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May is Asthma and Allergy Awareness Month Part II: Asthma



Asthma is a condition in which airways narrow and swell and produce extra mucus. This makes breathing difficult and can trigger coughing, wheezing, and shortness of breath. Asthma effects vary from person to person. For some, asthma can be a minor nuisance, while for others, it can be a major problem that interferes with daily activities. Some may have infrequent asthma attacks or have symptoms only at certain times - such as when exercising - or have symptoms all of the time.


According to a 2018 Asthma Surveillance Data by the CDC, more than 26 million Americans have asthma. Asthma affects about 8% of adults and children. This study also showed that asthma has been increasing since the 1980s in all age, sex, and racial groups.



Asthma Signs & Symptoms:


Asthma signs and symptoms include:

  • Shortness of breath

  • Chest tightness or pain

  • Trouble sleeping caused by shortness of breath, coughing, or wheezing

  • A whistling or wheezing sound when exhaling

  • Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

If you have asthma, it's very important to track your signs and symptoms as asthma can change over time. If your symptoms are more frequent, have more difficulty breathing, or need to use a quick-relief inhaler more often, talk to your doctor to adjust your treatment plan.


For some people, asthma only flares up in certain situations. The most common are:

  • Exercise-induced, which may be worse when the air is cold and dry

  • Occupations asthma, triggers by workplace irritants such as chemical fumes, gases, or dust

  • Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste, or pet dander

Other common asthma triggers include:

  • Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste

  • Respiratory infections, such as the common cold

  • Physical activity (exercise-induced asthma)

  • Cold air

  • Air pollutants and irritants, such as smoke

  • Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)

  • Strong emotions and stress

  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine

  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat


Risk Factors:


There are a number of risk factors that are believed to increase your chances of developing asthma. These include:

  • Having a blood relative (such as a parent or sibling) with asthma

  • Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)

  • Being overweight

  • Being a smoker

  • Exposure to secondhand smoke

  • Exposure to exhaust fumes or other types of pollution

  • Exposure to occupational triggers, such as chemicals used in farming, hairdressing, and manufacturing


Diagnosis


If you think you have asthma, your doctor will ask you some questions and will do a physical exam in order to rule out other possible conditions such as a respiratory infection of chronic obstructive pulmonary disease.


You may be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include:

  • Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.

  • Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings.

Lung function tests often are done before and after taking a medication called a bronchodilator, such as albuterol, to open your airways. If your lung function improves with the use of a bronchodilator, it's likely you have asthma.


How asthma is classified

To classify your asthma severity, your doctor will consider your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests.


Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments.


Asthma is classified into four general categories:

Mild intermittent

  • Mild symptoms up to two days a week and up to two nights a month

Mild persistent

  • Symptoms more than twice a week, but no more than once in a single day

Moderate persistent

  • Symptoms once a day and more than one night a week

Severe persistent

  • Symptoms throughout the day on most days and frequently at night


Prevention/Treatment:


While there's no cure or way to prevent asthma, it is manageable. By working together, you and your doctor can formulate a plan to help manage your asthma and prevent asthma attacks. The Mayo Clinic lists that following to help manage asthma:

  • Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan.
Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life in general.

  • Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.

  • Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.

  • Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter.

  • Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control your symptoms.
When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed and immediately stop any activity that may have triggered the attack. If your symptoms don't improve, get medical help as directed in your action plan.

  • Take your medication as prescribed. Just because your asthma seems to be improving, don't change anything without first talking to your doctor. It's a good idea to bring your medications with you to each doctor visit, so your doctor can double-check that you're using your medications correctly and taking the right dose.

  • Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn't under control. See your doctor about adjusting your treatment.

  • Stay healthy, get regular exercise and maintain a healthy weight. Having asthma doesn't mean you have to be less active. Treatment can prevent asthma attacks and control symptoms during activity.
Regular exercise can strengthen your heart and lungs, which helps relieve asthma symptoms. If you exercise in cold temperatures, wear a face mask to warm the air you breathe.


The Asthma Control Test is a way to help you and your doctor determine if your asthma symptoms are well controlled. You can take an online test below and share your score with your doctor at your next visit. This test is for those 12 years and older.

https://www.asthma.com/additional-resources/asthma-control-test.html


If your child is 4-11 years old, take the Childhood Asthma Control Test.

https://www.asthma.com/additional-resources/childhood-asthma-control-test.html


For more information, the Center for Disease Control have a great 2019 toolkit to help teach you and your loved ones about asthma!


As always, if you have any questions or concerns, call our office to set up an appointment with your Blue Hills doctor today.


Resources:

https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653

https://www.aafa.org/asthma-facts/