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Controlling Episodes
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What is Asthma? | Triggers: Know Your Troublemakers
Working With Your Doctor | Controlling Episodes
Help Your Medicines Help You | Kinds of Asthma Medicines
Live Better and Feel Better
HOW CAN I CONTROL AN EPISODE ONCE IT STARTS? Asthma episodes seldom happen suddenly, even though they sometimes seem to. They give early warning signals that give you time to take action.
What are the early warning signals of an asthma episode?
The pattern of signals varies from person to person, but watch for any of these:
a feeling of tightness in your chest
light wheezing
extra effort to breathe
coughing when you don't have a cold
restlessness while trying to sleep
Another important sign is reduced air flow in your lungs. Your doctor may suggest that you have a peak flow meter at home, a simple device that will let you measure your air flow.
What should I do when an episode is just beginning?
First, take the medicine your doctor has prescribed to prevent the episode from getting worse. Don't try to "tough it out." The right action at the right time can save you much distress. And it can prevent you from needing much stronger medicines later.
While the medicine begins to work to open your airways, you can help it by relaxing, and taking control of your breathing.
Learning to relax when you think an episode is beginning is important. The next section teaches you one way to do this.
Relaxed muscles will help reduce the breathlessness of asthma. Learn special relaxation exercises to help control an oncoming asthma episode.
Relax to breathe more easily.
The beginning of an asthma episode can make you feel anxious, fearful, or angry. Those feelings are natural, but they increase your shortness of breath.
Knowing how to relax gives you a skill you can use whenever you start to feel uncomfortable. If you practice the following exercise once or twice a day for three or four weeks, you'll improve your ability to relax.
Even if you don't feel upset, your muscles may be tight, making it harder for you to breathe.
To make your breathing easier, here's one way to relax:
1. Sit upright in a chair. Let your arms hang loosely at your sides. Breathe slowly and evenly.
2. Sit one to two minutes with your eyes closed.
3. Gently tighten the muscles in your face, making a frown. Count to 2. (Don't hold your breath.) Let your face muscles relax completely. Count to 4.
4. Clench your fists. Shrug your shoulders. Tighten muscles in your arms. Count to 2. (Don't hold your breath.)
5. Let your shoulders fall down, and let your arms hang loosely with your hands open. Count to 4. Keep breathing slowly and evenly.
6. Tighten your legs and feet. Count to 2.
7. Completely relax. Let all your muscles go loose from your forehead to your toes. Count to 4.
Repeat the entire exercise 2 or 3 times.
In an asthma episode, how can I get my breathing back to normal?
When you're short of breath, you may feel nervous and try to breathe faster. More air may get trapped in your lungs, and then you feel worse. Before you can breathe in fresh air, you need to get the stale air out, and that's hard if your airways are clogged and narrowed.
Don't gasp for air. Instead, follow these steps:
1. Relax. Let your neck and shoulders drop.
2. Breathe in slowly through your nose.
3. Purse your lips in a whistling position, and blow out through your mouth slowly and evenly. Try to take at least twice as long as you did breathing in.
4. Relax. Repeat the pursed-lip breathing until you no longer feel breathless. If you get dizzy, rest for a few breaths.
When you breathe out slowly through pursed lips, you keep up the air pressure in your airways. That helps them stay open so that you can breathe out more stale air, and return your breathing to normal faster.
Once you've gained control of your breathing, keep it by staying relaxed and breathing slowly.
How can I control coughing?
If your asthma causes a coughing spell, that can add to your feeling short of breath and frightened. When it happens in public, you may feel embarrassed as well. Uncontrolled coughing is useless and tiring.
You can control your cough and make it effective. A cough is effective when it brings up mucus and helps clear your airways. An effective cough should not tire you or take your breath, and it need not embarrass you.
When you feel a cough coming on, follow these steps:
1. Breathe in deeply.
2. Hold your breath for a second or two.
3. Cough twice, first to loosen the mucus in your airways, then to bring it up. or two. or two.
4. Get rid of mucus. Use strong tissues or paper towels. Swallowing mucus may upset your stomach.
5. Breathe in by sniffing gently.
The best position for coughing effectively is to sit with your head slightly forward, feet on the floor.
When should I call a doctor?
If your asthma is getting worse even though you have taken your medicine and done everything else you can think of, it's time to call the doctor.
If you are unable to reach your own doctor, find out if another doctor is on call. As a last resort, call your hospital emergency room and ask to speak to the doctor on duty. If possible, have someone else in your household make the call for you while you practice relaxing, trying to breathe slowly, and coughing effectively to clear your airways. People with asthma have two opposite types of problems to avoid:
Letting fear take over. Some people are so fearful they are unable to help themselves and become dependent on hospital emergency rooms.
Waiting too long to get a doctor's help when needed. When people do that, their condition could worsen and become dangerous.
Time and practice will help avoid both of these problems.
What should I tell my doctor?
Speaking slowly and clearly, tell the doctor your name.
Describe the asthma symptoms. A clear picture of what is happening will help the doctor make fast decisions.
Tell the doctor what medicine has been taken, when, and how much.
Listen carefully. Make sure you know the doctor's name, and get clear instructions. The doctor may tell you to stay home, or to go to the office or the hospital emergency room.
If the doctor say to stay home, do so, but ask when you should call back to report your progress, or lack of it. Then follow instructions carefully. Those instructions may include:
taking more medicines.
taking more fluids.
continuing relaxing and breathing exercises.
If you feel confused or think of other important questions after you hang up, call again. Don't worry about "bothering" the doctor. A good doctor will want to give you as much help as you need, and you have the right to it.
After you have followed all of doctor's instructions and have waited a reasonable time, if you are malting no progress, call again. While timely home treatment usually controls asthma episodes, you may sometimes need medicines that can be given only in the doctor's office or at the hospital.
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Taking Control "I was sick nearly all last winter with colds and asthma and finally I landed in the hospital in tough shape. It took them three days to get me breathing right.
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"You must stop acting as though your asthma didn't exist until you become desperately ill."
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When I left the hospital they gave me medicines to take and an appointment with the doctor. Later, I felt better so I stopped taking the pills. The doctor didn't like that a bit. 'Matt,' he said, 'you need this medication every day whether you feel well or not. You must stop acting as though your asthma didn't exist until you become desperately ill.' He said, 'Not many people die from asthma anymore because we know how to treat it, but if you keep going the way you are, you could become a statistic." I was burned. I don't like pills and I don't like lectures. I figured I shouldn't have to take medicine when I'm feeling okay. I never did before. Maybe this doctor's wrong, I thought. Maybe I should get another one.
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Then I saw a TV announcement about getting a second opinion. It said you can call the medical society for doctors' names. I got some names and called one near my neighborhood. I wanted to just go on the sly, but he wanted to see my records, so my doctor found out I was going. I thought he'd probably be sore, but maybe I wouldn't go back anyway.
Well, I went to see this second doctor, a specialist. He examined me, asked me a lot of questions, and studied my records. He took a few minutes to show me a better way to breathe in one of the medicines I use.
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"I still don't like having to take medicines every day, but now that I know more about it, I think it's the best thing I can do for myself."
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Then he talked to me about the medicines my doctor ordered for me, and why it was important to take the pills every day. He said in the end I'd be using less medicine, not more, because I'd prevent bad asthma episodes.
When I went back to my doctor, I thought he might be annoyed at me. But he said he was glad to have the other doctor's report and I should always feel free to ask him questions or ask for another opinion.
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I still don't like having to take medicines every day, but now that I know more about it, I think it's the best thing I can do for myself. Maybe I can stay out of the hospital and have a better winter this year."
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Researchers at the Division of Pulmonary & Critical Care Medicine, University of Washington are seeking volunteers, 18 to 59 year olds to participate in a study about the causes of asthma. Compensation is provided for participation. Volunteers must be diagnosed with asthma by a physician, capable of exercise on a treadmill, and have no other major health problems.
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For more information...
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Seeing the Sun Rise from Mount Rainier
