Asthma is one of the most common chronic illnesses in America. In fact, an estimated 25.7 million people are afflicted with the condition. That works out to 1 in 11 children and 1 in 12 adults living with asthma in the United States. Asthma accounts for 1.9 million emergency room visits and 480,000 inpatient admissions every year and is the third leading cause of hospitalization in children under the age of fifteen. School age children miss 13.8 million school days a year due to asthma and asthma related medical costs are estimated to be $56 billion annually. Every year, over 3,000 people die from asthma related causes.
The large number of people afflicted with asthma and the high costs of treating it are major reasons why treatment and control methods are vital to helping asthmatics. Here are 5 things you need to know about asthma and how it is treated:
1.What is Asthma?
Asthma is a chronic disease characterized by inflammation of the airways in the lungs. Asthma sufferers can experience intermittent flare ups of asthma symptoms, or asthma attacks, where the airways to the lungs become very inflamed and swollen and the muscles surrounding the airways tighten, constricting airflow into and out of the lungs, making it difficult to breathe. Symptoms of an asthma attack include coughing, wheezing, shortness of breath, and chest tightness. Although there is no cure for asthma, it can be effectively managed with proper treatment.
Asthma attacks are often triggered by environmental factors. Asthma triggers will vary from patient to patient although some things, like various allergens, are known to be common asthma triggers. Some of the more common triggers include:
- Pet Dander
- Cockroach droppings
- Stress or Excitement
- Vigorous Exercise
- Cold air/sudden temperature change
- Exhaust fumes
- strong odors
One of the best ways to treat an asthma attack is to avoid having one all together. While asthma attacks are not always predictable, common risk factors and triggers are predictable and avoiding these risk factors could help reduce the likelihood of having an asthma attack. The best ways to prevent asthma attacks are:
- Avoid allergens. Allergies and asthma often go seem to go hand in hand. Many things that can cause an allergic reaction in asthmatics can also trigger an asthma attack. Asthma sufferers should avoid known allergens as much as possible.
- Don't smoke! Smokers are more likely than non-smokers to suffer from asthma. Smoking can not only trigger an asthma attack, it can also exacerbate the symptoms.
- Get a Flu shot! Individuals with asthma experience harsher cold and flu symptoms affecting the respiratory system than individuals who do not have asthma.
- Recognizing triggers. When an asthma attack strikes, it is important for asthma sufferers to pay attention to where they were and what they were doing when the asthma attack occurred. By recognizing what caused the asthma attack in the first place, it makes it possible to try and avoid that trigger in the future.
- Having an action plan. Individuals who suffer from asthma should work with their doctor to come up with an asthma action plan to help recognize the signs and symptoms of when an asthma attack may be forthcoming, and what action should be taken.
- Medication Management. Taking a combination of both long term control and quick relief medicines for asthma can help reduce the frequency of asthma attacks. Patients with asthma should check with their doctor about what medications they should be taking to control their asthma.
4.Asthma Action Plan
Everyone who has asthma should create an asthma action plan with their physician. An Asthma action plan is a written document to help asthma patients recognize when their asthma symptoms are worsening and what actions and medications to take to help control their asthma. The asthma action plan uses three zones, the red zone, yellow zone and green zone, to help the patient determine how well they are controlling their asthma.
Creating an Asthma Action Plan To create an asthma action plan the patient must first measure their peak expiratory flow(PEF), the speed at which a person can exhale. To do this a patient will use a peak flow meter to measure their PEF 2-3 times a day over a 2-3 week period. Measurements should be taken at the same times every day and when the patient is exhibiting no asthma symptoms. The highest measurement of PEF is known as the "personal best" airflow. The personal best airflow reading is then used as a benchmark for monitoring PEF in the future.
Green Zone – When a patient is in the green zone, they are exhibiting no symptoms of respiratory distress. Their PEF is above 80% of their personal best PEF and they do not feel the need to use their rescue inhaler or any quick relief medications. In the green zone it is ok to continue normal activities. Any long term control medications should be taken as directed by a physician and should be listed on the Asthma Action Plan along with instructions on how and when the physician has directed them to be taken.
Yellow zone – When a patient is in the yellow zone, their PEF is between 50%-80% of their personal best PEF. At this point the patient may be exhibiting mild to moderate symptoms such as coughing, wheezing, shortness of breath or chest tightness. In this stage the patient may also need to use their quick relief medications as directed by their physician. If the symptoms were caused by an environmental trigger, the patient may want to take note of it or log it in a journal or diary so they can better prepare to deal with that situation in the future.
Red zone – The red zone is the danger zone. PEF is below 50% of personal best and symptoms are severe. The patient is experiencing extreme shortness of breath and coughing and may have trouble speaking. At this point the patient may have already taken their quick acting medications and may not be getting any better. It may be necessary for the patient to go see their doctor or even go to the emergency room.
Medications are essential to controlling asthma and asthma symptoms. Here are some of the long term controllers, quick relief medicines, and antiallergenic medications that can be used to treat or control asthma.
Quick relief Medications are used to quickly relieve the symptoms of an asthma attack by relaxing and opening the airways. Some examples of quick relief medications are:
- Inhaled Short-Acting Beta-2 Agonists. Inhaled Short-Acting Beta-2 Agonists are bronchodilators, most commonly albuterol, which dilate constricted bronchial tubes by relaxing bronchial muscles which helps increase air flow to and from the lungs. Rescue inhalers and nebulizers are common examples of Inhaled Short-Acting Beta-2 Agonists that use albuterol.
- Anticholinergics. Anticholinergics relax the airways and prevent them from narrowing during an asthma attack. While not as fast acting as the Inhaled Short-Acting Beta-2 Agonists, anticholinergics begin to work within 15 minutes and their effects can last several hours. They should always be used in combination with Inhaled Short-Acting Beta-2 Agonists, usually for severe asthma attacks, to help relieve the symptoms for a longer period of time.
Long term control medications are medications that are taken daily in order to control asthma symptoms and try to prevent future asthma attacks. Common long term control medications include:
- Corticosteroids. Corticosteroids are the preferred long term control medication for treating asthma. They reduce inflammation of the airways and reduce the mucus made by the bronchial tubes in order to make it easier to breathe. They do not offer the quick relief of the short acting medications, instead offering long term relief from asthma symptoms. Corticosteroids can be taken as oral or inhaled medication, inhaled being the preferred method since it brings the medication directly into the lungs.
- Long-Acting Beta-2 Agonists. Long-acting beta-2 agonists are another bronchodilator used to help open the airways and typically offer relief for up to 12 hours. Long-acting beta-2 agonists have been shown to possibly increase incidents of severe asthma attacks when taken alone and are recommended to be taken in combination with corticosteroids. Combination medications of long-acting beta-2 agonists and corticosteroids include Advair® and Symbicort®. Like corticosteroids, long-acting beta-2 agonists can be taken as an oral or inhaled medication.
Anti-allergenic medications help to relieve allergy symptoms that can trigger an asthma attack. Allergies are a common–and often unavoidable–trigger for asthma. Examples of anti-allergenic medications to control asthma symptoms are:
- Anti-IgE injection. The anti-IgE injection, known as Omalizumab, is used to treat patients with severe, persistent, allergic asthma that is uncontrolled by corticosteroids. Omalizumab is an antibody that reduces allergy symptoms by binding IgE in the blood.
- Leukotriene Modifiers. Leukotrienes are chemicals released by the body once it comes into contact with an allergen. Leukotriene modifiers block the action of leukotrienes thereby mitigating the allergic response.