When It’s Not a Breath of Fresh Air: A Review of Asthma
By Sarah Reichhoff, MD
With Spring in full swing, bringing with it allergy season, decreased air quality and more people out and about getting exercise, now is a good time to brush up your knowledge of asthma. This is a relatively common condition that affects up to 7% of children and up to 10% of adults in Minnesota. However, while common, this condition is not one size fits all and every person who has this is affected differently.
In general, asthma is a condition that affects the lungs and makes it difficult to breathe at times. In response to triggers, the airways of the lungs become smaller due to inflammation, increased mucus, and tightening of the muscles around the airways. All of this leads to a smaller area for air to come in and out of the body. Understanding how asthma works explains the symptoms that patients often experience, like wheezing or noisy breathing (think of wind whistling through a small space), a tight feeling in the chest, difficulty catching a breath and coughing as the lungs try to clear the airways. While the causes of asthma are complex, including genetic and environmental factors, this is a condition which has treatments to control and even prevent symptoms!
When seeing a medical provider about asthma, they will ask questions about how often you are experiencing symptoms, if they ever wake you from sleep, if they prevent you from doing any of your normal daily activities, if you have had to go to the Emergency Department for treatment or had to be admitted to the hospital, and how often you have to use your medication if you have any. These questions help to determine how well the asthma is controlled, whether it is mild, moderate or severe and whether it is intermittent or persistent. Your provider will also ask if there are any triggers that you have recognized; some people notice that they only have symptoms with exercise, while others have worsening asthma related to allergies, respiratory illnesses, polluted air or cold/ dry weather. Along with these questions, diagnosis and management are sometimes assisted by a breathing test called Pulmonary Function Testing or PFTs.
The treatment for asthma is individualized to each person’s symptoms, triggers and severity. Some people will just need a short acting inhaler occasionally when symptoms appear, or may take that inhaler before coming in contact with something they have found to be a trigger. Other people may need a longer acting inhaler or other medication to take daily to control symptoms before they arise. Your medical provider may also help make an Asthma Action Plan, especially for young children. This will designate green, yellow and red zones based on symptoms and will detail which medicines to take at each level, and when it might be necessary to go to the hospital for further treatment. Sometimes, when asthma symptoms increase quickly during an “asthma attack”, stronger and more frequent treatments need to be given to decrease inflammation and relax the muscles around the airways.
So, what should you do with this information? If you have asthma or have experienced the symptoms discussed above, take some time to think about when the symptoms happen, how often you are experiencing them, how severe they get, and if you have medications on hand which help relieve the symptoms. If you aren’t sure your symptoms are well controlled, or if you have questions and want to make sure you have the most up to date plan for yourself, make an appointment with your primary care provider to address this. And, if you are ever concerned for quickly increasing difficulty breathing that is not fixed by a “rescue” inhaler, go to your local Emergency Department for assessment and treatment.
Dr. Reichhoff is a family physician at Allina Health United Family Physicians, 233 Grand Ave, St. Paul, MN 55102, 651-241-5200
