Just diagnosed

With the right care and medicines, most people can keep their asthma under control and live a full and active life.

Below are the answers to some of the questions you may have about your asthma now you have just been diagnosed.

Asthma is a condition that affects your airways – the small tubes that carry air in and out of your lungs. Asthma makes the lining of your airways swollen and sensitive (inflamed) and also makes the muscles around your airways tighten, making it harder to breathe. Sticky mucus or phlegm can be produced which you may cough up. All of these reactions cause the airways to become narrower and irritated which may make you:

• cough
• wheeze or make a whistling sound in your chest
• feel short of breath
• have a tight feeling in your chest.

These are the main symptoms of asthma. You may have only one of these symptoms or you may have more than one. Some people experience them from time to time; a few people may experience these symptoms all the time.

It is hard to say for sure what causes asthma. What we do know is that:

• asthma can start at any age
• you are more likely to develop asthma if you have other people in your family with asthma, eczema or allergies
• smoking during pregnancy increases the chance of a child developing asthma
• air pollution can make asthma symptoms worse
• some asthma may develop after a viral infection, such as a cold or flu
• some substances found in the workplace may lead to a person developing asthma (this is called occupational asthma)

Over five million people in the UK have asthma, so you are not alone. You can find more information about asthma and what causes it on the Asthma UK website.

Things that make your asthma worse are called asthma triggers. A trigger is anything that irritates your airways and causes the symptoms of asthma. Your triggers may not be the same as those of other people with asthma.

It can be difficult to identify exactly what triggers your asthma. Sometimes the link is clear, for example when your symptoms start within minutes of being near a cat or dog. But some people can have a delayed reaction to an asthma trigger, so some extra detective work may be needed.

Common triggers include cold or flu, tobacco smoke, changes in the weather, pollution and exercise. Allergens are also common asthma triggers. Allergens are substances which cause you to have an allergic reaction and include tree and grass pollen, house-dust mites, and furry or feathery animals.

It is not always possible to keep away from your asthma triggers all of the time, but avoiding them whenever you can is an important way to help your asthma stay under control.

You can find more information about asthma triggers on the Asthma UK website.

There is currently no cure for asthma. However, there are safe and effective treatments available to help you control your asthma.

If you have occupational asthma - the type of asthma that is caused by certain substances in the workplace - and it is diagnosed quickly and the cause is removed, your symptoms may go away completely.

Chemicals called isocyanates are the most common cause of occupational asthma in the UK. Jobs that may bring you into contact with these chemicals include spray painting, and making foundry cores and surface coatings. Other causes of occupational asthma include dust from flour and grains, and wood dust.

When children are diagnosed with asthma, some of them will lose their symptoms by the time they are adults. But the underlying condition does not go away and their symptoms may come back again in later life.

With the right care and medicines, most people with asthma can keep their asthma under control. It is very likely that you will be able to carry on living a full and active life, doing all the things that you enjoy.

To help keep your asthma under control you may need to take regular asthma medicines. Your doctor or asthma nurse will talk with you and agree the best medicines for you.

You will need to be careful about your asthma triggers. For example, if exercise triggers your asthma, your doctor or asthma nurse will be able to advise you how to adjust your medicines so that you can continue to enjoy keeping fit and active. Many professional sports men and women have asthma but are still able to perform at a high standard.

Children and young people, and their parents and carers, often worry about how asthma will affect life at school. Asthma UK can offer you lots of help and information about this. To find out more, go to the Asthma UK website.

You can also call the Asthma UK Adviceline where you can talk to a trained asthma nurse in confidence. Call 08457 01 02 03 on Monday to Friday, 9am to 5pm, calls are charged at a local call rate of 4p per minute.

The most effective way of taking many asthma treatments is to inhale the medicine so it goes straight to your airways. There are two main types of inhaled medicines.

‘Reliever’ inhalers work by relaxing the muscles that surround your airways. The airways can then open up. Relievers are usually blue, and the medicine in them works within a few minutes. Like everyone with asthma you should have a reliever inhaler, even if your asthma is very mild. They are essential in treating asthma attacks and you should always carry your reliever inhaler with you.

If you have asthma symptoms that mean you need to use your reliever inhaler three or more times a week, your doctor or asthma nurse will probably advise you to also take a ‘preventer’ inhaler.

Preventers work to help control the swelling and inflammation in your airways making them less sensitive. They reduce your chances of having an asthma attack. Preventers are usually brown, beige, red or orange. They protect your airways from being sensitive but only if you remember to take them every day, even when you are feeling well, as the protective effect builds up. If your asthma is not kept under control with preventer and reliever inhalers you may need to add on other asthma treatments. These can include other types of inhalers and tablets. The Asthma UK website has lots more information about asthma treatments.

Find out more information about asthma medicines for children.

You can also call the Asthma UK Adviceline where you can talk to a trained asthma nurse in confidence. Call 08457 01 02 03 on Monday to Friday, 9am to 5pm, calls are charged at a local call rate of 4p per minute.

There are lots of different inhaler devices available and it is important that you are given one that you are comfortable with and can use properly. Your doctor or asthma nurse will help you with this. They should also show you how to use your inhaler/s correctly.

You can see a demonstration of how to use some of the most common inhaler devices on the Asthma UK website.

You may be given an aerosol (press and spray) inhaler. These are easier to use with a spacer. Spacers are important because they help the medicine get to your airways more effectively. A spacer is a large plastic or metal container, with a mouthpiece at one end and a hole for the inhaler at the other. You can read more about spacers at the Asthma UK website.

Young children should always take their aerosol (press and spray) inhalers through a spacer. Children under about three years old will need a spacer with a mask. You can find out more about spacers for children on the Asthma UK website.

Asthma medicines are safe and effective and the benefits of taking your medicines usually far outweigh any possible side effects. Taking your asthma medicines means you are much less likely to have an asthma attack. They keep your asthma under control so you can live a full and active life. They can also help prevent your airways from becoming permanently damaged.

Because inhaled medicine goes straight to where it’s needed in your airways, each dose is very small. This means that less medicine goes into the rest of your body than if you were taking it as a tablet and you have less chance of side effects.

Occasionally, reliever inhalers can increase your heartbeat for a short time or give you mild muscle shakes. These effects are more common when taking high doses. However, they generally wear off within a few minutes or a few hours at most.

If you use a preventer inhaler there is a small risk of having a sore tongue, sore throat, hoarseness of the voice or a mouth infection called oral thrush. To help prevent these side effects, rinse your mouth out and brush your teeth after using your preventer inhaler. Using a spacer will also help reduce the possibility of thrush.

You can read more about side effects of asthma medicines on the Asthma UK website.

You can also call the Asthma UK Adviceline where you can talk to a trained asthma nurse in confidence. Call 08457 01 02 03 on Monday to Friday, 9am to 5pm, calls are charged at a local call rate of 4p per minute.

It is difficult to say for sure how long you will need to take your asthma medicines. Many people do need to take them for life.

It is normal for your asthma to be better at some times than others. This means that you may have to take more medicines when your asthma is worse so that your symptoms don’t interfere with your life too much. But there may also be times when you need less asthma medicine. Some people have times when they only need to use their reliever inhaler now and again.

Most medicines used to treat asthma are available on the NHS but you will still need to pay standard prescription charges unless you are entitled to help with your health costs. Unfortunately, asthma is not one of the long-term medical conditions covered by the prescription charge exemption system in the UK.

If you have to pay for your prescriptions, you may find it works out cheaper to buy a prescription pre-payment certificate (PPC) where you pay a certain amount ‘up front’. You can then get unlimited prescriptions. PPCs can be bought at three-monthly or yearly intervals.

For more information, please read the factfile ‘Prescription Charges’ on the Asthma UK website.

To find out whether you are entitled to help with your prescription costs, or to find out about PPCs, visit the Prescription Pricing Authority.

Asthma medicines are safe and are the most effective way to control your asthma. Some people are interested in trying treatments and therapies that do not use prescribed medicines. They are often called complementary therapies and can include things such as yoga, acupuncture, homeopathy and breathing techniques.

At the moment, there is not enough evidence to show that complementary therapies work well to treat asthma, especially when they are used on their own. If you are interested in trying one of the many complementary therapies available, you should speak to your doctor or asthma nurse first.

It is very important that you don’t stop taking your normal asthma medicines without talking to your doctor or asthma nurse first.

For more information about complementary medicines, read the factfile ‘Non-drug approaches to managing your asthma’ on the Asthma UK website.

From time to time, you may need to measure how well your airways are working. This is done by blowing into a small device called a peak flow meter. Your doctor or asthma nurse should show you how to use a peak flow meter. You can get one on prescription or over the counter at your pharmacist. Peak flow meters are not suitable for young children (usually under six years old) because the readings can be unreliable.

Sometimes, no matter how careful you are about taking your asthma medicines and avoiding your triggers, you may find that you have an asthma attack. It is important that you know how to recognise an asthma attack, and that you know what to do.

You are having an asthma attack if any of the following things happen:

• your reliever inhaler does not help your symptoms
• your symptoms are getting worse (coughing, wheezing, tightness in the chest or shortness of breath)
• you are too breathless to speak, eat or sleep.

The following steps are suitable for both children and adults and explain what you should do if you have an asthma attack.

• Take your reliever inhaler (usually blue), straight away.
• Sit down and ensure that any tight clothing is loosened. Do not lie down.
• If you do not feel better straight away, continue to take one puff of your reliever inhaler every minute for five minutes or until symptoms improve.
• If your symptoms do not improve in 5-10 minutes – or if you are in doubt – call 999 or a doctor urgently.
• Continue to take one puff of your reliever inhaler every minute until help arrives.

Do not be afraid of causing a fuss, even at night. If you are admitted to hospital or an accident and emergency department because of your asthma, take details of your medicines with you.
Most asthma attacks happen after symptoms have gradually got worse over a few days - so if you notice this happening, don’t ignore it.

Follow the advice from your doctor or asthma nurse but if you are unsure what to do make an urgent appointment to see them.

Quite often, using your reliever is all that is needed to relieve your asthma symptoms when you start to have an asthma attack. At other times, symptoms are more severe and more urgent action is needed.

Asthma UK produces an Asthma Attack Card that contains information about what you should do if you are having an asthma attack. They can also help people around you to know what to do. If you would like to order a free Asthma Attack Card call 08456 03 81 43 or visit the Asthma UK website to order online.

There are a few things you can do that will help you to stay well and keep your asthma under control.

• Follow the advice of your doctor or asthma nurse. This should be written down in a personal asthma action plan. The plan should be completed by your doctor or asthma nurse, in discussion with you. It should contain details about your asthma medicines, how to tell when your symptoms are getting worse and what you should do about it, and emergency information on what to do if you have an asthma attack.
  Get more information about personal asthma action plans on the Asthma UK website.
  
• Avoid your asthma triggers wherever possible.
  Get more information about triggers on the Asthma UK website.
  
• If you smoke, think about trying to stop. Smoking is particularly bad for someone who has asthma. It can increase your risk of having an asthma attack and it could permanently damage your airways. Smoking may also prevent some of your asthma medicines from working properly.
  Get more information about asthma and smoking on the Asthma UK website.
  
• Try and follow a healthy lifestyle by eating a healthy diet with plenty of fresh fruit and vegetables and doing regular exercise. This will help you stay well so you can fight off cold and flu viruses which are common asthma triggers.
  

Regular exercise is good for everyone, including people with asthma. The majority of people with asthma should be able to take part in any type of activity or exercise they enjoy, as long as their asthma is under control. If exercise triggers your asthma, ask your doctor or asthma nurse how you can get your symptoms under control so you can exercise safely.

There are some tips about exercising with asthma on the Asthma UK website.

The Asthma UK website has lots of information about asthma. The section called ‘All About Asthma’ is a good place to start.

Asthma UK has lots of information to help you manage your asthma that you can order online.

Or speak to Asthma UK’s Supporter & Information Team, 08456 03 81 43 or info@asthma.org.uk.

You can also talk to an asthma nurse specialist, in confidence, by calling the Asthma UK Adviceline 08457 01 02 03  (weekdays 9am to 5pm), calls are charged at a local call rate of 4p per minute.

The Asthma UK Adviceline can be contacted using Typetalk, and an interpreting service is also available if required.

Or if you have a simple question about your asthma, you can send an email to the Asthma UK Adviceline nurses.

Finding out that you have asthma can be confusing and frightening, especially if you have had an asthma attack. It is important to remember that if you learn to take control of your asthma you can still live a full and active life.

Sometimes sharing your feelings with other people who also have asthma can help and reassure you. There may be a local support group in your area. Your doctor or asthma nurse should be able to give you this information. You might also want to share your feelings with your family and friends so they know how your asthma affects you.

The Asthma UK website also has an online discussion forum where you can share your experiences and feelings about your asthma. To take part you will need to register.

If you would like to speak to someone about your asthma face-to-face, make an appointment to have an asthma review with your doctor or asthma nurse. You can also ask your pharmacist if you can discuss your asthma with them next time you are in your pharmacy. They can offer you a Medicines Use Review where you can discuss your medicines and how they work.