Thursday, October 30, 2008

Tracking Asthma Symptoms: Key to Control

Asthma symptoms are like the weather -- they change often and may seem unpredictable. But also like the weather, careful tracking of asthma symptoms can help identify patterns and what they may say about your asthma control.

Research has shown that tracking and rating your asthma symptoms are key steps in successfully managing asthma. One study even found that it helps keep kids with childhood asthma out of the emergency room.

Most asthma action plans track your “peak flow” (measured by a portable, hand-held meter used at home to gauge asthma severity). Based on “peak flow” results, the plans divide how you’re feeling into green, yellow, and red zones.

  • Green is optimal -- at your goal and nearly free of asthma symptoms.
  • Yellow means that you’ve had some increase in symptoms, a decrease in lung function, and your asthma control is worsening. You’ll need to adjust your medications.
  • Red indicates that your asthma is not under control and your medications are failing to control your symptoms. You’ll need to use medications to help open the airways and get your peak flow measures back to the yellow and green zones. The red zone may signal that emergency care is needed.

Along with your peak flow measures, here are some of the asthma symptoms you should be tracking daily -- or helping your child track if they have childhood asthma:

  • Coughing
  • Wheezing
  • Chest tightness
  • Headaches
  • Decreased appetite
  • Shortness of breath
  • Decreased physical activity
  • How often you’re using your inhaler
  • Dark circles under the eyes

Take note of when these symptoms occur and what triggers you were exposed to. Also note what asthma medications you took and how your asthma symptoms responded. And keep in mind that these asthma action plans should be personalized for you or your child. You shouldn’t be comparing your asthma symptoms with someone else’s.

“Everybody coughs, everybody wheezes,” says Shirley Joo, MD, an asthma specialist at Washington University of St. Louis School of Medicine. “But the levels vary by patient, and there’s an expected range based on a lot of factors and tests that we do in the office. You’re striving for your personal best.”

Even if you’re not actually coughing or wheezing, it’s also important to note if you can’t be as physically active as you’d like. If your child has asthma, you may have to watch this carefully.

“Kids, of course, will not come to their parents and say that they think their asthma feels worse, so look at their activity level,” says Joo. “Are they playing as much as usual, or are they sitting on the sidelines or coming in earlier than they used to?” Children should be able to go as fast as they want. When they can’t keep up with their friends, that’s an indicator that doctors should take a look at how well their asthma is controlled.

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