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Long Term Conditions:

Looking after Asthma - yours or your child's

Asthma is a common condition starting and affecting people of any age. It ranges from very mild intermittent symptoms to life-threatening attacks or severe day to day disability. It causes breathlessness, a recurrent or persistent cough , tightness in the chest (like a band squeezing and restricting the breaths) and wheezing (whistling or rustling noises in the lungs when breathing).

It is due to the small airways (tubes in the lungs) narrowing due to inflammation and muscular spasm in the walls. This can be triggered by different things in different people: allergens like pollen and house dust mite, pollution and fumes - including cigarette smoke, cold air, infections like colds or flu, exercise.

Asthma can come and go and even disappear or it can be with you life-long.

Diagnosing asthma is usually straightforward but sometimes more tests are needed.

Most asthma can be well controlled but it depends on you, the patient, understanding your particular type of asthma, what triggers it and how best to monitor and manage it.

It also is vital you understand how to identify a serious problem - an 'asthma attack' (an exacerbation or worsening) - and respond promptly as asthma does kill around 3 people a day (over 1,200 a year) and this is among the higher rate in Europe. Many of these deaths could be avoided with better management.

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Asthma Attacks

It is important to recognise an asthma attack and act quickly to stop it becoming more serious.
You're having an asthma attack if you are experiencing any of these:

  • Your blue reliever isn't helping, or you need to use it more than every four hours
  • You're wheezing a lot, have a very tight chest, or you're coughing a lot
  • You're breathless and find it difficult to walk or talk
  • Your breathing is getting faster and it feels like you can't get your breath in properly
Sit up straight   Don't lie down. Try to keep calm.

Take your blue inhaler   Take one puff of your reliever inhaler every 30-60 seconds, up to a maximum of 10 puffs.

Call 999 if you don't feel better   Do this if you feel worse at any point, or if you don't feel better after using 10 puffs of your reliever inhaler. Remember to take your written Asthma Action Plan with you to A&E

Take your blue inhaler again after 15 minutes  If you're waiting for the ambulance for longer than 15 minutes, take one puff every 30-60 seconds, up to a maximum of 10 puffs.

Important: This asthma attack information is NOT for people on a MART regime. If you are on a MART regime, speak to your GP or asthma nurse to get the right asthma attack advice for you.

Going to A&E could save your life
Tragically, three people in the UK die from an asthma attack every day. Nearly half of these people die before they get emergency medical care. So if you're having an asthma attack, getting treatment quickly could save your life. Lots of people worry about bothering the NHS, but if you call an ambulance the paramedics can treat you on the way to hospital, saving vital seconds.

Treating your Asthma

There's no cure for asthma but you should be ale to control it and lead a normal life. There are several types of inhaler which can help relieve or prevent symptoms , sometimes tablets and weight loss, exercise (including breathing exercises) and - crucially - stopping smoking, all help. Some people find dietary changes or complementary treatments help for them but this is an individual response.

Inhalers

There are two main types: Relievers (to reduce symptoms when you have them) and Preventers (to stop you getting symptoms and prevent attacks).

Whichever type you use, it is vital to use them properly - and most people don't have good Inhaler Technique. Do you?

There are lots of different types of inhaler so Asthma UK has made these excellent short videos on the way to use each type:

You must take your Preventer inhaler regularly every day, as prescribed, in order to keep your asthma at bay and reduce the risk of an attack. Many people stop them because they think the asthma has gone away or because the inhaler does not seem to do much - it won't seem to and that's how is meant to be!

The Reliever, on the other hand does make you feel better, quickly in most cases and many people end up relying on it , which can be dangerous. You should keep your Reliever with you all the time but well controlled asthma should mean you only rarely need it, if ever. (One of the reasons we may call you in for review, is if we see you using a large amount of your Reliever).

If you use your Reliever more than three times a week it means you do not have good control. Here is more REALLY IMPORTANT information about Relievers and how to use them properly

Preventer inhalers contain steroids. Because these go straight to the lungs they can be given in tiny doses, so they rarely cause side effects. They reduce the inflammation in the lungs which leads to the narrowing of the tubes. Here is REALLY IMPORTANT information about Preventers and how to use them properly.

Combination inhalers are commonly used now as there is evidence they can help control asthma better and can make treatment more convenient. They contain a small dose of Preventer steroid and a long acting Reliever. They must be taken regularly each day, as prescribed. You should still carry a blue Reliever inhaler with your in case you might need it. Information about Combination inhalers

Spacers are often recommended to make inhalers more effective and there are different techniques which you may be recommended to use: tidal breathing and single breath and hold

Tablets are sometimes used, particularly in severe asthma and in young children. Short courses of steroid tablets are important to stop or prevent an attack.

Managing your asthma

Getting to know your asthma, what triggers it, what signs and symptoms you notice and how to manage it is vital if you want to control it and reduce the risks of attacks.

Self- monitoring with the use of Peak Flow testing provides a useful objective assessment. Keep a Peak Flow Diary (download a Peak Flow Diary here - there are also several Apps , though none approved by the NHS yet). This can help you understand the normal course of your asthma and by noticing changes can even help predict when you are heading for a problem. If you make changes to your treatment you can monitor the effects and when you visit the doctor or nurse you should always take your record with you. You can obtain a Peak Flow Meter on prescription.

Make sure you have a Personal Care Plan - fill in an Asthma Action Plan online and print or save to your devices - do it with the help of the Nurse or Doctor and keep it handy for reference and take it to your appointments. In it you will have written a manual for your own asthma and how to respond to changes in signs and symptoms with changes to your medication. In this way you will become your own doctor, stay safe and well-managed and reduce the risk of attacks.

Come for an annual Asthma Review. - we'll call you in your birth month and you should bring your Peak Flow Diary and Asthma Action Plan and all your inhalers. We'll send you some assessment questions by eConsult to complete. What happens at the Annual Review? It is your chance to look at your asthma in detail; how well it has been managed and how it has affected you in the past year and if you have identified any triggers and what you might do to avoid them. It's a chance to review your treatment and any other health issues affecting your asthma and carry out a few checks and update your Asthma Action Plan.

Contact us any time if you are concerned about your asthma.
We hope you will have enough reorders to manage your asthma and to ask for help when things are beginning to be a problem for you, well before it becomes a restriction or an emergency.

There is a wealth of advice on Living with Asthma on the Asthma UK site. Also information about Complementary Therapies.

Children's asthma

Diagnosing asthma in children can be a bit different and will depend a lot on parents' observations.

You may notice a recurrent cough at night or in the early morning or after exercise, or a long-term cough which doesn't go, maybe a whistling sound in the chest (not the nose), usually when breathing out, or possibly your child rubs their chest or tummy saying it hurts or feels funny (chest tightness). You need to watch for signs of rapid breathing at rest or using more effort to breath, maybe with the shoulders going up and down. They may get out of breath more than normal when playing, and they may avoid talking because it's hard to talk when you're short of breath or they may avoid exercise.

If your child is struggling to breathe, dial 999 maybe with the skin sucking in between the ribs or the front of the throat, the tummy going in and out more than usual, or 'gulping' air or not being able to finish sentences, and act extremely urgently if they then start to become pale and go very quiet or have blue lips.

Treating children's asthma is also a bit different as inhalers can be difficult to use and a frightening for the child. The use of a spacer with a mask or a spacer without a mask may make the treatment much easier and more effective. Looking after a child with asthma can be sometimes scary and challenging but more often can be very well managed and there is plenty of good advice for parents from Asthma UK.

The 'one-stop shop' for information and resources about your asthma. With its origins in 1927, Asthma UK is now merged with the the British Lung Foundation to create a powerful research funding and educational organisation hoping to stop asthma attacks and one day finding a cure. This short video says what they do  HELPLINE: Tel 0300 222 5800 for independent, confidential advice.
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