For some individuals, asthma causes only occasional mild symptoms. For others, every day can be a struggle to breath. Asthma attacks may last only a few minutes or persist for days. Asthma affects 15 to 16 million Americans, and its incidence is on the rise world wide, particularly among children.

Asthma, a chronic inflammatory lung disorder, narrows the bronchi and their many branches (called "bronchioles). Individuals afflicted by asthma, may experience asthma attacks during which tightened airway muscles, swollen bronchial tissue, and excess mucus production, act together to narrow the lung’s airways. This traps air in portions of the lungs and limits the exchange of oxygen.  

Attacks may cause difficulty breathing, chest tightness, wheezing, and coughing. The bronchi of asthma sufferers exhibit hypersensitivity to certain “triggers” which can bring on an asthma attack. During a severe episode the airways become so narrow it becomes extremely difficult, if not impossible, to breath.

For some asthma is a minor problem, for others it can be life threatening. But many famous asthma sufferers have lived full and rewarding lives, among them are Ludwig van Beethoven, composer, Elizabeth Taylor, actress, John F. Kennedy, 35th President of the United States, and Jackie Joyner-Kersee, Olympic track and field athlete.

The factors causing asthma symptoms can be different for each person with asthma. Hyper-reactive airways narrow to certain stimulator triggers more easily than in non-asthmatics. Asthmatics are usually allergic to inhaled allergens, which act as an attack trigger. The exact cause of the asthmatic airway hyper- reactivity is not known, but the role of genetic factors is currently under study. Another area of study is targeting the possible role of immune system responses to environmental allergens.

Many factors act as asthma triggers and the triggers vary from person to person. But some triggers are almost universal:

• Stress (intense emotions such as laughing or crying
• Exercise, especially in a cold dry environment.

• Exposure to cold winter air

• Chemicals such as perfume, air pollution, or chemicals in the workplace

• Allergens such as dust mites, animals, pollen, molds, or tobacco smoke

• Drugs such as aspirin or beta-blockers

• And many personal triggers are of an unknown nature

People with asthma have breathing difficulties, wheezing, and coughing (sometimes with phlegm). They may experience a tight feeling in the chest or chest pain. Symptoms often worsen at night, awakening the patient. This results in restlessness or sleep problems. Individuals differ in the warning signs experienced before an attack.

Please review warning signs of asthma episodes from The American Medical Association to help you identify your personal warning signs.

To diagnose asthma your physician conducts a detailed medical history and a thorough physical examination focusing on the upper respiratory tract, chest, and skin. During the physical exam physicians look for evidence of airflow obstruction episodes and exclude all other possible problems such as respiratory tract infections. You’ll be given a pulmonary function test (PFT) to measure the maximum volume of air you can forcibly exhale after a maximum inhalation. It is an indicator of how well your lungs are working.  The results are effort dependent.  You must put out a good effort in order for the results to be reliable and consistent. Ask your doctor how to use the peak flow meter properly and if it is a helpful part of monitoring you asthma. Additional tests may be considered to evaluate alternative diagnoses, assess asthma severity, identify your personal precipitating factors (triggers), and investigate potential complications.

Work with your doctor to develop an individualized asthma management plan that tells you which medications to take and when to take them. Follow your management plan to prevent or reverse asthma symptoms. It may take some time to determine what triggers your asthma symptoms, methods for avoiding the triggers, and the best medications for your symptoms.

The Peak flow meter provides you with information on how your respiratory system is functioning and serves as a valuable tool for monitoring your asthma. By checking your peak flow daily, you may avoid attacks because you'll know about the narrowing of your airways even before symptoms begin. Be sure to use your peak flow meter before beginning the day's activities.

General instructions for use of the peak flow meter are provided below. There are three possible zones, often identified by color. Each person with asthma will have his or her own personal-best numbers identified by your doctor.

Set the indicator at the base of the numbered scale.

1. Stand up.
2. Breathe deeply.
3. Place the meter in your mouth.
4. Close your lips around the mouthpiece tightly; do not put your tongue in the opening.
5. Blow out -- as quickly and with as much force as you can.
6. Write down the number indicated on the scale.
7. Repeat steps 1 through 6. Write down the number.
8. Repeat steps 1 through 6 again. Write down the number.
9. Now look at the three numbers and record the highest one onto your peak flow daily chart.

Green means all clear. 

Yellow means you need to be careful. You may not be able to do all of your activities or sleep through the night.  

Red means danger (call your doctor).

The following links provide charts, which you can print out and use for daily monitoring of your peak flow and self-management plan.

You may need medications to help control your asthma. There are two main types of asthma medications:

1) Anti-inflammation medicines are long term management medications to help prevent and reverse airway inflammation and reduce airway sensitivity. This reduces the likelihood of asthma attacks.

2) Bronchodilators relieve acute attack symptoms and provide help in emergency situations.

• Inhaled medications are preferred due to their high therapeutic ratio: high concentrations of the drug are delivered directly to the airways with potent therapeutic effects and few systemic side effects.

• Devices available to deliver inhaled medication include pressurized metered-dose inhalers (MDI's), breath-actuated metered dose inhalers, dry powder inhalers, and nebulizers. Spacer (or holding chamber) devices make inhalers easier to use. Spacers also reduce systemic absorption and side effects of inhaled corticosteroids.

In general:

• For patients using spacers, the spacer must fit the inhaler. For children, the size of the spacer must increase as a child grows and lung size increases.
• Patients who are having severe attacks should seek immediate attention or dial 911.
• Different devices need different inhalation techniques. Your doctor should teach you the proper technique and provide illustrated instructions.

Monitoring your personal attack triggers and the results of your daily peak flow meter readings can reduce the intensity and frequency of attacks. With appropriate treatment and control of asthma, most patients can prevent severs attacks, and live productive lives with near normal lung function

Even with a family history of asthma, avoiding exposure to dust mites, cat allergens, and smoke may help prevent an infant from developing asthma.

Exercise Induced Asthma Some people develop asthma attacks only as a reaction to exercise. About 90 % of asthma sufferers are susceptible to exercise induced attacks. Activity in a cold, dry environment is more likely to precipitate an asthmatic response than exercising in a warm, dry environment.

 VIEW WRITING PORTFOLIO