Rules for Managing Asthma  

Some of the practical advice for managing asthma may seem a little extreme: Pull up carpeting in your house and tread instead on clean, bare floors. Change the filters frequently in your heating and air conditioning units. Dust regularly, change bedding regularly, maybe give up some favorite foods—or even some favorite pets.

"Even if steps like these are a bother, they're worth every bit of it," says Linda Boyer, executive director of the Greater Washington, D.C., chapter of the Asthma and Allergy Foundation of America (AAFA). Boyer, a longtime asthma sufferer herself and a mother who raised a child with severe asthma, goes to the trouble to follow the experts' advice.

She likens the difficulty of managing asthma with the trouble people with diabetes or allergies must endure when taking regular insulin or allergy shots.

"If you want to feel good, maintain your health and lead a normal life, you have to get into a routine," Boyer adds.

Recognizing asthma

Asthma is a serious and often life-threatening disease. The American Lung Association (ALA), estimates that millions of Americans have asthma. Thousands of people die from asthma each year.

For someone with asthma, the underlying inflammation of the airways is always present, even without breathing difficulties. An asthma "attack" occurs when the person is exposed to a trigger. This exposure causes the lining of the airways to swell, the muscles around them tighten, and a buildup of mucus. All of these cause a constriction in the flow of air to the lungs.

Yet many adults with asthma don't recognize the classic symptoms, such as shortness of breath, tightness in the chest, wheezing, a whistling sound while breathing, or a dry hacking cough that may worsen at night.

If you suffer from any of these symptoms, see your health care provider, or an allergy or lung specialist, who may know more than your general practitioner about how to test and treat you properly. If you have asthma, here are some recommendations to help you manage your condition.

Identifying triggers

The lungs of a person with asthma overreact when exposed to various stimuli called triggers. Triggers differ from person to person, and can range from viral infections to gas, pollution, chemicals, or fragrances. Common asthma triggers include tobacco smoke, dust mites, animal dander, cockroach droppings or remains, indoor mold, and strong odors from perfume, cleaning fluids, hair spray, gasoline, and other substances. For some people, exercise or cold air sparks it. 

Monitor your symptoms and their severity each day, and write them down. The patterns you discover can prove invaluable.

For example, "I might notice that every Wednesday I go to the park with my daughter, and every Wednesday night I cough and can't sleep," Boyer says. "Or I'll see that I go to Sue's for the book club every Thursday, and every Thursday night I have symptoms. It could be that Sue burns candles with a strong fragrance or that she serves a certain food I'm allergic to."

Here are some tips to help control your asthma triggers:

  • If you're allergic to dust mites or mold, remove or regularly clean anything in your home that might harbor them. 

  • Remove carpeting and install linoleum or hardwood floors.

  • Wash mattress and pillow covers regularly. Special covers are available for your pillows and mattress to reduce allergy symptoms to dust mites.

  • Have the furnace and air conditioning unit serviced and cleaned annually, and change the furnace filters according to the manufacturer's recommendation.

  • Use a vacuum with HEPA filters.

  • Remove stuffed toys from the bedroom.

  • If you use a nebulizer, a type of breathing treatment, keep it clean—not only the mouthpiece, but also the tubes.

  • Avoid foods that contribute to your asthma symptoms, especially if you have a food sensitivity or allergy.

  • Avoid secondhand smoke, and if you smoke, quit.

  • Avoid animal dander if you're allergic to it. Do not keep a pet, or at least, keep it outside or out of the bedroom.

  • Reduce outdoor activities when pollen counts or ozone levels are high.

  • Follow your doctor's recommendations to prevent exercise-induced asthma. Use your inhaler before exercise and exercise in a warm and humid environment, such as a swimming pool.

  • Develop an asthma action plan with your doctor. This plan can help you manage asthma attacks and know when to seek professional help.

Taking medication

Asthma medication is part of an asthma management plan. As part of that plan, use a peak flow meter to monitor your asthma control. Medication usually includes long-term control, or maintenance medication that helps reduce inflammation of the airways and quick acting medication that are taken when you have at the first sign of asthma symptoms to prevent asthma attacks..

The long-term medications include inhaled corticosteroids, long-acting beta 2-agonists, leukotriene modifiers, Cromolyn, and theophylline. Inhaled corticosteroids and cromolyn reduce the sensitivity to triggers and helps prevent an asthma attack. Newer medications called leukotriene modifiers stop the action of chemicals called leukotrienes, which play a role in the inflammation of the airways. Theophylline is a long-acting bronchodilator. Remember, long-acting forms of beta 2-agonists are used to provide control—not quick relief of asthma.

Short-acting bronchodilators are quick, short-acting “rescue” medications that relax the bronchial muscle, allowing the airways to reopen. These medications include beta 2-adrenergic agonists and anticholinergics. Oral steroids such as prednisone can also be used for a short time to relieve asthma attacks, but they are slow acting and therefore used in conjunction with a quick-acting, “rescue” medication.

Visit your doctor at regular intervals to assess your condition and the effectiveness of your therapies. Learn how to use your peak flow meter to monitor your control. These are signs of poor control:

  • You frequently wake up coughing or with shortness of breath.

  • You often end up in the hospital emergency room.

  • You use your rescue inhaler more than twice a week.

"If you can't maintain regular activity levels, it's time to get an evaluation because something's gone awry," Boyer says. "There may be a new trigger or something causing stress, or maybe you're not using medication as prescribed."

Living your life

"You can live a normal life, you can do anything anybody else can do," Boyer adds. "But, you have to take care of yourself. Just say to yourself, 'Today I have to change the bedding. It will help me sleep better, and feel better the next day.'"

Most important, she stresses: Don't ignore the symptoms.

"It's so simple to go to the doctor and find out what's wrong," Boyer says. "If your asthma is not in control, make an appointment for an evaluation."

Asthma resources

  • The AAFA provides a variety of services, educational programs, and support to people with asthma. Visit http://www.aafa.org for low-cost resources and helpful free information about asthma and allergies. Click on "chapters" to find the AAFA chapter nearest you.

  • ALA offers asthma information at its Web site, http://www.lunguse.org.

  • The National Heart, Lung, and Blood Institute offers a practical guide for controlling asthma. Visit http://www.nhlbi.nih.gov/health/public/lung/index.htm.

  • The American Academy of Allergy, Asthma, and Immunology offers plenty of information about asthma and how to deal with it at http://www.aaaai.org.

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