Asthma

Studies show us that asthma patients in the United States are treated inadequately over 40% of the time. That means that you may be continually running to the doctor or ER with a crisis instead of receiving the correct dosages of the incredible medications we now have to control asthma.

But asthma is complicated, and that’s one reason that doctors don’t always treat it correctly. There are a lot of moving parts. To be adequately treated, you have to determine: 1) what classification of asthma you have, 2) what medications you should take with your classification, 3) how to use a peak flow meter, and 4) how to develop and use an Asthma Action Plan. That’s a lot of work for a typical 8-minute doctor’s visit.

And the information on the Internet about asthma is massive. Just at WebMD, there are over 60 topics on asthma. The trick is to find the kernels of information that will really make you successful in knowing enough about asthma so that you can help your doctor treat you correctly.

If you want to know the real basics of asthma, and how to gain control of it, then follow these step-by-step instructions that will lead you to the best and simplest way to get to the heart of controlling your asthma. (It will be most helpful if you can print out all of these online articles, and then number them #1-#6.) And remember this: Controlling your asthma isn’t just about being able to breathe better and not having asthma attacks. Controlling your asthma also controls the damage that out-of-control asthma can do to your lungs.

Note:  at these websites I’m sending you to for information, you don’t need to “look around” on the website for what you need, or do any additional clicking.  Just use your brower’s print icon to print out the exact page I’m sending you to.

#1. First find out about asthma. Print out and read the asthma topics “What is It?” through “Additional Info” at http://symptomchecker.about.com/od/man/eyes/Diagnoses/asthma.htm#treat. (You don’t have to read all this, but it’s the best background article I’ve found.)

#2. Next, determine what “classification” your asthma is. There are 4 different classifications, and the classification that you fit in determines what medications you should be on. Go to http://www.familyallergy.com/diseases/classification.asp and look at the classifications. Note specifically the first 2 or 3 symptoms under each heading (the others you may not understand yet). Your classification depends a lot on how many times a week you have asthma symptoms, and how many times a month you have nighttime asthma symptoms. Your classification level is the highest level at which you have any of the symptoms in that category. (The levels get higher as you go down that page.) (Levels in order of lowest to highest: 1) Mild intermittent asthma; 2) Mild persistent asthma; 3) Moderate persistent asthma; and 4) Severe persistent asthma.)

#3. Now go to a website that tells you about asthma medications. Ten classes of asthma medications are described at http://asthma.about.com/od/treatmentoptions/a/asthmamedication_hub.htm.

#4. Now go find out what medications you should be on, for your classification of asthma. Go to http://www.iscribe.com/pdf/asthmaAdultChild.pdf and print out that page. Note on the left the “Steps” 1 through 4. These are the classifications. See which classification you are in on the left, then go to the “Daily Medications” column on the right, and see the medications you should be on to control your asthma. If you’re not on the medications you should be on, then take the info in, and ask your doctor for the meds described for your classification (or “step”) of asthma.

#5. Get a “peak flow meter” from a medical supply store and learn how to use this inexpensive, yet life-saving tool. See http://webmd.com/asthma/guide/peak-flow-meter for instructions.

#6 (a & b). Make an “Asthma Action Plan.” Print out the one at http://asthma.com/learn/index.html. (Make sure to print it out in color!) Then go to the 4 pages at www.webmd.com/asthma/guide/developing-an-asthma-action-plan, and pay particular attention to the info on the green, yellow, and red “zones.” Note that your peak flow meter helps you know when you need to take rescue medications or go to the ER, and that you have to start with a baseline reading of your “best” peak flow when you’re not having symptoms. Then you’re in the Green Zone when your peak flow reading is 80-100% of that “best” reading; you’re in the Yellow Zone when your peak flow is 50-80% of that “best” reading; and you’re in the Red Zone when your peak flow is less than 50% of that “best” reading.

#7. Look back at the asthma daily medications that you should be on (in #4 above). Your “controller” medicine(s) (which you should put into the Green Zone and take daily) are listed in the right-hand column on that page. Your “Rescue (Quick Relief)” medicine that you should take when you’re in the Yellow Zone is listed at the bottom of that page (“Quick Relief All Patients”). [These “Rescue (Quick Relief)” medications are the same as those mentioned on your #3 handout as “Short Acting Beta Agonists (SABA) such as Albuterol” (number 2. on the #3 handout).

8. Note the “Goals of Therapy: Asthma Control” on the classifications and medications sheet (#4 above). And note the “Step down” and “Step up” guidelines on that same page: Step up the medications if not controlled; step down the medications if you’re controlled for 1-6 months, and want to try to reduce the meds.

9. After you’ve learned all the above—then you can go to the 61 articles on WebMD or other articles all over the Internet to find out the very fine points of asthma. But at least I’ll know that you: 1) know about your disease; 2) know what classification you’re in; 3) know about asthma medications; 4) know what medications you should be on for your classification; 5) know how to use a peak flow meter; 6) know how to make and use an Asthma Action Plan; and 7) know to talk with your doctor whenever you find you’re not getting something that you need.

Good luck! (I never said this would be easy—but you can be successful with a little practice and study!)

For those of you who are well-controlled and don’t need to know all this, then you may be one of those 55% of people getting the correct asthma treatment from your physician. Congratulations on your good fortune! But if you’re not well-controlled, then by following the advice above, you can learn to be the “expert” on how to correctly treat asthma, and learn to work with your doctor and ask your doctor for what you need.