How to prevent asthma from worsening in 48-year-old women?

Question

Hi doctor,

I am a 48-year-old woman, and I have been struggling with uncontrolled asthma for the past year, despite using inhalers and other medications for colds and coughing during my attacks. I still experience symptoms like wheezing, tightness in my chest, and shortness of breath. What could be causing this worsening of my asthma, and how can I prevent these episodes from happening? Are there specific steps I should take for both prevention and treatment? Should I undergo any specific tests to help diagnose the underlying issues and achieve better control? I just want to feel normal again. I need some guidance.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

As you already described, you are suffering from uncontrolled bronchial asthma. The key to the treatment of asthma is the use of inhaled medications. For adequate asthma control, appropriate inhalers with 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, and it has not been done recently:

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 (gastroesophageal reflux disease), 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. Regularly start using inhalers containing Formoterol and Budesonide (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. Spacer and mask device (it is to be attached to the inhaler; the technique of its usage can be learned online).

3. Consult a pulmonologist either physically or virtually on a regular basis (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 a week with the results. I will then evaluate if your asthma is controlled or not.

I hope this information helps you.

Follow up with the results of investigations or earlier if further queries are there.

Thank you.