Fighting for Breath: Managing Chronic Asthma
James Elvis, MSN, FNP-C
Imagine yourself going for a walk with your dog on a beautiful, crisp morning. You prefer the dry, chilled air over the heat and humidity, though it does agitate your sinuses a little. You cough, trying to clear your throat of a small tickle to little effect.
You stop to let a school bus pass, then hustle across the street before the next wave of cars arrives. You make it safely to the other side, but the tickle has worsened as you start to cough hard. You can feel your heart racing and break out in a sweat despite the cool breeze. Becoming lightheaded, you sit down on the cold sidewalk and struggle to catch your breath. The annoying tickle in the back of your throat becomes a growing tightness. You feel as if you’re breathing through a drinking straw. Then it hits you – you’re having an asthma attack.
This is an example of what an asthma attack could look like. Asthma is a chronic lung disease in which inflammation of the airway causes swelling, leading to coughing, wheezing, and shortness of breath. Asthma attacks are often sudden, can be triggered by a variety of factors, and are life-threatening without treatment or medical intervention.
Other symptoms of an asthma attack may include:
- Difficulty speaking or eating
- Fast breathing
- Increased mucus
- Rapid pulse
- Pale, sweaty face
- Blue lips or fingernails
The National Center for Health Statistics reports there are between 27 and 28 million people in the United States living with asthma, including almost five million children.
There is also a higher prevalence of asthma in Black and Indigenous populations compared to white and Hispanic groups, which may be explained in part by racial and ethnic disparities, as well as genetic and cultural differences.
Early detection of asthma is key for preventing severe disease and complications. Health care providers who suspect a patient has asthma can confirm a diagnosis with a combination of a medical history assessment and physical exam. Often other studies, such as a pulmonary function test, blood tests, and x-rays of the chest and sinuses may be needed.
While the diagnosis and management of asthma is similar for children and adults, there are some significant differences in how these populations respond to the illness that can influence treatment.
Adults and children respond to asthma attacks differently. Adults living with asthma often require more intensive treatment compared to pediatric patients following a severe asthma attack, including prolonged hospitalization and full recovery taking a week or more. Also, adults are six to eight times more likely to die from an asthma attack than children.
Children tend to be more resilient following asthma attacks, recovering quickly. However, their condition can deteriorate rapidly during an asthma attack if medicines are not given promptly due to their smaller lung capacity and could require a trip to the emergency department.
If you suspect your child may have asthma, it is important to share your concerns with your child’s provider.
Now that we have a clear picture of asthma and how it presents in adults and children, let’s explore disease management, including ways to avoid or prevent asthma attacks.
Managing asthma takes a combination of planning and preparation, avoiding triggers, and using allergy medications along with special medications such as a rescue inhaler or nebulizer when flare-ups and attacks occur.
Health care professionals recommend people living with asthma see their primary care provider for regular appointments at least twice per year for better supervision and disease management. Patients should also be vigilant about filling their prescriptions, including allergy medications, and take them consistently as directed. People with asthma should keep their rescue inhaler with them at all times in the event of a severe attack or use a nebulizer when appropriate.
People with asthma should develop an Asthma Action Plan with their provider, which is a written set of instructions and information to assist patients and others with responding to an asthma event. They should also educate everyone in their social groups (family, friends, coworkers, etc.) about their asthma and ensure people know how to respond in an emergency, such as helping to access a rescue inhaler or calling 911.
For children, parents and guardians should educate themselves on the disease and stay informed about their child’s care. They should ensure schools and other care providers also understand their child’s condition and can assist with providing medication, such as their rescue inhaler, in an emergency.
It is crucial to be aware of and avoid asthma triggers. Common triggers can include:Allergens (pollen, dust mites, mold, pet dander, and cockroaches)
- Intense emotions (stress, anxiety, laughter)
- Environmental pollutants
- Exercise (especially for normally inactive individuals)
- Personal hygiene (dry skin)
- Respiratory infections
- Smoke
- Strong fragrances and irritants (perfumes, cleaners, air fresheners, industrial fumes)
- Climate changes (cold and dry air, humidity)
Staying current with vaccinations for flu, RSV, and COVID-19 can also help to reduce asthma flare-ups, which can be triggered by respiratory illnesses.
Asthma is a challenging, life-threatening, chronic condition, but it doesn’t have to rule your life. With adequate medical supervision, prescription adherence, and lifestyle changes to avoid triggers and promote good health, children and adults can manage asthma for a healthy, vibrant life.
If you or a loved one need help with managing asthma, contact HopeHealth to schedule an appointment. HopeHealth provides primary and specialty care for both adults and children. For more information, visit hope-health.org or call (843) 667-9414.
James Elvis provides care at HopeHealth in Kingstree and has over 20 years of experience in caring for patients of all ages. He received his undergraduate degree from Francis Marion University and his master’s from Graceland University, Independence, MO. In 2013, Mr. Elvis participated in medical missions to Honduras.
