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Better Health Guide
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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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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.
REQUIRED BARCODE POSITION
14 Chapter 4
Medicines
Medicines Chapter 4
15
A dry powder inhaler contains
Overuse of reliever medicine
medicine in a powder form.
Since reliever medicine quickly
MEDICINE
WHAT THEY HOW THEY
POSSIBLE
You breathe in quickly and deeply
reduces symptoms, people
ARE TAKEN
SIDE EFFECTS
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
❑
Barrier:
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
WHEN HOW MUCH MOST YOU CAN
• 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.
Symptoms:
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.
Symptoms:
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
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