Cough-Variant Asthma

Cough-variant asthma is common, especially in children. If you have cough-variant asthma, your main symptom is coughing, frequently at night. During the day, you feel fine and have no other symptoms. In fact, you may even find it hard to believe that your cough is asthma because you don't wheeze or have other typical asthma symptoms.

If you find you're not sleeping at night because you keep waking up coughing, you may have cough-variant asthma. Or, if you find that you are coughing during the day but do not have a cold or other illness, you may have cough-variant asthma. Your doctor may ask you to monitor your asthma using a peak-flow meter for two weeks. The goal of this monitoring period is to see how your breathing ability changes over time. A peak- flow meter can tell you whether your airways are narrowed.

Once your diagnosis is established, you and your health care provider will develop a personal asthma management plan for you, "Managing Your Asthma Day to Day." This plan includes asthma medications and a medicine plan, "Asthma Medications."

Situations of Living With Asthma - Under the Weather

It's morning and you don't quite feel well. Should you go to work or school or stay home? In general, you can probably go to the office or school if you have a stuffy nose but are not wheezing or if have a little wheezing that goes away after taking your asthma medicine. It's probably a wise decision to stay home from work if you have:

- a sore throat; swollen, painful neck glands; or other physical signs of infection

- a temperature greater than 100 degrees Fahrenheit (F) [oral] or 101 degrees F (rectal)

- wheezing or coughing that still bothers you after 1 hour after taking your asthma medicines

- weakness or fatigue that makes it difficult to perform your daily activities

- difficulty breathing or breathing very fast

- peak-flow reading below 65 to 70 percent of your personal best and no response to treatment

If you are unsure whether you should stay home, call your doctor. Be prepared to describe your symptoms and when they appeared.

Medicine Plan of Special Types of Asthma

The goal of a medicine plan for this kind of asthma is to help you maintain normal activity levels without asthma symptoms. Your health care provider will tell you how to prepare your airways for exercise or other strenuous activity. As with other forms of asthma, the key is to treat your airways before symptoms begin, or at least worsen.

For most people with exercise-induced asthma, inhaling a short-acting beta9 agonist within an hour before exercise prevents asthma symptoms. You can usually count on the medication working for about two to three hours. Other medications your doctor may prescribe are cromolyn and nedocromil. Again, these medications are taken before exercise.

You also may get less, and less severe, exercise-induced asthma if you use anti-inflammatory medications on a regular basis. You and your doctor will decide if this option is better for you.

What to Remember About Inhaling Asthma Medicine

You Have A Choice. When deciding how to inhale quick reliever or long-term controller medications, you have several options. MDIs are the most popular way to inhale asthma medicine. But you also can try a dry powder inhaler or, if you have severe asthma, a nebulizer. Consider using a spacer, which makes inhaling medication easier. Keep in mind that inhalers are improving. Ask your doctor about different types.

Technique Matters. Your inhaler only works if you use it correctly. Learning how takes time, patience, and practice. Ask your health care provider how to use an inhaler. While still at the doctors' office, practice. Also, get written instructions about using inhalers. Last, bring your inhaler to your check-up visits. Each time, show your doctor how you're using it. All this may sound like a lot of effort just to take your medication. But it's worth it. Good inhaler technique will help you get the full effect of your medication.

What should you do before going to the doctor

During the time leading up to your appointment, start a list of things you want to discuss. Take notes. Write down questions and symptoms as soon as they occur to you. Plan to update your doctor about anything that has happened since your last visit. For example, you should let your health care provider know about a recent emergency room visit; a recent cold or other illness; any changes in your weight, sleep, energy level, or appetite; side effects from medication you may be taking; and any major stresses or changes in your life.

If you start an asthma diary, you might keep your "topics to discuss" list with that diary. This list will help jog your memory when you're at the doctor's office. On the day of your doctor's appointment, bring this list. Also bring your asthma diary and medications, including those prescribed by other health care providers and nonprescription drugs that you take regularly.

How to use a nebulizer correctly

1. Wait one hour after eating before using your nebulizer. Alternatively, you can use the nebulizer before eating. Wash your hands before you get started.

2. Measure the amount of saline (salt water) solution and medicine to go into the nebulizer cup. Most people like to buy pre-mixed medication that you can just pour into the cup.

3. Attach the mouthpiece to the T-shaped part and then attach this to the nebulizer cup. (If you're using a mask instead of mouthpiece, fasten it to the cup.)

4. Put the mouthpiece in your mouth, and tightly close your lips around it. (Or place the mask on your face.)

5. Turn on the air compressor machine.

6. Slowly take deep breaths in through your mouth.

7. Hold each breath for a second or two before breathing out.

8. Repeat this procedure for about 10 minutes or until all the medicine is gone from the cup.

What To Remember About Quick Relievers

Don't Overuse Them. If you need to use a quick-reliever medicine often, it may be a sign that the swelling in your airways is getting worse. It also may mean your medication isn't working properly. If you need a short-acting beta agonist at least 3 times a week, see your doctor. You may need to take a controller medication every day, while using a quick reliever just during asthma attacks. (One exception to the no-more-than-3-times-a-week rule is exercise-induced asthma. If you are an athlete with asthma, ask your doctor how often to take asthma medication.)

Technique Matters. No matter what your asthma symptoms, your doctor probably will suggest that you keep an inhaler nearby in case you need a quick reliever medication during an asthma attack. To get the full benefit of these drugs, you must use the right inhaler technique.

Exercise-Induced Asthma

What do track star Jackie Joyner Kersee and diver Greg Louganis have in common? Both have won Olympic medals. Both also have asthma. They and other athletes, including "weekend warriors", know that it's possible to exercise even if you have asthma. Most people with asthma get symptoms during vigorous activity.

For some, exercise is the only trigger. Either way, you don't have to stop being active, but you do need to take special care. If your asthma only occurs during a game of tennis, pick-up basketball, a run through the park, or other sports activity, you have exercise-induced asthma. Having this form of asthma doesn't mean you have to avoid these sports. Often, using an inhaled bronchodilator before, during, or after your workout (or sometimes all three) can control this kind of asthma.

Which Drugs Are Unsafe For Pregnant Women?

There are a few drugs you should avoid taking while pregnant, if possible. Ask your doctor about specific medications if you have a condition that requires medicine. In general, avoid taking:

- Decongestants: These over-the-counter medicines are used to treat colds.

- Live virus vaccines: Ask your doctor before getting any vaccine while pregnant. Killed-virus vaccines, in which the virus is deactivated entirely, are okay.

- Immunotherapy: These allergy shots are okay if you already are taking them. If you aren't, wait until after your pregnancy to begin.

- Iodides

- Over-the-counter inhalers: Don't use over-the-counter medications, like epinephrine, phenylephrine, or brompheniramine. Instead, ask your health care provider which medicine is right for you.

Trigger of Special Types of Asthma

Exercise-induced asthma, sometimes called exercise-induced bronchospasm-, is believed to be caused by a loss of heat, water, or both from your lungs because you are breathing more heavily than normal. Typically, the air you inhale is cooler and drier than air in your lungs, which is warm and moist. The exchange of air leaves your airways dry and cold. There is disagreement, however, whether cold or dry air is the true culprit.

During exercise-induced asthma, your airways constrict minutes after you become active. You may cough, wheeze, feel tightness or pain in your chest, or get other asthma symptoms. Exercise-induced asthma usually happens during or minutes after vigorous activity, peaking about 5 to 10 minutes after you stop. Symptoms go away 20 to 30 minutes later.

Occupational Asthma

Sometimes, your workplace can cause asthma. About 2 percent of all cases of asthma are related to the job. What are the clues? Symptoms usually appear within a few months to about four years after your first exposure. Your coworkers might have similar symptoms, such as wheezing, chest tightness, and difficulty breathing. You should suspect occupational asthma if you notice that asthma symptoms go away when you're away from work for several days, such as for a vacation or at the end of a weekend.

You might miss this cause-and-effect relationship if your symptoms appear only after you've been at work for several hours. Asthma symptoms may occur within your first hour at work, or as much as eight hours later, or even at night.