5 Pulmonologist Tips for People With Severe Asthma

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    You can get control of your severe asthma.
    I’ve been a pulmonologist, or lung doctor, for 10 years now, and in that time, we’ve learned a lot. A decade ago, we had some decent options for treating asthma. But now, new medications are coming to the market all the time that more specifically treat the root of some types of severe asthma and help ease symptoms. My patients with severe asthma—asthma that’s uncontrolled despite trying many treatments—now have new therapy options that block inflammation at the root to ease symptoms. Because we understand severe asthma better, we can treat it better. Here are the things I want my patients to know about controlling severe asthma.
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    1. Find the right pulmonologist.
    Finding a doctor you connect with can be a tough nut to crack. But partnering with your pulmonologist will help you better manage and understand your severe asthma, which is why it’s so important to find the right one. Patients should look for pulmonologists who listen to them, show empathy and interest in their lives, and take the time to treat them as an individual. Everyone’s severe asthma is different, so finding the right treatment can be a long process--find a pulmonologist you trust and that process will be a lot smoother.
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    2. Avoid triggers as much as possible.
    Severe asthma symptoms often worsen when a patient is exposed to specific triggers. Everyone’s triggers are different, but the most common ones include dust mites, pollen, cockroaches, molds, animals dander, and even hot or cold weather. Work with your pulmonologist to narrow down your triggers, and once you do, try your best to stay away from them if possible.
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    3. Keep “stepping up” treatments until you find a combination that works.
    One way to identify severe asthma is if a patient tries every available treatment but still can’t get control of asthma symptoms. Patients will usually try a rescue inhaler, then a steroid inhaler, a long-acting inhaler, and allergy medications. People with poor asthma control will often need courses of steroid pills. If a patient has used all these medications and still has poor asthma control, that’s when we try a new biologic agent, which is injected or given by infusion. We’ll also test patients with severe asthma to see how high their eosinophil count is—eosinophils are white blood cells that contribute to inflammation in some cases of severe asthma. If you have eosinophilic asthma, new treatments that block eosinophils will likely help you get control of your asthma. I tell my patients to stay hopeful; it might take a while, but eventually we can find the right treatment approach to help you manage your severe asthma.
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    4. Make sure you’re using proper inhaler technique.
    Typically, we find a treatment that works to control severe asthma. But sometimes, patients come to me with worsening asthma symptoms and we realize they’re just not using their inhalers the right way. When you use your inhaler improperly, less medicine gets to your lungs. If you’re having trouble with inhaler technique, don’t be afraid to ask your doctor for guidance. There are also helpful videos online that demonstrate how to use inhalers properly, and sometimes I go over those videos with patients in my clinic. Additionally, I might recommend my patients use a spacer device connected to the inhaler, because it can help them inhale the appropriate amount of medicine.
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    5. Monitor your symptoms and inhaler use.
    My patients do best when they take some ownership over their care. Track how often you need to use your rescue inhaler and report that back to your physician. If your severe asthma symptoms worsen, record your symptoms in a diary so you and your physician can determine the best steps forward. Communicate with your pulmonologist as much as you need to, so you both know whether or not it’s time to step up treatment.
Severe Asthma Tips | Asthma Doctor Tips

About The Author

Dr. Praveen Akuthota is a board-certified pulmonologist with UC San Diego Health. He’s also an associate clinical professor at UC San Diego School of Medicine, where his research focuses on eosinophils and inflammation. View his Healthgrades profile >
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THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.