Taking Control: A Guide for People With Asthma

If you have asthma, this page has good news for you. Asthma treatment guidelines issued by the National Heart, Lung and Blood Institute's National Asthma Education and Prevention Program can help you live life to the fullest by showing you how to work with your doctor in order to take an active role in your treatment.
Understand Your Condition

If you have asthma, you may experience wheezing, shortness of breath, a feeling of tightness in your chest or a persistent cough, especially late at night or early in the morning. Medical problems other than asthma can also cause similar symptoms.

When caused by asthma, these breathing problems are the result of conditions in the airways of your lungs:

An inflamed and swollen airway lining, producing thick mucus that may clog the airways
Airway muscle spasm that constricts and narrows the airways
Sensitivity to common allergens like pollen, dust mites, cockroaches, molds, animal dander
Irritation of the airways by asthma triggers such as tobacco smoke, air pollution, the common cold, sinus infections and cold air
Exercise
When asthma gets worse, inflamed airways become increasingly constricted, making it difficult to breathe. The information on this page can help you breathe easier and live a fuller, more symptom-free life by showing you how to work with your doctor to control your asthma and the inflammation of your airways.

Early Diagnosis, Proper Treatment, Ongoing Monitoring and Self-Management

Many of the 14 million to 15 million Americans who suffer from asthma make unnecessary lifestyle compromises to accommodate their disease. Asthma also can be deadly: an estimated 5,000 people die each year. Underdiagnosis and improper treatment are major contributors to these alarming statistics.

While there is yet no cure for asthma, it can be controlled with an accurate diagnosis, the right treatment and ongoing monitoring by you and your physician.

Early Diagnosis
Your asthma may be diagnosed by your personal or family physician or by an asthma specialist such as an allergist. The important thing is that the symptoms of asthma be recognized early and dealt with effectively. The longer you wait, the more permanent the damage to your lungs may be.

Because symptoms vary widely from patient to patient, it is essential that you and your doctor determine the severity of your asthma to develop the best plan to treat it. The new guidelines classify asthma into four categories: mild intermittent, mild persistent, moderate persistent and severe persistent.

Proper Treatment
Once asthma is diagnosed, aggressive treatment is recommended to gain quick control of your asthma. Regardless of the severity of your condition, the goals of asthma treatment are the same: control of your symptoms and a normal lifestyle. You and your doctor will work together to develop a treatment plan that can:

End the coughing, wheezing and breathlessness, especially at night and in the morning;
Enable you to participate in all normal activities including exercise;
Avoid emergency room visits or hospitalizations;
Avoid the possible side effects of asthma medications; and
Meet your goals for a good quality of life.
Often the most effective and fastest way to bring asthma under control is to reduce your exposure to whatever is triggering the asthma. Avoidance and environmental control should be the first consideration in an overall treatment plan.

When allergy triggers cannot be avoided, immunotherapy ("allergy shots") may be considered. Immunotherapy is especially helpful when symptoms occur year-round or during a majority of the year, or when it is difficult to control symptoms with medication.

Asthma medications also play an important role in asthma therapy. No matter how severe your asthma, a quick-relief medication must be readily available for treatment of acute symptoms. If your asthma is more than mild and intermittent, a preventive "controller" anti-inflammatory medication should be used on a regular basis.

Ongoing Monitoring
Regular visits with your doctor to monitor your condition will help you meet your treatment goals. During your visits, the doctor will review your asthma symptoms, activities, peak flow records and medications.

Between visits you'll likely be using a peak flow meter and keep a diary to monitor the health of your lungs. Close monitoring of your condition will help you and your doctor determine if any changes in your treatment are necessary.

Education and Self-Management
The more you learn and know about your asthma and medications to treat it, the better you'll be able to work with your doctor to control your asthma.

How severe are your asthma symptoms?

The frequency and intensity of your asthma symptoms will help you and your doctor determine the treatment that's right for you. The Guidelines discuss how severity can be categorized, although most people with asthma don't fit perfectly into one category or another. In order to make an initial assessment of asthma severity, take a moment to describe your asthma as it would be without treatment or medication by answering these questions.

Mild Intermittent
Do you ...
Have symptoms twice a week or less, and nighttime symptoms twice a month or less?
Have symptoms that are brief, lasting from a few hours to a few days with the intensity of the attack varying?
Have no symptoms between more severe episodes?
Mild Persistent
Do you ...

Have symptoms more than twice a week but less than once a day, and nighttime symptoms more than twice a month?
Have more severe episodes that sometimes affect your activity?
Moderate Persistent
Do you ...

Have symptoms daily, and nighttime symptoms more than once a week?
Use a quick-relief medication daily?
Change your daily activity because of your asthma?
Have more severe episodes that occur twice a week or more and may last days?
Severe Persistent
Do you ...

Experience frequent severe episodes?
Have a continual daytime symptoms and frequent nighttime symptoms?
Have symptoms that cause you to limit your activity?
Understand How Medication Controls and Prevents Your Symptoms

Today, effective medications are available for the treatment of asthma. The new guidelines recommend a stepwise approach to using these medications with the type and amount determined by the initial assessment of the severity of your condition. When your asthma is worse, you increase or step up your medication, and when your asthma is under control, you often can decrease or step down your medication. Always consult your doctor before making any change in prescribed medications.

There are two types of asthma medications: long-term preventive "controller" and quick-relief "rescue" medications.