Asthma Exacerbation: What Is It? (Because It Sounds Really Scary.)

Getting an asthma diagnosis means you have to learn some new lingo. Your doctor may throw around phrases like “peak flow readings” (a way to measure how well your lungs are functioning), “short-acting beta agonists” (a class of asthma medication), and other terms you’re not familiar with while trying to explain how to manage your condition. But there’s one thing in particular that your doctor will likely warn you about again and again: an asthma exacerbation.

You’re probably more familiar with what this is than you think. “An asthma exacerbation is the same as an asthma attack,” Raymond Casciari, M.D., a pulmonologist with St. Joseph Hospital in Orange, California, tells SELF. “Doctors tend to say ‘exacerbation,’ but the public better understands the word ‘attack.’”

Whatever you call it, this is not something that you want to experience.

An asthma exacerbation (or attack) is basically when your respiratory system completely loses its cool and makes it tough for you to breathe. See, asthma screws with the airways that go from your nose and mouth to your lungs, according to the National Heart, Lung, and Blood Institute (NHLBI). When you’re exposed to triggers like animal fur, pollen, dust, mold, exercise, and respiratory infections, your airways can start to close up and restrict your airflow. Right on cue, the muscles surrounding your airways can constrict, too. This domino effect can also cause your airways to churn out more mucus than normal. The end result? An asthma exacerbation.

An asthma exacerbation can cause symptoms like severe shortness of breath, coughing, wheezing, and chest tightness or pain, the NHLBI says. If you use a peak flow meter (a portable device that quantifies how hard you exhale), your peak flow readings will likely be on the lower side, the Mayo Clinic says, signifying that your airways aren’t able to work at their full capacity. Also, if you’re having an asthma exacerbation, your symptoms may not back down enough when you use medicine like a short-acting beta antagonist you can inhale to open up your airways.

You can have a minor asthma exacerbation with symptoms that get better with quick treatment at home or a severe exacerbation that is life-threatening and requires a trip to the emergency room, according to the Mayo Clinic. Either way, the exact mix of signs and symptoms of an asthma exacerbation can vary from person to person. This is why it’s really important to work with your doctor to identify your personal red flags that your asthma is getting dangerous.

There are a few things you can do to lower the odds you’ll have an asthma exacerbation.

The first and probably most important thing is to come up with what’s known as an asthma action plan with your doctor, Dr. Casciari says. This is a written document that will outline the steps you need to take to keep your asthma under control, like how often to use certain medications, as well as how to step it up if your symptoms start to spiral, the American Lung Association says. An asthma action plan can also offer straightforward guidance on when your symptoms are so bad that you should call your doctor or go straight to the ER.

Knowing your triggers—and doing what you can to avoid them—can also go a long way toward preventing an asthma exacerbation, Purvi Parikh, M.D., an allergist/immunologist with Allergy & Asthma Network and NYU Langone Health, tells SELF. That can be really tough to do, especially if your triggers are seemingly ubiquitous, like dust or pollen. Even then, there are ways to take control. Check out how to get rid of as much dust in your home as possible, along with how to pollen-proof your place.

Your asthma can change over time, so it’s crucial to touch base with your doctor regularly to make sure you have the right medication to keep your asthma under control and that your asthma action plan is up to date, the Mayo Clinic says. If your asthma isn’t under control, you’re at a higher risk of having an exacerbation in the future—and without a current asthma action plan, you might not know what to do if it happens.

If you do have an asthma exacerbation, it’s important to act quickly.

That typically means using an inhaler filled with a medication like a short-acting beta antagonist (sometimes called a rescue inhaler, quite fittingly) as soon as you feel an exacerbation coming on, Dr. Casciari says. In your asthma action plan, you and your doctor should specify how many puffs to take when you feel symptoms arising, along with how often to repeat those puffs. For example, you may need to take two to six puffs, then wait 20 minutes to see if you need more, the Mayo Clinic explains, though your specific protocol may be different based on your doctor’s recommendation.

If you’re having severe symptoms, like trouble speaking because you’re so short of breath, you should use your rescue inhaler but also get to the ER or your doctor’s office immediately, the Mayo Clinic says. Your doctor may recommend that you use your rescue inhaler every three to four hours for a day or two after the exacerbation and may also have you take an oral corticosteroid for a short period of time to reduce airway inflammation. In extremely severe cases, your doctor may need to put a tube down your throat for mechanical ventilation, but that’s really only a prospect if you’re having a life-threatening asthma exacerbation.

If you’re having asthma exacerbations on a regular basis, it’s time to check in with your doctor, even if you think they fall on the mild end of the spectrum because your medication gets you back to normal pretty quickly.

Frequent asthma exacerbations could be a sign that your treatment plan needs tweaking, Dr. Casciari says, and making some adjustments should help get things under control.

Whatever you do, don’t take your symptoms lightly, Dr. Parikh says: “Ten people still die on a daily basis of asthma in this country.” While having asthma—or even having regular asthma exacerbations—doesn’t mean you’re going to die from this condition, it’s important to do everything you can to reduce the risk of your breathing issues entering life-threatening territory.


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