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Asthma

What is Asthma?
Asthma is a chronic disease of the airways that makes breathing difficult. With asthma, there is inflammation of the air passages that result in a temporary narrowing of the airways that carry oxygen to the lungs. This results in asthma symptoms, including coughing, wheezing, shortness of breath, and chest tightness. Some people refer to asthma as ďbronchial asthma.Ē

Even though there are seemingly miraculous treatments for asthma symptoms, asthma is still a serious -- even dangerous -- disease that affects more than 22 million Americans and causes nearly 2 million emergency room visits ever year. With proper asthma treatment, you can live well with this health condition. Yet inadequate asthma treatment limits the ability to exercise and be active. Poorly controlled asthma can lead to multiple visits to the emergency room and even hospital admission, which can affect your performance at home or at work.
There are three major features of asthma:
   ball1.gif (1653 bytes)1. Airway obstruction. During normal breathing, the bands of muscle that surround the airways are relaxed, and air moves freely. But in people with asthma, allergy-causing substances and environmental triggers make the bands of muscle surrounding the airways tighten, and air cannot move freely. Less air causes a person to feel short of breath, and the air moving through the tightened airways causes a whistling sound known as wheezing.
   ball1.gif (1653 bytes)2. Inflammation. People with asthma have red and swollen bronchial tubes. This inflammation is thought to contribute greatly to the long-term damage that asthma can cause to the lungs. And, therefore, treating this inflammation is key to managing asthma in the long run.
   ball1.gif (1653 bytes)3. Airway irritability. The airways of people with asthma are extremely sensitive. The airways tend to overreact and narrow due to even the slightest triggers such as pollen, animal dander, dust or fumes.
Asthma Symptoms
People with asthma experience symptoms when the airways tighten, inflame, or fill with mucus. Common symptoms of asthma include:
   ball1.gif (1653 bytes) Coughing, especially at night
   ball1.gif (1653 bytes)Wheezing
   ball1.gif (1653 bytes)Shortness of breath
   ball1.gif (1653 bytes)Chest tightness, pain, or pressure

Still, not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your asthma symptoms may also vary from one asthma attack to the next, being mild during one asthma attack and severe during another.

Some people with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks. Others might have asthma symptoms every day. In addition, some people with asthma may only have asthma during exercise or asthma with viral infections like colds.

Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild symptoms to help you prevent severe episodes and keep asthma under better control.
1. Early Asthma Symptoms:
Early warning signs are changes that happen just before or at the very beginning of an asthma attack. These asthma attack symptoms may start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening.

In general, these signs are not severe enough to stop you from going about your daily activities. But by recognizing these signs, you can stop an asthma attack or prevent one from getting worse. Early warning signs include:
   ball1.gif (1653 bytes)Frequent cough, especially at night
   ball1.gif (1653 bytes)Losing your breath easily or shortness of breath
   ball1.gif (1653 bytes)Feeling very tired or weak when exercising
   ball1.gif (1653 bytes)Wheezing or coughing after exercise
   ball1.gif (1653 bytes)Feeling tired, easily upset, grouchy, or moody
   ball1.gif (1653 bytes)Decreases or changes in lung function as measured on a peak flow meter
   ball1.gif (1653 bytes)Signs of a cold, or allergies (sneezing, runny nose, cough, nasal congestion, sore throat, and headache)
   ball1.gif (1653 bytes)Trouble sleeping
2. The Asthma Symptoms in Children:
Asthma affects as many as 10% to 12% of children in the United States and is the leading cause of chronic illness in children. For unknown reasons, the incidence of asthma in children is steadily increasing. While asthma symptoms can begin at any age, most children have their first asthma symptoms by age 5.

Asthma is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes. Not all children with asthma wheeze. Chronic coughing with asthma may be the only obvious sign, and a childís asthma may go unrecognized if the cough is attributed to recurrent bronchitis.
3. The Symptoms of an Asthma Attack:
An asthma attack is the episode in which bands of muscle surrounding the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed and the cells lining the airways produce more and thicker mucus than normal.

All of these factors -- bronchospasm, inflammation, and mucus production -- cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack include:
   ball1.gif (1653 bytes)Severe wheezing when breathing both in and out
   ball1.gif (1653 bytes)Coughing that won't stop
   ball1.gif (1653 bytes)Very rapid breathing
   ball1.gif (1653 bytes)Chest pain or pressure
   ball1.gif (1653 bytes)Tightened neck and chest muscles, called retractions
   ball1.gif (1653 bytes)Difficulty talking
   ball1.gif (1653 bytes)Feelings of anxiety or panic
   ball1.gif (1653 bytes)Pale, sweaty face
   ball1.gif (1653 bytes)Blue lips or fingernails

The severity of an asthma attack can escalate rapidly, so it's important to treat these asthma symptoms immediately once you recognize them.

Without immediate treatment, such as your asthma inhaler or bronchodilator, your breathing will become more labored. If you use a peak flow meter at this time, the reading will probably be <50%.

As your lungs continue to tighten, you will be unable to use the peak flow meter at all. Gradually, your lungs will tighten so there is not enough air movement to produce wheezing. This is sometimes called the "silent chest," and it is an ominous sign. You need to be transported to a hospital immediately. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.

If you do not receive adequate asthma treatment, you will eventually be unable to speak and will develop a bluish coloring around your lips. This color change, known as cyanosis, means you have less and less oxygen in your blood. Without aggressive treatment for this asthma emergency, you will lose consciousness and eventually die.
4. Unusual Asthma Symptoms:
Not everyone with asthma has the usual symptoms of cough, wheezing, and shortness of breath. Sometimes individuals have unusual asthma symptoms that may not appear to be related to asthma. Some "unusual" asthma symptoms may include the following:
   ball1.gif (1653 bytes)sighing
   ball1.gif (1653 bytes)fatigue
   ball1.gif (1653 bytes)inability to exercise properly (called exercise-induced asthma)
   ball1.gif (1653 bytes)difficulty sleeping or nighttime asthma
   ball1.gif (1653 bytes)anxiety
   ball1.gif (1653 bytes)difficulty concentrating
   ball1.gif (1653 bytes)chronic cough without wheezing
   ball1.gif (1653 bytes)Also, asthma symptoms can be mimicked by other conditions such as bronchitis, vocal cord dysfunction, and even heart failure.
5. Infections Trigger Asthma Symptoms:
Sometimes a virus or bacterial infection is an asthma trigger. For instance, you might have a cold virus that triggers your asthma symptoms. Or your asthma can be triggered by a bacterial sinus infection. Sinusitis with asthma is common.

Itís important to know the signs and symptoms of respiratory tract infections and to call your doctor immediately for diagnosis and treatment. For instance, you might have symptoms of increased shortness of breath, difficulty breathing, or wheezing with a bronchial infection. In people who donít have asthma, the bronchial infection may not trigger the same debilitating symptoms. Know your body and understand warning signs that an infection might be starting. Then take the proper asthma medication as prescribed to get rid of the infection and regain control of your asthma and good health.
Causes of Asthma
No one really knows the causes of asthma. What we do know is that asthma is a chronic inflammatory disease of the airways. The causes of asthma symptoms can vary for different people. Still, one thing is consistent with asthma: when airways come into contact with an asthma trigger, the airways become inflamed, narrow, and fill with mucus.

When you have an asthma attack, spasms of the muscles around the airways, inflammation and swelling of the mucosal membrane lining the airways, and excessive amounts of mucus contribute to airway narrowing. This makes airway resistance increase and the work of breathing more difficult, causing shortness of breath, cough, and wheezing. You may have coughing with asthma because of the irritation inside the airway and the bodyís attempt to clean out the accumulations of thick mucus.

So why do you have asthma and your friend doesnít? No one really knows for sure. We do know that allergy plays a role in many people with asthma but not in all. As with allergy, you can blame your family history, as there is a strong genetic component for asthma.

If you or a loved one has asthma, itís important to understand the many triggers or causes of asthma. Once you identify and reduce exposure to the specific triggers or causes of asthma, you can take an active role in controlling your asthma and reducing the frequency of asthma attacks. For example, if you find that allergies are the cause of your asthma, you may have allergic asthma. Being aware of allergies and avoiding them can significantly help in asthma prevention by reducing the frequency or severity of asthma attacks. Or if environmental pollution seems to cause your asthma, itís important to stay indoors during periods of heavy air pollution. Try to find the specific triggers or causes of your asthma, and then plan to avoid these triggers and have better asthma control.

People with asthma have very sensitive airways that react to many different things in the environment called "asthma triggers." Contact with these triggers cause asthma symptoms to start or worsen.
Here are the most common causes of asthma:
ball1.gif (1653 bytes)Allergies
Allergies with asthma is common. Eighty percent of people with asthma have allergies to airborne substances such as tree, grass, and weed pollens, mold, animal dander, dust mites, and cockroach particles. In one study, children who had high levels of cockroach droppings in their homes were four times more likely to have childhood asthma than children whose homes had low levels. Asthma exacerbation after dust exposure is usually due to dust mite allergy.
   ball1.gif (1653 bytes)Food and Food Additives Trigger Asthma
While itís not common for food allergies to cause asthma, food allergies can cause a severe life-threatening reaction. The most common foods associated with allergic symptoms are:
   ball1.gif (1653 bytes)Eggs
   ball1.gif (1653 bytes)Cow's milk
   ball1.gif (1653 bytes)Peanuts
   ball1.gif (1653 bytes)Soy
   ball1.gif (1653 bytes)Wheat
   ball1.gif (1653 bytes)Fish
   ball1.gif (1653 bytes)Shrimp and other shellfish
   ball1.gif (1653 bytes)Salads & fresh fruits
   ball1.gif (1653 bytes)Food preservatives can also trigger asthma. Sulfite additives, such as sodium bisulfite, potassium bisulfite, sodium metabisulfite, potassium metabisulfite, and sodium sulfite, are commonly used in food processing or preparation and may trigger asthma in those people who are sensitive.
   ball1.gif (1653 bytes)Exercise-Induced Asthma
Strenuous exercise can cause a narrowing of the airways in about 80% of people with asthma. In some people, exercise is the main trigger for their asthma symptoms. If you have exercise-induced asthma, you will feel chest tightness, coughing, and difficulty breathing within the first five to eight minutes of an aerobic workout. These symptoms usually subside in the next 20 to 30 minutes of exercise, but up to 50% of those with exercise-induced asthma may have another asthma attack six to 10 hours later.
   ball1.gif (1653 bytes)Heartburn and Asthma
Severe heartburn and asthma often go hand-in-hand. Recent studies show that up to 89% of those with asthma also suffer from severe heartburn, known as gastroesophageal reflux disease (GERD). GERD generally occurs at night when the sufferer is lying down. Normally a valve between the esophagus and stomach prevents stomach acids from backing up into the esophagus. In GERD, the valve does not function properly. The stomach acids reflux, or back up, into the esophagus; if the acid reaches into the throat or airways the irritation and inflammation can trigger an asthma attack.
   ball1.gif (1653 bytes)Certain clues that suggest reflux as the cause of asthma include the onset of asthma in adulthood, no family history of asthma, no history of allergies or bronchitis, difficult-to-control asthma, or coughing while lying down.
   ball1.gif (1653 bytes)Smoking and Asthma
People who smoke cigarettes are more likely to get asthma. If you smoke with asthma, it may make your symptoms such as coughing and wheezing worse. Women who smoke during pregnancy increase the risk of wheezing in their babies. Babies whose mothers smoked during pregnancy also have worse lung function than those whose mothers did not smoke. If you have asthma and you're a smoker, quitting is the most important step you can take to protect your lungs.
   ball1.gif (1653 bytes)Sinusitis and Other Upper Respiratory Infections
Much like asthma causes inflammation in the lining of the airways, sinusitis causes inflammation in the mucous membranes that line the sinuses. This inflammation causes the mucous membranes in the sinuses to secrete more mucus Ė also similar to asthma. When the sinuses get inflamed, the airways respond similarly in many people with asthma, leading to sinusitis with asthma. Prompt treatment of a sinus infection is often necessary to help relieve asthma symptoms.
   ball1.gif (1653 bytes)Infections and Asthma
Cold and flu, bronchitis, and sinus infections can cause an asthma attack. These respiratory infections that trigger asthma can be viral or bacterial and are a common cause of asthma especially in children under age 10. This airway sensitivity that causes the airways to more easily narrow can last as long as two months after an upper respiratory infection. Itís thought that anywhere from 20% to 70% of asthmatic adults have coexisting sinus disease. Conversely, 15% to 56% of those with allergic rhinitis (hay fever) or sinusitis have evidence of asthma.
   ball1.gif (1653 bytes)Medications and Asthma
Many people with asthma have aspirin-sensitive asthma and possibly sensitivity to medications such as anti-inflammatory drugs like ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), ketoprofen (Orudis) and beta-blockers (used to treat heart disease, high blood pressure, and glaucoma). If you know youíre sensitive to these medications, make sure your doctor has the medication/asthma problem documented on your chart, and always talk to your pharmacist about this reaction before taking a new medication.
   ball1.gif (1653 bytes)Other Causes of Asthma
Irritants. Many irritants, including tobacco smoke, smoke from wood-burning appliances or fireplaces, strong odors from perfumes, cleaning agents, etc., are all irritants that can trigger asthma. In addition, air pollution, occupational dust or vapors can also trigger an attack.
   ball1.gif (1653 bytes)Weather. Cold air, changes in temperature and humidity can cause asthma.
   ball1.gif (1653 bytes)Strong emotions. Stress and asthma are often seen together. Anxiety, crying, yelling, stress, anger or laughing hard can trigger an attack.
How Do the Causes of Asthma Make It Worse?
In people with asthma, the airways are always inflamed and very sensitive, so they react to a variety of external factors, or "triggers." Coming into contact with these triggers is what causes the symptoms of asthma -- the airways tighten and become inflamed, mucus blocks the airways and results in a worsening of asthma symptoms. An asthma attack can begin immediately after exposure to a trigger or several days or even weeks later.

There are many causes of asthma. Reactions to the causes of asthma are different for each person and vary from time to time. Certain causes of asthma may be harmless to some people but contribute to inflammation in others. Some people have many causes of their asthma while others have no identifiable ones. Recognizing and avoiding the specific causes of asthma, when possible, is an important way to control asthma. Keep in mind, however, that the best way to control is with asthma treatment and asthma medicines.
How Do I Identify What Causes My Asthma?
Determining what factors were present when your asthma symptoms started is the first step to identifying the causes of your asthma. Although there are many different asthma triggers, you may not react to all of them. Some people have only one cause or trigger, while others have many causes.

Many causes of asthma can be identified through a history of reaction and skin or blood testing. Your doctor may also recommend using a device called a peak flow meter. The peak flow meter measures how much and how quickly air is exhaled from the lungs. It can alert you to changes in your breathing and the onset of asthma symptoms.

Ask your asthma doctor if using a peak flow meter would be helpful to you as you narrow down the causes of your asthma.
Asthma Risk Factors
There are usually reasons or risk factors that predispose you to asthma and respiratory problems. Asthma does not just happen randomly to anyone without asthma risk factors.

Let's look at some asthma risk factors and see how they increase the chance that a person will have the asthma symptoms of cough, wheezing, and shortness of breath associated with asthma. After determining your personal risk factors for asthma, decide on the ones you can control and try to make some lifestyle changes. Avoidance of the risk factors you can control is crucial in preventing asthma symptoms. While you cannot change your gender or family history, you can avoid smoking with asthma, breathing polluted air, and obesity. Take control of your asthma -- by controlling your asthma risk factors. Be sure to read in-depth articles that link to health topics within some of the following sections. By understanding all the risk factors, you may be able to prevent or control your asthma.
Asthma Risk Factor: Gender
Childhood asthma occurs more frequently in boys than in girls. It's unknown why this occurs although some experts find a young male's airway size is smaller when compared to the female's airway, which may contribute to increased risk of wheezing after a cold or other viral infection. Around age 20, the ratio of asthma between men and women is the same. At age 40, more females than males have adult asthma.
Asthma Risk Factor: Family History
Blame Mom or Dad or both for your asthma. Your inherited genetic makeup predisposes you to having asthma. In fact, it's thought that three-fifths of all asthma cases are hereditary. According to a CDC report, if a person has a parent with asthma, he or she is three to six times more likely to develop asthma than someone who does not have a parent with asthma.
Asthma Risk Factor: Airway Hyperreactivity
It appears that having airway hyperreactivity is another risk factor for asthma, although researchers are not sure why this is true. In asthma, the airways are hyperreactive and become inflamed when they meet such asthma triggers as allergens or cold air. Not all people with airway hyperreactivity develop asthma, but in those who do have it, the airway hyperreactivity appears to increase the risk of asthma.
Asthma Risk Factor: Atopy
Atopy means allergic hypersensitivity that affects different parts of the body that do not come in contact with allergens, substances that trigger the body's allergic reaction. Atopy can include eczema (atopic dermatitis), allergic rhinitis, allergic conjunctivitis, and asthma.

Studies indicate that 40% to 50% of children with eczema or atopic dermatitis develop asthma. Some findings indicate that children with atopic dermatitis may have more severe and persistent asthma as adults.
Asthma Risk Factor: Allergies
Allergies and asthma often coexist. Indoor allergies are a predictor of who might be at risk for an asthma diagnosis. One nationwide study showed levels of bacterial toxins called endotoxins in house dust were directly related to asthma symptoms and use of asthma inhalers, bronchodilators, and other asthma medications.

Sources of other indoor allergens include animal proteins (particularly cat and dog allergens), dust mites, cockroaches, and fungi. Changes that have made houses more "energy-efficient" over the years are thought to increase exposure to these causes of asthma, thereby increasing the prevalence of asthma.
Asthma Risk Factor: Environmental Factors
Indoor air pollution such as cigarette smoke, mold, and noxious fumes from household cleaners and paints can cause allergic reactions and asthma. Environmental factors such as pollution, sulfur dioxide, nitrogen oxide, ozone, cold temperatures, and high humidity are all known to trigger asthma in susceptible individuals. In fact, asthma symptoms and hospital admissions are greatly increased during periods of heavy air pollution. Ozone is the major destructive ingredient in smog. It causes coughing, shortness of breath, and even chest pain -- and can boost the susceptibility to infection. Sulfur dioxide, another component of smog, also irritates the airways and constricts the air passages, resulting in asthma attacks.

Gas stoves are the primary source of indoor nitrogen dioxide. Studies show that people who cook with gas are more likely to have wheezing, breathlessness, asthma attacks, and hay fever than those who cook with other methods. It is estimated that more than half of the households in the U.S. use gas stoves.

Weather changes can also result in asthma attacks in some people. For instance, cold air causes airway congestion, bronchoconstriction, secretions, and decreased mucuciliary clearance. Increases in humidity may also cause breathing difficulty -- in a certain population.
Asthma Risk Factor: Cigarette Smoke
Several studies confirm that cigarette smoking is linked with an increased risk for developing asthma. There's also evidence that cigarette smoking among adolescents increases the risk of asthma. Even more findings link secondhand smoke exposure with the development of asthma in early life.
Asthma Risk Factor: Obesity
A review of seven studies revealed that asthma was 38% more common in overweight adults (those with a BMI greater than 25 but less than 30) and nearly twice as common among obese adults (those with a BMI of 30 or greater). Researchers thought that this risk might be greater for nonallergic asthma than allergic asthma.
Asthma Risk Factor: Pregnancy Factors
Maternal smoking during pregnancy appears to result in lower pulmonary function in infants compared to those whose mothers did not smoke. Premature birth is also a risk factor for developing asthma.
Who Are at Risk?
Asthma affects 22 million Americans. Asthma in children occurs in approximately 10%-12% of kids. Asthma may occur at any age, although it's more common in younger individuals (under age 40).

People who have a family history of asthma have an increased risk of developing the disease. Allergies and asthma often occur together. Smoking with asthma, a dangerous combination, is still seen commonly.

However, anyone can develop asthma at any time, and adult-onset asthma happens frequently. If you have symptoms of asthma, talk to your doctor. If you have adult-onset asthma, your doctor will instruct you in using the asthma inhalers and other asthma medications to prevent further breathing problems.
Asthma in Children
Asthma is increasingly prevalent among children. Nearly one in 10 American children now has asthma, a sharp rise that still has scientists searching for a cause. An estimated 6.5 million children under age 18 (8.9%) are now diagnosed with the disease. The rate of childhood asthma has more than doubled since 1980, according to the CDC.

Asthma symptoms can vary from episode to episode in the same child. Signs and symptoms to look for include:
   ball1.gif (1653 bytes)Frequent coughing spells, which may occur during play, at nighttime, or while laughing. It is important to know that coughing with asthma may be the only symptom present.
   ball1.gif (1653 bytes)Less energy during play
   ball1.gif (1653 bytes)Rapid breathing
   ball1.gif (1653 bytes)Complaint of chest tightness or chest "hurting"
   ball1.gif (1653 bytes)Whistling sound when breathing in or out. This whistling sound is called wheezing.
   ball1.gif (1653 bytes)Seesaw motions in the chest from labored breathing. These motions are called retractions.
   ball1.gif (1653 bytes)Shortness of breath, loss of breath
   ball1.gif (1653 bytes)Tightened neck and chest muscles
   ball1.gif (1653 bytes)Feelings of weakness or tiredness
Asthma Attack
An asthma attack is a sudden worsening of symptoms. With an asthma attack, your airways tighten, swell up, or fill with mucus. Common symptoms include:
   ball1.gif (1653 bytes)Coughing, especially at night
   ball1.gif (1653 bytes)Wheezing (a high-pitched whistling sound when breathing out)
   ball1.gif (1653 bytes)Shortness of breath
   ball1.gif (1653 bytes)Chest tightness, pain, or pressure

Not every person with asthma has the same symptoms of an asthma attack. You may not have all of these symptoms, or you may have different symptoms at different times. Your symptoms may also vary from one asthma attack to the next, being mild during one attack and severe during another.
Status Asthmaticus: Severe Asthma Attacks
Prolonged attacks of asthma that do not respond to treatment with bronchodilators are a medical emergency. Physicians call these severe attacks "status asthmaticus" and they require immediate emergency care.
How Is Asthma Diagnosed and Treated?
If you suspect that you have asthma, see your asthma specialist. He or she can examine you and run tests for asthma to determine if you have it. If an asthma diagnosis is made, there are many treatments available to make you feel better and improve the underlying problems that caused the asthma.

If you or a loved one has asthma, itís important that you know about the most effective asthma treatments for short-term relief and long-term control. Understanding asthma treatments will enable you to work with your asthma doctor to confidently manage your asthma symptoms daily. When you do have an asthma attack or asthma symptoms, itís important to know when to call your doctor or asthma specialist to prevent an asthma emergency. Be sure to read all the in-depth articles that link to topics within each of the following sections. By doing so, you will gain new insight into asthma and how itís treated.
Asthma Medications
Asthma medications can save your life -- and let you live an active life in spite of your asthma. There are two basic types of medications used in asthma treatment:
   ball1.gif (1653 bytes)Steroids and Other Anti-Inflammatory Drugs
Anti-inflammatory medications, particularly inhaled steroids, are the most important treatment for most people with asthma. These lifesaving medications prevent asthma attacks and work by reducing swelling and mucus production in the airways. As a result, the airways are less sensitive and less likely to react to asthma triggers and cause asthma symptoms.
   ball1.gif (1653 bytes)Bronchodilators
Bronchodilators relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways.

Short-acting bronchodilator inhalers are used to quickly relieve the cough, wheeze, chest tightness, and shortness of breath caused by asthma (they dilate or widen the bronchial tubes). The most commonly prescribed short-acting bronchodilator is albuterol. However, albuterol only lasts for a few hours. If you need to use an asthma reliever more than twice a week, then your asthma is not optimally controlled. Ask your doctor about improving your asthma controller medication.

Long-acting bronchodilators are often combined with inhaled steroids when someone has asthma symptoms more than once a week despite treatment with an inhaled steroid alone.
   ball1.gif (1653 bytes) Asthma Inhalers
Asthma inhalers are the most common and effective way to deliver asthma medication to the lungs. There are some combination asthma inhalers, which contain two different medications: an inhaled steroid and a long-acting bronchodilator. These combination asthma inhalers are popular due to their convenience, and the medications last for at least 12 hours.
   ball1.gif (1653 bytes) Asthma Nebulizer
If youíre having difficulty using small inhalers, your doctor may prescribe an asthma nebulizer, also known as a breathing machine. The asthma nebulizer with a mask is typically used for infants, small children, elderly adults or anyone who has difficulty using inhalers with spacers. The nebulizer changes asthma medications from a liquid to a mist, so that they can be more easily inhaled into the lungs. This takes a few more minutes of time when compared to inhalers.
   ball1.gif (1653 bytes) Prednisone and Asthma: Stopping an Asthma Attack
If you have a serious asthma attack (exacerbation), your doctor may prescribe prednisone pills for five to 14 days. Prednisone (or prednisolone) is the strongest (most effective) asthma medication available, but does cause side effects. When used for less than two weeks, these side effects are only temporary, but when used for many months, these side effects can be serious and permanent. After the severe symptoms of your asthma attack have been successfully treated, your doctor will work with you to minimize your need for prednisone in the future. Faithfully taking an inhaled corticosteroid every day is the most commonly successful method to do this.
   ball1.gif (1653 bytes) Talk to Your Asthma Specialist
If you have been diagnosed with asthma but your treatment no longer seems to work, then itís time to check in with your doctor again. There are many new asthma treatments. Finding a new medication or new method of delivery will help you breathe better and allow you to be active again. Likewise, if youíve been diagnosed with asthma and you have symptoms that require you to use your asthma rescue inhaler too frequently, go see your asthma doctor. You may need a different asthma medication to decrease inflammation. Your doctor can determine the problem -- and solution -- so you feel better and breathe right.

While asthma is a common disease, it's also very serious breathing problem that demands a proper medical diagnosis and targeted asthma treatment.
Self-care: Asthma Relief
For optimal asthma relief, itís important to take responsibility for self-care. With the help of your doctor, you can get the best asthma relief by checking your peak flow daily, developing an Asthma Action Plan with your doctor, keeping an asthma diary, avoiding asthma triggers, and using natural asthma therapies to help increase relaxation. Getting the best asthma relief means staying on top of your asthma triggers, signs and symptoms, and medications to prevent asthma problems.

Using a Peak Flow Meter for Asthma Care Using a peak flow meter may help you manage your asthma symptoms. With asthma, the inability to exhale air out of the lungs is responsible for a many of the symptoms of asthma. A peak flow meter is an inexpensive, portable, handheld device that is used to measure how well air moves out of your lungs. Measuring your peak flow using this meter is an important part of managing asthma and preventing you or your child from becoming seriously ill.

A peak flow meter works by measuring how fast air comes out of the lungs when you exhale forcefully after inhaling fully. This measure is called a "peak expiratory flow," or "PEF." By keeping track of your PEF, you can know if your asthma is in control or worsening. If it is worsening, thatís a sign to call your doctor immediately.
Developing an Asthma Action Plan
Your doctor can assist you in developing an asthma action plan. This asthma action plan can help you to manage your asthma and prevent asthma attacks. The asthma action plan is designed to tell you what to do when you experience changes in the severity of your symptoms and in your peak flow numbers. For instance, your asthma action plan might list your asthma triggers and some ways to avoid them. Your asthma action plan may also list routine asthma symptoms and what you should do if these symptoms occur. The asthma action plan gives you and your family information that can be used in the event that you experience an asthma emergency. You can also develop a childís asthma action plan in order to have a simple way to understand and manage your childís asthma.
Keeping an Asthma Diary
Keeping an asthma diary allows you to record your asthma symptoms, triggers, and treatment, so you can monitor your asthma. With the asthma diary, you can also record your peak expiratory flow (PEF) readings, compare your PEF readings with your asthma zones, and keep track of how often you use asthma medications for a sudden asthma attack. Keeping an asthma diary will help you recognize asthma attacks and head them off before you become seriously ill. Your doctor can use this diary to evaluate how well your asthma action plan is working.
Managing Your Childís Asthma at School
Itís important to communicate with your childís teachers and other caregivers for optimal asthma relief when your child is away from home. Managing your childís asthma at school is vital even if the child has only a mild case of asthma and even for children who do not need to take medicines when they are at school.

With one out of every 10 children diagnosed with asthma today, most schools have many children with asthma, so many teachers -- and certainly the school nurses -- are very familiar with helping children with asthma. Still, it is important to learn the key steps necessary to ensure that your child gets adequate asthma support and that all the relevant people at school are familiar with what is needed to help your child. Also, if your child is bringing asthma medications to school, itís important that you instruct the teacher and any other adult who cares for your child how to properly administer these medications.

Controlling asthma triggers is possible if you know which triggers or allergens cause your symptoms. Your asthma triggers may be dust mites, molds, pollens, pets, cockroaches, and household irritants. Secondhand tobacco smoke may also be a trigger in your home or workplace. Other asthma triggers include ozone, environmental toxins, strong odors, weather fronts, cold air, and humidity.

Once you know your asthma triggers, make plans to avoid these triggers at home, at work, and during recreational activities.
Do You Need an Air Filter?
If you suffer with asthma at home, an air filter may help reduce allergy triggers.
Natural Asthma Remedies
Natural asthma remedies may include treatment such as herbs, dietary supplements, acupuncture, chiropractic, massage therapy, biofeedback, homeopathy, nutrition, and botanicals. The problem is there are few research studies on natural therapies.

Natural therapies such as yoga breathing exercises may help people with asthma learn how to control their breathing and relieve stress, a common asthma trigger. Massage therapy may increase relaxation, helping the person with asthma breathe easier. Dietary changes are another natural remedy as you avoid foods that may trigger asthma symptoms. Itís important for your doctor to be aware of any herbs or supplements youíre taking as they may interfere with your asthma medications.
A Natural Cure for Asthma?
After suffering with asthma for months or years, you may wonder if thereís a natural cure for asthma. If so, millions with asthma would benefit! But the reality is there is no natural cure for asthma. In fact, itís highly advisable to avoid any remedy, natural or otherwise, that claims to be a ďcureĒ for asthma.

Some natural relaxation remedies like deep abdominal breathing, progressive muscle relaxation, guided imagery, and biofeedback can help relieve stress. Emotional stress is a trigger of asthma symptoms, so learning to relax is important in managing your asthma and reducing breathing problems. Numerous safe and effective asthma medications, particularly asthma inhalers, can decrease inflammation and treat and prevent asthma symptoms. While these medications do not cure asthma, they can help you to breathe normally most of the time.
Special Situations
Pregnancy and Asthma
Just because you have asthma, doesn't mean that you can't have a healthy pregnancy. Still, whether you're pregnant or not, you have to keep your asthma symptoms in control. Asthmatics who see their doctors (both their allergist and/or internist and obstetrician) regularly throughout their pregnancy have as good a chance of having a normal pregnancy and healthy baby as women without asthma.
Can Pregnancy Make My Asthma Worse?
It may. There is no clear answer to this question. For some women, their asthma gets worse during pregnancy, for others, it stays the same, and for even others it improves. In general, if your asthma is severe, chances are it may become a little worse during your pregnancy. On the other hand, if you were pregnant before and your asthma did not get worse, it likely will not get worse during the next pregnancy.

Asthma is almost never a reason to not get pregnant. However, if you have severe asthma, it is worth talking to your doctor for asthma support before you get pregnant.

What Harm Can Come to My Pregnancy and Baby If My Asthma Isn't Well Controlled? If you do not keep your asthma under control during your pregnancy, you may suffer from high blood pressure, severe bleeding, eclampsia (also called toxemia) and have a complicated labor. Your baby may be born prematurely with a low birth weight and could be at risk for an early death. For these reasons, it is very important to keep your asthma in control during your pregnancy.
What Should I Do to Control My Asthma While I am Pregnant?
During pregnancy, just as any other time, one of the best ways to control your asthma is to avoid asthma triggers.

For instance, if you have allergies and asthma, you can prevent asthma attacks by avoiding the things you're allergic to. So if you are allergic to pets, do not allow them in your house. If you are allergic to dust mites and dust, use air filters, filters on your vacuum cleaner, coverings for your beds and pillows, and so on. These are essentially the same things that you would otherwise do to prevent an asthma attack; however, when you are pregnant, it is important to be even more thorough and careful.

In addition, by following your asthma action care plan and continuing to maintain a daily asthma diary, you will be less likely to have problems.
Can I Continue to Take My Asthma Medicine While I am Pregnant?
Several scientific studies have shown that if you do not control your asthma properly during pregnancy, you are much more likely to harm both yourself and your baby than if you use appropriate asthma medicines to control your asthma.

If you are using an asthma inhaler, most doctors believe that because the amount of medicine you get from a puff of inhaler is small and goes straight to your lungs, it is not likely to harm your baby.

If you take oral asthma medications or shots to control your asthma, you may want to talk to your doctor about decreasing the dose, switching medicines or using an inhaler. Oral medications and shots can be absorbed into your bloodstream and there is a small chance that they may harm your baby, especially during the first trimester.

The most appropriate thing to do is to talk to your doctor, who will look at how severe your asthma is and what treatment is appropriate for you.
Can I Take Allergy Shots and Flu Shots During My Pregnancy?
You should tell your allergist if you are pregnant. Allergy shots are usually not started if a woman is pregnant. But if you are already taking allergy shots, your doctor will probably continue them and monitor you for any problems.

If you have moderate to severe asthma, a flu shot is generally a good idea. Some experts recommend that the flu shot be given during the second and third trimesters only. Again, your doctor is the best person to determine if you should receive a flu shot during pregnancy.
Can I Take My Asthma Medicine During Labor and When Breastfeeding?
In general, the same asthma treatment that is appropriate when you are pregnant is appropriate when you go into labor and when you breastfeed your baby. Talk to your doctor to make sure your asthma medicine is safe to keep taking in these circumstances.
Asthma Prevention
If you have asthma, you need to know some key strategies for prevention of asthma symptoms. While thereís no asthma cure, there are steps you can take to reduce the chances of having the frightening asthma symptoms such as coughing, wheezing, and difficulty catching your breath.
Identify Triggers for Asthma Prevention
Certain asthma triggers can set off the cascade of asthma symptoms. These causes of asthma might include dust mites, air pollution, cold air, a cold virus, sinusitis and asthma, cigarette smoke, and fragrances, among others. Itís vital to learn to identify your triggers.

Keep track of your asthma symptoms for several weeks, detailing all the environmental and emotional factors that are associated with your asthma. When you have an asthma attack, go back to your asthma diary to see which factor, or combination of factors, might have contributed to it. Some common asthma triggers are not always obvious, such as molds and cockroaches. Ask your asthma doctor about allergy skin testing or RAST testing to determine to which allergens you have become sensitized. You can then take measures to minimize your exposure to those allergens.

If you have exercise-induced asthma or are planning vigorous exercise or exercise in cold, humid, or dry environments, prevent exercise-induced asthma by following your doctor's advice regarding asthma treatment (usually with an asthma inhaler containing the asthma medicine albuterol).
Take Steps for Asthma Prevention With Allergies
If you have allergies and asthma, itís important to take asthma prevention steps at home. Asthma attacks (worsening of asthma symptoms) can be triggered by allergies, which can temporarily increase the inflammation of the airways in a susceptible person. Avoiding or minimizing contact with the substance you are allergic to will help prevent an asthma attack.

Smoke and asthma are a bad mix. Minimize exposure to all sources of smoke, including tobacco, incense, candles, fires, and fireworks. Do not allow smoking in your home or car, and avoid public places that permit smoking. If you smoke cigarettes, get help to quit successfully. Smoking always makes asthma worse.

In addition, avoid close contact with people who have a cold or the flu since your asthma symptoms may worsen if you catch the infection from them. Wash your hands thoroughly after touching items that may have been handled by others with a respiratory infection.
Allergy-Proof Your Environment for Asthma Prevention
Whether youíre at home, work, or traveling, there are specific measures you can take to allergy-proof your environment and reduce the risk of having asthma. For example, avoid eating in restaurants that are smoky or allow cigarette smoking -- a known trigger of asthma. Call ahead when traveling and ask for a smoke-free hotel room. And bring your own bedding and pillows in case the hotel only supplies feather pillows and down comforters, which may harbor dust mites and cause asthma symptoms.
Get a Flu Vaccine for Asthma Prevention
Get a flu shot every year to protect against the flu virus, which almost always makes asthma much worse for days to weeks. People with asthma are more likely to have complications from the flu, such as pneumonia, and are more likely to be hospitalized from the flu. Also get a pneumonia shot (Pneumovax) once every five to 10 years. People with asthma are about twice as likely as others to get pneumococcal pneumonia, a common type of bacterial pneumonia.
Consider Allergy Shots (Immunotherapy) for Asthma Prevention
If your doctor finds that you have allergies, allergy shots (immunotherapy) for asthma may help prevent future allergies and asthma. With allergy shots, small doses of allergens (substances to which you are allergic) are injected under your skin on a regular schedule. Over a period of time, your body may become accustomed to the allergen and less responsive with asthma symptoms.

Source: WebMD
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