Severe Asthma: 8 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Karon Warren on September 5, 2020
  • smiling-doctor
    Education and action are key components to controlling severe asthma.
    Asthma is a chronic lung disease. During an asthma attack, the airways of your lungs become inflamed and swollen, making it difficult to breathe. Episodes of coughing, wheezing, fast breathing, breathlessness, chest tightness, and cyanosis (bluish skin from low oxygen) are common. Asthma stages depend on frequency and severity of symptoms and include intermittent asthma, mild persistent, moderate persistent, and severe persistent, or severe asthma. Working with your pulmonologist, you can develop a plan to control your asthma. Here is what these practicing doctors who treat severe asthma would like you to know about this condition.
  • doctor-showing-patient-inhaler
    1. Be honest with your doctor.
    Although tests help diagnose severe asthma, pulmonologists also rely on you to fully understand how asthma and your asthma treatment plan affects your quality of life. “The key thing is to find out the individual’s concerns so they’ll feel more comfortable following through on their treatment plan,” says Andrew G. Weinstein, MD, associate clinical professor of pediatrics at Thomas Jefferson Medical College in Wilmington, Del. “We need to address those upfront.” Weinstein recommends bringing a list of questions or concerns with you to your appointment.
  • Doctor, patient
    2. Get involved with your care.
    Rather than leave your severe asthma treatment decisions solely to your doctor, be proactive in your care to best control your asthma. “I have seen tremendous benefits when a patient understands his or her disease, grasps the concept of airway inflammation, and then uses this knowledge to control it,” says Thomas Ardiles, MD, FCCP, a board-certified internist with Banner University Medical Center in Phoenix. “Once our patients engage in their care, they see the greatest benefit.” You and your doctor are partners in your care. Work with your doctor to understand your asthma and fine-tune a treatment plan that you can consistently follow to manage your severe asthma.
  • man wiping nose
    3. Asthma triggers are not limited to allergies.
    Asthma triggers are different for everyone. Airborne substances, pollutants, physical activity, and even changes in the weather can bring on an asthma episode. It might surprise you to know that other conditions can also increase your risk for an asthma attack. “There is a myriad of triggers, such as acid reflux (GERD), sinusitis, nasal polyps, and respiratory infections—particularly viruses, that affect those with severe asthma,” says Clifford W. Bassett, MD, founder and medical director of Allergy & Asthma Care of New York in New York City. Talk with your doctor about your medical history and other seemingly unrelated symptoms you are experiencing.
  • closeup of inhaler on table
    4. Inhaled steroid medications have minimal side effects.
    It’s common for asthma patients to express concern about taking inhaled steroids, thinking they could have the same effects as oral steroids. However, that is not the case. “Inhaled steroids are one of the most effective medications [for treating asthma],” Dr. Bassett says. “In general, these invaluable medications are not usually associated with side effects, and when they are, [side effects] are often quite mild.” Common side effects of inhaled steroids include hoarseness, a change in voice quality, and growth of yeast in the mouth or throat. Discuss any concerning side effects with your doctor.
  • Woman using inhaler
    5. Proper use of inhalers is essential to treatment.
    If you feel like your inhaled steroid is not providing relief, it may have to do with how you are using your inhaler. Patients often report their inhaled steroids are not working. However, when doctors dig deeper, they typically discover patients are not using their inhalers correctly. This results in getting an incomplete dose of medication. “Poor inhaler technique is a common cause of lack of response to asthma therapy and should be evaluated when starting or before adjusting inhaled mediations,” says Schuman Tam, MD of Marin General Hospital in Greenbrae, Calif. If your doctor prescribes an inhaler, make sure you know how to correctly use it and don’t hesitate to ask questions.
  • concerned woman sitting in chair
    5. Depression can be associated with severe asthma.
    Episodes of severe asthma can deter people from going out with friends, can interfere with work, or keep you from participating in a favorite hobby, leading to bouts of depression. “Many patients will have issues of depression resulting from dislocation,” Dr. Weinstein says. “We have to find out their interests and encourage them to get back at it.” As patients achieve control of their symptoms, become more active, and resume their usual social interactions, Weinstein says the depression will go away. Tell your asthma specialist or primary care doctor if you are experiencing symptoms of depression—such as lack of interest in activities, trouble sleeping, and unexplained irritability—longer than a couple of weeks.
  • Woman writing in journal
    7. Create an asthma action plan as part of treatment.
    “A written asthma action protocol helps lead to successful severe asthma control, reducing the risk of serious complications,” Dr. Bassett says. Elements of the asthma action plan include your pulmonologist’s name and contact information, an asthma severity rating based on your symptoms, a list of daily medications, a baseline peak flow level of asthma severity, and symptoms when to seek medical attention. An asthma action plan can help you recognize when your symptoms are getting worse and when to seek urgent care for wheezing, cough, and trouble breathing that is not responding to your prescribed treatment plan.
  • Women friends
    8. Involve caregivers in any treatment plan.
    Many severe asthma patients enlist the support of family and friends when treating their disease. Doctors recommend that trusted individuals be included in any asthma treatment plan. “I see the caregiver as part of the team,” Dr. Ardiles says. “This individual’s level of education and understanding of the disease, the medication regime, and trigger control are key to a good outcome for the patient and can be equally as important as the engagement of the patient himself.” A trusted friend or caregiver can help recognize asthma triggers and changes in your symptoms and help you treat an asthma attack. If you experience a severe asthma attack, that person will know what to do to help you get the care you need.
Severe Asthma: 8 Things Pulmonologists Want You to Know
Contributors
  1. Asthma. Centers for Disease Control and Prevention. https://www.cdc.gov/asthma/default.htm
  2. Asthma Severity among Adults with Current Asthma. Centers for Disease Control and Prevention. https://www.cdc.gov/asthma/asthma_stats/severity_adult.htm
  3. Asthma Severity among Children with Current Asthma. Centers for Disease Control and Prevention. https://www.cdc.gov/asthma/asthma_stats/severity_child.htm
Was this helpful?
65
Last Review Date: 2020 Sep 5
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.