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Chest and Respiratory Problems

Asthma

Prevention - Home Treatment - When to Call a Health Professional

Asthma is a condition that causes long-term inflammation of the airways. The inflammation makes the airways overreact to certain particles in the air. During an asthma episode, the muscles surrounding the tubes that carry air into the lungs (bronchial tubes) go into spasm; the mucous lining of the lungs swells; and secretions build up in the lungs, suddenly making breathing difficult.

A person who is having an asthma episode (attack) may make a wheezing or whistling sound while breathing. The person usually coughs a great deal and may spit up mucus. Sometimes a chronic, dry cough, especially at night or early in the morning, is the only symptom of mild asthma.

Many things can trigger asthma, including allergens such as dust, pollen, cockroaches, and animal dander. In general, viral respiratory infections, such as colds, are the most common triggers of asthma. Other triggers include exercise, cold air, cigarette or wood smoke, chemical vapors, pain relievers (especially aspirin), food preservatives and dyes, and emotional stress.

Asthma usually develops during childhood but may also begin later in life. The first episode often follows a cold or the flu. Asthma is more common in children who are exposed to cigarette smoke in the home. Many children outgrow

asthma symptoms as they get older, but the symptoms may return later in life.

Most children and adults can control their asthma by avoiding triggers that cause attacks and using medications to manage symptoms. Severe attacks can usually be treated with inhaled or injected medications. Asthma attacks are rarely fatal if they are treated promptly and appropriately.

Prevention

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There is no way to prevent asthma. However, you may be able to limit the length and severity of asthma episodes if you can avoid or control your exposure to things that trigger asthma symptoms.

  • Review Home Treatment for allergies.

  • Control cockroaches. Do not leave food or garbage in open containers. Use poison bait and traps to kill cockroaches. Avoid chemical sprays, which can trigger an asthma attack.

  • Avoid smoke of all kinds. If you smoke cigarettes, stop. See Be Tobacco-Free for tips on quitting. Avoid places where other people may be smoking. Stay away from wood-burning stoves.

  • Avoid irritants in the air. Stay indoors when the air pollution or pollen count is high. Try to avoid strong odours, fumes, and perfume.

  • Avoid breathing cold air. In cold weather, breathe through your nose, and cover your nose and mouth with a scarf or a cold weather mask.

  • Aspirin, ibuprofen, and similar pain medications can cause severe asthma attacks in some people. Discuss the use of these medications with your doctor, and use them with caution. If these medications bother you, don't use them. Try acetaminophen instead.

  • Do not use nonprescription cold and cough medications unless your doctor tells you to do so.

  • Stress may be a factor in triggering asthma attacks. Practise the relaxa- tion exercises on See Relaxation Skills.

  • Reduce your risk of colds and flu by washing your hands often and getting a flu shot each year.

  • If you use a humidifier, clean it thoroughly once a week.

  • Build up the strength of your lungs and airways:

    • Get regular exercise. Swimming or water aerobics may be good choices because you are less likely to have an asthma attack when you breathe moist air. If vigorous exercise triggers asthma attacks, talk with your doctor. Adjusting your medication and your exercise routine may help.

    • Practise roll breathing as described on See Roll Breathing.

Asthma Control Plan

An asthma control plan is a written plan that tells you how to manage your asthma symptoms at home. It helps take the guesswork out of treating your asthma. The plan will outline the medication you will take for your asthma symptoms and when to take it, depending on the zone you are in (green, yellow, or red). In order to determine what zone you are in, you will have to know how to measure your ability to exhale using a peak flow meter. The plan may also tell you when to talk to your health professional about your asthma symptoms.

The asthma control plan zones include:

  • Green zone plan: Routine care to keep asthma symptoms from starting.

  • Yellow zone plan: How to stop asthma symptoms and keep an asthma episode (attack) from getting worse. This may involve taking other medications in addition to the ones you usually take to control your asthma.

  • Red zone plan: What to do for a severe asthma episode. This is a medical emergency.

  • Work with your doctor to develop an asthma control plan so you can manage your symptoms at home. Make sure family members and friends know about your plan so they can help you during an asthma episode. See Asthma Control Plan.

  • When you aren't having symptoms, follow your plan to treat ongoing airway inflammation. Get regular checkups to make sure your asthma control plan is working well for you.

  • Learn to use a peak flow meter to monitor your ability to exhale. Used regularly, this device will give you an idea of how your lungs normally function. It also helps you tell when an asthma attack may be coming so you can take steps to prevent or treat it.

    Since triggers for asthma attacks are often not known, you need to monitor your symptoms so you can prevent or treat asthma attacks before they become severe. Using an asthma control plan developed by a doctor to guide your Home Treatment, you will be able to prevent emergency room visits or admissions to the hospital for asthma symptoms.

    Home Treatment

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    Once an asthma attack begins, prompt Home Treatment can provide relief.

    • Learn to use a metered-dose inhaler. Inhalers help get the right amount of medication to your airways. A device called a spacer is now recommended for use with an inhaler. Ask your doctor to watch you use your inhaler and spacer to make sure you are doing it right. With practice, most people can use an inhaler and spacer correctly.

    • Drink extra fluids to thin the mucus in the bronchial tubes. Try to drink at least 2 L (2 qt) of water per day.

    • Be confident that your Home Treatment will control the severity of the attack.

    • Keep a diary outlining your asthma attack. After you've had an attack, write down what triggered it, what helped end it, and any concerns you have about your asthma control plan. Take your diary when you see your doctor for your regular checkups. Ask questions you may have about your plan or medication.

      To get more information about managing asthma, contact your local health unit or public health office, or your provincial Lung Association or Allergy/Asthma Association.

    When to Call a Health Professional

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    Always follow your asthma control plan if you have one. Call 911 or seek emergency care if you are having severe asthma symptoms and:

    • You are having severe difficulty breathing.

    • Your medications have not helped after 20 minutes.

      Call a health professional:

    • If you have symptoms that may indicate heart problems, such as chest pain or shortness of breath. See Chest Pain.

    • If you are having a severe asthma attack (peak flow is less than 50 percent of your best), even if your medications have relieved some symptoms.

    • If your asthma symptoms don't get better after you follow your asthma control plan.

    • If you are coughing up yellow, dark brown, or bloody mucus.

    • If acute asthma symptoms (wheezing, coughing, difficulty breathing) have happened for the first time.

    • To discuss exactly what to do when an attack begins. Once you understand and have confidence in your asthma medication, you can often handle mild attacks without professional help.

    • If you begin to use your asthma medication more often than usual. This may be a sign that your asthma is getting worse.

    • If you or the people who live with you have not been educated about immediate treatment for asthma attacks.

    • If the medication required to treat an asthma attack is not available.

    • To talk about adjusting your medication. Your doctor needs your feedback to figure out the best medicine and the right dosage for you.

    • To assess allergies, which may worsen asthma attacks.

    • To get a referral to a support group. Talking with others who have asthma can give you information and boost your confidence in dealing with Prevention and treatment.

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