Asthma symptoms are like the weather -- they change often and may seem unpredictable. But also like the weather, careful tracking of asthma symptoms can help identify patterns and what they may say about your asthma control.
Research has shown that tracking and rating your asthma symptoms are key steps in successfully managing asthma. One study even found that it helps keep kids with childhood asthma out of the emergency room.
Most asthma action plans track your “peak flow” (measured by a portable, hand-held meter used at home to gauge asthma severity). Based on “peak flow” results, the plans divide how you’re feeling into green, yellow, and red zones.
- Green is optimal -- at your goal and nearly free of asthma symptoms.
- Yellow means that you’ve had some increase in symptoms, a decrease in lung function, and your asthma control is worsening. You’ll need to adjust your medications.
- Red indicates that your asthma is not under control and your medications are failing to control your symptoms. You’ll need to use medications to help open the airways and get your peak flow measures back to the yellow and green zones. The red zone may signal that emergency care is needed.
Along with your peak flow measures, here are some of the asthma symptoms you should be tracking daily -- or helping your child track if they have childhood asthma:
- Chest tightness
- Decreased appetite
- Shortness of breath
- Decreased physical activity
- How often you’re using your inhaler
- Dark circles under the eyes
Take note of when these symptoms occur and what triggers you were exposed to. Also note what asthma medications you took and how your asthma symptoms responded. And keep in mind that these asthma action plans should be personalized for you or your child. You shouldn’t be comparing your asthma symptoms with someone else’s.
“Everybody coughs, everybody wheezes,” says Shirley Joo, MD, an asthma specialist at Washington University of St. Louis School of Medicine. “But the levels vary by patient, and there’s an expected range based on a lot of factors and tests that we do in the office. You’re striving for your personal best.”
Even if you’re not actually coughing or wheezing, it’s also important to note if you can’t be as physically active as you’d like. If your child has asthma, you may have to watch this carefully.
“Kids, of course, will not come to their parents and say that they think their asthma feels worse, so look at their activity level,” says Joo. “Are they playing as much as usual, or are they sitting on the sidelines or coming in earlier than they used to?” Children should be able to go as fast as they want. When they can’t keep up with their friends, that’s an indicator that doctors should take a look at how well their asthma is controlled.
The need to use an inhaler is another important sign that asthma is not under control. It’s a common misconception that using an inhaler is a normal part of daily life with asthma; doctors call it a “rescue inhaler” for a reason.
“The goal is never to use it,” says Joo. “If you have good controlling medications and are minimizing your exposure to allergens, you shouldn’t be using your inhaler on a regular basis. If you’re using it every day, that’s an indicator to the doctor that you might need an increase in your controlling medications.”
Tracking asthma symptoms isn’t only a daytime task. Nighttime symptoms should be tracked, too. Nighttime coughing, in particular, can indicate that asthma is not well controlled.
If you’re not sure whether or not a symptom is related to your asthma, take note of it and ask. And if you’re having trouble with the side effects of an asthma medication, make note of that, too. Don’t just stop taking your asthma medication or cut down on the dosage. “Everyone should feel comfortable communicating their symptoms to their doctor,” says Joo.
All this may sound daunting, but it doesn’t have to be. There are a number of tools available to help you track asthma symptoms and peak flow, and figure out if you’re in the green, yellow, or red zone.
- WebMD’s Asthma Action Plan
- The Online Interactive Asthma Diary provided by the National Jewish Medical and Research Center
These simple tools help you work with your doctor to catch flare-ups before they get out of hand. “Putting out a small brush fire is better than a big forest fire,” says Joo. “If you’re going from the green to the yellow zone, it’s an indicator that there’s probably inflammation. If we wait too long to control it, it may take longer to quiet that flare-up down. Ultimately, the goal is to take charge of your asthma!”