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Asthma

Asthma treatment

This page talks about asthma treatment and explains how you can manage your asthma symptoms. On another page, we give detailed information about asthma medications and how to take them.

There is no cure for asthma, but you can treat it and manage your symptoms. With proper asthma treatment, you should be almost symptom-free and enjoy an active life.

Asthma is a long-term disease – you have it all the time, even when you don't feel the symptoms. To stay healthy and safe, follow your asthma treatment every day, even on days when you feel fine.

Take these steps to manage your asthma:

  1. Work with doctor to get your asthma under control
  2. Follow your written asthma action plan
  3. Avoid your asthma triggers: smoke, cold air, etc.
  4. Avoid your asthma inducers: allergies, viruses, etc.
  5. Use your asthma medications as prescribed
  6. Know what to do in an asthma emergency (asthma attack)

1. Work with your doctor to get your asthma under control

For most people with asthma, it's possible to achieve good asthma control. If you have a lot of asthma attack or a lot of symptoms, your asthma is probably not as controlled as it could be. See you doctor, and ask for help getting control of your asthma.

Signs you have good asthma control

Your asthma is under control if:

  • You have daytime symptoms less than four times a week
  • You don't miss school or work because of asthma symptoms
  • Your asthma doesn’t get in the way of exercise and physical activity
  • Symptoms disturb your sleep only one night a week, or not at all
  • You need your rescue medicine (blue puffer) less than four times a week
Signs your asthma is not controlled

Your asthma is out of control if:

  • You wake up at night because of coughing, wheezing or feeling short of breath more than once a week
  • Your rescue medicine (blue puffer) doesn't work quickly or completely to relieve your asthma symptoms
  • You are using your rescue medicine (blue puffer) more than three times a week
  • Your asthma symptoms are stopping you from doing regular activities like exercise

If you have any of these signs of poor asthma control, see your doctor. Follow your doctor's advice.

Ask your doctor for a written asthma action plan that tells you how to manage your symptoms. If you don't have an asthma action plan, print one and ask your doctor to fill it in. Your doctor can explain what you should do if you are running into problems with your asthma. You can also ask a Certified Asthma Educator or Certified Respiratory Educator to explain how to use your asthma action plan to manage your asthma symptoms.

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2. Follow your written asthma action plan

To take the guesswork out of managing your asthma, use an asthma action plan. Your asthma action plan tells you:

  • What symptoms you should watch for
  • What your symptoms mean
  • How to adjust your medication according to your symptoms
  • When to call the doctor or 911

Ask your doctor to fill out an asthma action plan for you. Make sure you understand what the plan says. If you have any questions, ask your doctor. You can also talk about your action plan with a Certified Asthma Educator or Certified Respiratory Educator, a healthcare professional with special training in asthma management.

Download your asthma action plan (PDF). Asthma Action Plan
Asthma diary card

This asthma diary card can help you keep track of your symptoms. Use the diary card to record your symptoms every day. You and your doctor or Certified Asthma Educator can look at your diary card to see if there is a pattern to your asthma symptoms. For example, your diary card might show that they are certain days your symptoms are worse. You can ask yourself “What am I doing on the days I get worsening asthma symptoms?” It could be your asthma is worse on days you go to a smoky bar, or on days you mow the lawn. The diary card can help you see patterns in your symptoms and figure out the things that make your asthma worse- your triggers and inducers.

If your doctor has changed your medicine or dosage, it's also a good time to record your symptoms on a diary card. That way you can see if your symptoms get better after the change in your medication.

Download your asthma diary card (PDF)

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3. Avoid your asthma triggers

The best way to control your asthma is to avoid your asthma triggers. Asthma triggers are things that make your asthma symptoms worse by irritating your airways. Asthma triggers make the muscles around your airways squeeze tightly. This muscle tightening can make you wheeze, cough, and feel short of breath.

Asthma triggers cause symptoms that:


Each person has his own set of asthma triggers. Some common asthma triggers are fumes, smoke, and exercise. The table below gives more information on asthma triggers and how to avoid them.

Common asthma triggers, and how to avoid them

Trigger What you can do
Exercise

Exercise is a trigger for many people who don’t have good asthma control.
  • Make sure you have good asthma control before exercising
  • Warm up slowly before you exercise and do gentle cooling down exercises afterwards.
  • Keep your rescue medicine (blue puffer) close by.
  • Follow your asthma action plan. If it tells you to take your rescue medicine (blue puffer) before or during exercise, take it.
  • Slowly increase the amount of time you exercise. Don't push it and do more exercise than you can handle. Give yourself time to get into shape.
  • Read more about Exercise and asthma
Cold air

You might breathe cold air outdoors or at an ice rink.
  • Drape a scarf loosely over your nose and mouth, to warm and humidify the air before you breathe it in. You could also wear a cold-weather face mask made for exercising oin cold weather. You can buy a cold-weather mask at a sporting goods store.
  • Try breathing through your nose; your nose can warm and humidify the air before it gets to your lower airways.
  • If your doctor recommends it, take a dose of your rescue medicine (blue puffer) before you go outside
Smog

Smog can happen anytime of the year, but it's most common from May to September.

Smog can trigger asthma symptoms right away. It can also trigger symptoms that you notice later on, even the next day. Read more about smog.
Other pollution and fumes

There are many sources of fumes, indoors and outdoors:

Wood smoke: Smoke from fireplaces, grills, wood heaters and chimneas contains many harmful chemicals. Wood smoke can cause asthma symptoms right away and make asthma worse over time.
Exhaust fumes from cars and trucks can also trigger asthma symptoms and cause long-term damage to lungs.
Household chemicals with strong fumes (for example, oven cleaners) can trigger symptoms. If at all possible, do not heat your home with wood. If you must heat with wood, follow these tips to reduce wood smoke.
  • If at all possible, do not heat your home with wood. If you must heat with wood, follow these tips to reduce wood smoke.
  • Avoid outdoor bonfires, chimineas, and other open burning.
  • If possible, avoid spending a lot of time in places that are less than 150 metres (500 feet) from a busy road or that are near a road used by diesel trucks. (A busy road is a road that has 15 000 vehicles or more per day).
  • Use safe, environmentally-friendly cleaning products like vinegar and baking soda, instead of harsh chemicals. Read about alternatives to harsh cleaners on the non-profit website TheLessToxicGuide.ca.
  • Wear a protective equipment like a mask when you’re dealing with chemicals. Follow the instructions that came with the chemical product. You may have to use it outdoors, or with a venting chamber.
Hot, humid air
  • On very hot, humid days, especially days that are also smoggy, stay indoors in a clean air-conditioned place. (Make sure the place you choose has clean air – this means no tobacco smoke, no harsh fumes, etc.).
Scents

Chemicals from perfume and cologne, fabric softener, air fresheners (and many other products) can make asthma worse.

Read more on scents and how to avoid them
  • Avoid using perfumes, and ask the people you work with and live with to avoid them as well.
  • Make sure your soap, body lotion, shampoo, detergent, etc. are scent-free. Read more about scents.
Emotional upsets, anxiety

Feeling stressed, laughing or crying can all make asthma worse.

Feeling anxious about getting an asthma attack can also make your asthma worse.

A Certified Asthma Educator can help you understand your asthma, what to expect, and what to do if you feel symptoms coming on.

If you know what to do if you are having breathing problems, you can feel more in control and less anxious.
  • Take your blue rescue inhaler as directed
  • Try some relaxation and breathing techniques
  • Ask a Certified Asthma Educator or Certified Respiratory Educator for help in dealing with anxiety about asthma.
  • If you have a lot of stress and your asthma is getting worse often, see your doctor for more advice on how to cope. People who learn how to relax and control their stress can have fewer asthma symptoms.
Hormones

Some women notice worsening asthma symptoms at the time of their period.

Pregnancy also can make asthma symptoms worse.
  • Follow your asthma action plan if you're having trouble.
  • Pay special attention to your asthma during pregnancy, to keep you and your baby safe and healthy. Learn more about asthma in pregnancy.
Smoking

Smoking is unhealthy for everyone, but it’s especially bad for people with asthma.

If you have asthma and you smoke, your asthma symptoms will be much worse.
  • If you don’t smoke, that's great. Do not start smoking.
  • If you do smoke, get help to quit.

When people with asthma quit smoking, their lung function improves quickly. They can move more air in and out of their lungs. Their lung function can improve in as little as one week after quitting.1 If you have asthma and you quit smoking, you’ll notice benefits right away and in the long term. Learn about how to quit smoking and where to get help.

Second-hand and third-hand smoke

Second-hand smoke (also called ETS) can come from cigarettes, cigars, cigarillos, pipes and marijuana. Read more about second-hand smoke.

Third-hand smoke is the smoke that drifts into the air and gets trapped in hair, skin, fabric, carpet, furniture, walls and toys. It builds up over time. Each time someone smokes, more smoke gets trapped in the things around them. If you are in a room or car where people usually smoke, even if they aren't smoking right then, you are exposed to third-hand smoke. This means you are exposed to toxic chemicals like lead and arsenic. Read more about third-hand smoke.

Other asthma triggers: Workplace triggers, food triggers

Some people have asthma triggers at work – things like smoke, fumes, or cold air. If your asthma is triggered by something at work, you have work-exacerbated asthma. Read more about work-exacerbated asthma and what to do about it.

Most people's asthma triggers are inhaled (breathed in). But for some people, asthma symptoms can be triggered by things they eat, drink, or swallow. These are some other asthma triggers:

  • Sulphites, chemicals used to preserve some food, like dried fruit and red wine
  • MSG (monosodium glutamate), a flavour enhancer use in food
  • Aspirin

Some people with asthma also have food allergies. People with any allergy that causes anaphylactic shock should keep their epinephrine kit (EpiPen©, EpiPen Jr.©, Twinject©) with them at all times.

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4. Avoid your asthma inducers

Another great way to control your asthma is to avoid your asthma inducers. Asthma inducers are things that make your airways swollen, red, and filled with mucus. Each person with asthma has their own set of inducers. The inducers that affect one person may not affect another person.

Common asthma inducers include:


Asthma inducers give you symptoms that:


Viral infections: colds, the flu, and other viruses

Viruses like the cold and flu can infect people's airways and lungs. Viral infections are a common cause of asthma symptoms. In children, cold and other viral infections are the number one cause of worsening asthma symptoms. Some viruses that can cause lung and airway infections are:


If you avoid catching viruses, you will have fewer asthma symptoms. Here are some ways to avoid viruses and prevent viral infections:


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Allergies

Many allergies can bring on asthma symptoms; you may be allergic to pets, pollen, mould, dust, or something else. Read more about allergies and asthma and learn about common allergens and how to avoid them.

Some people have asthma inducers (including allergens) at their workplace. They may have asthma symptoms from working around lab animals, mould, dust, shellfish, or another allergen. If your asthma is caused by – or worsened by – something at your work, it's called work-related asthma. Read more about work-related asthma.

How do I know what my asthma triggers and inducers are?

To find out about your triggers and inducers, get allergy tests and pay attention to your symptoms. Skin prick testing, done by a specialist doctor called an allergist, can show what you're allergic to. Learning your other inducers and triggers may be a little more difficult. It helps if you pay attention to when and where your asthma gets worse. Is it when the air is cold? When you are near your neighbour's cat? Paying attention to your symptoms will give you clues about your triggers and inducers. Try using an asthma diary card to keep track of your symptoms and your surroundings. Show your asthma diary card to your doctor or Certified Asthma Educator or Certified Respiratory Educator for more help.

Asthma triggers and inducers can work in combination

Keep in mind, asthma triggers and inducers can work in combination. For example, if your airways are already swollen because you have a viral infection, and then you go into a smoky room, your airways are less able that usual to cope with the smoke. The inducer (the viral infection) and the trigger (the smoke) “gang up” to make your asthma worse.

Don't get rid of every possible asthma trigger and inducer – just the ones that set off YOUR asthma

Each person with asthma has their own set of triggers and inducers – things that make their asthma worse. Find out what makes your asthma worse, and stay away from those things. If your asthma gets worse when you're around dogs, stay away from dogs. If your asthma is worse when you mow the lawn, ask someone else to mow it. It's expensive and time-consuming to get rid of every possible asthma trigger and inducer around you – and it's not necessary. You don't have to get rid of every possible asthma trigger and inducer, just the ones that bother you.

5. Take your asthma medications as prescribed

To keep your asthma well-controlled and to prevent asthma attacks, it's very important to take your asthma medications exactly as prescribed by your doctor. Taking your medication regularly means you can avoid asthma emergencies.

Many people think they can skip their asthma preventer medications when they don't feel any symptoms – that's not true. Asthma is a chronic (long-term) disease. If you have asthma, you have it all the time, even when you don't feel symptoms. You have to manage your asthma every day, not just on days when you feel symptoms. Follow your doctor's advice and take your asthma medication as prescribed.

Read more about asthma medications and how to use them.

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References

1. Chaudhuri R. et al. Effects of smoking cessation on lung function and airway inflammation in smokers with asthma. Am J Respir Crit Care Med. 2006 Jul 15;174(2):127-33. Epub 2006 Apr 27.