Stephen J. Schueler, M.D.

Asthma Home Care

Home care for asthma includes:

  • If you are a smoker, stop smoking.
  • Avoid exposure to secondary smoke.
  • Identify and avoid potential asthma triggers
  • Learn how to use your peak flow meter.
    • Learn why a peak flow meter is important
  • Measure your peak expiratory flow rate regularly
    • Learn why your peak flow numbers are important
    • Learn when to use your peak flow meter
  • Do not take cold medications without your doctor's consent.
  • Ask your doctor about vitamin D supplements
  • Take your asthma medications as directed:
    • Avoid running out of your asthma medications
    • Avoid skipping doses
    • Become familiar with any potential drug side effects

Home care for chest wall pain associated with asthma includes:

Asthma First Aid

First aid for an asthma attack includes:

  • Prepare an action plan with your doctor, so that you know what to do when an attack occurs.
  • Use your inhaler at the first signs of an asthma attack
  • Use maximum doses of your inhaler.
  • Seek medical attention immediately if symptoms do not improve.
  • Seek medical attention immediately if your peak expiratory flow is in the red zone.
  • Remain calm, but do not lie down.
  • Stop cough and cold medicines if you are taking them.
  • Drink plenty of clear liquids.

Asthma Inhaler Use

The first step in controlling asthma symptoms is learning how to properly use an asthma inhaler.

Directions for the proper use of an inhaler with a spacer:

  • Remove the cap from the inhaler.
  • Hold the inhaler with the mouthpiece at the bottom.
  • Shake the inhaler.
  • Insert the spacer if you have one, and place your mouth around the spacer.
  • Tilt your head back slightly.
  • Gently exhale.
  • Begin a slow, deep breath and activate the inhaler.
  • Continue to inhale slowly and deeply over 3 - 5 seconds.
  • Hold your breath for 5-10 seconds.
  • Repeat steps 3 through 10 if you require more than one puff.

Directions for the proper use of an inhaler without a spacer:
  • Remove the cap from the inhaler.
  • Hold the inhaler with the mouthpiece at the bottom.
  • Shake the inhaler.
  • Hold the mouthpiece 1.5 inches (4 cm) in front of your mouth. Your mouth should not touch the mouthpiece.
  • Tilt your head back slightly and open your mouth widely.
  • Gently exhale.
  • Begin a slow, deep breath and activate the inhaler.
  • Continue to inhale slowly and deeply over 3 - 5 seconds.
  • Hold your breath for 5-10 seconds.
  • Repeat steps 3 through 10 if you require more than one puff.

Tips on using an inhaler:
  • Keep your inhaler with you at all times. Use it at the first sign of wheezing.
  • Learn to use a spacer with the inhaler.
  • Use the inhaler every 20 minutes for the first hour of an attack. Continue the medication every 4 hours until symptoms are gone.

Asthma Taking Control

The successful treatment of asthma requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared.
  • Before the visit, think about what makes your problem better or worse. Your doctor will probably ask you questions about this.
  • Most doctors ask many questions about unrelated symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Asthma Testing Peak Flow

The peak expiratory flow rate or PEFR is used to assess the severity of wheezing in those who have asthma. PEFR measures how quickly a person can exhale air from the lungs. You need to have peak flow meter device if you want to measure your PEFR.

It is important to learn the proper technique for using your peak flow meter. Your doctor or nurse will help you learn how to measure your PEFR. Younger children can have trouble with this, but most children over 5 years of age can learn how to use the peak flow meter correctly.

Important values for you to know:

  • Your personal best PEFR:
    • This is the highest PEFR you can blow when you don't have asthma symptoms.
    • Make this determination when you feel good.
  • Your peak flow zone:
    • Make this determination only when you have asthma symptoms
    • Your PEFR zone is measured by how close your current PEFR is to your personal best PEFR.

PEFR zones:
  • Green Zone:
    • Your current PEFR is 80-100% of personal best PEFR
    • This is a mild asthma attack
    • You should have a treatment strategy in place for when you are in the green zone
  • Yellow Zone:
    • Your current PEFR is 50-80% of personal best PEFR
    • This is a moderate asthma attack
    • You should have a treatment strategy in place for when you are in the yellow zone
  • Red Zone:
    • Your current PEFR is less than 50% of personal best PEFR
    • This is a severe asthma attack and will need to see a doctor now.
    • You should have a treatment strategy in place for when you are in the red zone

When you communicate with your doctor by phone or email, make sure you tell him or her your PEFR zone.

Asthma Warning Signs

Notify your doctor if you have asthma and any of the following:

Continue to Asthma Prevention

Last Updated: Dec 1, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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