What is asthma?
Asthma is a chronic (long-lasting) lung disease in which the airways to the lungs are often swollen or inflamed. The airways are also sensitive to certain irritations or “triggers.” An asthma trigger can be something you are allergic to such as pollen, animal dander, or dust. A trigger can also be an irritant such as tobacco smoke, cold air, or a cold virus. When the airways react to a trigger, the muscles around the airway tighten, and the lining swells and often produces thick mucus. This causes the airways to narrow and makes it harder to breathe. This is called an asthma attack. An asthma attack can be mild, moderate, or severe. When you are having an attack, you will usually need to take medicine to control the symptoms.
Asthma does not go away when you are not having symptoms. The airways are still inflamed. You need to have an Asthma Action Plan and close follow-up by a healthcare provider.
What are the symptoms?
Symptoms of asthma come and go and may include:
- Wheezing (a high-pitched whistling or musical sound while breathing out)
- Coughing (especially at night or in the early morning)
- Chest tightness
- Trouble breathing
- Trouble breathing or coughing during or after exercise
How long does it last?
Asthma can be a long-lasting disease, but asthma symptoms improve during the teenage years for more than half of young people who have asthma. Asthma attacks can be frightening, but they are treatable. When medicines are taken as directed, the symptoms can be controlled or completely clear up.
What type of medicine do I need?
Quick-relief or rescue medicines
Quick-relief medicines, also called relievers or rescue medicines, quickly open your airways and are used when you are having an asthma attack. These medicines are also called relievers or bronchodilators.
If you are having asthma symptoms (wheezing, coughing, trouble breathing), take your quick-relief medicine, check your peak flow, and follow your Asthma Action Plan. If you have any doubt about whether you are wheezing, take your asthma medicine. The longer you wait to take the medicine, the longer it takes to stop the wheezing. Once you have started taking the medicine, keep taking the reliever according to the dose prescribed by your healthcare provider. (You may need to take the reliever medicine for several days.) The usual dose is 2 puffs using a spacer. Wait 1 minute between each puff.
Caution: if the inhaler hasnâ€™t been used in over 7 days or is new, test spray it twice into the air before using it for treatment.
Long-term control medicine (controllers)
Long-term control medicines help keep the airways in your lungs from getting inflamed and irritated and help prevent asthma attacks. Many teens with asthma do not need controller medicine and only need to use quick-relief medicines during brief asthma attacks. Teens with the following symptoms usually need to take controller medicines every day to allow them to participate in normal activities:
- 2 or more attacks of wheezing per week
- 2 or more nighttime attacks a month
- Asthma flare-ups lasting several days
- The need for urgent medical care despite proper inhaler use
- Asthma triggered by pollens (may need to use daily asthma medicines during the entire pollen season)
How can I take care of myself?
- Hay fever. For hay fever symptoms, it’s OK to take antihistamines. Poor control of hay fever can make asthma attacks worse. Research has shown that antihistamines don’t make asthma worse and may improve asthma control.
- Colds. Many people wheeze when they get coughs and colds. If this is true for you, take your quick-relief asthma medicine at the first sign of any coughing or wheezing. The best “cough medicine” for a person with asthma is an asthma medicine, not a cough syrup. Monitor your symptoms carefully when you have a cough or cold, check your peak flow and follow your Asthma Action Plan. Call your health care provider for advice if you are not responding to medicines or your symptoms are getting worse.
- Exercise. Most people with asthma get 15- to 30-minute attacks of coughing and wheezing when they exercise strenuously. Prolonged vigorous exercise such as long distance running, especially in cold air, is a major trigger. You can usually avoid the symptoms by using a quick-relief medicine 15 to 30 minutes before exercise. If you still have frequent symptoms with exercise even after using a quick relief medicine, talk with your healthcare provider.
If you are recovering from a viral illness and need a few days to fully recover, you may need to avoid gym class or sports for a short time.
- Going to school. Asthma is not contagious. You should go to school if you are having a mild asthma attack, but should avoid gym or vigorous activity on these days. Have a written Asthma Action Plan on file and arrange to have a peak flow meter and your asthma medicines available at school. Have permission to keep your quick relief medicine with you so you can use it when you need it. If you can’t go to school because of asthma, contact your healthcare provider that same day for advice about treatment.
- Common mistakes. The most common mistake is delaying the start of prescribed asthma medicines or not replacing them when they run out. Nonprescription inhalers and medicines are not helpful.
Another serious error is continuing to expose yourself to an avoidable cause of asthma. For example, do not keep a cat if you are allergic to it. Also, do not smoke or allow smoking in your home or car. Avoid social situations where you are exposed to smoke. When you are having an asthma attack, don’t panic. Fear can make tight breathing worse, so try to remain calm.
Don’t let asthma restrict your activities, sports, or social life. If your asthma symptoms are worsening and affecting your lifestyle, make an appointment to discuss your concerns with your healthcare provider. A change or increase in asthma medicines will help you gain better control of your asthma.
How can my asthma attacks be prevented?
- Try to identify and avoid the substances that trigger your asthma attacks. Smoking or second-hand tobacco smoke is a common trigger. If you or someone in your household smokes, you will have more asthma attacks, take more medicine, and need more emergency room visits.
- Try to keep pets outdoors or at least out of your room. Keep the door to your room closed.
- Learn how to dust-proof your bedroom. Change the filters on your furnace or air conditioner at least monthly.
- For allergies to molds or dust mites, try to keep the humidity in the house at 30 to 50%. Use a dehumidifier if necessary.
- If you wheeze after contact with grass, pollen, weeds, or animals, there may be pollen or animal dander remaining in your hair and clothing that can cause symptoms. You should shower, wash your hair, and put on clean clothes.
When should I call my healthcare provider?
Call IMMEDIATELY if you:
- Have severe wheezing
- Have trouble breathing
- Have wheezing that has not improved after the second dose of asthma medicine
- Need to use your quick-relief medicine more than every 4 hours
- Your peak flow is 50% or less of your personal best.
Call within 24 hours if:
- Your wheezing is not completely gone in 5 days.
- Your peak flow remains in the yellow zone even when you follow your Asthma Action Plan.
- You have other questions or concerns.
Written by Barton D. Schmitt, MD, author of â€œMy Child Is Sick,â€ American Academy of Pediatrics Books.
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright Â©1986-2015 Barton D. Schmitt, MD. All rights reserved.