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Asthma: your 10-point action plan

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: a chronic condition of inflamed airways, present at all times in nearly all asthma patients, and an acute condition of bronchospasm. Both these conditions have to be adequately treated to achieve proper asthma control. The chronic inflammation needs daily, long-acting controller treatment  and the acute attack immediate treatment with a reliever (bronchodilator). The daily treatment to control the airway inflammation is the cornerstone of good asthma control, and more important than doctors realised a decade ago. 

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. Never 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 a peak flow meter.

Step 6. Monitor your asthma control
If you need to use your reliever more often than usual, or if you feel the relief is not as effective as you hope it to be, consult your doctor. He will re-assess your asthma control, and will step up your treatment by increasing the dose of your inhaled corticosteroid, or add medication to bring your asthma under control as quickly as possible.

Step 7. If you get asthma symptoms when exercising.
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.
Wear a scarf around your face on cold days.

Step 8. 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 9. Give your body a fighting chance
Boost your immune system by healthy eating, getting enough sleep, drinking plenty of liquids, and exercising regularly.

Step 10. Watch out!
1. Are you very stressed? Stress is a common asthma trigger. Practice relaxation techniques such as visualisation, yoga or meditation.

2. 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.

3. 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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