Asthma is a chronic inflammatory disease of the lungs. Inflammation of the lining of the airways makes it difficult for a person to breathe. This is followed by other asthma symptoms such as coughing, wheezing and heaviness in the chest.

Asthma is an allergic reaction to triggers and it has no cure. But, with proper treatment and an asthma action plan, you can manage your asthma very well. An asthma management plan provides some important guidelines that can help to manage asthma and control the symptoms.

What is an asthma management plan?

An asthma action plan is a written plan developed with a doctor’s help. The asthma treatment and management action plan shows how to control asthma daily, what kinds of medicines to take and when to take them. This further explains what medicines to take and steps to follow if asthma symptoms start to worsen. This action plan is different for every asthmatic according to the type of asthma, their pattern of symptoms and different triggers. Generally, the plan will have three zones:

Doing well (Green): In this situation, controller medications must be taken and the symptoms can be easily controlled. The peak expiratory flow rate must be 80% of the personal best.

Asthma is getting worse (Yellow): The symptoms get worse in this situation; therefore, quick-relief medicine must be taken. The peak expiratory flow rate must be 60% to 80% of the personal best.

Medical Alert (Red): This can be a life-threatening situation. After taking the quick-relief medicines, one needs to visit the doctor immediately. The peak expiratory flow rate is below 60% of the personal best.

The Asthma control plan can be shared with the family and friends of an asthmatic so that they are prepared to take care of any emergencies. It is also meant to be shared with the teachers at school for children who suffer from asthma. This gives clear instructions on when to call the doctor or go to the nearest hospital. There are some more ways to manage asthma and prevent the symptoms.

Education about the disease and modifying behavior is vital. The patient should also be encouraged to change lifestyle and control the environmental trigger factors. Patients should be asked to maintain healthy body weight as evidence reveals that the disorder is more difficult to control in overweight individuals. Patients should avoid tobacco and use of beta-blockers, aspirin.

Dr. M.G. Kartheeka, MBBS, MD

Different ways to manage asthma:

Avoid asthma triggers

Asthma is an allergic reaction and that is why when an asthmatic comes in contact with certain allergens, it triggers asthma symptoms or flare-ups. Everyone’s asthma is different, so their triggers are different as well. To control the problem, it’s important to identify the triggers and avoid them. The common asthma triggers are tobacco smoke, dust mites, animal dander, pollen from plants, mould/fungus, outdoor pollution, odour, etc. There are other triggers like strenuous exercise, changes in weather, food additives and fragrances that can also lead to symptoms of asthma.

Asthma flare-ups during pregnancy can cause decreased oxygen in blood, which means less oxygen reaches the baby. This puts the baby at higher risk for premature birth, low birth weight and poor growth. Inhaled steroids are found to relieve the symptoms to a great extent in pregnancy.

Dr. Ashish Bajaj – M.B.B.S, M.D.

Take regular medication

Asthma medicine is usually given via inhalers so that it reaches the lungs directly and causes minimal side effects. The doctor will often prescribe two kinds of medicines – long-term (Controller or Preventer) and quick relief(Reliever or Rescue).

Control long-term persistent inflammation – Controllers: It is taken to prevent symptoms and asthma attacks. These medications help to counter the underlying inflammation of the airways in a person with asthma. Controllers are taken only once or twice a day as they have a prolonged effect.

Relieve acute asthma symptoms – Relievers: These medications relax the airways and make it easier to breathe. They provide immediate relief and are used during the flare-up of symptoms. These are basically bronchodilators that dilate the ‘bronchus’. It is essential to take these medicines as prescribed to keep your asthma symptoms under control. Using the controller medicine regularly can also help in reducing the need for reliever medicine. These medicines can be taken 3 to 4 times a day, but their frequent use means that the asthma symptoms are not under control or that the controller medicines are not effective.

Using the peak-flow meter

A peak-flow meter is a small hand-held device which helps to monitor the respiratory health of asthma patients. This device measures the peak expiratory flow rate, which gives an idea of the obstruction in the lungs.

• Peak Expiratory Flow Rate (PEFR) is the maximum speed at which a person can exhale air from the lungs.
• Forced Expiratory Volume in 1 Second (FEV1) is the volume of air expelled within the first second after inhaling a deep breath.

The peak flow meter will help an asthmatic to know if the symptoms are in control and also help to determine the effectiveness of prescribed controller medications. This device must be kept clean and used only by one person. If a decrease is seen in the peak flow, one can refer to the doctor for an asthma management plan and know about the action that needs to be taken. Ideally, peak flow reading should be taken thrice a day which can be difficult; therefore, two times a day is also a safety measure. Healthy people show a peak flow of approximately 350 and 650 l/min. People with asthma have peak flows between 200 and 400 l/min. In severe attacks, peak flow may even fall below 100 l/min

Regular doctor visits

It’s important to visit the doctor on a regular basis, irrespective of whether the asthma symptoms are under control or not. Asthmatics must describe in detail the symptoms they experience so that the doctor can optimise the asthma action plan along with effective prescribing medications. This way, the doctor can help a person control and manage asthma symptoms and reduce the frequency of asthma attacks. The best outcomes are seen when both the doctor and the asthmatic are committed to the diagnosis and treatment of asthma.

Follow a healthy lifestyle

The choice of diet and daily activities have a significant impact on people with asthma. It is important to adapt to a lifestyle that can help to prevent asthma symptoms or attacks. Therefore, asthmatics must follow the following:

A healthy diet – A healthy diet is important for an asthma patient as it can improve the overall health status. The diet must include food with vitamins D and E, which is present in milk, salmon, eggs, almonds, raw seeds, broccoli, hazelnuts etc. Asthmatics must avoid food that contains sulfites and salicylates.

Exercise -It proves beneficial in preventing asthma symptoms. Precautions need to be taken while performing any exercise or physical activity. Inhalers must always be kept near while exercising. One can start routine exercise only after consulting the doctor. It is good to start with exercises like stretching and low-impact cardiovascular workouts such as walking.

Yoga – Certain Yoga Asanas (poses) such as Savasana, Sukasana, forward bend, seated spinal twist, side bend and cobra pose are the yoga asanas that can benefit the lungs. Also, there are a few breathing exercises called (Pranayama) that can help to improve breathing.

Other physical activities – An asthmatic must consult the doctor before doing any other physical activities. Activities such as cycling, swimming and walking provide a cardiovascular workout that expands lung capacity and engages each muscle of the body. Another activity to follow for better breathing is cycling. It helps to build lower body endurance and this is a key component of physical therapy programs.

The goal of asthma treatment is to ‘Achieve and Maintain Asthma Control’. Asthma management has advanced with the diagnosis and ways of monitoring asthma. This can help physicians optimise the treatment for an asthmatic. To manage asthma successfully, the person must stay committed to the asthma treatment required. This will help to ensure a favourable outcome and an enhanced quality of life.

Brought to you by Cipla.

Disclaimer: The information included on this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.