Severe Asthma Typically Requires A Combination Approach To Treatment
If someone experiences asthma symptoms more than twice a week, their asthma is termed persistent. And among those with persistent asthma, doctors further categorize the condition as mild, intermediate, or severe.
The symptoms of severe asthma are similar to those of mild asthma, theyre just more frequent and more severe, and require more medications to keep them under control, says Emily Pennington, MD, a pulmonologist and asthma specialist at the Cleveland Clinic in Ohio.
Often, if someones symptoms require a combination of asthma medications such as high-dose inhaled corticosteroids as well as longer-acting drugs that persons asthma is termed severe. The same term applies to people who dont respond well to treatment.
We dont entirely understand why some people dont respond as well to medication, Dr. Pennington says. Genetic and underlying molecular factors are likely explanations, she says, but the exact causes of severe asthma are complex and likely vary from one person to the next.
Theres also an informal term, uncontrolled asthma, that refers to people whose asthma symptoms are not well managed. This can happen for a number of reasons:
- Other conditions, such as heart disease, that make asthma hard to manage
- Lifestyle choices, such as the decision to smoke cigarettes, that exacerbate asthma symptoms
- Not following a doctors advice or guidelines when taking medications
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How Do Healthcare Providers Diagnose Asthma
Your healthcare provider will review your medical history, including information about your parents and siblings. Your provider will also ask you about your symptoms. Your provider will need to know any history of allergies, eczema and other lung diseases.
Your healthcare provider may order a chest X-ray, blood test or skin test. Your provider may order spirometry. This test measures airflow through your lungs.
Why Might Someone With Asthma Be Without An Inhaler
However, this doesnât mean that everyone with asthma has an inhaler with them at all times. Often when someone has been living without symptoms for a long time, they may assume that their asthma has gone, and so get out of the habit of carrying one. Some people might develop symptoms suddenly for the first time as an adult, with no preparation. Others might just sometimes forget. Unfortunately, not having an inhaler wonât stop an attack.
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Are You Having An Asthma Emergency
Signs and symptoms of a severe asthma attack emergency include:
- Trouble walking or talking because you are short of breath
- Not getting relief from your rescue inhaler or nebulizer treatment
- Blue lips or fingernails
- A peak flow reading of 50 percent or less of your personal best
Not all asthma emergencies happen quickly. A dangerous asthma attack can start in a matter of minutes or develop slowly over hours. So, even if you aren’t in immediate danger, it’s important to pay attention to the symptoms of an asthma attack.
Early warning signs that your asthma is getting worse include:
- Coughing, wheezing, or tightness in your chest
- Shortness of breath
- Symptoms that wake you up or begin when you are active
- A peak flow reading at 50 to 79 percent of your personal best
Asthma Emergencies In Children
Symptoms of an asthma attack can worsen and develop into an asthma emergency. To prepare for an asthma emergency, make sure your childs doctor has written an asthma action plan for your child.
Have a copy of your childs asthma action plan pinned up somewhere easy to access at home, and send a copy to anyone who cares for your child, including their school, kinder, childcare service, family members and friends. You may like to take a photo of their asthma action plan so you always have a copy with you.
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How To Reduce The Risk Of An Asthma Attack
- Take the prescribed medicines regularly.
- Visit your doctor regularly for check-ups.
- Make sure you are using the inhaler properly. Monitor your inhaler use.
- Avoid all known triggers whenever possible.
- Avoid first and second-hand smoking!
- Practice relaxation and deep breathing exercises to build lung capacity!
- Reduce unwanted weight for a healthier form.
- Avoid contact with persons who may have respiratory infection even colds and flu. Take flu vaccinations every year.
And donât forget to download our comprehensive ebook on Asthma Management here. If you have registered before, please make sure you are logged in. If you have not registered before, you will need to register.
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What Is An Asthma Attack
Asthma is a chronic disease that affects the lungs. During an asthma attack, the airways become narrower than normal and can cause difficulty breathing.
The severity of an asthma attack can range from mild to very serious. Some asthma attacks may require prompt medical attention.
The preferred way of treating an asthma attack is to use a rescue inhaler, which contains medication that expands your airways.
But what if youre having an asthma attack and dont have your rescue inhaler available? There are several things that you can do while you wait for your symptoms to subside or for medical attention. Read on to learn more.
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What To Do To Prevent An Asthma Attack
There are steps you can take to help decrease your chances of having an asthma attack. The below points are important for all asthmatics whether your condition is mild, moderate or severe.
- Attend regular reviews of your condition with your doctor or asthma nurse
- Take your medication as it has been prescribed
- Check that you are using the correct inhaler technique
- Maintain a healthy weight
- Try and avoid your asthma triggers as much as possible
- Do not smoke
Side Effects Of Relievers And Preventers
Relievers are a safe and effective medicine, and have few side effects as long as they are not used too much. The main side effects include a mild shaking of the hands , headaches and muscle cramps. These usually only happen with high doses of reliever inhaler and usually only last for a few minutes.
Preventers are very safe at usual doses, although they can cause a range of side effects at high doses, especially with long-term use.
The main side effect of preventer inhalers is a fungal infection of the mouth or throat . You may also develop a hoarse voice and sore throat.
Using a spacer can help prevent these side effects, as can rinsing your mouth or cleaning your teeth after using your preventer inhaler.
Your doctor or nurse will discuss with you the need to balance control of your asthma with the risk of side effects, and how to keep side effects to a minimum.
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Asthma Attack Triggers And How To Prevent Them
If youve ever had an asthma attack, you know how scary it can be when your chest tightens, making it difficult to take breaths between coughing. These are just some of the symptoms that characterize an asthma attack. Asthma attacks can be triggered by many things, making it all the more frightening when you suddenly cant breathe.
Understanding what triggers your asthma is the first step toward preventing an asthma attack. Well explain what you need to know about common asthma attack triggers, so you can do your best to prevent symptoms from interrupting your everyday life.
What Are The Most Common Triggers Of Asthma Attacks
Common asthma attack triggers include:
- Coming into contact with allergens, such as pollen, animal fur, mould or dust
- Eating certain foods
- Environmental factors, such as pollution, poor air quality or cold air
- Taking non-steroidal anti-inflammatory medications, such as ibuprofen
- Taking medication such as beta blockers
- Stress or extreme emotion
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Recognizing A Severe Asthma Attack
Your symptoms of coughing, wheezing and chest tightness are continuous. You are very short of breath. Your anxiety level is increasing. You can only speak in short sentences. Your lips and nailbeds are pink. Your peak air flow is less than 50% of your best readings. You need to take immediate steps to halt the asthma attack.
How To Control An Asthma Attack When Caught Without An Inhaler
Breathing is so automatic for most people that we hardly ever give it a second thought. If you have asthma, or if your child has asthma, though, you never take breathing for granted.
When you suffer from asthma, your airways narrow and swell and can even produce extra mucus, all of which make breathing difficult. Asthma can also cause lots of wheezing, coughing, and shortness of breath.
This is especially true if you experience a full-blown asthma attack. Most people with asthma try to keep a rescue inhaler with them so they can have quick access to medicine such as albuterol, which can control their symptoms.
But what if you have an asthma attack while you dont have your inhaler with you? This can be a dangerous situation, but at Sulkowski Family Medicine, weve learned a few tips over the years that can help you out. Heres what we recommend:
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What To Do If You Have An Asthma Attack And Dont Have Your Rescue Inhaler
As a person with asthma, I do my best to ensure I have my rescue inhaler with me at all times because having an asthma attack and no inhaler can be problematic. In fact, I have a rescue inhaler stashed in several places in my car, in my purse, at my house. This way if I have an asthma attack, my inhaler is generally within reach. Theoretically.
However, we all know that things happen. Life happens. When I was working as a floor nurse, a cleaning product being used by the housekeeper sent me into an asthma attack.
My inhaler was in my purse, which was in my locker. You would think that working on a nursing unit, Id have an albuterol inhaler readily available, but that was not the case.
It was a very busy night and I thought to myself, Ill answer one more call right before grabbing my inhaler., Ill give one more medication.
Before I knew it, my wheezing was so severe that my manager could hear me from her office and she wheeled me to the ER. I spent the remainder of my shift there before the physician sent me home, prednisone prescription in hand.
I learned my lesson that night I need a back-up plan for when my inhaler is not readily available.
How Is Asthma Prevented And Treated
There is no cure for asthma. Control symptoms by taking asthma medicines and avoiding your triggers. With proper treatment and an asthma management plan, you can reduce your symptoms and enjoy a better quality of life.
Talk to your health care provider about your asthma symptoms and be sure to discuss any changes in your asthma management or status.
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Everyday Treatment For Asthma In Children
The main aims of day-to-day asthma treatment are to:
- keep symptoms under control
- keep lungs as healthy as possible
- stop asthma from interfering with school or play
- help your child enjoy a full and active life.
Your doctor will help you to develop a plan to manage your childs asthma which will include an asthma action plan , and will prescribe the correct medication to help you do so.
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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Home Remedies For Asthma Attacks
While some asthma attacks are mild, lasting just a few minutes, others are severe and may need immediate medical treatment. Many milder attacks can be handled at home. Heres what to try.
Avoid your triggers. If you know what your triggers are, try to stay away from them so you can avoid asthma attacks altogether. Sometimes, this isnt possiblebut if you find yourself having an asthma attack and you know why, do what you can to get away from the culprit.
If you walked into someones house with a cat, then get outside,” says Dr. Rathkopf. “If youre outside and its cold, then get inside or cover up your mouth with a scarf.
Follow your action plan. Every patient should leave their doctors office with an asthma action plan, says Dr. Li. These individualized plans will guide you through the best next steps during an asthma attack.
Preparation is key, says Dr. Li. Attacks happen.
That goes for everyoneeven if youve never had an asthma attack. Patients have felt like they cant really have asthma because theyve never had an attack, says Dr. Rathkopf. Thats fortunate for them, but it doesnt mean they couldnt have one.
The first step after getting away from your triggeror if you cant avoid your trigger or dont know what it isis usually medication.
Take anywhere from two to four puffs, advises Dr. Li.
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How Do You Know If Youre Having An Asthma Attack
An asthma attack is usually indicated by one or more of the following:
- your reliever inhaler is not helping to reduce your symptoms
- you are breathless, making it difficult to talk, eat or sleep
- your asthma symptoms are worsening
- you are unable to catch your breath and your breathing is getting faster
- younger asthmatics may complain of stomach ache
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How Do You Stop An Asthma Attack Without An Inhaler
If you are diagnosed with asthma, you should make sure you have an inhaler with you at all times. However, if a worst case scenario occurs and you experience when you dont have a reliever inhaler with you, there are practical steps you can take to ease your symptoms.
- Stay as calm as you can find a way to reduce any anxiety, such as holding someones hand or playing music
- Sit upright this will help keep your airways open
- Breathe slowly and deeply slowing down your breathing can reduce the risk of hyperventilating
- If something appears to have triggered your asthma, such as breathing in cold air or being exposed to smoke, move away from the trigger
- Try breathing exercises the pursed lip breathing technique can help you deal with shortness of breath
- Have a drink containing caffeine there is some evidence to suggest that caffeine can help improve airway function for up to four hours.
Asthma can be a life-threatening condition, so at the very least, aim to keep a spare reliever inhaler in your handbag, locker at work or coat pocket.
Triggers For Asthma In Children
Asthma triggers are substances, conditions or activities that lead to asthma symptoms. These include :
- wheezing whistling noise when breathing
- coughing .
Your child may have all of these symptoms or just a few. Symptoms are often worse at night, in the early morning, during exercise or due to other triggers.
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What To Do After An Asthma Attack
An asthma attack can be a learning experience if you and your doctor use it to refine your asthma action plan. Get some tips on what to do after an asthma attack.
An asthma attack is a sudden worsening of asthma symptoms that causes your air passages to become smaller and makes your breathing more difficult. Symptoms of an asthma attack may include difficult and painful breathing, coughing, and . Anyone with asthma needs to have a plan for what to do during an asthma attack. But you should also know what to do after an asthma attack.
You cant always avoid an asthma attack, but you can check in with your doctor and use an asthma attack as a way to improve your asthma management, said Jonathan Bernstein, MD, an associate professor in allergy and asthma at the University of Cincinnati Academic Health Center. In some cases, an asthma attack may be an indication that you need to make some changes.
Seeing your doctor after an asthma attack is especially important if you are newly diagnosed. Discussing the attack with your doctor can help you learn more about your asthma and empower you to manage your asthma better in the future, said Sumita Khatri, MD, co-director of the asthma center at the Cleveland Clinic.
How Is Asthma Treated
Take your medicine exactly as your doctor tells you and stay away from things that can trigger an attack to control your asthma.
Everyone with asthma does not take the same medicine.
You can breathe in some medicines and take other medicines as a pill. Asthma medicines come in two typesquick-relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. If you need to use your quick-relief medicines more and more, visit your doctor to see if you need a different medicine. Long-term control medicines help you have fewer and milder attacks, but they dont help you while you are having an asthma attack.
Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor about the side effects of your medicines.
Remember you can control your asthma. With your doctors help, make your own asthma action plan. Decide who should have a copy of your plan and where he or she should keep it. Take your long-term control medicine even when you dont have symptoms.
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