Topic Overview

The severity of asthma can vary, and asthma often requires changes in your treatment to control it. To ensure that you are getting the proper treatment, you have to continuously monitor and evaluate the disease and communicate with your doctor.

Symptoms

Know the symptoms of poorly controlled asthma—wheezing, cough, chest tightness, or shortness of breath. Having a written record of what to do during an asthma attack (asthma action plan) will give you guidelines for increasing medicine if your or your child’s asthma starts to get out of control.

Your doctor should periodically assess your asthma. He or she will ask how you have been doing since your last visit. Your doctor will ask about daytime asthma symptoms, nighttime awakenings, and symptoms early in the morning that do not get better with medicine.

Lung function

In asthma, how severe your symptoms are does not always match the results of your lung function tests. Some people will not notice severe symptoms until their lung function is very bad. For this reason, you should consider periodically testing your lung function.

Spirometry is generally used to test lung function. It is done after treatment has begun and again when symptoms have stabilized. This test should be performed at least every 1 to 2 years to assess your lung function. If your treatment helps you only a little, or if your symptoms change, you may need more spirometry tests. This test may be difficult for small children. It usually can be done with children older than 4 years.

You can monitor your lung function at home with a peak flow meter. This records the airflow as you blow out as hard and fast as possible. The number recorded is the peak flow achieved.

Peak flow monitoring can be used long term to monitor the changes in how well your lungs function. It can help you know in advance when you may have a sudden increase in your symptoms (asthma attack), so you can start treatment.

Quality of life/functional status

An assessment of quality of life is essential to gauging the success of asthma therapy. This includes how often you or your child has missed work or school because of asthma, any reduction in usual activities, and any disturbances in sleep.

History of asthma attacks

Asthma attacks usually occur after exposure to substances that cause inflammation in the airways (triggers), such as animal dander, viral infections, and pollen. How often you have episodes, how severe they are, and knowing what triggers them can help your doctor determine the best treatment.