time to act as it takes a     roundabout route to the lungs
2.      Side effects are minimal as it acts at a much lower dose. 3.      Most of the drug reaches the body parts where it is not required. Therefore more amount is available for producing side effects.

Use your Inhalers the right way
Though it is important to use an inhaler it is more important to use it correctly. There are different types of inhalers. Some use sprays. Some use powder. The technique for inhaler use is not difficult. In fact, today, inhalers are so technologically advanced that a minimum effort is required to use them.

How to use a spray inhaler

Remember to breathe in slowly.

  1. Take of the cap.

Shake the inhaler.

  1. Stand-up.

Breathe out.

  1. Put the inhaler in your mouth or put it just in front of your mouth. As you start to breathe in, push down the top of the inhaler and keep breathing in slowly.

How to use an Accuhaler

  1. Hold the ACCUHALER in one hand with the dose counter facing you. Put the thumb of your other hand in the thumb grip and push the thumb grip around as far as it will go.
  2. You’ll now see the lever. Hold the mouthpiece towards you and push the lever away from you until you hear a loud click.
  3. Breath out as much as if comfortable, then put the mouthpiece to your lips and breathe in quickly and deeply. You may taster some of the lactose in your mouth. This is okay. Take the ACCUHALER away from your lips and hold your breath for 10 seconds or as long as is comfortable.
  4. Close the ACCUHALER by sliding the thumb grip back to its original position. This will prime the Accuhaler for your next dose.

Step – 2      Know Your Self

Recognize your Triggers

The things that cause  asthma symptoms are usually referred to as triggers. Triggers vary from person to person. You may have some or all on this list of the common triggers. And you may have some that are unique to you.

Learn to recognize what things trigger your symptoms and keep track. Try this checklist to start:

  • Dogs, cats and other animals
  • House dust, mites or mould
  • Infections, cold or flu
  • Odours from sprays, perfumes & paints
  • Pollen from trees, grass, weed,
  • Stress full situations
  • Cigarette smoke
  • Very cold weather
  • Pollution
  • Physical activity
  • Crying, yelling loudly, laughing
  • Aspirin or other medication
  • Certain foods or food additives
  • Exercise
  • others

Keep things that start asthma attacks, away.

Learn to recognise the signs of an attack
Asthma attacks can happen anywhere, anytime. Hence it is important to anticipate    attacks & act quickly.

Have an emergency plan prepared
If you are in control of your asthma, there should be fewer emergencies.

However, asthma is a serious condition, and it can be life threatening. So, as a precaution, have an “action plan” for getting help fast if you need it. Know the best way to reach your doctor and the fastest access to urgent care available to you where you live, work, and vacation.

Step- 3 Get on with the daily programme

Monitor your Peak Flow

The Peak flow meter is an important in the control of asthma.
Peak flow monitoring is a simple tool and very important part of managing your asthma. It measures how well air is moving out of your lungs. By checking your peak flow daily, you can avoid attacks because you’ll know about the narrowing of your airways even before the symptoms begin. Make sure you use your peak flow meter daily.
Here’s how it’s done:

  1. Set the indicator at the base of the numbered scale.
  2. Stand up.
  3. Breathe deeply.
  4. Place the mouthpiece in your mouth.
  5. Close your lips around the mouthpiece tightly; do not put your tongue in the opening.
  6. Blow out—as quickly and with as much force as you can. (Blow really hard, as you would blow the candles on your birthday cake.)
  7. Write down the number indicated on the scale.
  8. Repeat steps 1-6 write down the number.
  9. Repeat steps 1-6 again. Write down the number.
  10. Now look at the three numbers and record the highest one.

The “three-zone” system will keep you on track

Your doctor will give you a range for your “personal best” peak flow. There are three possible zones, often identified by colour. Each person with asthma will have his or her own colour range. Write your own range for each colour as your doctor has suggested.

Green – Go
Green means all clear. Your asthma should be under control. You should be able to do your regular activities, sleep through the night and ideally have few or no symptoms. Continue to take your asthma medications.

Your Green Range
Yellow – Caution
Yellow means you need to be careful. You may not be in control of your asthma. You may not be able to do all of your activities or sleep through the night. You may be coughing, wheezing, or having chest tightness. Ask yourself, have you taken your medication? Have you been exposed to a trigger? Take the steps recommended by your doctor to get back in control.

Your Yellow Range

Red – Stop – Danger
Red means danger. You may be having asthma symptoms when you are resting or when active. Take your medication and follow your action plan for getting help fast. Once you recovered, review events, find out why this occurred. Get back in control.

Your Red Range

Keep a detailed record

Keeping a daily record can help in several ways. It can help you remember your routine & your treatment programme. When you write things down, they tend to register more firmly in your mind.

Fill in the details & carry these details on every medical visit. If you do have symptoms, it is important to keep track of them so your doctor knows your condition better.

NOTE: Your asthma treatment plan is not working if you still have symptoms when you:

  • Perform routine activities
  • Exercise
  • Sleep
  • Relax
  • Get up in the morning if you are having any of these, don’t accept this as normal. Talk to your doctor about your treatment plan
Week______ Sunday

AM     PM

 Monday

AM     PM

 Tuesday

AM     PM

 Wednesday

AM     PM

 Thursday

AM     PM

 Friday

AM     PM

 Saturday

AM     PM
Peak Flow
Medications
1.___x____
2.___y____
3.___z____
4.________
Symptoms
Coughing
Wheezing
Chest tightness
Waking up at night
Shortness of breath
Can’t do normal activities
Missed work/school
Doctor visit due to asthma
Others
Triggers

Stick to your Medication Schedule
Record in a daily diary your medications and when you take them. This way, your doctor can see whether you are having symptoms even while taking prescribed plan. Write down all your medications including medications beside those you take for asthma and the number of times you take each one. Also include medication you bought without prescription.

Prepare for Medical Visits
They will be more productive! Write down any questions or problems you went to discuss on your records with you. Review it with your doctor.

Step 4 – Stick With the programme
Remember you may not feel your asthma every day, bit it’s there & you need to treat it every day.

  • You need to follow your treatment plan even on “good days”.
  • Asthma doesn’t go away when the symptoms do.
  • If you just treat attacks, you’re not controlling your asthma
  • Develop a routine for those medications that need to be taken, at the same time each day (meal time, after brushing your teeth, after your shower etc.)
  • Know and avoid your asthma triggers.
  • Keep reminders around your home and workplace.

Hope the programme changes your approach to asthma. No matter what you do in life, don’t let asthma come between you & your own goals.
AND as said earlier “Asthma control is all about attitude” So stay well & stay aware. Make the commitment to control asthma. And for the sense of wellbeing you’ll feel, it will be more than worth it to you; not to mention those who care about you.

Warning Signs of Asthma

If you have any of these warning signs, call your doctor:

  • You are having asthma attacks more often, or your asthma attacks are getting worse.
  • You are using your rescue medicine for asthma attacks more than once a week.
  • You are waking up in the night coughing and wheezing from asthma more than once a month.
  • When you have a cold or other illness that affects breathing, it lasts longer than usual.
  • You are having problems breathing during physical activity or exercise.