Q:

What does asthma feel like?

A:

Asthma symptoms typically come and go. You have trouble breathing, your chest feels tight and you can hear wheezing when you breathe or cough. These symptoms often occur during exercise or during the night.

An asthma attack is when your symptoms rapidly become more severe, usually rather suddenly. During an asthma attack, you have more trouble breathing.

You may get used to the asthma symptoms and not realise that your airflow is impaired and could be improved by treatment.

When your asthma is under good control, the airways are clear and air flows easily in and out.

Top of page

---

Q:

What happens during an asthma attack?

A:

When asthma is not under control, the airways become inflamed. Inflammation of the airways causes asthma symptoms (wheezing, breathlessness, chest tightness and coughing) by restricting or limiting the airflow to and from the lungs.

• The airways become red and swollen, which makes them narrower. This can often take several hours or days to develop and may take just as long to reverse after the asthma attack has passed.
• Tightening of the muscles that surround the airways (also called bronchoconstriction) makes them even narrower. This tightening can happen very quickly, depending on the type of trigger and underlying inflammation.
• The airways make more mucus, which can plug up or partly block the airways.

Attacks can range from mild to severe.

Top of page

---

Q:

What causes an asthma attack?

A:

Some causes and triggers are common to all people with asthma, and some are more individual, especially allergens. There are very big differences between people in how readily and how severely they react to different triggers. The severity of the symptoms can differ in the same person at different times, and the effects of treatment can also vary.

Your asthma does not stay the same, but changes over time, and every person with asthma has good days and bad days (or longer periods). However, if asthma is properly treated, there can also be long periods without symptoms or attacks.

A number of different triggers can cause asthma symptoms or start an asthma attack:

• infections, usually those caused by a virus (e.g. colds or flu)
• allergens, most commonly from house dust mites, pets or pollen
• exercise, especially in cold weather
• emotions, such as excitement, fear or anger
• irritants, such as air pollution
• smoking people with asthma and the parents of asthmatic children should avoid smoking
• changes in the weather (e.g. a cold spell)
• food additives, such as tartrazine (an artificial food colouring), or food allergens, such as peanuts (sensitized or allergic individuals can have a very severe allergic reaction).
• certain medications some people may be allergic to some drugs (e.g. aspirin).

Top of page

---

Q:

What are the signs of a severe and dangerous asthma attack?

A:

• Symptoms that are rapidly becoming more severe and do not get better even after you take your airway opener (bronchodilator) medication
• Symptoms that do not improve at all, or rapidly return after you have taken your airway opener medication
• Difficulty talking because you are short of breath
• A peak flow reading below 50% of your normal value, which is not improved by the airway opener medication
• A peak flow reading that according to your Asthma Management Plan puts you at risk of an asthma attack

Top of page

---

Q:

Can a person die from asthma?

A:

Unfortunately, deaths still occur in acute, severe asthma. But this is unusual and can be prevented.

Most asthma deaths occur in people who have not received enough treatment, perhaps because they did not realize or did not want to admit how serious their asthma was, or because they had not received adequate guidance from their doctors and nurses.

The correct use of controlling and preventive medication is the key to preventing these tragedies. People with asthma sometimes forget or choose not to take their anti-inflammatory medication, especially during periods when they are feeling well. When they start to get symptoms of asthma, they increase the dose of airway opener (bronchodilator). However, this will not treat the underlying inflammation, which may lead to severe life-threatening attacks. If you have stopped taking your anti-inflammatory medication, you should re-start it at the first sign of symptoms of asthma, in addition to using an airway opener.

If you are using regular inhaled corticosteroid treatment, you should not stop using this at any time unless you have discussed this with your doctor first.

Top of page

---

Q:

Why do I lose my breath?

A:

You lose your breath during an asthma attack because the airways become narrow, which restricts or limits the airflow to and from the lungs. The airways become restricted because:

• The lining of the airways becomes inflamed
• The production of mucus (phlegm) increases and may block the airways
• The muscles in the walls of the airways tighten

During an asthma attack, all of these things happen in different degrees.

You can also lose your breath for other reasons than asthma, for example during physical exercise, especially if you are not in good shape. If you lose your breath without typical asthma symptoms, and if your asthma medication has no effect, you should see your doctor.

Top of page

---

Q:

How do I know if I am having an asthma attack?

A:

During an asthma attack, you will find it harder to breathe because your airways have become narrower. Your chest feels tight, and you can hear wheezing when you breathe or cough. You may feel as if you are trying to breathe through a straw in your mouth while holding your nose.

If the PEF value drops to half of the usual level, its time to seek emergency help.

Top of page

---

Q:

Can the peak flow meter tell me if I need to see the doctor?

A:

If you take peak flow readings regularly or know the reading you get when your asthma is well controlled then, as a general rule, if the reading falls to less than two-thirds of the usual level, it is time to be cautious and to increase the amount of medication. A reading that is less than half the usual level often indicates the need for immediate help, but this varies from person to person.

It is best if you and your doctor together set a personal peak flow reading that indicates when it is time for you to increase the dose of medication or seek acute help. This should be combined with a written treatment plan for your medications.

It is important to realize that your treatment should not be entirely determined by your peak flow readings. Whenever the usual treatment does not have the effect you wish on the control of your asthma you should discuss this with your doctor, regardless of the peak flow reading.

Top of page

---

Q:

Can asthma medication help prevent asthma symptoms?

A:

Yes. Asthma medications include very effective airway openers. Even more importantly, they include very effective controllers (inhaled steroids), which can prevent most asthma attacks when used regularly.

Top of page

---