Updated 01 November 2017

Your 10-point action plan to manage asthma

With careful management you can keep your asthma under control. The key is to identify what triggers your attacks and, where possible, to remove them from your life.


You may also need to make some lifestyle changes that will help keep you on top form.

Here is you checklist.

Step 1. Have you been diagnosed?
If not:
1. Do you have any symptoms of wheezing, coughing, chest tightness or breathlessness during the day, even if only twice a year?
2. Do you sometime wake up at night coughing, or with chest tightness or have difficulty sleeping because of these symptoms? Do wake up feeling that you might breathe better if you sit up, even only once a year?

If you answer yes to any of these two questions, consult your doctor.

Step 2. Understand what is happening in your lungs
Asthma is actually two conditions all rolled into one: the underlying chronic airway inflammation, present in nearly all asthmatics, and acute events of bronchoconstriction.

Both these conditions need to be treated. Chronic airway inflammation should be controlled on a daily basis with controller therapy (most often an inhaled corticosteroid or a leukotriene inhibitor tablet), and acute attacks with fast-acting reliever therapy.

The mainstay of good asthma control is daily control of the airway inflammation. 

 Step 3. Know the severity of your asthma
The frequency and severity of your asthma symptoms will determine how your doctor will initiate your treatment.

Step 4. Take your medication as prescribed.
1. If your doctor has prescribed daily treatment (and he will if you have asthma symptoms more than twice a week or more than twice a month), stick to it. It is very important to take your inhaled corticosteroid daily as prescribed even if you feel better and have no asthma symptoms. The inhaled corticosteroid is the reason your symptoms are less severe and less frequent.
2. Use your bronchodilator inhaler if and when needed. Rather use it too soon and more often than too late or not at all.

Take action when warnings signs appear and don't panic. You know what to do, so get on calmly and do it.

Step 5. Do not underestimate the severity of your asthma.
Rather use your bronchodilator inhaler too soon or more often than too late or not at all. Learn more about an asthma emergency. Make sure your family and friends know what to do if you are in distress.

Step 6. Monitor your level of asthma control.
If you need to use your bronchodilator more often or feel the relief is not as effective as you hope it to be, consult your doctor.

He might step up your medication, by either adding medication (temporary), increase the dose of your inhaled corticosteroid, or prescribe oral cortisone for 7 - 10 days to bring you asthma under control as quickly as possible.

Keep a diary to help your to achive total control.

Step 7. Use a peak flow meter if you have Moderate or Severe Intermittent Asthma (Categories 3 and 4).
Using a peak flow meter to monitor your lung function, can help you take the right action when and as needed. Learn more about a peak-flow meter.

Step 8. If you get asthma symptoms when exercising, this is an indictation that your asthma is not well-controlled.
Discuss this with your doctor, because exercise and cold air are just two more asthma triggers. If you show asthma symptoms about 6 minutes after starting to exercise, your astma was probably triggered by exercise or cold air while you exercise. This is an indication that the control of your "normal" asthma and airway-inflammation should be stepped up. 

It will also be useful to use your bronchodilator inhaler before exercising and warm up slowly.

Exercise outdoors during hot weather and indoors on cold days.

If you exercise outdoors in cold weather, tie a bandana round your face to cover your mouth and nose - this will help to warm the air before your inhale.

Although exercise may trigger an asthma attack, it also helps strengthen the lungs, which in turn can help prevent asthma symptoms, so don't stop exercising, but aim for better asthma control.

Wear a scarf around your face on cold days.

Step 9. Identify your asthma triggers and try to avoid them.
Try to identify your asthma triggers by:
1. Keeping a diary of your asthma symptoms. This can also help you to monitor the frequency of you asthma symptoms as in Step 5. Take note of what you eat, the weather, when you've taken medication, exercise, and possible allergens.
2. Get tested: a skin prick test (SPT) or blood test (RAST) can be used to identify asthma allergens in people from the age of 6 months.

Common asthma triggers include house-dust mites, pollens, animal dander, cockroaches, tobacco smoke, perfumes and even cold air

Step 10. Give your body a fighting chance
Boost your immune system by healthy eating, getting enough sleep, drinking plenty of liquids, and exercising regularly. Stress is a common asthma trigger. Practice relaxation techniques such as visualisation, yoga or meditation.

If you're prone to heartburn, don't eat or drink within three hours of bedtime. Raise your head in bed. For persistent heartburn, consult your doctor.

Establish if aspirin and other drugs spark symptoms in your case. This may happen in some sensitive people. Check with your doctor or pharmacist about the asthma risk of every medication you take.

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Asthma Expert

Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute

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