The asthma experts have some tips for what you should be doing in your quest to obtaining ideal asthma control. Your doctor most certainly has some advice for you too. And, most certainly, there are probably some things you’ve learned on your own along the journey as well, things that, when you do them — or don’t do them — lead to better asthma control.
Now, every asthmatic is unique. I personally have allergic asthma. I’ve been living with this disease for nearly half a century now, so I pretty much know my own personal asthma rules and what happens when I don’t follow them. Still, as the old saying goes, we are humans, and all humans are flawed. So, here is my own personal list of things I know I should follow to a tee but don’t always do.
Take your medicine EVERY day
The hard part for me is that, when I started out this journey, asthma was treated as an acute disease. This meant taking medicine only when you were feeling symptoms. Along the way, the emphasis of asthma control changed from treating acute symptoms to controlling and preventing asthma by taking asthma controller medicines every day of your life even when you felt good — especially when you felt good. It’s easy taking medicine when you feel sick. But, once you start feeling good, it’s easy to get out of the habit for one reason or another. We get busy. We forget. We get lazy. We get stupid: “Oh, I’m fine. I don’t need that inhaler today!” But then we get sick again, and the reason is obvious.
Get your prescriptions refilled before you run out
This goes back to the we are just humans theme I started above. For most of my life we didn’t have dose counters on inhalers, so we had an excuse for not knowing the inhaler was close to empty. Today, however, with that counter, there is no excuse. Still, we are just humans, and humans are flawed. For one reason or another, we don’t have our daily dose, and then we violate rule #1, and the obvious result ensues (asthma attack).
Use your peak flow meter every day
If I had a dime for every time my doctor, or therapist, or nurse, told me to use my peak flow meter every day or asked to see my peak flow trends, I could quit my day job. As an ironic twist here, my day job is as a respiratory therapist, and I am trained to teach all asthmatics to use peak flows and record the results. For crying out loud, as a lifelong asthmatic and RT, I know more than anyone the benefits of peak flows in the treatment of asthma. In fact, I have more peak flow meters — nearly every one ever made — in my home than are at the hospital I work for. Still, I haven’t used one in several years. In fact, most peak flow meters in my home live lonely lives, unless one of my kids decides to use one as a toy.
Use a spacer with that inhaler
Every single time I give a patient their inhaler at my work I make sure that they use a spacer. This is protocol. This is common sense. Nearly every study ever done on the subject has shown that metered dose inhalers, when taken with a spacer, work just as well as nebulizers. This also results in better inhaler technique, better distribution of medicine throughout airways (by as much as 75%), and a significant reduction in side effects. Despite knowing all this, even I don’t use one very often. They are too bulky to put into your pocket with your inhaler. They are expensive (about $30 each). But they work. Hey, you can even use a toilet paper roll, and that’s free. Studies show a toilet paper roll works just as well as a store bought spacer. Any of you ever use a toilet paper roll as a spacer?
Keep your windows closed in the spring
Tree pollen is prevalent in the spring. The recommendation is you keep the windows and doors closed to keep pollen out. Lord knows that’s not going to happen. You are cooped up all winter in the house, now it’s spring and the windows are going to be OPEN! There’s little more enjoyable than a fresh, spring breeze.
Watch pollen counts
Who has time to do this every day? Not this guy. And even if an app tells me pollen counts are high, it doesn’t stop me from enjoying the outdoor weather. This is one of those risk/ reward things. But it’s no fun staying indoors because of stupid pollen. And when I have the time to go for a jog or run or walk outdoors, I’m certainly not going to wait for the pollen count to go down — I’m just going to go. To do otherwise would be no fun and make John a dull and out of shape guy.
Wear mask and goggles when you mow the lawn
Um, yeah right! You know how stupid I would look, let alone how uncomfortable it would feel. Have you ever tried to wear a mask on a hot summer day? It’s no fun. Not going to happen.
Cover your mouth and nose with a scarf when you are in the cold outdoor air
Cold air tends to hold less water. Cold, dry air tends to irritate asthmatic airways, causing asthma symptoms. The scarf causes you to re-breathe some of your exhaled air, which is humidified. This helps to humidify some of the inhaled air, making it less likely to trigger asthma symptoms. Personally, I hate doing this. It feels uncomfortable. It makes me feels claustrophobic. I mean, sure, this tip comes in handy at times. But, for the most part, I would rather not go outdoors than wear a scarf over my face. And when I do go outdoors, you probably won’t see a scarf on me. In fact, I don’t even own one.
Get someone else to do it
I remember when I first became an RT and was working when my uncle, who was over 70, was admitted to the hospital with broken bones from falling off a roof. I said, “What were you doing on a roof?” He said, “I had a job to do and I knew how to do it.” In a similar fashion, even though I know I shouldn’t cut the grass and should get someone else to do it, I often find myself thinking, “It needs to be cut. I’m a capable guy. I’m cutting the grass.” Sure, this does get me into trouble at times, but at least the yard looks nice.
Rinse after using your inhaled medicines
The purpose of the inhaled route is to apply a topical medicine directly to your airways. A second purpose is to eliminate systemic side effects. While side effects of most asthma inhalers are generally negligible, any medicine that remains in your upper airway (i.e. your mouth) can be absorbed into your bloodstream, and may potentially contribute to side effects, such as tremors with rescue medicine. Plus, steroid inhalers may cause oral thrush, a side effect that can almost be eliminated by rinsing. Still, despite knowing this, there are times I forget to rinse. And then, once I observe a side effect (like oral thrush), I’m reminded why I need to do it.
Avoid pets. Bathe dogs once a week. Okay, so this rule is one I have gotten pretty good at. We do not have any pets in my home. But, it’s not even because of this asthmatic, it’s because my 6-YO son is allergic to them, and his eyes swell up. Still, even when we used to have a dog, we did not bathe it, even though we knew we should.
For the record, I do take my asthma controller medicine on most days. I have learned that this is the best way to control asthma, making it easier to violate some of the other no fun asthma rules. This makes it that much easier to live a normal life with this disease.
So, now you have my confession. Do any of these rules/rule violations ring a bell with you? What are some things you’ve discovered you should do to control your asthma, but probably don’t?