An asthma attack can be scary for the patient and family alike. As one of the most common chronic conditions that affects both children and adults—7 to 8 percent of the U.S. population, according to the CDC—asthma is a frequent cause of visits to the ER where I work and those all across the country.
Asthma is also complex, with many triggers and treatment options. While you cannot cure asthma, you can control it. If you follow these steps, adopt a holistic approach, and regularly evaluate your medication needs, you can live a life in which you control your asthma—instead of the other way around. Here are a few points that I always try to share with my patients to help them on this path:
1. Don't confuse an acute illness with chronic asthma.
If you've just been to the doctor or emergency room for the first time with wheezing and shortness of breath (but have never had an asthma diagnosis before), wait until the acute illness has passed before assuming that you are now "asthmatic." There are many acute illnesses (such as several viruses, leading to post-viral tussive syndrome) that can mimic asthma in the short term. So, wait until your acute illness has improved; if you still continue to have asthma-like symptoms, then go back to your primary physician for a full asthma workup.
2. An asthma diagnosis isn't always simple.
There are many chronic conditions that can mimic asthma (which is why the diagnosis of asthma can often be unclear). These can include vocal cord dysfunction, GERD (gastroesophageal reflux disease), chronic postnasal drip, and even allergies in the form of allergic rhinitis or rhinosinusitis. Talk to your physician if you think you may have one of these conditions instead of asthma; also, these can coexist with asthma, making it worse.
3. You might grow out of it.
Between 30 and 70 percent of all children who are diagnosed with asthma have either recovered fully (i.e., no longer have asthma) or significantly improve by the time they reach adulthood. That's especially the case for kiddos with asthma when they're younger than 6. Once they grow a bit and their airways widen out, the problems that initially caused their asthma symptoms resolve.
4. Control your triggers to control your asthma.
The key to keeping your asthma in check is minimizing attacks by limiting your exposure to triggers. Everyone with asthma can have different triggers (ranging from environmental to food to hormonal), so it's important to identify yours by looking critically at the environments in which you typically have attacks. Keep a journal for a month, noting when and where you have attacks to find your triggers. Once you've identified them, you can take steps to minimize your triggers—with the most important places always being your bedroom (given how much time you spend there) and the rest of your home.
5. Address common home triggers.
Some of the most common home triggers are dust mites, mold, animal dander (skin, fur, feathers, saliva), and cockroaches (Yes. Eww.). Use hypoallergenic covers for pillows and mattresses, and minimize exposure by removing carpets from the bedroom and reducing the number of stuffed animals (and wash them weekly). Keep humidity low to reduce dust mites and mold. Cockroaches may be a trigger you don't even see, so consider an inspection for them, and remove garbage and food waste promptly from kitchen counters and your home overall. Here, the CDC gives further guidance on how to address these in-home triggers.
6. Watch out for that time of the month.
You may be surprised to hear this, but 20 to 40 percent of women with asthma have "perimenstrual asthma." This means their symptoms worsen just before and during their period, so track your symptoms; if they worsen around your cycle, speak to your doctor about modifying your medication regimen monthly in time with your cycle or taking measures to better regulate your hormones. Also, some people have their asthma triggered by anti-inflammatory medications (such as ibuprofen). If that's the case, avoid taking these medications for cramps—as they'll only worsen your asthma.
7. Be wary of sulfites.
Sulfites in foods may be a trigger for some people's asthma. That includes foods such as vinegar, dried fruit, beer and wine, grape juice, some gravies or sauces, and corn syrup.
8. But don't give up on exercise!
For some with asthma, exercise can trigger an attack—but that's the last thing you want to avoid! In fact, exercise may actually decrease your sensitivity to asthma triggers. So, this is one trigger you don't want to avoid—you just need to modify your behavior. Start new exercises gradually with a good warmup, avoid exercising outdoors in extremely cold weather (or cover your mouth and nose with a scarf), and consider taking a puff or two of your albuterol inhaler around five minutes before starting exercise, with your doctor's approval.