Treating Asthma: Partnering With Your Doctor
Want to get your asthma symptoms under control? Start by working closely with your doctor. Here's how.
Tips for Finding a Specialist continued...
Some nonprofit organizations can help you find a specialist. Both of the following have "physician finders" on their web sites to help you find a licensed expert in your area.
- The American Academy of Allergy, Asthma & Immunology (AAAAI)
Web site: www.aaaai.orgT
- he American College of Allergy, Asthma and Immunology (ACAAI)
Web site: http://www.acaai.org/
Toll-free physician referral line: 800-842-7777.B
But one of the best ways to find a specialist is still word of mouth.
"Asthma is a really common disease, so you'll meet a lot of people who have it," says Hugh H. Windom, MD, associate clinical professor of immunology at the University of South Florida. "If you keep hearing the same specialist recommended over and over again, that's probably the person you want to see."
What to Expect from Your Doctor
As a patient, you have the right to the best treatment you can get. Here are some of the things that you should expect your doctor provide.
A proper diagnosis. "We see a lot of people who have been diagnosed with 'asthma' who don't actually have it," says Korenblat. Instead, they were misdiagnosed by a doctor who never did all of the necessary tests, like basic lung function analysis.
"We're now in the scientific-evidence based era," says Bernstein. "We wouldn't treat people for high blood pressure without making a diagnosis. It should be the same with asthma."
Your doctor should also work hard to figure out which specific allergens or irritants are causing you problems. This may involve allergy testing.
A plan. You and your doctor should come up with specific short-term and long-term goals for your treatment. You should also develop an action plan. This is a written document that spells out what to do if your symptoms worsen.
Explanations. In your first appointment, your doctor should go over the causes of asthma. When it comes to treatment, your doctor shouldn't just tell you what to do. He or she should also explain why you need a particular treatment and why it will help.
"Compliance is really improved if the patients know why their doctor has prescribed a certain treatment rather than just being told to do it," says Windom.
Clear instructions. Learning how to use a nebulizer or inhaler can be tricky. "Taking asthma medications isn't always simple," says Windom. "You don't need instructions on how to swallow a pill, but you do need instructions for how to use an inhaler."
So your doctor should demonstrate how to use any devices -- including peak flow meters -- and make sure that you understand. Edelman says that your doctor should watch you take your medicines at least once.
Also, make sure your doctor explains when to take your medicines. "Sometimes, people don't really understand what their medicines do," says Edelman. So make sure you know which ones are for long-term control and which are for quick-relief.
Openness to your questions. Your doctor should always give you the time to ask questions and take the time to answer them.
"Questions from an educated patient should not be intimidating to a good physician," says Bernstein. "If a physician gets defensive when you ask questions, he or she should either read up more or get out of the job. If your doctor isn't giving you the answers you need, then you may need to see a new doctor."
Sensitivity to your circumstances. No two cases of asthma are the same. Your doctor should keep your specific situation in mind when developing your treatment. For instance, are other medical conditions or medications affecting your treatment? Are you exposed to allergens that you can't avoid? Your doctor should be sensitive to your situation and adapt the treatment so that it fits with your life.
One of the touchiest issues is money. "Doctors can be awfully quick to write prescriptions, but we don't always think about the costs," says Bernstein. Asthma medications can cost hundreds of dollars a month. If price is an issue for you, your doctor may be able to help. See if you could use a cheaper medication. Bernstein says that your doctor may be able to provide you with some free samples. Or you could see whether you qualify for the assistance programs that some pharmaceutical companies offer.
Thoroughness. "When you've been seeing a specialist, I think every once in a while, he or she should treat an appointment as if it's your first visit," says Edelman. "You start again from the beginning, going over your complete history, your symptoms, and the medicines you take." It's a good way of seeing the big picture, Edelman says, and of finding out things that you might forget to mention.