diagnosed with asthma: managing support, resources and triggers
8 minute read
overreliance on rescue inhaler medications—using them more than twice a week on average—can have health consequences, making symptoms worse.
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asthma is a chronic lung disease that is often underestimated when it comes to the impact on daily life. while most of us are familiar with the telltale symptoms of wheezing, coughing and shortness of breath, the challenges that people living with asthma face often go overlooked. the main issue is that asthma is unpredictable. with triggers like air quality, stress or a change of weather, people have to deal with the anxiety of not knowing when the next attack will strike. so, how do you plan activities or travel, or commit to a work deadline?
experts say that managing asthma takes vigilance, emotional resilience, and lifestyle adjustments. most important, a diagnosis should be a call to action to take care of yourself and let your circle of friends and family know what you’re dealing with.
as jeffrey beach, president and ceo of asthma canada stresses, “one of the things that we’re really trying to do is not just raise awareness about asthma but raise concern as well because it tends to be a disease that people downplay. we’ve even heard stories of families who say that their loved ones who unfortunately passed away following an asthma attack had literally said to people around them, ‘oh, don’t worry, it’s just my asthma’ as they’re gasping for breath.”
asthma is serious, he says. “for me, the most rewarding thing is to really try to change that narrative and get these stories out so that people can learn from them and understand what asthma control really is.” he has mild asthma himself, so brings a deeper level of understanding to his role and a passion to help people on their own journey.
for people newly diagnosed, here are steps to take to get the best care and learn how to take control of your disease.
ask for help from the experts
“for most of us, you’re diagnosed with asthma, you’re sent home with some medication, and then it’s like you’re on your own,” beach says. advocates would like to see a pathway similar to diabetes where people typically are referred to a diabetes educator so they can learn extensively about disease control. “diet, exercise, medication, all those things with asthma isn’t usually very well managed,” he says.
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through its services as a health charity, asthma canada offers certified respiratory educators to counsel patients and families, but there’s a need for more of these practitioners in community-based healthcare. many of these educators are respiratory therapists with additional training for certification, while nurses, pharmacists and other healthcare providers can pursue certification to meet the rising need for asthma support and education. call asthma canada at 1-866-787-4050 or email info@asthma.ca to be connected with a certified respiratory educator.
with 4.6 million people in canada living with asthma, research shows that only one in two have their condition under control–and uncontrolled asthma can lead to severe illness, hospitalizations and even death.
learn about asthma and what good control looks like
asthma is all about the respiratory system where the disease causes inflammation and tightening of the airways, making it difficult to breathe. when you’re diagnosed, typically you’re given two types of medication: a controller and a reliever or “rescue medication.”
the controller is usually an inhaled corticosteroid for everyday use to control the symptoms of the disease. just as it sounds, the rescue medication inhaler is designed for managing symptoms when you’re exposed to an asthma trigger, like pollen, dust, dust mites or wildfire smoke.
beach says that education is key for people to understand that asthma is a disease that should be taken seriously and for most people, should be controlled. “you should be able to live the life that you want to in terms of having asthma not affect your daily life. but if you don’t take it seriously and you don’t ensure that it’s controlled properly, then it does have potential to impact your life.”
mental health is a common issue, and some of it relates to the stigma of asthma and the perception of the “weak kid with the inhaler,” he says of kids who are made to feel outcast and different because they need help breathing and use an inhaler. that perception and self-consciousness follows through to adulthood.
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there’s also the tendency when people have a chronic disease that they don’t perceive as necessarily life-threatening, they want to put it to the backburner. people don’t want to have to deal with something all the time, and they don’t want their families to worry about it too, beach explains. “people will say, ‘oh, yeah, i have asthma, but it doesn’t affect me. once in a while it flares up.”
so, what is good asthma control? ideally, you shouldn’t be having any breathing difficulties, coughing or wheezing most days. while you’re going to have days where your asthma symptoms are flaring up, but if that’s happening frequently, then you should start to question whether your asthma is controlled or not. good asthma control means you’re not needing to use a reliever or a rescue inhaler as a rule. but if you’re using a rescue inhaler more than twice a week, that’s a good indicator that your asthma is not well controlled. “some people don’t even keep track of how often they’re using it,” he says.
“i think that’s often an eye-opener for people who say their asthma is well controlled because they have a way to deal with it.”
other signs of good asthma control would be sleeping through the night without being woken by symptoms like coughing, wheezing, chest tightness. on the flip side, people whose asthma is not well controlled tend to have a lot of difficulty with sleeping, which impacts other aspects of your health and mental well-being.
another red flag is missing school or work due because of asthma, or “presenteeism,” where people are going to work, but not performing at their best because they’re not feeling well.
asthma canada has a library of webinars with healthcare professionals talking about asthma and good asthma management for self-advocacy and learning.
connect with your care team
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working with a respirologist or allergist on a treatment plan and continued monitoring is important for chronic management. they can test your lung function to determine what’s working and what’s not in terms of medication and lifestyle. most people with severe asthma have tried at least seven different medications before they find something that works, so it can be difficult to manage.
building a good relationship with your specialist can also help you access new medications, like biologics, which are a different type of controller medication that helps with the inflammatory response that’s involved in asthma. “there are people who have for years been suffering with severe asthma, who have been put on to biologic medications who have now found a whole new lease on life. they were people who couldn’t walk with their family or had difficulty climbing stairs. now their asthma is well treated because of the new biologic drugs.”
as well, overreliance on rescue inhaler medications—using them more than twice a week on average—can have health consequences, making symptoms worse. these medications are not designed to be used all the time, so you should have your medication assessed.
exercise is good for your lung health
conventional thinking was that exercise could bring on an asthma attack, but that’s changed. exercise should be something that’s not limited by asthma that is under control. people may need to take medication before they exercise or monitor their heart rate during activity, but movement is medicine. it improves lung function, strengthens breathing muscles, and benefits overall health and immunity. talk to your doctor about how to exercise so it works well for you with an appropriate warmup, cooldown and how to get started.
as researchers in brazil wrote in 2023 for frontiers in rehabilitation sciences, “asthma is associated with increased anxiety and depression symptoms, medication use, and reduced lung function, sleep quality, and physical activity levels, leading to impaired quality of life. in contrast, exercise training improves almost all outcomes in patients with asthma.”
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manage your triggers
another part of living well with asthma is trigger avoidance and trigger management. there are common triggers, but people can react differently to each one. some people have reactions to perfumes and need scent-free workplaces, for example, or experience wheezing from smoke, pet dander or pollen. air quality in general is something that people need to monitor, referencing air quality data with the understanding that, “especially in the summer with really bad air quality days, it might be a good day to just stay indoors or at least not do any strenuous activities outdoors where you’re breathing more.”
as beach explains, “it really is a bit of trial and error.” asthma canada has created an asthma action plan for people to download to document symptoms and discuss management strategies with their doctor.
know that asthma is not just a breathing problem
asthma has a number of related health conditions to be aware of, like nasal polyps, that can happen with chronic rhinosinusitis (stuffy nose). nasal polyps develop in the cavities of the nasal system and are difficult to treat. some people who have these find it even more difficult to breathe when asthma symptoms flare up, and they can also lead to loss of smell. talk to your doctor about treatment.
loss of smell means more than not being able to taste and enjoy food, there are safety issues, like not being able to smell smoke in the case of fire or not realizing that a food item has spoiled.
a 2020 study in nature outlined other comorbidities that can influence asthma management include gastroesophageal reflux disease (gerd), obstructive sleep apnea (osa), vocal cord dysfunction and obesity.
do a basic self-check
asthma canada is launching the a.c.t. on asthma campaign, urging people with asthma to take three crucial steps toward better asthma management:
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t talk to your doctor about managing your asthma effectively.
“people with asthma can live well. most people with asthma who are managing the disease properly with medication and other asthma management strategies can live symptom-free lives, and that’s something we want people to understand.”
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