What steps to be taken when asthma affects daily life?

Question

Hi doctor,

I have had asthma since childhood, but lately, it feels like my symptoms are worse than ever, even with my current medications. I am constantly out of breath, and it is affecting my ability to exercise and live an active life. What steps can I take to get my asthma under control? Are there new treatments or approaches that might help stabilize my condition so I can return to a more active lifestyle?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

As you already described, you are suffering from bronchial asthma (a chronic lung disease that causes the airways of the lungs to become inflamed and narrow). The key to asthma treatment 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:

Complete blood count.
Serum total IgE.
Chest X-ray.
Pulmonary function test (spirometry pre- and post-bronchodilator).

Causes for repeated exacerbations include:

Presence of comorbid conditions like allergic rhinitis, GERD (gastroesophageal reflux disease), and obesity.
Incorrect inhaler technique or if the inhaler is not being used regularly.
If incorrect inhaled medicines are being used.

The following advice is to be followed:

Start regularly using inhalers (MDI Budetrol (200/6), two puffs twice daily with 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 the pulmonologist.
Mac spacer (it is to be attached to the inhaler; the technique of its usage can be learned online via videos).
Consult a pulmonologist either physically or virtually regularly (at least once a month).
Take vaccinations appropriate for the age if not taken already.
Control of co-morbid conditions, if any, like allergic rhinitis, since uncontrolled allergic rhinitis and GERD often exacerbate asthma, leading to poor asthma control.
Ensure you have a written asthma action plan that outlines how to manage your symptoms and what to do in an emergency. This can help you feel more in control.
Avoid triggers: Identifying and avoiding triggers (like smoke, pollution, pets, or certain foods) can significantly improve your condition.
Pulmonary rehabilitation: Some programs offer education and exercises to improve lung function and overall fitness.
Lifestyle changes: Regular exercise (as tolerated), maintaining a healthy diet, and managing stress can all contribute to better asthma control.
Monitoring and technology: Using a peak flow meter to monitor your lung function can help you detect worsening asthma early. There are also smartphone applications that can help track symptoms and medication use.
Emergency preparedness: Make sure you have an emergency plan in place, including access to emergency medications and knowing when to seek urgent care.

Get all the investigations and follow up after one week with the investigations, which will then evaluate whether your asthma is controlled or not. Take care to follow up with investigations or earlier if further queries arise.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.