What is Asthma?
Asthma is a chronic inflammatory condition of the airways that can make it hard to breathe (Ontario Lung Association, 2015).  If you have asthma, your airways (breathing passages) can get inflamed causing it to swell and produce extra mucous, or the muscles around your airways can tighten up (“twitchy”).  This condition leads to narrowing of the airways which makes it difficult for the air to pass through.

Asthma signs and symptoms include:

• Coughing
• Wheezing
• Chest tightness
• Shortness of breath (at rest or when exercising)

The exact cause of asthma is unknown.  However, there are different things that can cause asthma attacks. These triggers can affect the person with asthma differently.  The Asthma Society of Canada (2017) classified these triggers based on how they affect the airways.

1. Inflammatory/allergic triggers can cause inflammation in the lining of your airways (i.e., irritation, redness, swelling) producing more mucous.  This makes your airways narrower and harder for the air to pass through.  Examples of inflammatory triggers are:

• Dust mites
• Animals
• Cockroaches
• Moulds
• Pollens
• Viral infections
• Certain air pollutants

2. Symptom/non-allergic triggers generally do not cause inflammation.  However they can make the muscles surrounding the airways sensitive (“twitchy”), and can tighten up especially if they're already inflamed.  This make your airways narrow and less area for the air to pass through. Examples of symptom triggers are:

• Smoke
• Exercise
• Cold air
• Chemical fumes and other strong-smelling substances like perfumes
• Certain food additives like sulfites
• Certain air pollutants
• Intense emotions

Management of Asthma
Asthma cannot be cured but it can be managed.  With good asthma management, you should usually be free of symptoms and enjoy a full and active life.  Good asthma control is achieved when:

• You are using your reliever (short-acting puffer) less than 4 times per week (except for exercise);
• You are having daytime asthma symptoms less than 4 times per week;
• You are having night time asthma symptoms less than once per week;
• You have no absence from work or school related to your asthma

You can make sure your asthma is consistently well-controlled by:

• avoiding your asthma triggers
• taking your asthma medications as prescribed   https://www.on.lung.ca/page.aspx?pid=404
• following your written Asthma Action Plan  provided by your doctor
• getting your vaccination (annual flu shot, pneumococcal vaccines)
• work with your healthcare team (doctor, RN, pharmacist) to get your asthma under control

Take this quiz (link) to find out if your asthma is well-controlled:
https://howmuchistoomuch.ca/en/

Follow your Written Asthma Action Plan
If you don’t have an Asthma Action Plan, ask your doctor.  You can also print one out and ask your doctor to fill it in.  An Asthma Action Plan is a personalized written set of instructions what medications to take based on your symptoms.  It tells you the following:

• what symptoms you should watch for
• what your symptoms mean
• how to adjust your medication according to your symptoms
• when to call your doctor or 911

The action plan uses 3 colored zones.  The green zone describes good control of asthma and continue with the current therapy.  The yellow zone defines a decrease in controlling asthma symptoms.  This means that you need to adjust the medications or seek medical assistance.  The red zone occurs when your asthma is out of control and severe enough to seek an urgent medical care/emergency.

Resources and Support
The Lung Association (https://www.on.lung.ca)
Asthma Society of Canada (http://asthma.ca)
Lung Health Information Line 1-888-344-LUNG (5864), Mon-Fri, 8:30am-4:30pm