Have asthma

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  • 1. So You Have Asthma
  • 2. So You Have Asthma NIH Publication No. 07-5248 March 2007
  • 3. Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 AsthmaSome Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Why You? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 How Does Asthma Make You Feel? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 How Do You Know If You Have Asthma? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 How To Control Your Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 Your Asthma Management Partnership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 Your Asthma Medicines: How They Work and How To Take Them . . . . . . . . . . . . . 14 Taking Your Medicines: Hows Your Technique? . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Your Asthma Triggers and How To Avoid Them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 How To Control Things That Make Your Asthma Worse . . . . . . . . . . . . . . . . . . . . . .26 Asthma and Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Monitoring Your Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 How To Use Your Peak Flow Meter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Taking Your Peak Flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 What If My Asthma Gets Worse? Reacting Quickly to Worsening Symptoms . . . . .32 Putting Your Asthma Action Plan Into Action . . . . . . . . . . . . . . . . . . . . . . . . . .35 Your Treatment Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Following Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 So You Have Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 For More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 Sample Asthma Action Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
  • 4. Introduction Its like breathing through a straw. Thats how many people with asthma describe what asthma feels like. But for most people with asthma, it doesnt have to be that way! We know a lot more about asthma today than we did just a decade ago, and we have a much better understanding of how to treat it. In fact, based on what we now know, most people with asthma should be able to gain control of it and keep it under control for a lifetime. By working closely with your doctor or other health care provider, you should be able to learn how to control your asthma. And once it is controlled, you should usually be able to do whatever someone without asthma can dowhether its sleeping through the night every night or competing in the Olympics. In other words, you should be able to live a normal active life! The following list shows what your life could be like if your asthma were controlled: As a rule, you should have: Few, if any, asthma symptoms Few, if any, awakenings during the night caused by asthma symptoms No need to take time off from school or work due to asthma No limits on your fully participating in physical activities No emergency department visits No hospital stays Few or no side effects from asthma medicines Introduction 1
  • 5. Doctors often refer to this list as the goals of asthma treatment. Happily, most people with asthma can reach these goals by taking the following four actions: 1. Work closely with your doctor or other health care provider to learn how to manage your asthma. This is the key to keeping your asthma under control. 2. Learn which medicines you should take and when you should take each of them. Also learn how to use an inhaler and spacer correctly. Then take your medicines just as your doctor recommends. 3. Identify the things that bring on your asthma symptoms your asthma triggers. Then avoid them or, at least, reduce your exposure to them. 4. Learn how to monitor your asthma and to recognize and respond quickly to warning signs of an attack. This guide gives you the very latest on asthma and provides practical suggestions for managing it effectively. It contains information about the most effective medications for treating it and describes how to take them. It also includes information about common warning signs of an asthma attack and explains how to act quickly to keep your asthma symptoms from getting worse. Welcome to So You Have Asthmayour one-stop source for the latest information on controlling your asthma. 2 So You Have Asthma
  • 6. AsthmaSome Basics Here are some basic facts about asthma that should help you understand more about how to control it. Asthma is a lung disease. It is not an emotional or psychological problem, or an illusion. Dont let anyone tell you your asthma is just in your head. It is real! You are not alone if you have asthma. More than 20 million Americans report they have asthma. Asthma is on the increase, not just in the United States, but throughout the world. It is estimated that 300 million people worldwide have asthma. Inflammation of the lining of the airways is a major factor in asthma. Inflammation is produced by your immune system. The immune systems job is to defend your body against things that it sees as foreign and harmfulfor example, bacteria, viruses, dust, chemicals. It does this by sending special cells to the organs that are being affected by these things. These cells release chemicals that produce inflammation, or swelling, around the foreign substance or substances to isolate and destroy them. Although inflammation is a defense mechanism for our bodies, it can be harmful if it occurs at the wrong time or stays around after its no longer needed. Because our lungs are used to breathing in air with irritants, such as bacteria, viruses, pollens, and dusts, all day every day, theyve developed ways of dealing with these things, and normally, an inflammatory response does not occur. But the airways in the lungs of people with asthma are more sensitive to many of these things, and the immune system in these people overreacts by releasing many different kinds of cells and other chemicals to the airways. AsthmaSome Basics 3
  • 7. These cells cause the following changes in your airways: s The inner linings of your airways become swollen or inflamed (inflammation), leaving less room in the airways for the air to move through. s The muscles surrounding the airways tighten up, which narrows the airways even more. (This is called bronchospasm.) s The mucus glands in the airways may produce lots of thick mucus, which further blocks the airways. These changes make it harder for you to breathe. They also make you cough and wheeze and feel short of breath. People with asthma can develop ongoing inflammation that makes the airways super sensitive. As a result, if the inflammation is not treated, each time your airways are exposed to your asthma triggers, the inflammation increases, and you are likely to have symptoms. (This is called bronchial hyperresponsiveness.) Because inflammation plays such an important role in asthma, treatment for most people with asthma includes taking medicine every day for a long time to reduce and control it. Asthma is a chronic disease, like diabetes and high blood pressure. This means that once you develop asthma, you are likely to have it for a lifetime. It cannot be cured. Even when it is not causing symptoms, even when you are feeling just fine, the asthma is still there and can flare up at any time. 4 So You Have Asthma
  • 8. How Asthma Affects Your Airways Normal Airway Airway Under Attack The healthy airway is open to allow the air that you breathe into your lungs to move in and out freely. When you are exposed to your asthma triggers, the sides of your airways become inflamed or swollen, and the muscles around the airways tighten, leaving less room for the air to move in and out. Source: American College of Chest Physicians A chronic condition like asthma requires daily attention. Depending on how severe your asthma is, that may include monitoring your breathing and taking medicine every day, even when you do not have symptoms. Taking care of your asthma must become a routine part of your life, just like monitoring and taking diabetes or blood pressure medicines are for people with those chronic conditions. Your asthma can be controlled! By managing your asthma effectivelytaking your medicines as prescribed, avoiding your asthma triggers, and monitoring your asthmayou should be able to getand keepyour asthma under control. You should expect nothing less! AsthmaSome Basics 5
  • 9. Why You? Doctors still dont know what causes some people to develop asthma. They think that many different