How to manage asthma in 54-year-old elderly?

Question

Hello doctor,

My 54-year-old father has been struggling with uncontrolled asthma, and I am really worried about his constant shortness of breath and frequent flare-ups. Despite using his inhaler, he still experiences difficulty breathing, especially during cold weather. What steps can we take to better manage his asthma and prevent these attacks from becoming so frequent? Are there additional treatments, like biologics or other medications, that can help when the inhalers are not enough? How can we ensure he is receiving the right care, and what environmental factors should we focus on reducing at home to help him breathe easier?

Please help.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and can understand your concern.

According to your history, your father seems to be suffering from bronchial asthma (a chronic respiratory condition characterized by inflammation and narrowing of the airways). The key to the treatment of asthma is the use of inhaled medications. For adequate asthma control, appropriate inhalers in the right dose are to be used with adequate technique, and they should be used regularly.

Investigations to be done on newly diagnosed or uncontrolled bronchial asthma:

1. Complete blood count.

2. Serum total IgE (immunoglobulin E).

3. Chest X-ray.

4. Pulmonary function test (spirometry pre- and post-bronchodilator).

Causes for repeated exacerbations include:

1. Presence of comorbid conditions like allergic rhinitis, GERD, and obesity.

2. Incorrect inhaler technique or if the inhaler is not being used regularly.

3. If incorrect inhaled medicines are being used.

The following advice is to be followed if bronchial asthma is diagnosed:

1. Start regularly using metered-dose inhalers Budetrol (200/6) (two puffs twice daily with a spacer followed by mouthwash). Inhalers are to be used daily without any break for at least six months. No dose is to be skipped unless advised by a pulmonologist.

2. Mac spacer (it is to be attached to the inhaler; the technique of its usage can be learned in online videos).

3. Consult a pulmonologist either physically or virtually regularly (at least once monthly).

4. Take vaccinations appropriate for the age if not taken already.

5. Control of comorbid conditions, if any.

Get all the investigations and follow up after one week with investigations, and then evaluate if his bronchial asthma is controlled or not and if he requires any further treatment options like biological medications. Take care to follow up with investigations or earlier if further queries are there.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.