What does it take to control your asthma?
Anyone who has asthma is all too familiar with the onset of an asthma episode, more popularly known as an “asthma attack.” This may start off as a mild tickle or an “itchy feeling” in the upper chest followed soon enough by the urge to cough. The cough then persists and becomes more bothersome at night or early in the morning, resulting in sleep disturbance. Daytime symptoms then manifest as chest tightness and breathlessness on exertion and, as the problem worsens, shortness of breath, even after doing usual daily activities.
The typical chest “whistling” or wheezing may not be audible to the asthmatic, but if it occurs, the asthma attack is likely under way. The enormous impact of poorly controlled asthma on the lives of millions of asthma sufferers is well known, from missed work or school days, to hospital admissions, and worse, death.
During an asthma episode, the walls of the airways become inflamed and swollen causing narrowing or “bronchoconstriction.” This occurs because asthmatic airways are “hyperreactive” or “hyperirritable,” and react easily upon contact with various triggers. Knowing whatever triggers one’s asthma and staying away from them may help minimize asthma episodes. Strict avoidance measures may not be so easy, however, since many asthma triggers such as allergens, irritants, stress, weather changes and common colds are part of our environment and our daily lives.
Although there is no cure for asthma, it can be controlled with proper treatment so it no longer becomes bothersome. Asthma control is the key to preventing asthma episodes. With good asthma control, most asthmatics can lead a healthy, normal life. Working with the doctor through regular checkup to get asthma under control is the first step. Learning to recognize when asthma is getting worse and monitoring one’s peak flow rate are important components of a management plan. A decreasing peak flow rate may signal an impending attack. An asthma action plan that details what to do in such instances will enable the asthmatic to adjust medications in order to catch the episode before it becomes full-blown, and help determine how bad the attack is and when to seek consult.
When there are no asthma symptoms, this does not mean there is no more asthma. Asthma control requires managing asthma in the long term. The most effective way to do this is by taking medicines, called controllers, that target the “irritable” airways by suppressing the inflammation and keeping the airways open. Additional medicines called relievers can then be taken on an “as needed” basis for quick relief when “breakthrough” asthma symptoms occur, however, if you are taking your reliever more than twice a week, it is a good indication to visit your physician.
Dr. Dina Diaz is the past president of the Philippine College of Chest Physicians, past president of the Lung Center of the Philippines’ Physicians Association and board member of the American College of Chest Physicians, Philippine Chapter. The A to Z of Health Information Advocacy is a joint initiative of a group of medical specialists and supported by AstraZeneca Philippines aimed at raising public awareness on various diseases and providing health information and updates to the healthcare community.
