Partnership between Doctor and Patient
A good partnership with your doctor or other health care provider is the first step in asthma control. "It's designed to give you insight into your disease and its causes and how to control it and your environment," explains Clifford W. Bassett, M.D., Assistant Clinical Professor of Medicine at State University of New York Health Sciences Center in Brooklyn. The partnership should consist of the following:
- Give and take. "I want to get to know the patient a little," says Sutherland. "I need to understand what happens to her over the course of time so I can optimize treatment." Initially, Dr Sutherland sees a patient every six weeks or so to identify her triggers and stabilize her asthma. Follow-up visits monitor how the patient is doing. "It's not uncommon to see a patient once or twice a year," says Dr. Sutherland.
- Education. It's important to understand why you need certain medicines and when. "People will take an inhaled steroid and not feel better instantaneously," says Dr. Sutherland. "If you don't tell people that the steroid will control inflammation over time so they have fewer attacks, they'll think you're asking them to take a drug that has no effect." In addition, patients need to know their triggers, how to use an inhaler and how to operate a peak flow meterwhich measures their ability to push air out of their lungsand interpret the findings.
- A Written Action Plan. The National Institutes of Health provides a chart for doctors to complete so they know which medicines to take and when, and what do when asthma is under control; worsens; or requires emergency treatment.
Asthma Medicines At a Glance
There are two categories of asthma medicines. Here's what you need to know about each:
- Long-Term Controllers
- Reduce airway swelling, or inflammation, and the mucus build-up that can trigger an asthma attack.
- Daily-inhaled corticosteroids are the first choice for persistent asthma.
- Leukotriene modifiers, taken orally, block production of a substance that causes airways to swell and narrow. May be prescribed for mild or moderate asthma on their own or in tandem with an inhaled corticosteroid.
- Long-acting beta-agonists (LABAs) relax airway muscles. Inhaled, they are recommended for use in combination with corticosteroids, if needed. An advisory panel to the FDA recently found a small, increased risk of serious side effects among asthma patients who used LABAs on their own.
- Quick Relievers/Rescue Inhalers
- Quickly relax airway muscles for easier breathing.
- Short-acting beta-agonists, which are inhaled, are commonly used.
- Oral corticosteroids may be used during a severe attack.