Asthma

Living with asthma

How can I manage my symptoms?

Keeping your asthma under control means you rarely have asthma symptoms. The best way to manage your asthma symptoms is to prevent them.

This means taking your controller medications every day, even when you don’t have symptoms. But sometimes symptoms might happen.

The common symptoms of asthma are coughing, breathlessness, tightness of chest and wheezing. When this happens, you need to take some steps:

  • Stop what you are doing.
  • Take your reliever medication.
  • Wait for the symptoms to go away. This should start to happen quickly, and your symptom should be gone within 10 minutes.

Speak to someone on your healthcare team about your asthma control if:

  • You need to take your reliever more than twice a week. OR
  • You wake up at night or early in the morning with asthma symptoms. OR
  • You are having symptoms during activity more than twice a week.

What can I do to prevent getting sick?

Taking your controller medications regularly is a good way to control your asthma and prevent symptoms. Avoiding triggers, following your Asthma Action Plan , quitting smoking and getting vaccinated are other powerful ways to stay well, even with asthma.

Quitting smoking

Smoking tobacco is particularly bad for people with asthma for two reasons.

  1. Tobacco smoke irritates the airways every time you inhale smoke. This irritation causes more inflammation making the airways more sensitive. This makes it harder to control symptoms.
  2. Tobacco smoke prevents some of the effect of ICS. These medications do not work as well if you smoke. This makes it harder to control symptoms.

Quitting smoking is difficult for most people. But there is help! In fact, counseling and medication gives you the best chance to quit smoking for good. There are different medications to help you. You may use these on their own or two in combination. The medications include:

  • Nicotine replacement therapy (NRT) – patches, gums, sprays, or lozenges. These provide you the nicotine your body craves.
  • Champix® (varenicline) – this medication needs a prescription. It works at the same spot in the brain as nicotine. This helps stop craving and withdrawal. It also does not allow nicotine to work in the brain making smoking less satisfying.
  • Zyban® (bupropion) – this medication needs a prescription. It is believed to work with the chemicals in your brain to help stop craving and withdrawal.

Medication works best when paired with counseling. Your healthcare team can help you create a plan to quit smoking that includes methods to manage cravings and withdrawal. For more information see https://www.lung.ca/tobacco

Vaccines

Vaccines (shots) for flu, COVID-19 and pneumonia help protect you against these illnesses and lower your chance of a flare-up.

You need to get a flu shot every year to be protected. The flu vaccine is effective in lowering your chance at having a severe flare up of asthma.

Avoid your triggers

One of the best ways to prevent an asthma flare up is to avoid things that trigger your asthma. These ‘triggers’ are things that make your lungs to over-react and cause asthma symptoms. Each person has their own set of triggers. Some triggers are irritants, some are allergies and others include lung infections, hormones, and emotions.

The table below gives more information on asthma triggers and how to avoid them.

Trigger

What is it?

What can I do?

Tobacco smoke

  • Tobacco smoke causes your airways to be irritated and inflamed and are more sensitive.

  • This includes second-hand and third-hand smoke

 

Tobacco smoke makes it harder to control your asthma. Inhaled corticosteroid medications do not work as well when you smoke.

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

Third-hand smoke is the smoke that gets trapped in hair, skin, fabric, carpet, furniture, walls, and toys. 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, you are exposed to third-hand smoke.

  • Speak to your health careteam about quitting.

  • Make your home and car completely smoke-free.

  • Avoid smoke at work.

  • Stay away from smoky places like bars and clubs.

  • Speak to your friends and family about not smoking around you.

  • If you must visit someone who smokes inside, speak to your healthcare team about steps you can take to protect your lungs.

Air pollution

  • Air pollution can trigger asthma symptoms right away or in a couple of days.

Air pollution can happen anytime of the year, but it is most common from May to September.

It is caused by vehicle exhaust or factory emissions of tiny particles that are carried by air, and then breathed deep into your lungs. It is also caused when the exhaust or emissions are exposed to sunlight making ozone that can be breathed into the lungs.

Air pollution is worse on hot, sunny or windy days.

  • Pay attention to the air quality reports on the news. Or visit  weather.gc.ca to find out the air quality in your area.

  • Stay indoors in air conditioning on bad air days if possible.

  • Exercise early in the morning or after dark if possible.

  • Consider wearing a mask with a charcoal filter if outdoors during bad air quality days.

  • Consider electric powered vehicles and low emission heating, cooking, and cooling.

Wood smoke

  • Smoke from any source can irritate the airways and cause inflammation and more sensitive airways.

  • Wood smoke can cause asthma symptoms right away and make asthma worse over time.

Smoke from fireplaces, grills, wood heaters and chimneys contain many harmful chemicals.

 

If at all possible, do not heat your home with wood. If you must heat with wood, follow these tips to reduce wood smoke.

Other ways to avoid wood smoke include staying away from outdoor bonfires, chimneys, and other open burning when possible.

Weather

  • Cold air in winter can make sensitive airways over-react and the muscles around them to spasm.

  • Hot, humid air can also make sensitive airways over-react like cold air. Hot, humid air can also cause some inflammation as it can make air pollution worse.

Cold air can cause cough or other asthma symptoms when the airways cool. The symptoms should not last after you enter a warm place.

 

Hot, humid air can also cause problems with breathing. This can be because we breathe faster when we are hot, and our airways might get warmer than normal.

Cold air:

Hot, humid air:

  • Stay indoors on hot humid days.

  • Use air-conditioning if possible. If not possible, keep windows and doors closed during the heat of the day and use fans. (fans blowing over a bowl of ice can help cool the air)  A dehumidifier can help dry the indoor air if you do not have an air-conditioner.

  • Don’t exercise or other heavy activity during the heat of the day.

  • Check air quality reports.

  • See “How to protect your lungs on hot and humid days” for more information.

Products with strong scents

  • For some people, scents cause their airways to over-react and the muscles around them to spasm.

Examples of things with strong scents include cleaning products, laundry products, candles, body wash and soaps, perfumes, deodorants, etc.

 

  • Use scent-free products when possible.

  • Use low-odour paints.

  • Discuss scent-free policies at work and school.

Allergies

  • Not everyone with asthma has allergies. You will need to be tested to find out if you have allergies.
  • Allergies can cause the airways to become inflamed and more sensitive. The symptoms can last for days after you breathe in an allergy.

Many allergies can bring on asthma symptoms. You may be allergic to:

  • dust mites,
  • dander from furry or feathered pets,
  • mold
  • cockroach
  • tree or grass pollen

Steps to lower your exposure to allergens should only be used if you have a diagnosed allergy.

  • There is little or no evidence that taking steps to reduce dust mites, including removing carpets and hot water washing etc. improves asthma control.
  • There is little to no evidence that taking steps to remove dander including removing pet from home or bedroom, HEPA-filter air cleaners, removing carpets etc. improves asthma control.
  • There is some evidence that reducing the dampness and molds in home improves asthma control.
  • There is some evidence that baits to remove cockroaches improves asthma control.
  • Closing windows and doors and remaining in air-conditioned spaces during high pollen and mold count days. Air quality and weather reports may include this information.

Lung infections

  • Viral infections can cause the airways to become inflamed and more sensitive.

 

Viruses are the cause of the common cold and the flu.

There are many different types of viruses that cause the common cold. Rhinovirus, coronavirus, RSV, and parainfluenza are a few. These may only cause sore throat and sneezing, coughing and stuffy nose.

 

There are two main types of influenza virus that cause the flu. These viruses have many subtypes and each year a different group of subtypes is most active.

Viral lung infections are the most common cause of asthma flare-up in children.

Influenza can cause pneumonia and severe illness in some people.

  • Wash your hands
  • Try not to touch your eyes, nose, or mouth with unwashed hands.
  • Stayaway from people who have a cold, or the flu is also very helpful.
  • Get your flu shot every year can help protect you against the flu.

Hormones – premenstrual and pregnancy

  • Poor asthma control during pregnancy can result in more problems for the baby and mother. The baby is more likely to be born early or have low birth weight. The mom is more likely to develop pre-eclampsia (high blood pressure).

Asthma symptoms flare-up for about 1 in 5 women in the two weeks before their period begins. Women who are more likely to have this happen have more severe asthma, are older, have premenstrual syndrome and are overweight.

 

About one-third of pregnant women find their asthma symptoms are harder to control during their pregnancy.

  • For some women, oral contraceptives can help control their asthma during their cycle. Anti-leukotriene receptor antagonists may help control some women’s asthma during their cycle.

 

  • Continue your controller medications during pregnancy. This is important to your health and the health of the baby. Asthma controller medications have few risks to the baby, but uncontrolled asthma has much greater risk to the baby.

Emotions

  • Emotional stress can cause symptoms of asthma due to narrowing of the airways.

Breathing fast due to stress or emotions, like laughing, crying, anger, and fear can be a cause of airway narrowing.

 

Panic attacks also cause fast breathing and feelings of breathlessness. Panic attacks can cause airway narrowing.

 

Have a plan to help you manage your emotional stress.

  • Relaxation activities, like breathing exercises, progressive muscle relaxation, guided imagery, yoga etc. can help prevent the effect of stress on you and your asthma.
  • Physical exercise can help with relieving the effects of stress on you and your asthma.

Exercise

  • Exercise can cause narrowing of the airways and asthma symptoms if you do not have good control of your asthma.

Exercise causes us to breathe faster. However, exercise is helpful in many ways, including strengthening your heart and lungs, reducing the effects of stress, managing body weight.

There are a number of things you can do to help you exercise safely, including:

  • Make sure your asthma is in control.
  • Avoid triggers, like air pollution, weather extremes, pollen (if you have allergy) when you exercise outdoors.
  • Warm up and cool down when you exercise.
  • Remember if you need to take your reliever due to symptoms, take it. But, if you are needing it for exercise more than twice a week, speak to a member of your healthcare team. Follow your Asthma Action Plan

Workplace triggers

  •  Occupational asthma causes the same changes in the airways as other causes of asthma. Over time, the symptoms can become worse, even dangerous.
  • Some people with asthma symptoms at work notice they do not have the same symptoms when on holiday or even a long week-end.

Some things in the air in workplaces (like grain or flour dust, wood dust, paints, fumes and more) can cause asthma to develop for some people who did not have asthma.

 

Some things in the air at work can cause asthma symptoms to flare up for people who already have asthma, like smoke, fumes, cold air, animals, dust, etc.

Pay attention to your symptoms and when they occur. Some people find it easier to track this using an asthma diary.

If you think your workplace is causing asthma symptoms, speak to your healthcare team. There are tests that can help find out if this is the case.

See the occupational asthma webpage from the Canadian Centre for Occupational Health and Safety more information.

An asthma diary can be any way you choose to record your symptoms, reliever medication use, missed doses of controller and your activities. This information can assist you and your healthcare team to keep your asthma under good control.

Follow your Asthma Action Plan

An Asthma Action Plan contains information to help you manage your asthma at home. Your asthma action plan is designed just for you. It tells you what steps to take when your asthma is in control, when you are beginning to lose control of your asthma, and when you need to seek medical help. You and your healthcare team provider should work together to develop your asthma action plan. Most are based on the traffic light system – where Green means your asthma is in control, Yellow means your asthma is not in control and symptoms are happening, Red means you need to seek medical attention now.

Here are the basics:

Zone

Symptoms

Actions

GREEN ZONE

Your asthma is in control.

You take your reliever less than three times a week for any reason.

 

You take your controller regularly.

You avoid your triggers whenever you can.

You are active.

YELLOW ZONE

You are having symptoms for two days in a row. OR

You are waking at night or early morning due to asthma symptoms once a week. OR

You are missing activities due to asthma symptoms. OR

You find exercise more difficult due to asthma symptoms.

Take your reliever when needed.

Keep taking your controller medication.

Follow the instructions your healthcare team member has given you about what other medications to take.

RED ZONE

Your reliever does not stop your symptoms, or only works for a short while (less than 4 hours).

Your symptoms did not get better following the Yellow Zone instructions.

Your symptoms are getting worse.

You are scared.

See your healthcare team immediately.

If you cannot see your healthcare team, go to the Emergency Department or Urgent Care Centre.

If you are scared or are having trouble breathing or things are getting worse, call 911 and go to hospital immediately.

An Asthma Action Plan is a “living document” – this means it can be changed when needed. You should discuss your asthma action plan with your healthcare team after each time you need to take Yellow Zone medications or if you ever are in the Red Zone. You might also speak to your healthcare team about your asthma action plan when your asthma is in good control for a couple of seasons.

Download your Adult Asthma Action plan for those over 12 years old (adult) and for kids from 1-12 years old here. Download your Peadiatric Asthma Action plan here.

There are other things that can help you live well with asthma. For more information see Healthy Living with Asthma.

Speaking with your healthcare team

Tips for working with my health care team?

Working closely with your healthcare team can help best manage your health. Here are some things that can help you.

  • Prepare a written list of the questions you want to ask. Put the most important questions at the top of your list. Tell your team that you have questions when you meet with them.
  • Take notes when your question is answered. If you do not understand the answers, ask for more details.
  • Show your healthcare team a written list of all your symptoms. Be honest. It will help them see the whole picture.
  • Bring along all your medications or a list of all your medications (including herbal remedies).
  • If you are not sure you are taking your medication correctly, ask for a review of when and how to take them.
  • Bring a friend or relative to your appointment. He/she can help you remember details and take notes for you.
  • Ask about programs in your community that help people with COPD and other lung diseases. Ask about joining a pulmonary rehabilitation program.

What questions should I ask my healthcare team?

Asthma is a disease that can change over time. Things like the place you live, work and play can affect your asthma, so can your age and general health. For this reason, speaking to your healthcare team about your concerns can be helpful in controlling your asthma. Some things you might wish to ask are:

  • Could we work on an asthma action plan so I know what to do if my asthma symptoms flare-up?
  • What should I do if my asthma flares up and I can’t contact you? E.g. week-ends, holidays.
  • If I need to take pills for my asthma flare up, should I keep them at home? Or is it better to have them at the pharmacy? What should I do if the pharmacy is closed when I need the medication?
  • You may speak to your health care team if you would like to try a different inhaler if I don’t like the feel or taste of the one I have?
  • Do I need to be tested for allergy?

Who might be a member of my healthcare team?

Your healthcare team can help you learn more about asthma and how to live with it. People on your asthma healthcare team should include your family doctor, your support person (who might be a family member or friend) and your local pharmacist. Other members might include:

  • A nurse practitioner.
  • A certified respiratory educator (CRE), a health professional with special training in lung disease. If there is no CRE available in your area, you can speak to one from the Lung Association's free helpline (call 1-866-717-2673).
  • A respirologist if you have severe asthma or are having trouble controlling your asthma.
  • An allergist if you have troublesome or severe allergies.


 

AddThis Social Sharing Icon

Page Last Updated: 14/12/2021