Recently on social media I have become so aware that many with asthma do not have the essential tools they need to enable them to manage their asthma effectively and live a life where asthma does not impede their daily routine.
1. Personal Asthma Action Plan (PAAP)
or action plan for short. This is essential for every asthmatic no matter how mild or severe your asthma is having a PAAP is your go to if your asthma is bothering you. A PAAP needs to be filled out in conjunction with your asthma nurse, asthma consultant or GP- whoever has the most input to your asthma care. The PAAP is a basic step guide telling you what to do when you asthma symptoms get worse or if you are having as asthma attack.
There are many different types of PAAP available. I like the ones which are colour coded red, amber green but you get ones without colour but still have the same step system. There are also mobile apps available which you can input your information into.
If you have very severe asthma and your asthma does not fit on the generic PAAP you can make your own with your asthma team.
For example I have one that is just written on an A4 piece of paper with the different steps I need to take depending on how I am feeling and what my peak flow readings are. I am on maximal inhaled therapy which is why I cant use a generic PAAP but it doesn’t mean I cant have a PAAP.
Your PAAP should be reviewed at your annual asthma review or whenever your medication changes. Please make sure YOU ask your care provider to go through your plan and make sure it is accurate. Also make sure you know where it is and what you should be doing with it.
For template PAAP you can just google “personal asthma action plan” and it comes up with a host of different types of plan that can be used.
2. Peak flow
One of the key tools and device every asthmatic should have is a peak flow meter. The peak flow meter is the main tool used to monitor how well our lungs are functioning. Using a peak flow when we are well gives a base line so that if the peak flow reading drops we know that there is something up with our asthma. Often in some asthmatics the peak flow reading will drop before we feel any symptoms. This is key and acting on this change by following our PAAP can stave off an attack or becoming seriously unwell.
The peak flow is a key diagnostic tool in primary care (GP surgery or asthma nurse) and most will have had to do a 2 week peak flow diary prior to being diagnosed.
Keeping a peak flow diary allows us as asthmatics to see how our asthma is doing and identify any trends particularly for female asthmatics who may find their asthma gets worse prior to, during or after their monthly cycle. It is a faff to remember to write down your results but it is worth it. I have my peak flow meter next to my inhalers so if I forget to do my inhalers I forget my peak flow too but as I have an app on my phone that reminds me to take my meds (as well as them sitting out on the bunker next to my toothbrush) so I have no excuse. I also use an electronic peak flow meter which stores all my results because I was hopeless at writing the numbers down.
A peak flow is not very handy when you have an asthma attack as your breathing is a bit disordered during an attack but can be handy for seeing how you are recovering from the attack. This is why it is so key to know what your peak flow is when you are well so you can see where your lungs are.
If you do not have a peak flow meter you can either ask to be prescribed one or they are fairly inexpensive unless you want a really fancy one but every asthmatic needs one- no excuses!
3. Understanding your asthma & what your medication does.
I feel that to really get to grips with asthma control you need to understand what asthma is, the type of asthma you have and what your medication is and how it works.
There are so many misconceptions about asthma many which stem from the media but asthma can affect anyone at anytime. There are a large number of different types of asthma which require different types of treatment. A few types of asthma are: exercise induced asthma, adult onset asthma, cough variant asthma, allergic asthma, difficult to control asthma, severe asthma, occupational asthma, childhood asthma, seasonal asthma, and non allergic asthma. I am sure I have missed some types out but these are the main ones.
The asthma you have might not be the same as your friends and therefore the treatment plan may be different and also your PAAP will be different. Knowing what type of asthma you have will help you control it and be able to avoid triggers such as cigarette smoke, dust, or animals depending on what affects you.
A big part of asthma control is medication mainly in the form of inhalers. The common form of treatment will be a short acting beta agonist (blue inhaler) also known as a reliever or rescue inhaler and an inhaled corticosteroid (originally the brown inhaler but now there are just about all colours of the rainbow) also known as the preventer.
Most asthmatics will take their reliever because you can feel the effect it has almost instantly when you take it. However many don’t take their preventer because they either don’t feel they need it or they don’t feel the benefit from it. This is where understanding how the medication you are prescribed works and why you need to take it as prescribed.
Even though you don’t feel a preventer inhaler working when you take it I can assure you it is working away in the background without you knowing and in the long run you won’t need your reliever/rescue inhaler nearly so much.
4. Knowing when to get help and what help you need
This kind of comes under your action plan too but not always. If your asthma is bothering you and you are worried this is the time to get help. You may not have hit a target on your PAAP yet but that does not mean you shouldn’t be getting help. Asthma is such a fickle disease that if you the asthmatic are worried then you need to follow your gut.
So often I hear people say that they don’t want to go and get help because they are not that bad YET. But yet is the key word. It is like people like waiting for their asthma to get worse before getting help. I also hear so often that I don’t want to go to A&E because I will be told my sats are fine but this one statement does not mean the nurses and Drs are not caring about your condition. You should be glad of this statement, it is also a statement said not just to reassure you but also them. I know from experience as a nurse that there is nothing worse than an asthmatic presenting to A&E with low sats. This means they are in a bad way and anything could happen- basically low sats and asthma means there is a quick call to the critical care unit and then an anxious wait for them to arrive. Good sats is a good thing in asthma. You may not feel great but think about it from their point of view too. It does not mean they don’t care and they don’t think you should be there. It is a lot easier to turn an asthmatic around while their sats are good than when they are not.
What are the positives of going in early?
- You cause the A&E department way less stress
- You save the NHS money
- You don’t need as much medication
- You don’t need a blues and twos ambulance
But to you the positives are so much more than this!!
- The recovery time is way less
- The stress on your body is far less and your other organs don’t suffer nearly as much
- You don’t subject your body to all the toxic drugs required to correct a really severe asthma attack
- You will not become that patient that strikes the fear of god into the paramedics, A&E staff, Drs when you present in the future
- You life is not impacted nearly so much and you don’t need the weeks off work.
Trust me A&E and your boss would way prefer you to present early as asthma presented early to them is way easier to manage, can be managed way quicker, the nurses and Dr’s don’t need to work as hard and your boss doesn’t have you off work for huge chunks of time while you recover from an extended period of time in hospital.
But taking all you medication as prescribed and following your PAAP can help avoid needing any emergency intervention for your asthma.
These are just some key things I find help me to manage my asthma