Last week, I had the opportunity to talk to a group of respiratory therapy (RT) students at one of our local colleges. Each fall, this college’s RT department selects a non-profit organization to help with fundraising, volunteering, and raising awareness of its mission and services for the community.
From that presentation, my business partner Gerri Rivers and I had the opportunity to speak to one of the students who is a mom with an asthmatic child. Her son has severe asthma, and has a really tough time with his asthma during the winter months. She was terrified that if her son didn’t gain control of his asthma soon, he may not survive the coming winter. She felt scared, lost, and confused, and really needed some help navigating the health care system. Her story affirmed the reason why Asthma Allies exists. Her story also brought to mind how important it is for parents, caregivers, teachers, and others who care for a child with asthma to be aware of asthma symptoms, triggers, that child’s Asthma Action Plan and especially, how to administer or assist with taking his/her medication.
A proper medication regiment is crucial for controlling asthma. Determining what medicines a person with asthma should take depends on several factors. A few of them are:
"¢ the severity of the disease
"¢ age of the person with asthma
"¢ use of other medications
"¢ other medical diagnosis
"¢ personal goal of person with asthma
1. How severe is your asthma? Determining the severity of asthma is the first step to gaining control of one’s asthma. To establish asthma diagnosis, a primary care provider will gather a medical history that looks at past episodes of wheezing, chest tightness, shortness of breath, and chronic coughing; frequency of those episodes; a history of allergies; and perhaps ask if there are close family members with allergies and/or asthma. Along with this medical history, a person may also undergo a physical examination of the upper respiratory tract, chest and skin, which may include spirometry, chest x-ray, and allergy tests. These are all dependent on the person and his/her primary care provider.
2. What are your personal asthma goals? Once diagnosis and severity of asthma is determined, the next step is to set some personal goals for the person with asthma. The overall goal of asthma therapy is to prevent asthma symptoms and allow the person to live as normal of a life as possible. That means having normal lung function; having the person with asthma satisfied on the asthma care he/she is receiving; and having no or very little side effects from the medicines used to control asthma. Of course, none of this matters without the input of the person with asthma. If you have asthma, you have a huge part to play developing your personal goals. Ask yourself what you would like to do that you can’t do now because of asthma? Or what do you want to accomplish with your asthma treatment? Work with your primary care provider to set personal goals using the guidelines and your desired outcome of treatment.
3. What’s the best medication for you? Now that severity of disease and personal goals are established, proper medication needs to be determined. There are two classes of medicines used in asthma management: long-term control medicines and quick-relief medicines. Long-term control asthma medicines are taken daily. These medicines help to reduce inflammation of the airways. Inhaled steroids are the most potent and effective medicines to help tackle this part of asthma. A person with asthma that is experiencing symptoms more than 2 days a week, or waking up at night more than 2 times a month, should take an inhaled steroid.
The other class of asthma medicines are quick-relief medicines. These medicines help tackle the bronchoconstriction part of asthma - that’s when the muscles around the airways tighen, narrowing the passages your breath needs to get through. It’s accompanied by wheezing, shortness of breath, chest tightness, and coughing. This class of medicines work fast, and should only be taken at the early onset of asthma symptoms or when symptoms are already present. Regardless of the severity of their disease, EVERYONE with asthma should have a quick-relief medicine.
4. Do you know how to use your medicine properly? Part of gaining asthma control with the proper medicines is knowing when and how to use these medicines. For any type of inhaler, it is strongly recommended that inhalers are administered with a spacer or holding chamber. These tools ensure that the majority of the medicine makes it to the airways in the lungs. Of course, medications only work if they are taken they way they are prescribed. Skipping doses or not taking them at all will not help anyone gain control of their asthma. If a person is experience side effects from their medicines, or feel their medicines are not helping, talk to your primary care provider. There are so many options available today that most people can find something that works really well for them.
5. Do you have an asthma action plan? An Asthma Action Plan is also important for maintaining control. The asthma management plan outlines what and how much of medicines to take daily (if needed) or when asthma symptoms are present. It also outlines what to do if symptoms are just starting to appear, what to do if the person with asthma is sick, and what are the asthma triggers for that person. This plan is developed by a primary care provider and in conjunction with the person asthma, and should be shared with everyone who cares for that person with asthma. This plan also needs to be reviewed at each doctor visit to make sure that it is still the best way to care for that person with asthma.
So, take some time to review your asthma action plan and really take a close look at your symptoms. If your asthma medicines seem to be helping you gain and stay in control, continue your plan according to what you and your primary care provider have established. If you are having more than two days a week with symptoms, make an appointment to see your provider. Your asthma management plan may need to be modified to help you stay symptom free.