I’m wheezing and the doctor says I might have asthma: What do I do?

shutterstock_137805167Millions of people suffer from asthma worldwide.  The cause is due to narrowing of the airways (small tubes) in the lungs which is partially or completely reversible.

Symptoms of asthma:

1)   Coughing

2)   Wheezing

3)   Chest tightness

4)   Shortness of breath

Asthma symptoms tend to come and go and are affected by the amount of inflammation or narrowing of the airways are present.  Things that can cause the airways to narrow may include:

1)   Viruses that increase the production of mucus

2)   Allergens

3)   Exercise

4)   Certain foods

5)   Environmental conditions

Asthma Triggers:  We call factors that set off or worsen asthma symptoms “triggers.”  One of our goals is to identify factors that cause asthma flare-ups so we can reduce or prevent asthma attacks.  Some of these asthma triggers in most patients are:

1)   Smoke or chemical irritants

2)   Allergens such as dust, pollen or pet fur

3)   Respiratory infections

4)   Emotional stress

5)   Physical activity

6)   Menstrual cycle in some women

7)   Certain medications such as aspirin, ibuprofen or Aleve have caused asthma symptoms in a small number of patients.  This is rare however.

Categories of asthma:  We categorize asthma according to the severity and adjust the treatment plan depending on the patient’s age, level of control and severity of symptoms.

1)   Intermittent asthma:  These patients usually have symptoms that occur two or fever times per week, the asthma does not interfere with their daily activities and nighttime symptoms awaken the patient two or fever nights per month and oral steroid medication is needed no more than once per year to treat symptoms.

2)   Persistent asthma:  These patients have symptoms more frequently, and there may be days that activities are limited due to symptoms.  Symptoms tend to awaken to patient from sleep more often need to be treated more regularly than for intermittent asthma to keep symptoms from returning.

Treatment:  Asthma treatments tend to be separated into two catergories:

1)   Short acting bronchodilator medications to treat an acute asthma flare.  These medicines work by temporarily relaxing the muscles around the narrowed airways.  Albuterol (also called Ventolin, Proventil and Proair) is the most commonly used inhaled bronchodilator used in the US

There is no benefit to just using short-acting short acting bronchodilators on a regular basis.  If symptoms are occurring more than twice a week, other medications for asthma may be more helpful.

2)   Asthma controller medications:  For patients with more persistent symptoms, inhaled glucocorticoids, long acting bronchodilators, leukotriene modifiers, or oral glucocorticoids may be used.

The benefit of regularly using a inhaled glucocorticoid medication is that it will reduce of frequency of symptoms so that the need for the short acting inhaled bronchodilator (albuterol) is not needed as often and improves quality of life and decreases serious attacks.

Patients who present to the medical clinic or urgent care generally have progressed beyond treating a mild episode of asthma and usually require a medication in addition to a short acting bronchodilator such as albuterol.  We usually use an oral steroid medicine such as prednisone or dexamethasone.

In patients who use an inhaler, it is important to understand how to use it properly.  Most inhalers work best if you hold the mouthpiece of the inhaler 1 to 2 inches in front of your mouth when you activate it.  If you close your mouth on the mouthpiece of the inhaler, less medicine generally reaches the lungs.  A spacer can be very helpful because it allows you to breathe in slowly and fully to inhale more of the asthma medication.

Exercise induced asthma:  In patients who get asthma symptoms with exercise, we usually recommend an extra dose of albuterol before exercise to prevent the asthma symptoms.  Sometimes a leukotriene modifier (such as Singulair) or cromolyn may be used on a daily basis to prevent flares in these patients.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.


I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com


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