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Control your Asthma…Don’t let it control you!

Mary Lou Hayden, RN, MS, FNP, AE-C – Asthma is a chronic disease of the lungs causing swelling and inflammation of the lining of the airways.  This swelling narrows the opening of the airways and can lead to shortness of breath, tightness in the chest, wheezing or cough, and the production of extra phlegm.  Asthma symptoms occurring more than twice a week during the daytime or twice a month at night would be considered not well-controlled.   While there currently is no cure for asthma, it can be well-controlled or managed.

The best way to control asthma is to reduce exposure to factors that trigger symptoms.  For many asthmatics, a common cold will worsen asthma.  The cold virus causes inflammation not only in the nose and sinuses, but in the airways of the lung as well.  Cold, dry, winter air, and sometimes hot, humid, summer air can worsen asthma.  Other important triggers include allergens and air pollutants.   Allergens include pollens from trees, grasses and weeds; dander from cats, dogs, mice, rats and other animals; dust mites, molds, and insects such as cockroaches and ladybugs.  Air pollutants can come from industry and cars such as smog, tobacco smoke, fire place smoke, and gas from appliances.  It is important to know which of these are triggers for your asthma.  Ask your allergy specialist how to reduce your exposure to these triggers.

Daily asthma medications can also provide long term control by reducing inflammation in the lungs.  Many of these medications are inhaled steroids such as beclomethasone (QVAR), budesonide (Pulmicort), ciclesonide (Alvesco), fluticasone (Flovent), and mometasone (Asmanex).  Sometimes these medications are combined with a long-acting bronchodilator such as Advair, Dulera and Symbicort.  Bronchodilators work directly on the airways with little or no exposure to the rest of the body.  For medication to be effective, it is essential to use correct technique for inhalation to be certain the medication reaches the lungs.  Sometimes a spacer device is prescribed with the pressurized inhalers to assist patients who have difficulty coordinating the activation of the inhaler while breathing in.  If you are uncertain how to use your inhaler, ask your allergy/asthma specialist or the pharmacist.  Other commonly prescribed long term control medications include pills (or granules) such as Montelukast (Singulair) and Zafirlukast (Accolate).   There are a couple of new medications being studied which could change your treatment plan in the near future.

The other main type of asthma medication is “Quick Relief” or “Rescue” medication.  This medication is used as needed for asthma symptoms such as cough, wheezing, chest tightness and shortness of breath.   They may also be used a few minutes before exercise to prevent exercise related symptoms.  Albuterol is available as an inhaler (ProAir, Proventil, Ventolin) and as a nebulizer solution.  Levalbuterol (Xopenex) is available as an inhaler or nebulizer solution as well. Quick Relief inhalers also require proper technique to be effective.

With so many medications and devices, it is important that you understand your treatment plan.  Regularly visit your asthma specialist or your local BreatheAmerica and be sure to ask questions about your allergies, triggers for asthma, new treatments, and how to control asthma.  Don’t let your asthma control you or limit your favorite activities.

UPDATE: BreatheAmerica centers in Richmond, Columbus, and Tulsa have closed. Please visit our location page for information on our Albuquerque, El Paso, and Shreveport clinics.