November 14, 2007
What Triggers Your Asthma?
Without a doubt, the most important question is "What triggers your asthma?" Like those cute battery commercials on TV, what sets off your "asthma bunny" and keeps it going and going? If you can find the culprit and remove it from your environment, chances are you will be bothered by asthma no more. Sounds great, doesn't it? Most of you, however, will have to do some detective work. There will be some trial and error, but if you are patient and methodical, you will discover what makes your asthma tick and conquer it.
You probably know a lot about your asthma already, and I'm sure most of you can name five to ten things that contribute to your attacks. Now you probably even know what type of asthmatic you tend to be and realize that your asthma often shares the features of several different subtypes. While these asthma subtypes are somewhat artificial, they make us better asthma detectives. For those of you who think you have idiopathic asthma, after digging a little deeper we'll probably find at least a couple of things that trigger your asthma. The most important task of an asthma detective is to ask five basic questions each time you have an attack:
- Where am I?
- What am I doing?
- What is around me?
- Do I know what set off this attack?
- How severe is this attack?
After you answer these questions, take out your asthma journal and record the answers, along with the date and time of the attack. Everyone has their own method of keeping an asthma diary, but the following information is standard and will help you and your physician immensely in determining what gets your asthma hopping.
- Date: Date attack started.
- Time: Time you first noticed symptoms.
- Location: Where you were at the beginning of the attack.
- Circumstances: What you were doing when the attack started.
- Trigger: What you know or suspect triggered the attack. If it is a suspicion, put a"?" next to the trigger.
- Severity: How severe you believe the attack is before measuring peak flow. Use a mild-moderate-severe scale.
- Peak Flow During Attack: Actual peak flow during the attack. Remember to take and record three readings.
- Treatment/Interventions: How you attempted to abort the attack. For example, record what type and how much medicine you used, or what you did (for instance, just relax, breathing exercise) in an attempt to relieve your symptoms.
- Time to Resolution: How long it took to feel that the attack was over after the intervention.
- Efficacy: Did the intervention(s) work? Yes, no, or maybe.
- Duration of Attack: How long the attack lasted, from the time you first noticed symptoms to the time you believed the attack was over.
- Peak Flow After Intervention: Peak flow reading at the time you believed the attack was over. Once again, take and record three readings.
Keeping an asthma diary may seem like a pain; however, not only will your diary help you figure out what triggers your asthma, but the simple act of keeping an asthma diary may help your lung function. In one randomized trial, asthmatics who recorded stressful life events in a journal increased their FEV1 from 63.9 L at the beginning of the trial to 76.3 L after sixteen weeks; on the other hand, the control group started with a FEV1 of 64.0 L and ended with a FEV1 of only 65.3 L.
I hope that by recording this data you begin to recognize patterns. You may find that your asthma tends to be worse when in a certain room or performing a particular activity. Share your diary with your healthcare professional and a trusted friend or two, because you never know what a fresh eye may discover.
