Managing Your Asthma Flare
Am Fam Physician. 1998 Jul 1 58:109-113.
See related article on asthma.
To keep your asthma under control, you need to know what to do when you have a flare-up of symptoms . First, you need to know the symptoms that tell you your asthma is getting worse . Second, you need to know how to treat your asthma when it gets worse. Early treatment of flare-ups works the best and will help get your asthma under control quickly.
What Causes Asthma Symptoms To Flare Up
Your asthma can flare up for different reasons. If you’re allergic to dust mites, pollens or molds, they can make your asthma symptoms get worse. Cold air, exercise, fumes from chemicals or perfume, tobacco or wood smoke, and weather changes can also make asthma symptoms worse. So can common colds and sinus infections. Gastroesophageal reflux can also cause flare-ups. You can help yourself by paying attention to the way these things affect your asthma. Your doctor might test you to find out if you’re allergic to something. Then your doctor can help you avoid the things that bother your asthma.
The Temperature And Air Quality In The Place You’re Exercising
Exercise is one trigger of asthma. If you combine the trigger of exercise with these other triggers from the environment around you, you’re more likely to get asthma symptoms:
- cold air
- low humidity therefore exercising in cold, dry air outside during the winter can be hazardous
- pollution in the air
- inhaled allergens: grass, pollen, ragweed, etc.
- irritants such as strong fumes from art supplies, cosmetics and smoke
- car and truck exhaust and pollutants from factories, especially sulphur dioxide, nitrogen dioxide, ground-level ozone
- respiratory infections – a recent cold may cause a person to have more difficulty than normal with exercise
- emotional stress
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What Are The Symptoms Of An Asthma Flare
Common symptoms are coughing, shortness of breath , a feeling of tightness in the chest and wheezing. It’s important to watch yourself every day for symptoms of asthma. You may have only one or two of these symptoms.
Another clue that your asthma is flaring up is that you have to take extra doses of your quick-relief asthma medicine more than twice a week because of these symptoms.
What Types Of Medicines Treat Or Prevent Eib
There are three types of medicines to prevent or treat the symptoms of EIB. Your health care provider can help you find the best treatment program for you based on your asthma history and the type of activity.
- Short-acting beta agonist / bronchodilator : This medication can prevent symptoms when taken 10 to 15 minutes before exercise. It will help prevent symptoms for up to four hours. This same medication can also treat and reverse the symptoms of EIB should they occur.
- Long-acting bronchodilator: This needs to be taken 30 to 60 minutes before activity and only once within a 12-hour period. Salmeterol can help prevent EIB symptoms for 10 to 12 hours. This medication is for preventing symptoms. It does not offer any quick relief, so it not for treating symptoms once they begin.
- Mast cell stabilizers: Cromolyn sodium or nedocromil sodium need to be taken 15 to 20 minutes before exercise. These medications may also help to prevent the late phase reaction of EIB that some people experience. These medications are only for preventing EIB because they do not relieve symptoms once they begin. Some individuals use one of these medicines in combination with a short-acting bronchodilator.
If you have frequent symptoms with usual activity or exercise, talk to your doctor. An increase in your long-term control medications may help. Long-term control medicines, such as inhaled steroids, can help EIB.
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Other Forms Of Exercise
Many other types of exercise can also help improve the function of the lungs without overstraining them. These include:
- using an elliptical machine
- taking the stairs instead of the elevator
Other more strenuous exercises and activities are not necessarily bad for asthma, but it is best for each individual to talk to a doctor before deciding on the best exercise for them. The doctor can advise on the risks of specific sports, such as running, basketball, or soccer, and how to manage symptoms during these activities.
People who are new to exercising should avoid high-intensity activities, at least until they build up endurance. Running, jogging, or soccer can be too much for a person with asthma if they are not accustomed to exercising.
It is best to avoid exercising in cold, dry environments. The types of exercise that involve cold weather, such as ice hockey, skiing, and other winter sports, are more likely to cause asthma flare-ups.
It is also crucial to pay attention to the body during exercise. If a particular form of exercise is causing a flare, a person should stop doing the activity until their symptoms are under control.
According to the American Lung Association, a person can manage their asthma by taking the following six steps:
People Who Develop Asthma Later In Life Are Also Less Likely To Experience Remission
The age of asthma onset may also be a factor. One old, large 1999 study found that middle-aged and elderly adults who developed asthma later in life were less likely to experience remission.
Researchers in the study above determined that of 6,610 people, only 6 percent reportedly entered remission within 10 years.
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So Does Asthma Ever Go Away Completely
The short answer is: Yes, some kids stop experiencing asthma symptoms as they get older, Robert Giusti, MD, a pediatric pulmonologist at NYU Langone, tells Health. This is especially true for children who start wheezing at a young age. In some, the wheezing clears up, and they go on to live an asthma-free life. Doctors don’t know exactly why asthma clears up for some children but not others.
Asthma symptoms can become less and less frequents for adults, too, Marilyn Li, MD, an allergist at the Los Angeles County University of Southern California Medical Center, tells Health. “As to the about asthma persistence, it really is a multifaceted issue,” Dr. Li says. “Yes, in some adults asthma can go from persistent to intermittent.”
Total remissionmeaning the patient no longer experiences asthma symptoms at allis very rare. According to information from a clinical trial on asthma remission, which was published by the National Institutes of Health , only about 15 to 25% of people see complete asthma remission. “In a small subset of patients, their asthma resolves spontaneously. This phenomenon is called asthma remission,” the study reads. “Unfortunately asthma remission occurs only in a small subset of asthma patients.”
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Your Level Of Asthma Control
If your asthma is well controlled, your airways will be less sensitive to exercise. You’ll find exercise is less of a trigger for you.If you find exercise makes your breathing a lot worse, it could be a sign that your asthma is not controlled. Tell your doctor about your symptoms and ask how to get your asthma under control.If your asthma is usually well-controlled, but you’ve got a cold, flu, or other respiratory infection, you could be more likely to get symptoms while exercising. If you’ve been sick, pay careful attention to your symptoms. It may be a good idea to exercise less while you’re getting over your chest infection.
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How To Relax The Airways
Dr. Thiruchelvam says the primary goal is to ensure that you dont avoid exercise. Here are some practical things you can do if you have exercise-induced asthma:
Gaining and maintaining good control over exercise-induced asthma often requires teamwork. A primary care sports medicine physician can help you keep your asthma well-controlled, so that exercise is less likely to trigger symptoms.
How Is Eia Treated
If you have exercise-induced asthma, your doctor might want you to take asthma medicine before being really active. This is often the same quick-relief medicine used for flare-ups. You breathe the medicine directly into your lungs before exercising and it works immediately to open up the airways. Doctors sometimes call this pretreatment.
If pretreatment isn’t enough, your doctor may recommend that you also take daily long-term control medicine. This works over time to help keep the airways open. You need to take it every day, even when you feel well.
Many people find that if they take medicine as prescribed by their doctors, they can work out with few or no problems.
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Information About Asthma For Teenagers
Some things that are useful to know if you have been diagnosed with asthma include:
- You can continue to do what you used to do. Just make sure you look after your asthma.
- Lots of people have asthma .
- Make an appointment with your doctor to talk about your asthma. This will help make sure you are able to manage your asthma and keep doing the things you like to do.
- At your asthma review, talk to your doctor about what your triggers are, when your asthma symptoms get worse, and how often you are taking your reliever medication, and then ask for an Asthma Action Plan.
- Learn about asthma first aid and make sure you know what to do if you ever have an asthma attack this will be on your Asthma Action Plan.
- Teach your friends asthma first aid, then they can help you if you have an asthma flare-up.
- Learn about your medication what each type does and how to take it properly.
- Find out what triggers your asthma symptoms and try to avoid your triggers if you can .
- Make sure you keep your reliever puffer and spacer with you at all times .
- Learn how to recognise what your early asthma symptoms are to help prevent a more serious asthma attack.
- app to help manage your asthma.
What Sports Commonly Cause Asthma Symptoms
If you have sports-induced asthma, you may want to choose certain activities over others. Endurance sports and activities that take place in colder temperatures are more likely to trigger symptoms. Thats because cold, dry air can constrict the airways and trigger symptoms of asthma.
Sports that are most likely to trigger symptoms of asthma:
- Require constant physical exertion: Long-distance running, soccer, basketball and other endurance sports require you to breathe heavily and constantly with little rest.
- Take place in colder weather: Skiing, ice hockey, ice skating and snowboarding commonly cause symptoms due to colder air temperatures.
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Take These Before Hitting The Gym
- Short acting beta agonist or bronchodilator: Using this inhaler 10 to 15 minutes before exercise can prevent symptoms. It can also be used to treat symptoms after they occur.
- Long-acting bronchodilator: Inhaled 30 to 60 minutes before exercise, it prevents symptoms for 10 to 12 hours but offers no rescue benefit once symptoms occur.
- Mast cell stabilizers: Taken 15 to 20 minutes before exercise to prevent EIB.
Why Do Asthma Symptoms Disappear For Some Kids And Not Others
Some working theories:
- As a child gets bigger, so do the airways in their lungs. Inflammation of airways, an asthma hallmark, could go on unnoticed, Johnson says.
- Children who wheeze only when they have a cold or other upper respiratory virus tend to improve with time, he says.
- Children who are sensitive to allergens from a young age tend not to improve, Rachelefsky says. His observation is backed up by findings from a nine-year study of more than 1,000 asthmatic children that found fewer allergy-related antibodies in those who became symptom-free.
- Children with eczema, a skin disorder characterized by itchy rash, or a family history of asthma are likelier to have lasting asthma symptoms.
- The more severe the asthma past the age of 5, the likelier symptoms will continue, with or without allergies, Rachelefsky says.
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You Cant Exercise If You Have Asthma And Other Myths You Should Know
ACAAI busts five asthma myths for Asthma and Allergy Awareness Month in May.
ARLINGTON HEIGHTS, Ill. May is Asthma and Allergy Awareness Month the perfect time to bust some asthma myths that have been around for many years.
Asthma is a serious condition that affects more than 26 million Americans more than 8 percent of the population, says allergist Todd Mahr, MD, president of the American College of Allergy, Asthma and Immunology . One of the biggest dangers with asthma is that so many people who have asthma think its well-controlled, when it actually isnt, says Dr. Mahr. When people have good solid information about how to control their asthma and reduce symptoms, they are better able to live the kind of active lives they want.
Below are five myths from ACAAI, along with the facts you need to know.
To find an allergist near you who can help create a personal plan to deal with your allergies and asthma, use the ACAAI allergist locator.
What Types Of Sports Are Best For People With Eib
Activities most likely to trigger EIB:
- Sports or activities in cold/dry weather
- Sports or activities that need constant activity
Activities least likely to trigger EIB:
- Sports or activities that use short bursts of exercise
- Walking or leisure biking
- Swimming in a warm, humid environment
It is important to consult with your health care provider before beginning any exercise program. Pace yourself. With effective management, people with EIB can perform and excel in a variety of sports. Many Olympic athletes and professional athletes with EIB excel in their sports.
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What Does Asthma Remission Look Likeand Can You Flare After Being In Remission
According to the NIH study, the small number of people who see their asthma completely clear up never experience asthma symptoms again, nor do they need required inhaled treatments. Other adults simply see their asthma symptoms become more and more infrequent, Dr. Li says. “The diagnosis may ‘stay’ with the patient as they are at risk of a recurrence of the symptoms, but they may not need daily controller therapy if their symptoms are intermittent or are mild,” she explains.
And sometimes, even in those who have technically experienced asthma remission, symptoms may reappear, according to a 2003 paper published in Opinion in Pulmonary Medicine. The paper also shares that some adults can start to experience asthmatic symptoms even if they haven’t suffered from any since childhood.
Overall though, little is known about who is likely to see remission and who will likely need to stay on an asthma treatment for the rest of their life, so it’s a good idea to keep in contact with an asthma specialist and talk at length with them before quitting any treatments. according to Dr. Li. “My best advice is to see a specialist and understand what type of asthma ,” she says. “From there, with appropriate therapy and follow-up, that person’s asthma action plan tailored.”
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Q: Is Asthma More Dangerous For Adults
A: Yes. The death rate for adult-onset asthma is substantially higher than the death rate for childhood asthma.
One reason may be that adults either ignore asthma symptoms or attribute them to being overweight, being out of shape or getting older.
Asthma symptoms can also mimic those of other illnesses, including:
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Attitudes And Counseling Related To Weight Loss
Ford et al have, based on data from the Behavioural Risk Factor Surveillance System, reported that 27.3% out of 13,953 participants with current asthma had a BMI of 30, and that 72.9% of the obese participants with asthma reported trying to lose weight. Furthermore, 82.9% of obese participants receiving weight-loss advice reported trying to lose weight, compared to 63.8% among obese participants who had not received such advice. This study, therefore, illustrates, although so far not supported by other studies, the important role for health care professionals in educating their patients with asthma about the importance of weight control, and in assisting and supporting their overweight and obese patients with asthma in setting achievable weight goals.
How Can I Manage And Treat My Eib
With proper management, you can enjoy exercise and achieve your full potential. Proper management requires that you:
- Take steps to prevent symptoms
- Take medicine before exercising
- Do a proper warm up for 6 to 10 minutes before periods of exercise or vigorous activity
- Carefully watch your respiratory status before, during and after exercise
Children With EIB Inform teachers and coaches if you have a child with EIB. Kids with EIB should be able to take part in activities they just may need medication before an activity.
Athletes With EIB If you are an athlete, disclose your medicines and adhere to standards set by the U.S. Olympic Committee. Request a list of approved and prohibited medications from the Committee hotline at 1-800-233-0393.
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If My Child No Longer Has Asthma Symptoms Could It Be That They Were Misdiagnosed With The Disease
Perhaps. Rachelefsky says a lot of children diagnosed with asthma donât have it and many asthmatics go undiagnosed.
âSpirometry is standard, but many physicians in primary care practices donât have a spirometer. They diagnose sinusitis as asthma and mistake asthma for esophageal reflux,â he says.
But for children under the age of 2, it is difficult to do spirometry to test for asthma. When a child is that young, providing a diagnosis âis an imperfect science,â says Reynolds J. Panettieri Jr., a pulmonologist with the University of Pennsylvania.
âIf you have true asthma, you donât outgrow it,â so young children who are wheezing from a viral infection that hangs around for a long time may not have asthma but âtwitchyâ or hypersensitive airways that are a holdover from the virus, he says.
Johnson says, even if a child is too young for standard testing, âItâs better to err on the side of caution and treat kids whether they have asthma or not. The benefits are great,â he says.