Page 1 f 9 PED-ALL-003-1992 What Is Asthma? Asthma is a chrnic lung disease that lasts a lng time. It cannt be cured nly cntrlled. Airways are inflamed. That is, airway linings are swllen. Airways narrw and breathing becmes hard t d. This narrwing gets better (but nt all the way in sme patients), smetimes by itself, smetimes with treatment. Airways are super sensitive. They react t many things, such as cigarette smke, pllen, r cld air. Cughing, wheezing, tight chest, difficult breathing, r an asthma episde may result. What Are the Symptms f Asthma? The main symptms f asthma are: Shrtness f breath, Wheezing, Tightness in the chest, and Cugh lasting mre than a week. Nt all peple with asthma wheeze. Fr sme, cughing may be the nly symptms f asthma. Cughing ften ccurs during the night r after the exercise. It s imprtant t knw that treatment can reverse asthma symptms. And it s imprtant t treat even mild symptms f asthma s that yu can keep the symptms frm getting wrse. Nrmal Breathing When yu breathe in, air is taken in thrugh the nse and muth. It ges dwn yur windpipe, thrugh yur airways, and int the air sacs. When yu breathe ut, stale air leaves the lungs in the reverse rder.
What Happens During an Episde f Asthma? Page 2 f 9 Asthma affects the airways in yur lungs. During an episde f asthma: The lining f the airways becmes swllen (inflamed). The airways prduce a thick mucus. The muscles arund the airways tighten and make the airways narrwer. These changes in the airways blck the flw f air, making it hard t breathe. Yu need t knw the ways that asthma affects the airways s that yu can understand why it ften takes mre than ne medicine t treat the disease. Very simply, sme medicines relax the airways and thers reduce (and even prevent) the swelling and mucus. What Causes Asthma? The basic cause f asthma is nt yet knwn. What we d knw is that asthma is nt caused by emtinal factrs such as trubled parent-child relatinship. In shrt, asthma is nt "all in ne s head". It is instead a chrnic lung disease. What Causes Asthma Episdes? Peple with asthma have airways that are super sensitive t things that d nt bther peple wh d nt have asthma. These things are called triggers because when yu are near r cme in cntact with them, they may start an asthma episde. Yur airways may becme swllen, prduce t much mucus, and tighten up. Cmmn triggers fr asthma episdes include the fllwing: Dander (r flakes) frm the skin, hair, r feathers f all warm-blded pets (including dgs, cats, birds, and small rdents) Huse dust mites Cckraches Pllens frm grass and trees and mld Mld (indr and utdr) Cigarette smke; wd smke; scented prducts such as hair spray, csmetics, and cleaning prducts; strng drs frm fresh paint r cking; autmbile fumes; and air pllutin Infectins in the upper airway, such as clds (a cmmn trigger fr bth children and adults)
Exercise Shwing strng feelings (crying, laughing) Changes in weather and temperature Page 3 f 9 Is There a Cure fr Asthma? Asthma cannt be cured, but it can be cntrlled. Yu shuld expect nthing less. Hw Can Asthma Episdes Be Prevented? T prevent asthma episdes yu will have t wrk clsely with yur dctr t: Develp a medicine plan that keeps yu frm getting symptms. Plan ways t avid r reduce cntact with yur triggers. Hw Are Asthma Episdes Cntrlled? T cntrl asthma episdes when they ccur, yu will have t wrk ut a medicine plan with yur dctr that includes: Treating symptms early, Ding the right things fr any changes in symptms, and Knwing when a dctr s help is needed and seeking help right away. What Can a Patient with Asthma Expect Frm Treatment? With prper treatment mst peple with asthma will be able t: Be active withut having asthma symptms. this includes participating in exercise and sprts. Sleep thrugh the night withut having asthma symptms. Prevent asthma episdes (attacks). Have the best pssible peak flw number lungs that wrk well Avid side effects frm asthma medicines.
Warning Signs f Asthma Episdes Page 4 f 9 Asthma episdes rarely ccur withut warning. Mst peple with asthma have warning signs (physical changes) that ccur hurs befre symptms appear. Warning signs are nt the same fr everyne. Yu may have different signs at different times. By knwing yur warning signs and acting n them, yu may be able t avid a serius episde f asthma. Think back n yur last asthma episde. Did yu have any signs belw? Check yur warning sign(s). Shw them t yur dctr and family. Remember t fllw yur asthma cntrl plan as sn as these signs appear. Drp in peak flw reading Chrnic cugh, especially at night Difficulty breathing Chest starts t get tight r hurts Breathing faster than nrmal Getting ut f breath easily Tired Itchy, watery, r glassy eyes Itchy, scratchy, r sre thrat Strking chin r thrat Sneezing Head stpped up Headache Fever Runny nse Change in face clr Dark circles under eyes Other: My mst cmmn warning signs f an asthma episde are: 1. 2. 3.
Asthma Trigger Cntrl Plan Page 5 f 9 Because yu have asthma, yur airways are very sensitive. They may react t things called triggers (stimuli that can cause asthma episdes). Yur airways may becme swllen, tighten up, and prduce excess mucus in the presence f ne r mre f the triggers belw. These triggers may make asthma symptms wrse r keep yu frm getting better. It s imprtant t find ut what yur asthma triggers are. Learn ways t avid them. If yu cannt avid triggers, and yur medicine plan des nt wrk as well as yu and yur dctr think it shuld, yu bth shuld discuss allergy shts (immuntherapy). Ask yur dctr t help yu find ut what yur triggers are. Ask yur dctr fr help in deciding which actins will help the mst t reduce yur asthma symptms. Number each actin item in rder f imprtance. Carry ut these actins first. Once yu have cmpleted these actins, mve n t actins that are f lesser imprtance. Discuss the results f these effrts with yur dctr. Pllens and Mlds (Outdr) Stay indrs during the midday and afternn when the pllen cunt is high. Use air cnditining, if pssible. Keep windws clsed during seasns when pllen and mld are highest. Avid surces f mlds (wet leaves, garden debris). Huse Dust Mites These are actins yu shuld take t gain cntrl f dust mites: Encase yur mattress and bx spring in an airtight cver. Either encase yur pillw r wash it nce a week every week. Avid sleeping r lying n uphlstered furniture. Remve carpets that are laid n cncrete. Wash yur bed cvers, clthes, and stuffed tys nce a week in ht (130 F) water.
Page 6 f 9 These actins will als help yu gain cntrl f dust mites but they are nt essential: Reduce indr humidity t less than 50 percent. Use a dehumidifier if needed. Remve carpets frm yur bedrm. Use chemical agents t kill mites r t change mite s antigens in the huse. Avid using a vacuum, ne r mre f the fllwing things can be dne t reduce the amunt f dust yu breathe in. Use a dust mask Use a central vacuum cleaner with the cllecting bag utside the hme. Use a vacuum cleaner that has pwerful suctin. Animal Dander (r flakes frm the skin, hair, r feathers f all warmblded pets including dgs, cats, birds, and rdents). There are n such things as an allergen-free dg. The length f a pet s hair des nt matter. The allergen is in the saliva, urine, and dander. Remve the animal frm the huse r schl classrm. If yu must have a pet, keep the pet ut f yur bedrm at all times. If there is a frced-air heating in the hme with a pet, clse the air ducts in yur bedrm. Wash the pet weekly. Avid visits t friends r relatives with pets. Take asthma medicine (crmlyn r beta 2 -agnist ; crmlyn is ften preferred) befre visiting hmes r sites where animals are present. Chse a pet withut fur r feathers (such as a fish r a snake). Avid prducts made with feathers, fr example, pillws and cmfrters. Als avid pillws, bedding, and furniture stuffed with kapk (silky fibers frm the seed pds f the silk-cttn tree). Use a vacuum cleaner fitted with a HEPA (high-efficiency particulate air) filter. Cckrach Allergen Use insect sprays; but have smene else spray when yu are utside f the hme. Air ut the hme fr a few hurs after spraying. Use rach traps.
Indr Mlds Page 7 f 9 Keep bathrms, kitchens, and basements well aired. Clean bathrms, kitchens, and basements regularly. D nt use humidifiers. Use dehumidifiers fr damp basement areas, with humidity level set fr less than 50 percent but abve 25 percent. Empty and clean unit regularly. Tbacc Smke D nt smke D nt allw smking in the hme. Have husehld members smke utside. D nt allw any smking in yur bedrm. Encurage family members t quit smking. Their dctr can help them quit. Use an indr air-cleaning device (fr smke, mld, and dander). Wd Smke Avid using a wd burning heat stve t heat yur hme. The smke increases lwer respiratry symptms. Avid using kersene heaters. Strng Odrs and Sprays D nt stay in yur hme when it is being painted. Allw enugh time fr the paint t dry. Avid perfume and perfumed csmetics such as talcum pwder and hair spray. D nt use rm dedrizers. Use nnperfumed husehld cleaning prducts whenever pssible. Reduce strng cking drs (especially frying) by using a fan and pening windws. Avid air pllutin by staying indrs n days when the pllutin cunt is high. Clds and Infectins Avid peple with clds r the flu. Get rest, eat a balanced diet, and exercise regularly. Talk t yur dctr abut flu shts. D nt take ver-the-cunter cld remedies, such as antihistamines and cugh syrup, unless yu speak t yur dctr first.
Exercise Page 8 f 9 Wrk ut a medicine plan with yur dctr that allws yu t exercise withut symptms. Take inhaled beta 2 -agnist r crmlyn medicine befre exercising. Warm up befre ding exercise and cl dwn afterwards. Weather Wear a scarf ver yur muth and nse in cld weather. Pull a turtleneck ver yur nse n windy r cld days. Dress warmly in the winter r n windy days. REMEMBER: Making these changes will help keep asthma episdes frm starting. An asthma trigger cntrl plan is an imprtant part f cntrlling asthma. Summary f Steps t Manage Asthma Episdes Knw yur warning signs and peak flw znes s yu can begin treatment early. Take the crrect amunt f medicine at the times the dctr has stated. If the asthma cntrl plan includes increased dsage r a secnd medicine t be used during episdes, take it as prescribed. Always call yur dctr if yu need t take mre medicine than the dctr rdered. Remve yurself r the child frm the trigger if yu knw what it is. Treatment des nt wrk as well if the patient stays arund the trigger. Keep calm and relaxed. Family members must stay calm and relaxed t. Rest. Observe yurself r the child by nting changes in bdy signs such as wheezing, cughing, truble breathing, and psture. If yu have a peak flw meter, measure peak flw number 5 t 10 minutes after each treatment t see if peak flw is imprving. Review the list belw fr signs t seek emergency medical care fr asthma. They include: Yur wheeze, cugh, r shrtness f breath gets wrse, even after the medicine has been given and had time t wrk. Mst
Page 9 f 9 inhaled brnchdilatr medicines prduce an effect within 5 t 10 minutes. Discuss the time yur medicines take t wrk with yur dctr. Yur breathing gets difficult. Signs f this are: Yur chest and neck are pulled r sucked in with each breath. Yu are hunching ver. Yu are struggling t breathe. Yu have truble walking r talking Yu stp playing r wrking and cannt start again. Yur lips r fingernails are gray r blue. If this happens, G t the Emergency Rm Nw! Keep yur imprtant infrmatin fr seeking emergency care handy. Call a family member, friend, r neighbr t help yu if needed. Immediately call a clinic, dctr s ffice, r hspital fr help if needed. D Nt D the Fllwing: D nt drink a lt f water. Just drink nrmal amunts. D nt breathe warm mist air frm a shwer. D nt rebreathe int a paper bag held ver the nse. D nt use ver-the-cunter cld remedies withut first calling the dctr. Frm: Teach Yur Patients Abut Asthma: A Clinician's Guide Natinal Asthma Educatin Prgram Natinal Institutes f Health 1992 Pediatrics Dept. Divisin f Allergy, The University f Mississippi Medical Center 2500 Nrth State St. Jacksn, MS 39216-4505 The University f Mississippi ffers equal pprtunity in educatin and emplyment, M/F/D/V.