Asthma Health Center

During an asthma attack, the airways swell and narrow. This makes it hard to breathe. Asthma is a lifelong problem, but it does not have to limit you. If you take charge of your asthma, you can lead a full and active life.

You and your doctor will make an asthma action plan that outlines the two approaches to taking charge of asthma:

• Controlling asthma over the long term. Daily controller medicine helps reduce the swelling of your airways and prevent attacks.
• Treating attacks when they occur. The action plan will outline the steps to take and medicine to use to treat asthma attacks.

Using the asthma action plan also helps you keep track of your asthma and know how well your treatment is working.

If you or your child has been recently diagnosed, it may seem like there is a lot to remember. But the things you need to do to take charge of your asthma are really quite simple. With some practice, they will become part of your normal routine.

There are a few tools you can use to keep track of your asthma and know how well your treatment is working. Keeping track of your asthma lets you act quickly to stop an attack before it becomes an emergency. Your doctor and asthma educator can help you make the plans and learn the skills you need.

An asthma action plan tells you what controller medicine to take every day and when to take it. Controller medicine is usually an inhaled corticosteroid. Taking your controller medicine every day helps reduce the swelling of your airways and prevent attacks. The plan also tells you how to know when your asthma is not in control, how to change your treatment to prevent an attack, and what to do if you have an attack.

Your action plan may also include:

• A list of your asthma triggers-the things that make your asthma worse. Avoiding triggers can help you keep your asthma under control.
• Treatment goals. Having personal goals can help motivate you to follow your plan. For example, goals might include being symptom-free at night or being able to play sports.
• An asthma diary. In the diary, you write down your peak flow, what symptoms you are having and what caused them, and any medicines you used. See a sample asthma diary(What is a PDF document?).

You and your doctor will work together to create your asthma action plan. An action plan has zones that are based on your peak flow or symptoms. See a sample asthma action plan(What is a PDF document?).

Your doctor can teach you the skills you need to use your asthma action plan. These include:

• How to use a peak flow meter to check your peak flow (also called peak expiratory flow or PEF). Peak flow is a measure of how open your airways are. A drop in peak flow can show that the airways have narrowed even before you have symptoms. Then you can start treatment right away to help prevent an attack.
• How to use a metered-dose inhaler or dry powder inhaler. Using a metered-dose inhaler with a spacer is an easy way to get the medicine to your lungs. But you have to use the inhaler correctly for it to work well. If you are not sure that you are using your inhaler the right way, ask your doctor to show you how. Your doctor can also tell you if you need to use a spacer with your type of inhaler.
• What symptoms to watch for. Symptoms such as wheezing, coughing, or tiring quickly during exercise can mean that your asthma is not well controlled. Having these symptoms may mean that you need to see your doctor and adjust your treatment.
• How to identify, avoid, and reduce triggers.

If you have ever felt that asthma controls your life, the benefits of taking an active role in your treatment can be great.

• It can help you have fewer and less severe attacks.
• It controls the inflammation in your lungs so that you have fewer asthma symptoms.
• It puts you in control so you are not limited by your disease.

Follow your asthma action plan

• Take your daily medicines as prescribed. This can keep asthma under control and help you avoid asthma attacks.
• Keep your treatment goals in mind. This may help you stay on your treatment.
• Review your list of triggers. Avoiding triggers can help reduce the chance that you will have an asthma attack.

Check your peak flow

• Use your peak flow meter. This is the best way to check how well your lungs are working, which is called lung function. Your lung function can get worse without causing symptoms.
• Check your peak flow as often as your doctor tells you to. For many people this is twice a day, morning and evening.
• If you have trouble using your meter, talk to your doctor.

Know your asthma zones

Each time you measure your peak flow, check your action plan to see what zone you are in. If your peak flow drops below 80% of your personal best measurement, follow your action plan. To figure out what 80% of your personal best measurement is, multiply your personal best measurement by 0.80. For example, if your personal best peak flow is 400, then 80% of that is 400 times 0.80, which is 320. To figure what 50% of your personal best peak flow is, multiply your personal best measurement by 0.50.

• Green means Go. You are in the green zone if your peak flow is 80% to 100% of your personal best measurement.

  This is where you want to be. Keep taking your daily asthma medicines as prescribed.

• Yellow means Caution. You are in the yellow zone if your peak flow is 50% to 79% of your personal best measurement. You may not have any symptoms, but your lung function is reduced. When symptoms are present, you may cough, wheeze, or feel short of breath. Or your asthma may limit your activities or wake you up at night.

  You should take action. Your action plan will tell you what medicines you need to take, how much to take, and when to take them. If you keep going into the yellow zone from the green zone, talk with your doctor. You may need a different medicine or the dose of your medicine may need to be increased.

• Red means STOP. You are in the red zone if your peak flow is less than 50% of your personal best measurement. You may be very short of breath. Or the quick-relief medicines may not have worked. This is dangerous.

  Take the actions listed in your action plan. You may need to go to the emergency room or be admitted to the hospital.

Use your asthma diary

• Write down your peak flow readings in the asthma diary.
• If you have an attack, write down what caused it (if you know), the symptoms, and what medicine you took.

See your doctor to review your plan

Keep your regular follow-up appointments. During checkups, your doctor will ask if your symptoms and peak flow have held steady, improved, or gotten worse. He or she will also ask if you have asthma attacks during exercise or at night. Your doctor may want to see how you use your peak flow meter and inhaler. This information can help your doctor know if your asthma category has changed or if you need to change medicines or doses.

When you go to your doctor:

• Take your asthma action plan and your asthma diary, if you have one. Get answers to any questions you may have about your asthma plans or your symptoms. Let your doctor know if treatment is not controlling your asthma symptoms.
• Take your peak flow meter and medicines so your doctor can review your treatment and the way you use the meter and medicines.
• Make sure you know how and when to call your doctor or go to the hospital.
• Tell your doctor if you are having trouble following your action plan.

Now that you have read this information, you are ready to take charge of your asthma treatment. For related information, see:

Asthma: Measuring Peak Flow.

Asthma: Using a Metered-Dose Inhaler.

Asthma: Using a Dry Powder Inhaler.

Asthma in Children: Helping a Child Use a Metered-Dose Inhaler and Mask Spacer.

Asthma: Identifying Your Triggers.

Asthma: Using an Asthma Action Plan.

Talk with your doctor

If you have questions, take this information with you when you visit your doctor. You may want to mark areas or make notes in the margins where you have questions.

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