Asthma affects a large crowd of people around the world. Combining the cost of missed work and the resulting loss of productivity with missed school days, the total runs into the billions of dollars each year in the United States alone.

Asthma is classified as a reversible airway disease, which means that symptoms generally improve after treatment and that compromised airways can be restored to their functional state. Therefore, symptom management is the key to success and reduction of exacerbations or “attacks”. Asthma, which causes inflammation, excessive mucus production and spasms in the walls of the airways, can have a variety of symptoms, each of which can be, and generally will be, different from person to person. Let’s review some of these symptoms and their causes.

Inflammation: inflammation caused by a reduction in the diameter of the airways. This causes shortness of breath and increases turbulence in the airflow through that airway, which ironically causes more inflammation. An interesting tidbit that helps you put things in perspective on the difficulty you are experiencing when this occurs is this: If you were to take an airway one inch in diameter, give it a healthy dose of inflammation until it becomes half its size. or half an inch in diameter has obviously significantly increased your shortness of breath. It would make sense, looking at the numbers, to say that your difficulty now would be 50% higher than before, but this is not the case. In reality, it has become 16 times more difficult for you to move air through that airway. Talk about a change!

Mucus production: The walls of our airways are lined with cells specifically designed to excrete mucus. This mucus is present for our own good, and under normal circumstances it would be considered an ally. It helps catch foreign objects such as dust or foreign particles when it detects their presence and holds them while cilia (tiny hairs that line our airways) move that mass of mucus trapped in particles into our larger airways to expel when coughing. A perfect system … unless mucus is released as a result of triggers you are exposed to as a cause of your asthma, lung irritation, or other lung disease. If you take into account the inflammation that has probably already taken place in the airways, combine it with this excretion of mucus, you have just reduced the diameter of the airways even more and now you have “things” to cough up.

Spasms: Now let’s talk about spasms. Airway spasms are uncontrollable shaking of our airways, causing you to cough. Now this “shaking” doesn’t have to be very big at all for you to feel it very much. Sometimes they are very, very small, but they still carry with them a strong consequence. The cough that causes the tremor increases the turbulence of the air. This air turbulence, also mentioned above, increases irritation in the airways, increasing inflammation and mucus production, leading to additional irritation, which can cause more spasms, increasing air turbulence, thus that starts the whole cycle again. You can see why symptom management is so important.

Many things are done to manage symptoms. Avoiding triggers is the first thing to do. If you are unfamiliar or unable to “pin down” your symptoms, keep trying. It’s a continuous work in progress, as triggers can change based on the time of year, air quality and environment (both indoors and outdoors) and your ability to avoid them. Then take your medications as prescribed. Do not skip doses or stop taking them if you start to feel better. Many medications are used to keep the airways open and you will only notice how much they help when you stop taking them, which can obviously cause problems. Keep your rescue respirator with you at all times. Store it in your purse, backpack, glove box, briefcase, whatever is most convenient for you, just put it away. You never know when you may be exposed to a new or worsening trigger. Medications can achieve a common goal, but they use different doors to achieve it. We can compare it to your house: it has a back door, a front door, and probably a garage or side door. You can enter “the house” using any door, but each door uses a different route to get you there. Medications are the same way. In this case, they all work to “open” the airways, but there are several different paths they can take to do so, such as calming spasms, decreasing mucus production, or decreasing inflammation. All three maintain the integrity of the airway, all three do it differently.

If you’ve had asthma for several years or are experiencing strong symptoms (and really, even if you haven’t and if you haven’t), you should be very familiar with your medications and triggers and have an action plan in place for it. asthma. An action plan is exactly that – your action plan in case conditions get worse. This plan should be done with the help of your healthcare provider, be it a respiratory therapist, trained nurse, or your doctor, all of whom must be certified for asthma. That plan should include all of your medications, when and how to use them, including how often and when to call your doctor or seek medical attention. It should be specifically described and leave very, very little room for questions about what to do and how to proceed at the various levels of severity (green zone, yellow zone, red zone) as your exacerbation progresses. The phrase “very little” can be used because when dealing with each individual situation it will be something different and unique, like a fingerprint. No symptoms or attacks are exactly the same. There is always enough room for a little extra “surprise” problem to sneak into even the best thought out and well executed plans.

Last but not least, familiarize yourself with your action plan. Hang it in a place where you can easily access it. Keep an extra copy in your wallet. Let your loved ones know what your plan is, where it is, where your medications are, and what you need in case you need help. Asthma prevention is the prevention of symptoms. To be prepared. Know your triggers. Know your plan. Have your medications. And, of course, breathe and smile. You got it!