The severity of
asthma can vary, and asthma often requires changes in
your treatment to control it. To ensure that you are getting the proper
treatment, you have to continuously monitor and evaluate the disease and
communicate with your doctor.
Know the symptoms of poorly controlled asthma—wheezing, cough,
chest tightness, or shortness of breath. Having a written record of what to do
asthma attack (asthma action plan) will give you
guidelines for increasing medicine if your or your child's asthma starts to
get out of control.
Your doctor should periodically assess your asthma. He
or she will ask how you have been doing since your last visit. Your doctor will ask about daytime
asthma symptoms, nighttime awakenings, and symptoms early in the morning that
do not get better with medicine.
In asthma, how severe your symptoms are does not always match the
results of your lung function tests. Some people will not notice severe
symptoms until their lung function is very bad. For this reason, you should
consider periodically testing your lung function.
Spirometry is generally used to test lung function. It
is done after treatment has begun and again when symptoms have stabilized. This
test should be performed at least every 1 to 2 years to assess your lung
function. If your treatment helps you only a little, or if your symptoms
change, you may need more spirometry tests. This test may be difficult for
small children. It usually can be done with children older than 4 years.
You can monitor your lung function at home with a
peak flow meter. This records the airflow as you blow
out as hard and fast as possible. The number recorded is the
peak flow achieved.
Peak flow monitoring can be used long term to monitor the changes
in how well your lungs function. It can help you know in advance when you may
have a sudden increase in your symptoms (asthma attack), so you can start
Quality of life/functional status
An assessment of quality of life is essential to gauging the
success of asthma therapy. This includes how often you or your child has missed
work or school because of asthma, any reduction in usual activities, and any
disturbances in sleep.
History of asthma attacks
Asthma attacks usually occur after exposure to substances that
cause inflammation in the airways (triggers), such as
animal dander, viral infections, and pollen. How often
you have episodes, how severe they are, and knowing what triggers them can help
your doctor determine the best treatment.