Is "Asthma Attack" an Accurate Descriptor For You?

In my pre-asthma days especially, I understood asthma in terms of “asthma attacks”, probably as many people do. Once I was diagnosed with asthma when I was sixteen, I think part of what may have confused me about my own variety of asthma is that the term asthma attack didn’t often feel like it fit for me. I have had a few times where my lungs have clamped up rather quickly—one was early on in my asthma journey when I was in my basement on the computer, one time at the gym in university when I actually had to dismount the stationary bike, each time thankful I had my rescue inhaler in my pocket. I found that on these occasions that my symptoms actually resolved quicker than normal with medication too, but that might just be my perception of the feeling of the meds kicking in.

Asthma attacks, exacerbations or flare-ups?

Even when I’m well controlled, I do still experience asthma symptoms at baseline, though very mild. They are just background noise to my life, and I’ve come to not really notice anymore unless I pause and think about it. I tend to use the terms exacerbations or flare-ups (which some people may use as alternate terms for asthma attacks. In my head I use these terms without the suddenness I associate with the term attack. Technically, they are all the same). To me, these convey a noticeable increase in asthma symptoms, although I do tend to reserve the term exacerbation for symptoms that are more prolonged. Usually, my flare-ups last a number of days.

My exacerbations or flare-ups (which some people may also use as alternate terms for asthma attacks, but in my own head I use these terms without the suddenness I associate with the term attack—technically they are all the same) cause a noticeable increase in asthma symptoms. Depending on the severity of the symptoms or how long I’ve been hovering at a less-than-comfortable point below baseline, this is when I’ll increase my controller meds—that whole asthma action plan thing which is more in my brain than on paper. This, to me, is far from the sudden, severe breathing issues I associate with the term asthma attack. Maybe the media has done this to me, or maybe it’s the influence of my friends who have lived with this disease a long time and have come up with their own lingo for describing the world of asthma and the symptoms they are experiencing.

What terminology do doctors use?

Now, how does the medical profession use these terms? In my experience… they really don’t! My respirologist (Canadian for asthma doctor) asks if I’ve had any bad colds or viruses lately or if I’ve had any bad asthma symptoms and how often I need my rescue inhaler, Ventolin, and my Atrovent. My family doctor, who has for several years been careful to use the term baseline instead of control with me because early on I got frustrated by not being able to attain what guidelines call control with the treatments I was on at the time, even though we were trying just about everything (just not in the right combinations), simply asks how often I use my rescue inhaler most of the time. For most of us, this is probably the most tangible type of data anyways, combined with pulmonary function tests.

What kind of terminology do you use to describe your asthma symptoms worsening? How do you discuss this with your doctor—or with different people? I’d love to read your thoughts in the comments!

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