Medical History And Physical Exam
Your doctor will ask about your risk factors for asthma and your symptoms. They may ask also about any known allergies. This includes how often symptoms occur, what seems to trigger your symptoms, when or where symptoms occur, and if your symptoms wake you up at night.
During the physical exam, your doctor may:
- Listen to your breathing and look for symptoms of asthma
- Look for allergic skin conditions, such as eczema
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Why Is My Asthma Getting Progressively Worse
So what kind of things can make your asthma worse? The answer is a whole load of different things!
You may find that your asthma has certain triggers which can make your asthma flare up, such as exercise, dust, pollution, or pollen.
If you find that your asthma starts to flare up when youre around certain environmental factors, this could be the reason that it appears to be getting worse. It may even get worse around certain times of the year.
If you notice that your asthma is getting consistently worse despite environmental or seasonal factors, then there may be an underlying issue at play.
The main three factors will either lie in the fact that youre not taking your preventative inhaler as you should be, that you need to have your daily dosage adjusted, or that youre on the wrong inhaler for your asthma needs.
How Do I Know If A Flare
Here’s a good way to see how bad a flare-up is: measure your peak expiratory flow using a peak flow meter. Your doctor can show you how to use a peak flow meter to keep track of your asthma. A peak flow meter costs less than $30, and you only have to buy it one time. First, you find out your âpersonal bestâ peak flow. This is the highest reading you can get on the meter over a two-week period when your asthma is under good control.
Here are some general guidelines you can use to find out how serious an asthma flare-up is:
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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 Happens During An Asthma Episode

During normal breathing, the airways to the lungs are fully open. This allows air to move in and out of the lungs freely. Asthma causes the airways to change in the following ways:
These changes narrow the airways. Breathing becomes difficult and stressful, like trying to breathe through a straw stuffed with cotton.
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Signs Of Asthma Absolutely Everyone Should Know
You might think you know the signs of asthma because hey, it seems like one of those health conditions that is absolutely unmistakable. Its kind of obvious if you justcant really breathe, right? Sure, but asthma symptoms can present with a lot more complexity and subtlety than that. Many people do not realize they have asthma and deal with daily symptoms, Purvi Parikh, M.D., an allergist and immunologist with Allergy & Asthma Network, tells SELF. Because of that, you should be aware of the signs of asthma so you dont write them off for months or even years without realizing you have this persistentand ultimately treatablehealth condition.
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What To Do If You Have An Asthma Attack
If you think youre having an asthma attack, you should:
Never be frightened of calling for help in an emergency.
Try to take the details of your medicines with you to hospital if possible.
If your symptoms improve and you do not need to call 999, get an urgent same-day appointment to see a GP or asthma nurse.
This advice is not for people on SMART or MART treatment. If this applies to you, ask a GP or asthma nurse what to do if you have an asthma attack.
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When To See The Doctor
A good rule of thumb is you should visit your doctor if you have asthma and you wake up in the night more than once per week after using treatments. Your doctor can evaluate what may be causing your symptoms and help modify your treatment plan. Checking your breath in a peak flow meter at night may also be helpful.
If you are not diagnosed with asthma but have asthma-like symptoms at night, you should report the episodes to your doctor. While you may not have asthma, your doctor can point you in the right direction for treatment.
Other Ways To Prevent Asthma Attacks At Night
If a persons asthma is under control, then it would be rare for them to have a nocturnal asthma attack, said Carrillo. However, everybody has their own asthma triggers, so it is important to be mindful of your triggers, even when sleeping.She recommends four steps you can take to create an asthma-friendly sleep:
- Avoid sleeping near strong odors like perfumes or bed linen sprays
- Use pillow covers to prevent dust mites
- Wash your bed linens in hot water on a regular basis
- Keep pets out of the bedroom, especially if you are sensitive to their dander
- Get your flu shot and stay ahead of any respiratory illnesses
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Tips To Prevent Nighttime Asthma Attacks
Nighttime asthma attacks can be controlled. Take these steps to sleep better with severe asthma.
Many people with severe asthma find that symptoms like coughing, wheezing, and breathlessness are worse at night. There are a number of reasons why this is so, says Sonali Bose, MD, an assistant professor in the division of medicine, pulmonary, critical care, and sleep medicine at the Icahn School of Medicine at Mount Sinai Medical Center in New York City.
Some key factors that contribute to nighttime asthma attacks include:
- Your bodys internal clock. Your circadian rhythm causes some of your hormone levels to fall at night. Lower levels of hormones can cause your airways to narrow slightly. These narrowed airways can exacerbate your asthma symptoms, according to the Asthma Society of Canada .
- Dust mites. Your pillows, blankets, and mattress can all be a haven for these microscopic insect-like pests and their waste. Allergies to dust mites can worsen asthma, and you could be wallowing in them as you sleep, according to the ASC.
- Gravity. When you lie down, your chest and lungs naturally experience extra pressure, the ASC says.
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What Asthma Treatment Options Are There
You have options to help manage your asthma. Your healthcare provider may prescribe medications to control symptoms. These include:
- Anti-inflammatory medicines: These medicines reduce swelling and mucus production in your airways. They make it easier for air to enter and exit your lungs. Your healthcare provider may prescribe them to take every day to control or prevent your symptoms.
- Bronchodilators: These medicines relax the muscles around your airways. The relaxed muscles let the airways move air. They also let mucus move more easily through the airways. These medicines relieve your symptoms when they happen.
- Biologic therapies for asthma when symptoms persist despite being on proper inhaler therapy.
You can take asthma medicines in several different ways. You may breathe in the medicines using a metered-dose inhaler, nebulizer or other inhaler. Your healthcare provider may prescribe oral medications that you swallow.
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Keep Your Mattress Up Off Of The Floor
While you technically can use some mattresses directly on the floor, we dont suggest that for people with allergies Placing your mattress on the floor means youre closer to dirt, dust, and other germs that can more easily make their way into your sleep space. Using a mattress foundation or bed frame limits your exposure to these irritants.
What Are The Signs Of A Severe Asthma Attack

Asthma may lead to a medical emergency.
Rescue inhalers can help you: otc inhalers
Seek medical help immediately for:
- Fast breathing with chest retractions
- Cyanosis which is tissue color changes on mucus membranes and fingertips or nail beds the color appears grayish or whitish on darker skin tones and bluish on lighter skin tones
- Rapid movement of nostrils
- Ribs or stomach moving in and out deeply and rapidly
- Expanded chest that does not deflate when you exhale
- Infants with asthma who fail to respond to or recognize parents
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Asthma Patterns In Children
Every childs asthma is different. Some children have mild, occasional episodes of asthma or only show symptoms after exercising, or when they have a cold. Some experience daily symptoms, while others have symptoms continuously, which limit their level of activity.
Each pattern of asthma requires a different treatment approach. It is important to remember that children can still have a severe and even life-threatening attack, even if they generally have mild or occasional asthma.
What Are The Treatments For Asthma
If you have asthma, you will work with your health care provider to create a treatment plan. The plan will include ways to manage your asthma symptoms and prevent asthma attacks. It will include:
- Strategies to avoid triggers. For example, if tobacco smoke is a trigger for you, you should not smoke or allow other people to smoke in your home or car.
- Short-term relief medicines, also called quick-relief medicines. They help prevent symptoms or relieve symptoms during an asthma attack. They include an inhaler to carry with you all the time. It may also include other types of medicines which work quickly to help open your airways.
- Control medicines. You take them every day to help prevent symptoms. They work by reducing airway inflammation and preventing narrowing of the airways.
If you have a severe attack and the short-term relief medicines do not work, you will need emergency care.
Your provider may adjust your treatment until asthma symptoms are controlled.
Sometimes asthma is severe and cannot be controlled with other treatments. If you are an adult with uncontrolled asthma, in some cases your provider might suggest bronchial thermoplasty. This is a procedure that uses heat to shrink the smooth muscle in the lungs. Shrinking the muscle reduces your airway’s ability to tighten and allows you to breathe more easily. The procedure has some risks, so it’s important to discuss them with your provider.
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Lie On Your Left Side With A Pillow Between Your Legs
If youre a side sleeper with asthma, lying on your left side may help particularly if you have gastroesophageal reflux, also known as heartburn, which can trigger asthma especially at night. Sleeping on your left side uses gravity, the shape of the stomach, and the angle of the connection between it and the esophagus,which can reduce reflux. Lying on your left side with your head elevated may be enough to keep you comfortable through the night, but if its not, experiment by adding a pillow between your legs.
Adding the pillow may keep your spine stable throughout the night and may improve your sleep posture, which can help you breathe easily.
You Cant Maintain Your Normal Exercise Routine
You may notice that youre unable to keep up with any type of physical activity if your severe asthma symptoms are getting worse.
Talk with your doctor if you find yourself coughing or using your inhaler more often at the gym or during activities like jogging or playing sports.
If your chest tightens more often during everyday physical activities like climbing the stairs or walking around the block, you may need to change your medications to get your symptoms under control.
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When To Seek Help About Your Asthma Symptoms
Asthma attacks can happen any time and in any place. If you are experiencing asthma symptoms multiple times per week, then see your health care provider to discuss adjustments to your asthma care plan.
For people that do not have health insurance, Carrillo recommends looking for medication assistance programs in your area. It is important for people with asthma to have access to the proper medication, said Carrillo. In south Texas, we have the Medication Assistance Program through Healthy South Texas. These types of programs do exist, and they are ready to help.
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Asthma And Menopause: Whats The Connection
It may seem odd that two seemingly unrelated conditions menopause and asthma are linked. But the connection becomes a heck of a lot clearer once you understand one fact
Asthma is influenced by hormones.
Research shows that one-third of women have worse asthma symptoms just before or during their period, that teen girls are more likely to develop asthma than teen boys and that women are more likely to develop asthma during or after a pregnancy all because of hormones.
So its no wonder then that menopausal women who are going through the biggest hormonal shift of their adult life are at an increased risk. It makes perfect sense. But its also incredibly unfair.
Why do menopausal women who are already dealing with hot flashes, mood swings, vaginal dryness, insomnia, brain fog and weight gain have to deal with asthma too? And a pretty serious form of it at that
Adult-onset asthma tends to be more serious than the kind that strikes during childhood. Asthma symptoms come and go during childhood, but adults who develop asthma usually have symptoms that stick around and require medication.
So if youre a woman entering mid-life, you need to stay alert for the signs of asthma even if youve never had it before. Asthma symptoms include:
- Feeling short of breath
- Pain or tightness in the chest
- Coughing, wheezing or shortness of breath that leads to insomnia
- A whistling or wheezing sound when exhaling
- Coughing or wheezing attacks worsened by a cold or the flu
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Asthma Isnt An Excuse Not To Work Out
- Warm up and cool down before exercising. This will help you lungs get acclimated to the air.
- Avoid working out during cold weather. If you do, cover your mouth and nose.
- Avoid working out when you have a cold or viral infection.
- Always use your inhaler or prescribed medication before you work out.
You shouldnt use EIB as an excuse not to work out and get exercise. Its likely possible as long as you work with your doctor, find a regimen that works for you and take any medication as necessary, said EXPERT. Dr. Navitha Ramesh is a pulmonologist at Geisinger Wyoming Valley. To schedule an appointment, call 800-275-6401.
Geisinger Health Plan may refer collectively to Geisinger Health Plan, Geisinger Quality Options Inc., and Geisinger Indemnity Insurance Company, unless otherwise noted. Geisinger Gold Medicare Advantage HMO, PPO, and HMO D-SNP plans are offered by Geisinger Health Plan/Geisinger Indemnity Insurance Company, health plans with a Medicare contract. Continued enrollment in Geisinger Gold depends on annual contract renewal. Geisinger Health Plan Kids and Geisinger Health Plan Family are offered by Geisinger Health Plan in conjunction with the Pennsylvania Department of Human Services . Geisinger Health Plan is part of Geisinger, an integrated health care delivery and coverage organization.
What Is The Treatment For Asthma

Asthma symptoms can be treated with a variety of prescription medications that provide quick relief as well as long term control. Lifestyle changes can also reduce symptoms, especially if asthma is triggered by allergies to substances in the environment or to certain foods . Regular vaccinations for influenza and pneumonia are strongly recommended for older adults with asthma.
Keep in mind . . . Short-term use of oral steroids are helpful to treat acute asthma symptoms, or flare ups however, long-term use of oral steroids is usually avoided in older asthma patients. Over time, oral steroids can cause severe side effects, such as weakening of bones, ulcers, or high blood pressure.
People with asthma should develop a written asthma management plan with their physician. An asthma management plan outlines specific treatment and lifestyle practices, including what to do when asthma symptoms flare up or become out of control.
Older asthma patients should be sure to ask their physician about any aspect of their asthma treatment that they do not understand. Keeping the physician informed about how well treatment is working is important. Patients need to tell their physician if they are having trouble remembering to take their medications, or if they are having difficulty using devices such as an inhaler.
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