Good control, though, is both hard to find and hard to keep. "Asthma is a moving target," says Norman Edelman, M.D., chief medical officer for the American Lung Association (ALA). A number of things, from emotional upset to weather to allergies, can trigger a flare and leave you scrambling to regain control. "Management really requires cooperation between the patient and physician."
That's why the ALA and other asthma organizations recommend developing a written asthma action plan
with your doctor. An asthma action plan is individualized for your needs. It's designed to teach you how to recognize warning signs that your asthma is getting worse so you can seek treatment and get your medication adjusted accordingly.
One of the most common mistakes people with asthma make is to cut back on their medications when their symptoms start to improve. Some patients and even doctors think that asthma only occurs when you have an attack. It's actually a chronic disease, meaning it's there all the time, says Dr. Cowie. So, while your rescue inhaler should only be used for severe symptoms, you also need a daily controller inhaler--even when you feel fine--to decrease airway inflammation and maintain asthma control.
Another common mistake patients make is to ignore asthma triggers, which can worsen your symptoms and even induce a flare-up. These include tobacco smoke and other common allergens, like dust mites, animal dander, molds, pollen, cockroach droppings and even certain foods. Knowing your triggers--and avoiding them--is important for keeping your symptoms in check.
Still, even when they avoid triggers and use the right medication, less than half of people with asthma actually have optimum control of it. "Patients think they're okay, but that's compared with when they're feeling terrible," says Dr. Cowie. "We need to educate people with asthma to recognize what control looks like."
According to Dr. Cowie, the hallmarks of good asthma control are:
- Experiencing only mild symptoms, no more than twice a week
- Needing to use your rescue medication no more than twice a week (except before exercise)
- Few, if any, asthma flares
- Not waking at night with symptoms