BCBSNEMEMWKBCD.XML - 1768150 - VersionID: 1 Better Health Guide Jan Doe 1003 Main Street Anywhere, TN 11111 An Independent Licensee of the Blue Cross and Blue Shield 13810 Southeast Eastgate Way, Suite 200 Bellevue, WA 98005 Table of Contents
Living with asthma Chapter 1 1
Chapter 1
Living with asthma .1

Breathing easy with asthma: putting yourself in control .2 What is asthma? .2 What is an asthma attack? .2 How do I manage my asthma? .3 When to get help .3 Can I exercise and play sports? .4 What if I'm pregnant? .4 Smoking and asthma .4 Chapter 2
Know your symptoms and triggers .5

Know your symptoms .6 Know your triggers .6 Avoiding asthma triggers .6 Cold and flu season .7 Chapter 3
Use your peak fl ow .8

What is peak flow? .9 What is personal best? .9 Why are peak flow and personal best important? .9 Using a peak flow meter .10 What are asthma zones? .10 Charting your peak flow .11 Chapter 4
Medicines .12

Understanding your asthma medicine .13 What is an inhaler? .13 Using a metered dose inhaler with a spacer .13 Overuse of reliever medicine .14 Asthma medicines .14-15 Chapter 5
By learning how to live with asthma, you'll
Make an "asthma plan" .16
be on the right track to easier breathing.
Overcoming barriers .17 How do I work with my doctor? .18 Preparing for your asthma checkup .18 This begins with understanding how
Your doctor will also want some information from you .18 Your asthma plans .19 asthma affects you, what you can do to
Your asthma worksheets .19 Daily treatment plan .20 Asthma action plan .inside back cover control it, and why daily treatment is
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Printed in the United States of America 2 Chapter 1 Living with asthma
Living with asthma Chapter 1 3
How do I manage
asthma attacks. You will also use my asthma?
"reliever" medicine for asthma Asthma is becoming common in the United States – about 7. Develop and use 20 million Americans have it. However, asthma does not Set your goals, and work with necessarily get in the way your doctor to make asthma infl amed bronchus of their school, work, or plans. A treatment plan helps enjoyment of life. This is you control your asthma on a possible because they work daily basis. An action plan tells with their doctors to set up a you what to do when you have plan to manage their asthma. an asthma attack.
1. Know your goals.
Work with your doctor to set When to get help
realistic goals. For many people, Call 911 or other emergency the goal is to be symptom free. services immediately if you have If you have severe asthma, your severe asthma symptoms, such as: goal may be to limit your asthma You have taken your reliever
attacks or take part in your medicine and after 20 to 30 Asthma and asthma attacks
minutes you still don't feel better. Asthma affects your breathing. During an asthma attack, the airways 2. Understand your symptoms. You measure your peak flow
that carry air to the lungs (bronchial tubes) swell up (infl ammation) Know when your asthma is getting and it is less than 50% of your and make mucus, which clogs the airways. The airway muscles also worse and what to do when you tighten. All of this can make breathing very diffi cult. have an asthma attack. Keep You are breathing very fast.
track of your asthma zones and symptoms with an asthma diary.
Shortness of breath makes it
Breathing easy with asthma:
What is an asthma attack?
hard for you to talk or eat.
3. Know your triggers.
putting yourself in control
When you have trouble Certain things, such as cigarette You are working hard to breathe
breathing, you're having an using your neck, chest, and For many people, asthma is a smoke or cold air, can cause asthma attack. Your airways are belly muscles. If you are doing lifelong disease. However, it an asthma attack. These are very swollen, and it's hard to get this, the skin between your ribs does not have to disrupt your called triggers. When you know air through them. Think of trying falls inward with each breath. life. You can manage your your triggers, you take a step in to breathe air through a straw You may also open your nostrils asthma and, in doing so, control controlling your asthma.
while it's pinched.
wide when you breathe in.
your life. You just need a plan.
5. Use your peak flow meter. You may rarely have asthma A peak flow meter lets you know You are taking longer than usual
What is asthma?
attacks, or you may have them how well your airways and lungs to breathe out. You may even Asthma affects your breathing. often. They can be mild or are "working" – how well you wheeze when you breathe in.
It causes inflammation and severe. In severe attacks, your can breathe. Knowing this can You notice you are sitting up,
swelling in the airways that lead heart might beat faster, and it help you predict asthma attacks leaning forward, or sitting to the lungs. When this happens, may be hard to breathe even and take action to treat them. It with your nose tilted up as if the airways narrow, making it if you are sitting down. It may also helps your doctor find the sniffing the air to breathe.
hard to breathe.
even be hard to talk. If you have right treatment for you.
Your skin is pale, gray, bluish,
a very severe attack, you may How often you have trouble 6. Take your medicine. cold, or spotted. You also need emergency care. breathing depends on the You will use "controller" may notice a color change on severity of your asthma and what Between attacks, your breathing medicine to control asthma your tongue, lips, earlobes, triggers it. Some people breathe can seem completely normal. on a daily basis and prevent or nail beds.
normally most of the time, while But even when you do not others feel as if they are always have symptoms, asthma may be Experts do not really know why some people get asthma and others
short of breath. Other people hurting your lungs. If you do not may only have trouble breathing control your asthma, it can lead do not. It may run in your family. People with allergies seem to
at certain times – such as during to permanent changes in your have more asthma. But exact causes are not known.
exercise or at night.
airways and harm your lungs.
4 Chapter 1 Living with asthma
Know your symptoms and triggers Chapter 2 5
Can I exercise and
women, including some women play sports?
who have never had asthma before. Pregnant women Asthma doesn't mean you have manage asthma the same way to give up sports or being active. non-pregnant women do.
Keep the following in mind During pregnancy, asthma can to help make your exercise affect how much oxygen your session go smoothly: unborn baby gets from you. Ask your doctor if you should
However, this does not mean use reliever medicine right that having asthma will make before you start any exercise. your pregnancy more difficult or Warm up for 15 minutes before
dangerous for you or your baby. you exercise. Do some light Just be sure you take your medicine stretching or jogging.
and work with your doctor.
Keep your reliever medicine
See your doctor regularly while you are pregnant, and ask about the best asthma treatment Breathe through your nose
for you and your baby. Most during exercise.
asthma treatments are safe to use Take brief rests during exercise,
during pregnancy. It is far safer and use reliever medicine if to manage your asthma with symptoms start.
medicine than it is to leave asthma If it is cold out, cover your
untreated during pregnancy. mouth with a scarf or mask.
Smoking and asthma
Swimming, walking, easy
Combining asthma and smoking biking, and downhill skiing is a disaster in the making – are less likely to cause asthma you could easily end up in the attacks than many other sports.
Sports that make you work
If you smoke, your controller harder are more likely to medicine may not work as well, cause attacks. These include and you may have to use more and soccer, basketball, or long- more reliever medicine (see chapter distance running.
4 – Medicines.) This can also make Cool down after exercise.
your asthma even worse. Don't exercise while you have
Giving up smoking is much harder a cold or the flu, if it is very than simply changing a habit. cold, or when pollen counts are There is no one "quit plan" that high (if you have allergies).
works for everybody. You usually You can help control asthma symptoms
Don't exercise if you have
try different plans until something finally works for you. The important thing is to keep trying.
by knowing your asthma triggers. While
What if I'm pregnant?
Talk to your doctor about tools If you are pregnant and have to help you quit smoking. He or you may not be able to remove all of
asthma, there is no need to she may suggest nicotine patches, worry. It is a fairly common medicine, or ways to relieve stress.
health problem for pregnant your asthma triggers from your life, you
Did you know? Jerome Bettis of the Pittsburgh Steelers, Olympic
can be more aware of what they are and
track star Jackie Joyner-Kersee, Olympic swimmer Amy van Dyken,
and former basketball stars Isiah Thomas and Dominique Wilkins

avoid them in your daily activities.
all have asthma.
6 Chapter 2 Know your symptoms and triggers
Know your symptoms and triggers Chapter 2 7
Know your symptoms
Avoiding asthma triggers
Cold and flu season
Asthma symptoms vary among Below are some common Stay inside when pollen levels
Colds and the flu trigger asthma people. You may rarely have triggers and what you can do to are high. Watch local weather attacks for many people. There them, or you may have them reports for pollen counts in are things you can do to prevent often. They can be mild or Dust and dust mites colds and the flu.
severe. Common asthma (keeping your house clean) symptoms include: Keep windows and doors
Get a flu shot every year. Talk
Avoid carpet, upholstered
closed. Use air conditioning to to your doctor about this in Wheezing is a whistling noise furniture, and heavy drapes help keep pollen out of your early fall when flu shots are when you breathe. It happens that collect dust. If you do house. Do not use a fan with because your airways are not want to remove your an open window.
narrow. It can be loud, or you Ask your doctor about a shot
carpeting, consider removing it may hardly be able to hear it.
Avoid going outside on rainy
to prevent pneumonia.
only in the bedroom. or windy days when mold Coughing usually does not Wash your hands often.
Remove "dust collectors" from
spores may be in the air. bring up mucus, and it occurs bedrooms, such as stuffed Use a tissue rather than
mostly at night. It is the only Clean bathtubs, shower
toys, wall hangings, books, a handkerchief to blow symptom for some people.
stalls, shower curtains, and knickknacks, and artificial windowsills at least once a Shortness of breath is rapid, flowers. Wash bedding, month with disinfectant or Keep your hands away from
shallow breathing or difficulty including pillowcases and your nose, eyes, and mouth. mattress covers, in hot water Cold and flu germs are most Remove carpeting from any
(130°F or 54.4°C) every 2 weeks. likely to enter your body concrete floors, especially in through these areas.
Damp-mop hard floors (tile or
hardwood, for example) once a Eat a healthy and balanced
Tiring quickly during exercise day. Dust and vacuum once or diet, and get regular exercise.
Know your triggers
twice a week, including cloth- Do not go outside when
Do not smoke. Smoking harms
Sometimes your symptoms just covered furniture. Use a dry pollution levels are high.
your nose and lungs and happen – you can't really say cloth to wipe hard surfaces such Make sure any stove or heating
makes it harder to recover what causes them. However, as countertops and tables. Wear device you use is well-vented.
from a cold or the flu.
many people have asthma a face mask while you do this.
triggers – things that cause Finding your asthma triggers
symptoms or make symptoms Asthma triggers cause asthma symptoms or make the symptoms worse. To identify your worse. Triggers include tobacco Keep your pet outside of the
triggers, fill out the questions on the form below. Fill in the symptoms and your peak expiratory flow (PEF), if possible. Then discuss the list with your doctor.
smoke, dust and dust mites, house or at least out of your pollen, exercise, pets (animal Yes No Symptoms
Peak Flow
dander), or having a cold, flu, or Keep your pet in areas of the
other upper respiratory infection.
home that have hard floors I smoke or am around people who smoke.
If you know what your triggers that are easier to clean than carpeted floors.
I have symptoms when I am at home. are, you can avoid them or I have symptoms when I am at work.
take medicine before you Keep your pet away from
Part of my home or workplace is come in contact with them. your carpets or upholstered damp and musty.
This may help you reduce the I have a pet.
Wash rugs, pillows, or blankets
symptoms, limit how often you There are cockroaches in my home.
that your pet spends time on.
have attacks, and how severe I have symptoms when it is cold out.
they are. The fewer symptoms Wash or brush your pet once
I have symptoms when I go outside.
you have, the more you will be I work with chemicals or cleaners.
able to do, and the better you If your asthma is severe, consider
I have symptoms when I have a finding a new home for your pet.
cold or the fl u.
I have symptoms before, after, or If you feel you can control your attacks, you will feel more
during exercise.
confi dent about what you can do. You will be open to returning
Certain foods or drinks cause symptoms.
Certain medicines, such as aspirin, to old activities or trying new ones.
cause symptoms.
8 Chapter 3 Use your peak fl ow
Use your peak fl ow Chapter 3 9
What is peak flow?
Why are peak flow and
Peak expiratory flow (PEF or peak personal best important?
flow) measures how fast you Knowing your peak flow breathe out when you try your helps you tell if an asthma hardest. It tells you how well your airways and lungs are working. attack is going to occur. You measure peak flow with a Your peak flow level may begin peak flow meter, a simple device to drop before you get symptoms that you can use at home. of an asthma attack. If you know If you can breathe out quickly you are going to have an attack, you can take medicine to prevent and with ease, you will have a it or make it less severe. This may help you avoid having to go to This means you have a high peak the emergency room.
flow rate. Your lungs and airways Identify things that may are working well, and your trigger an asthma attack, asthma may not be bothering you. such as pollen, cigarette If you can only breathe out smoke, or dust mites. slowly and it is hard to do, You may find that your peak flow you will have a lower number. drops after you have been around This is called a low peak flow. one of your triggers or that it This may mean that your lungs improves if you avoid the trigger.
and airways are not working Check changes in your well, even if you don't have any of your usual asthma symptoms. breathing. Your peak flow readings can help What is personal best?
your doctor decide if you need Your personal best is your to change your daily controller highest peak flow. You find your medicine. It also helps your doctor personal best by taking peak flow know which medicines help your readings over 2 to 3 weeks when breathing and which do not. your asthma is under control – How often should I check when you feel good and have no symptoms. During these weeks, check and write down your peak Make checking your peak flow flow at least twice a day. Personal part of your daily routine. Check it best is never measured during an when you wake up and before you asthma episode.
take any medicine. Write down You need to check your personal this number in your asthma diary.
best every now and then to Also check your peak flow when see if it has changed. If it goes you have symptoms and during down, you may need to change Peak fl ow tells you how well your lungs
an asthma attack. This tells you or increase your medicines to how severe the attack is. Check it prevent your asthma from getting again after you have taken your worse. If your personal best are working. Knowing your peak fl ow
reliever medicine to find out how improves a lot, you may be able well the medicine worked.
to reduce your medicine. Talk to Your doctor can help you decide your doctor if your personal best makes you more aware if an asthma
how often to check your peak flow.
changes a lot in either direction.
Your peak fl ow level may begin to drop before you get symptoms
attack is going to occur.
of an asthma attack. If you know you are going to have an attack,
you can take medicine to prevent it or make it less severe. This
may help you avoid having to go to the emergency room.

10 Chapter 3 Use your peak fl ow
Charting your peak fl ow Chapter 3 11
Using a peak flow meter
What are asthma zones?
1. Put the pointer on the peak You use your peak flow to set Asthma zones are easy to remember – just think of a stoplight.
flow meter to 0 or the lowest up your asthma zones. Your number on the meter.
asthma zones are an easy way Your zone is If your peak fl ow is Symptoms
to keep you a step ahead of your 2. While standing, take a deep asthma. Which zone you are Your symptoms are Get help right away. in will determine the medicine probably bad. It may Take your reliever 3. Put the peak flow meter you need to use and whether be very hard to breathe. medicine. Follow mouthpiece in your mouth you need emergency help. Wait until your PEF gets your action plan.
and close your lips tightly This knowledge will build your better before you try around it. Do not put your confidence and give you greater any activities.
tongue inside the mouthpiece.
control over your asthma.
You may be coughing 4. Breathe out as hard and as fast Finding your asthma zones or wheezing. Your usual as you can for 1 or 2 seconds. Asthma zones are an easy way to symptoms may be worse. medicine. Follow A hard and fast breath usually see how well you are breathing. You may not be able to do your action plan.
produces a "huff" sound.
You find your asthma zones by your usual activities. You 5. Check the number on the using your personal best.
may be short of breath.
gauge and write it down.
Take your peak flow as soon
You have no symptoms. Take your controller Repeat steps 1 through 5 two as you get up in the morning You can do your usual more times. After you have and again in the afternoon. blown into the meter three Measure your peak flow at these
times, take the highest number times for the next 2 to 3 weeks. You can use this chart to track your peak fl ow.
you received and write it in your asthma diary or on another Your personal best peak flow is
the highest number you write down in this period of time. A.M. P.M. A.M. P.M. A.M. P.M.
If you cough or make a mistake during the testing, do the test over. If your best effort is in your Different brands of meters may red zone, take your reliever give different values for results. medicine right away, and If you change meters, you will call your doctor or go to the need to find your asthma zones emergency room.
using the new meter. Peak fl ow meters
With your personal best, you can fi nd your asthma zones. Use the table below to fi gure your peak fl ow ranges for each zone.
Peak fl ow meters come in Personal best
Multiply by
Zone range
many shapes and sizes.
(example) Green 0.8 (400 x .80 = 320) 320 and more REQUIRED BARCODE POSITION 12 Chapter 4 Medicines
Medicines Chapter 4 13
Understanding your asthma
medicine right to your airways Asthma medicine helps prevent Most people use a metered your symptoms and makes dose inhaler (MDI). it possible for you to do the It is a small canister that delivers activities you want to do. a set amount of medicine in an You will have two types of aerosol form. When you push asthma medicine – controllers the inhaler, you must breathe in and relievers.
a puff of medicine.
Use controllers every day. Using a metered dose
These prevent lung damage, inhaler with a spacer
asthma symptoms and attacks, and keep airways open. You 1. Shake the inhaler, remove the should not use controllers inhaler cap, and place the to relieve sudden asthma mouthpiece of the inhaler into symptoms. Always have a 30-day supply of controller 2. Remove the cap from the spacer.
medicine available.
3. Hold the inhaler up with the Use relievers according to mouthpiece at the bottom.
your action plan when you 4. Tilt your head back slightly, have an asthma attack. and breathe out slowly and They work on your symptoms to quickly open closed airways. 5. Place the spacer's mouthpiece Always have a 30-day supply in your mouth.
of reliever medicine. Make sure 6. Press down on the inhaler to you always have some reliever spray one puff of medicine medicine with you.
into the spacer. What is an inhaler?
7. Slowly take a deep breath. Controller and reliever asthma 8. Hold your breath for 10 medicine usually comes as an seconds by counting slowly inhaler – a device that lets you – one thousand one, one breathe the medicine in through thousand two, and so on. If your mouth. Inhalers deliver the you need to take a second dose, wait 30 seconds to allow the inhaler to refill.
Asthma medicine helps prevent your
Make sure you have a 30-day
supply of both your reliever
symptoms making it possible for you to
and controller medicines!
do the activities you want to do. You will
have two types of asthma medicines –
Metered Dose
Inhaler and Spacer

controllers and relievers.
This is one example of a metered-dose inhaler and spacer. There are other types.
Medicines Chapter 4 15
A dry powder inhaler contains Overuse of reliever medicine
medicine in a powder form. Since reliever medicine quickly MEDICINE
You breathe in quickly and deeply reduces symptoms, people ARE TAKEN
to get the medicine. How well the sometimes use it too much. dry powder inhaler works may However, this can cause depend on how well you breathe problems. Using too much can Relax and open • Inhaled • Fast heartbeat in. How to use a dry powder make your asthma worse or Ventolin, Proventil, Volmax, airways quickly • Feeling nervous inhaler depends on the medicine. cause your heart to beat fast or Brethaire, Brethine, Alupent, • Injected and restless Read your instructions carefully.
in an odd rhythm. Overusing it can also make your medicine Metaprel, Maxair • Dry mouth and throat Some people with asthma not work as well as it should.
need a nebulizer. Talk to your doctor if: This device delivers liquid You are using reliever medicine
Relax and widen • Inhaled • Fast heartbeat medicine in the form of a fine more than 2 times a week.
Serevent Diskus, mist (aerosol) or powder. You You are using more than one
Foradil Aerolizer • Sleeplessness breathe in the medicine through canister every 3 months.
a mouthpiece or face mask.
This does not include using • Tremor, shakes reliever medicine before exercise. What is a spacer? Talk to your doctor about using Inhaled steroids
Reduce swelling • Inhaled • Hoarseness Most doctors suggest that relievers before exercise.
everyone who uses an inhaler Azmacort, Flovent, also use a spacer, which is Pulmicort Turbuhaler, attached to the inhaler. A spacer It is important to understand Pulmicort Respules lets you first spray the medicine how asthma medicines differ, Bronchodilator plus steroid
Relax and widen • Inhaled See side effects for into a tube, and then breathe in. how you take them, and their This makes it easier to use and side effects. The table on the more likely that you're getting all opposite page briefly describes of the medicine. steroids above.
some commonly used asthma medicines. Talk to your doctor Relax and widen • Inhaled • Dry mouth Because you can't see the to get information on all • Increased wheezing medicine in the canister, it is important to keep track of how many puffs you take. This way, you will know when Systemic steroids Reduce
• Decreased or your inhaler is empty. The Deltasone, Liquid Pred, • Injected blurred vision inhaler package will tell you dexamethasone, prednisolone • Frequent urination how many puffs are in the (Orapred, Prelone, Pediapred), inhaler. Get a new canister long Medrol, Kenalog-10, Decadron, • Increased thirst before you reach this amount.
Solu-Medrol, A-Methapred (Talk to your doctor about long-term side effects.) Relax and open • Pills theophylline (Theo-Dur, • Injected • Nausea and vomiting Slo-bid, Uniphyl, Uni-Dur) period of time Using too much reliever medicine can make your asthma worse
Leukotriene modifi ers
• Vomiting and diarrhea or cause your heart to beat fast or in an odd rhythm. Overusing it
Singulair, Accolate, Zyfl o function • May affect liver can also keep your medicine from working as well as it should.
Mast cell stabilizers Reduce
• Throat irritation REQUIRED BARCODE POSITION 16 Chapter 5 Make an "asthma plan"
Make an "asthma plan" Chapter 5 17
Overcoming barriers
Ask your pharmacist to give There is a lot to know and you a phone call a few days do when you have asthma. before you need to refill your prescription. He or she may You need to keep track of your have a callback service.
peak flow, medicines, asthma plans, and triggers. It is easy to ❑ Barrier:
let some of this slide.
I can't afford asthma To avoid this, write down what medicines or treatment.
you are not doing, and then think about ways to improve. Contact social services or religious For example, if you are not groups about possible help. using your peak flow meter, it might be because it is not in a Get in touch with Medicaid, convenient place. A solution a government program that would be to put it next to your may be able to help you afford alarm clock, the coffeepot, or medicine and treatment. the kitchen table – someplace Talk to your doctor. He or she where you will see it and use it.
may have free samples.
Following are some common ❑ Barrier:
barriers and solutions. Read I take many medicines, and through them, and then write I'm not sure what to take, down your barriers. See if you or when to take it.
can find some solutions to them. Use another piece of paper if you need to.
Use color-coding or "personalize" your medicine in Barrier:
a way that will help you take the I don't measure my peak flow.
right medicine at the right time. ❑ Barrier:
Put the meter in a place where I just forget.
you will see it first thing in the morning.
Possible solution:
Put a note in the bathroom or
on the refrigerator. I run out of medicine.
Make it a habit to take your medicine at the same time as one There is a lot to know and do when you
Talk with your doctor or of your daily activities, such as pharmacist about how long when you eat or brush your teeth.
have asthma. You need to keep track of
your medicine lasts, and use a calendar or day planner your peak fl ow, medicines, asthma plans,
to remind yourself to get new medicine. and triggers. It's easy to let some of this
slide. Asthma plans help you understand
when and how to treat asthma.

An asthma diary is a good idea. It gives you a place to list your
symptoms, your medicine, and your asthma zones. Talk to your
doctor about how to do this.

REQUIRED BARCODE POSITION 18 Chapter 5 Make an "asthma plan"
Make an "asthma plan" Chapter 5 19
How do I work with
Do you know your peak flow. my doctor?
Is your personal best accurate? Bring your list of questions, your medicines, and your action See your doctor for regular Do you need to change how and treatment plans to your doctor's appointment. You may also checkups. You and your doctor often you measure your peak want to bring a friend or family member to help with questions will decide how often you do flow? Are your asthma zones and take notes on what your doctor says. this. To make the best use of accurate? Do you know how to your visit, be prepared. If you use a peak flow meter? Write down any other questions you may have: are using an asthma diary, bring it in. Also bring in a list of all Are you keeping an of the medicines, vitamins, and accurate asthma diary? herbs you are taking, and review Are you filling it out correctly? them with your doctor. Ask your Do you need to give your doctor doctor about your treatment and any other information? action plans and the medicines Your doctor will also
you are taking. Your doctor will want some information
want to know how often you have asthma symptoms and how Be prepared to answer the severe they are.
following questions: To prepare for your
How many days did you have
asthma checkup, read the
symptoms in the last week? following questions
How many nights in the
Are you confident that you last month did your asthma understand all you can about symptoms wake you or make asthma and your treatment? If it hard to sleep? you don't understand something, What have your peak flow
ask your doctor.
How many asthma attacks
understand asthma? Clinical content provided by Healthwise. Copyright 2005, Healthwise, Incorporated. have you had since your last All rights reserved.
Do you have any questions visit? How severe were the about what it does to your lungs? symptoms? Did you have to Are there any new treatments or Your asthma plans
helps you make quick decisions get emergency help? medicines available? An important part of managing during an attack. The action plan How often are you using
your asthma is to develop a daily is based on your green, yellow, Do you understand your your relievers? How long treatment plan and an asthma and red asthma zones. treatment and action plans? does a canister of reliever action plan. Your asthma action Your doctor will help you fill Do you feel they need updating? plan helps you act quickly during out your asthma action plan. Do you understand your Is asthma causing any
an asthma attack. You create He or she may ask you to add problems at work, school, or both of these with your doctor. information to it. Do you know which ones you in other areas of your life? Daily treatment plan.
Your asthma worksheets
need? Do they give you side A daily treatment plan includes effects? Do you understand how your personal goals and the The following worksheets can to use controller and reliever medicines you use every day. help you get and keep control of medicine? Do you know how to your asthma. Discuss them with Asthma action plan.
use a metered-dose inhaler? your doctor. You may want to An asthma action plan helps make copies of some of them so you manage asthma attacks. This that you can use them again. Ask your doctor about your treatment and action plans and the
medicines you are taking. Your doctor will want to know how

An asthma action plan helps you manage asthma attacks. This
often you have asthma symptoms and how severe they are.
helps you make quick decisions during an attack. Work with your
doctor to complete the asthma plans on the following pages.

REQUIRED BARCODE POSITION 20 Chapter 5 Daily treatment plan
Asthma action plan Chapter 5 21
Write your asthma goals and ask your doctor to fi ll out the details Make sure your red zone information is handy. Post this on your about your medicines in the chart below. This will help you and refrigerator, near your peak fl ow meter and medicines, and in your doctor develop the best plan to treat your asthma.
your car. Make sure you can always fi nd it easily. My asthma goals are:
Red zone means DANGER! Seek immediate medical help.
My red zone is . This is less than 50% of my personal best. Symptoms:
My symptoms are very bad. I have severe shortness of breath. It is diffi cult to talk. • Take puffs of my reliever medicine called . • Begin or increase treatment with oral steroids. Take mg now. MEDICINE
• Call my doctor at . USE IN A DAY
• If I cannot contact my doctor, I need to go directly to the emergency room. The emergency room phone number is _. • Other numbers I might call are _ Yellow zone means CAUTION! You need to act.
My yellow zone is . This is 50%-79% of my personal best.
I have increased symptoms, such as coughing, wheezing, or chest tightness. My Relievers (for attacks only)
symptoms may wake me at night. I may need more reliever medicine before my symptoms improve.
• Take _ puffs of my reliever medicine called _. Repeat _ times. • Take _ puffs of my medicine called _. Take it _ times a day. • Begin or increase treatment with oral steroids: • Call my doctor at if my symptoms don't get better.
Green zone means GO! You want to be in the green zone.
My green zone is . This is 80% or more of my personal best.
I have no symptoms. My breathing is good with no cough, wheezing, or chest Medicines may interact with other medicines and have side effects. tightness during work, school, exercise, or play. I can do my usual activities.
Talk to your doctor about possible interactions and side effects.
• I will continue with the controller medicines listed in my daily plan. REQUIRED BARCODE POSITION

Source: http://wellness.unl.edu/pdf/KnowNumbers/BCBSNE%20Adult%20Asthma%20Workbook.pdf

Microsoft word - headaches.doc

Headache can be classified into two broad categories: primary and secondary. Primary headaches include cluster and tension headaches. Secondary headaches are triggered by an underlying disorder – such as infection, injury or a Headaches can have more than one contributing factor the muscles and skin of the head, neck and shoulders


The Roles of β-Tubulin Mutations and Isotype Expression in Acquired Drug Resistance J. Torin Huzil1, Ke Chen2, Lukasz Kurgan2 and Jack A. Tuszynski11Department of Oncology, University of Alberta, Edmonton, Alberta. 2Department of Computer and Electrical Engineering, University of Alberta, Edmonton, Alberta, Abstract: The antitumor drug paclitaxel stabilizes microtubules and reduces their dynamicity, promoting mitotic arrest