For people with asthma, having an “asthma management plan” is the best strategy to prevent symptoms. An asthma management plan is something developed by you and your doctor to help you control your asthma, instead of your asthma controlling you. An effective plan should allow you to:
- Be active without having asthma symptoms.
- Participate fully in exercise and sports.
- Sleep all night, without asthma symptoms.
- Attend school or work regularly.
- Have the clearest lungs possible.
- Have few or no side-effects from asthma medications.
- Have no emergency visits or stays in the hospital.
Four Parts of Your Asthma Management Plan:
1. Identify and minimize contact with your asthma triggers. Avoiding your triggers is the best way to reduce your need for medication and to prevent asthma episodes. But first, you have to learn what those triggers are. Any time you have an asthma episode, think about where you were and what you were doing in the past day or so. Answer questions like these in a diary or on your calendar:
- Was I making a bed or vacuuming?
- Was I near an animal? Cigarette smoke?
- Did I have a cold or other infection?
- Was I running, playing or exercising?
- Was I upset, excited or tired?
Discuss your notes with your doctor to look for trends. As you identify your triggers, talk about which ones can be avoided, and how to best avoid them. For instance, if you are allergic to dust mites you should put an airtight cover around your pillow and mattress. You may also want to discuss with your physician how immunotherapy might help to prevent allergy symptoms.
2. Take your medications as prescribed. Asthma medicines are usually inhaled through a machine called a nebulizer, through a small device called a metered dose inhaler (also called an inhaler, puffer, or MDI) or through a dry powder inhaler (DPI). For inhalers to work well, you must use them correctly. But over half of all people who use inhalers don't use them properly. Ask your doctor or nurse to watch you and check your technique. If it is still difficult to use, you have two choices. Ask them to recommend a spacer or holding chamber. This device attaches to the inhaler to make it easier to use and to help more medicine reach the lungs. Or, ask about using a “breath-actuated” inhaler, which automatically releases medicine when you inhale.
Unless your asthma is very mild, chances are you have prescriptions for at least two different medicines. That can be confusing. The more you understand about what those medicines do and why they help, the more likely you are to use them correctly.
Although there are some potential adverse effects from taking asthma medications, the benefit of successfully controlling your asthma outweigh this risk. It is important to discuss each of your asthma medications with your physician to learn more about their effects.
3. Monitor your asthma and recognize early signs that it may be worsening. Asthma episodes almost never occur without warning. Some people feel early symptoms, including: coughing, chest tightness, feeling very tired. But because airways to the lungs narrow slowly, you may not feel symptoms until your airways are badly blocked. The key to controlling your asthma is taking your medicine at the earliest possible sign of worsening.
There is a simple, pocket-sized device called a peak flow meter that can detect narrowing in your airways hours, or even days, before you feel symptoms. You simply blow into it, as instructed in your doctor’s office, to monitor your airways the same way you might use a blood pressure cuff to measure high blood pressure or a thermometer to take your temperature. Peak flow meters come in many shapes and styles. Ask your doctor which is right for you. Your doctor may divide your peak flow numbers into zones (green = safe; yellow = caution; red = emergency) and develop a plan with you. Your peak flow number will help you know:
- Which medicine to take
- How much to take
- When to take it
- When to call your doctor
- When to seek emergency care
The good news is that using your peak flow meter should mean fewer symptoms, fewer calls to the doctor, and fewer hospital visits!
4. Know what to do when your asthma is worsening. If you understand your asthma management plan and follow it, you will know exactly what to do in case of an asthma episode or an emergency. If you have any questions at all, ask your doctor.
SOURCE: This information should not substitute for seeking responsible, professional medical care. First created 1995; fully updated 1998; most recently updated 2005.
© Asthma and Allergy Foundation of America (AAFA) Editorial Board