Dealing With Adult Asthma

Asthma is a disease that involves recurring (chronic) episodes of inflammation and variable narrowing of the airways. It affects 14-15 million people nationwide. Asthma “attacks” can be mild, moderate, or severe and usually occur when smooth muscles found in the airways of the lungs are stimulated to contract by inflammation.

The cardinal symptoms can be wheezing, breathlessness, chest tightness, and cough, particularly at night and in the early morning.

Asthma is the most common chronic disease in children, whose symptoms may disappear when they reach adulthood. When someone develops asthma for the first time as an adult, it may be a continuing problem for the rest of their life.

What happens when you have an asthma attack?
The airways in the lungs of people with asthma are always somewhat swollen or “inflamed”, even when the person is not having any “asthmatic” symptoms. When exposed to substances that are irritating or that the person is allergic to, the airways can become even more narrow than usual. They begin to produce extra mucus, and the tiny muscles in their walls begin to tighten or “contract.” This makes the airways even smaller, and it becomes harder to breathe in and out.

What causes an asthma attack?
In people who have a sensitivity to them, cold air, viruses, and tobacco smoke may bring on an asthma attack. An allergic reaction to dust, pollen, molds, and animal dander may trigger an attack as well. Some people experience coughing or wheezing only when they exercise. This is called exercise-included asthma.

The symptoms of asthma
When someone is having an asthma attack, they may experience: wheezing (the sound of air moving through the narrowed airways); coughing; shortness of breath (difficult breathing); and tightness in the chest.

How to find out if you have asthma
If asthma is suspected, your doctor will ask you about your history of breathing problems and will do a physical exam. This will probably include one or more breathing tests. You may be tested before and after taking medication, so the doctor can measure how well your body may respond to treatment.

Keep in mind that one attack of wheezing does not necessarily mean that you have asthma. Wheezing can also be brought on by certain infections and by exposure to some chemicals. Before deciding that you have asthma, your doctor may want to wait and see if you have another attack of wheezing first.

How asthma is classified
Asthma is classified as mild, moderate, or severe, based on lung function and other factors. In mild asthma, lung function is 80% of normal or better. In moderate asthma, lung function is between 60% and 80% of normal, and in severe asthma, it’s 60% or less.

Asthma is also classified by the frequency of symptoms. When asthma involves two or less episodes per week, it is called “intermittent.” If asthma episodes occur more than twice a week, the illness is called “persistent.”

How asthma is treated
There are two main types of asthma drug therapy, “quick relief” medications and “long term control” medications. Your doctor will prescribe the ones that are best for you and your type of asthma, taking into consideration how severe and how frequent your breathing difficulty, and other symptoms, are.

For mild intermittent asthma, where asthma attacks occur no more often than two times per week, your doctor may prescribe a “bronchodilator.” This is a quick relief medication that relaxes the muscles in the airways, making them larger and allowing more room for air to move in and out. Bronchodilators usually come in a device-“inhalers”-and are inhaled into your lungs as you spray or activate them into your mouth from receptacle. These can work quickly to relieve an asthma attack. It is vitally important for every person who has asthma to have this type of medication available. Talk to your doctor about which one is right for you.

For persistent asthma, your doctor may prescribe a long-term “anti-inflammatory” controller medication to be taken every day. These are available as inhalers and in other forms. They help reduce the swelling in your airways, but do not stop attacks of wheezing once they start. For wheezing, an appropriate inhaled bronchodilator should be used.

Because your breathing ability can change from day to day due to illness or allergies, your doctor may also prescribe a “peak flow meter.” This is a device you can use at home to check your breathing ability. It can alert you to when you might need your doctor to increase your medication.

Tips for keeping your asthma under control
If you suffer from asthma, chances are you will experience asthma attacks from time to time, especially if you are allergic to dust, pollen, mold or animal dander. But you can help to limit their number and severity by:

● Covering mattresses, box springs, and pillows with zippered plastic covers
● Washing bedding in hot water once a week
● Washing and drying pillows thoroughly once a month
● Making sure vaporizers and humidifiers are thoroughly cleaned before you use them
● Bathing pets weekly, vacuuming often, and using a powerful air filter
● Staying indoors when the pollen count is high
● Using air conditioners to cool your home instead of keeping windows open
● Avoiding attic fans, cigarette smoke, and vapors from harsh chemicals, such as bleach
● Taking your medicines exactly as your doctor prescribes them
● Having a “flu” shot every October


Supported as an educational service by Novartis Pharmaceuticals Corporation. This information is not intended for use as medical advice. You should discuss this information with your doctor.

Avaraham Henoch, MD
564 West 160th Street
New York, NY 10032
Phone: (212) 740-6400