Do you cough without a cold?  Do you get winded easily?  Hmmm. . . asthma comes to mind.

Frequently asthmatics are not adequately controlled.  Symptoms are frequently a wheeze, cough or feeling “tight.”  Some have a cough that they just can’t kick. . . so, a “cold” may actually be asthma.

A full history is needed.  How often are symptoms?  Any triggers?  Nighttime cough?  Any medicine used in the past?  How often was it dosed?  Did it work effectively? There may be triggers like seasonal allergies or exercise.   And, then, of course,  a physical exam.  Maybe a xray.

Next is

• patient education (do daily peak flows to show lung air volume) ,
• environmental control (even beloved pets should not sleep in bedrooms), and
• manage other conditions (like allergies).

Guidelines show a stepwise approach for asthma management is best.  Patients may need daily medication so that rescue inhalers are not used more than twice weekly.  There are long-term medications that work best to control symptoms, and then in another category are rescue medications (like a life-preserver is used when someone is drowning).

I have cared for adult asthmatics in the ICU that the rescue inhalers, taken (inappropriately) 30 times a day, no longer work.  Frightening and, occasionally, deadly.

The goal of asthma therapy is to live like you DON’T have asthma.   That is the goal!