August 18, 2009 in Features

Controlling asthma requires you to recognize the symptoms

Dr. Alisa Hideg
 

‘Just … give me … a sec … and I’ll catch … my breath,” said my friend.

“I think you’re having an asthma attack,” I replied.

“No … no … I don’t … have asthma … I’ll be fine … in a minute.”

Denial is often the first reaction when someone hears they have asthma. Sometimes with patients it helps if I name well-known athletes with asthma – it seems more normal.

Then we talk about wheezing, coughing, fatigue and the part everyone wants to hear: Treat this and you will feel better.

More than 20 million Americans have asthma – a chronic disease that can make breathing difficult – and about half of them have a serious attack at least once a year.

My friend’s 10-year-old daughter had her first attack while playing soccer. She collapsed and went to the hospital in an ambulance.

Asthma can develop in childhood or in adulthood and asthma may change over time. It’s an inflammation of the airways and lung tissue that causes tightening and spasm in the bronchioles (the tubes carrying air to the lungs) and the alveoli (the air sacs in the lungs).

Knowing how to prevent asthma symptoms and attacks can allow you to play more, be more active and even sleep better. And it could save your life.

Asthma symptoms range from obvious (wheezing) to the not so obvious (feeling tired). Early symptoms include:

•Coughing (especially at night or after exercise)

•Losing your breath easily

•Chest tightness

Unusual asthma symptoms include shallow breathing, sighing and anxiety. These may just seem annoying, but subtle signs can progress to an asthma attack, a dangerous tightening of the airways that can cause:

•Trouble talking

•Severe wheezing

•Uncontrollable coughing

I cannot overemphasize how important it is to treat asthma, even if you only have a nighttime cough. Left untreated over many years, asthma can cause the lungs to lose their elasticity – like a worn-out balloon – and they can get tighter over time. This does not have to happen.

If you think you have asthma, keep a diary of symptoms and what starts them and then talk to your doctor. What makes one person cough or wheeze does not necessarily do that to someone else.

You may do a “peak flow” test or pulmonary function tests at the doctor’s office to determine if your symptoms are really asthma. Both tests involve breathing into a tube to see how well your lungs work.

Once you know you have asthma, you can start controlling it. Ask your doctor for a peak flow meter so you can monitor your lung function at home.

Talk about preventive medications. Allergy medications and treatment are part of asthma control for most people. Consider an annual flu vaccine.

Stress is sometimes an asthma trigger and this is a good time to talk about stress with your doctor. If you smoke, ask your doctor for help with quitting.

There is more information about how to reduce asthma triggers at the Asthma and Allergy Foundation of America Web site ( www.aafa.org).

So what about those inhalers? Depending on the symptoms, your treatment may include a daily anti-inflammatory medicine that you breathe out of an inhaler (the tube with a mouthpiece on it).

Then there is the “rescue” inhaler that has albuterol – a medication that opens up the airways – to be used before exercise or when symptoms happen. Make sure you learn how to correctly use your inhaler; it can be tricky at first.

Most patients try to reduce exposure to the things that cause their asthma symptoms, but one exception to this is in exercise-induced asthma. Everyone still needs regular exercise.

Some asthma sufferers find it easier to exercise in hot weather and others feel better exercising in cool temperatures. Many do well with swimming. Regular exercise can reduce asthma problems over time.

Asthma control involves reducing triggers, keeping up with healthy habits like exercise and using medications properly.

With your doctor, develop an asthma action plan – a written plan outlining how to stay healthy, when to use each medication and what to do if your peak flow monitoring shows that your asthma is getting worse – so you can stop asthma attacks and know what to do if an attack becomes an emergency.

Managing asthma can make it possible to live the life you want and make it easier to get a deep breath.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Veradale Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your questions and comments to drhideg@ghc.org.


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