by Stewart B. Segal, MD
SERVICE MANUAL – ASTHMA
Patients with asthma require the same routine yearly preventative exams as those without asthma. In addition, they require daily exercise, maintenance of a smoke and toxin free environment and quarterly office visits to maximize their care. Asthma has to be controlled! In a previous article, I noted that ten people die every day from asthma. That truly is a shame as asthma is controllable.
People with asthma should have an “Asthma Action Plan”. They should know what to do when their asthma is quiescent and what to do when it flares. They should always be on guard even if they have “just a little asthma”. There is no such thing as “just a little asthma”. An asthmatic who has mild episodic asthma and has never had a severe attack could, at any moment, have a life threatening attack. Asthmatics should always have their rescue inhaler at the ready.
On a daily basis, patients with asthma should grade their lung health using the Asthma Control Test (ACT – www.asthmacontrol.com/). Scores above 19 are normal. Scores of 15 or less demand attention. Please see your doctor for advice and further care.
Even well controlled asthmatics should have quarterly or biannual medical checkups. Those visits should include a careful review of your home ACT scores, activity levels and limitations, blood pressure monitoring, pulse oximetry monitoring (oxygen level), an exam of mouth and nasal passages, heart and lungs, as well as pulmonary function testing (spirometry).
Yearly, patients with asthma should have spirometry, a complete physical with appropriate laboratory testing and other tests as dictated by age and severity of the disease.
If caught early and treated aggressively, with avoidance of inhaled irritants, allergens, smoking cessation, exercise and medication (when necessary), the scope of the disease can be seriously limited. As stated earlier, control is essential if we ever expect to lessen the impact of asthma on our children, ourselves and society.
Your lungs are precious. Breathing air is essential. Never smoke and if you smoke, stop smoking now! Asthma often goes undiagnosed and is mistaken for recurrent upper respiratory tract infections and bronchitis. If you have repeated respiratory infections, find yourself short of breath with exercise or simply cough too much, see your doctor. A simple spirometry test can help diagnose asthma or COPD.