Severe asthma is a challenging condition. Shortness of breath and chest tightness are common. A flare-up of symptoms can be unpredictable and unpreventable.
Do you take your rescue inhaler several times a day? Do you struggle with doing simple tasks like vacuuming the house or playing with the kids? If so, you might have severe asthma, which can greatly impact your quality of life.
From the best options for treating asthma to a new way of thinking about your symptoms, we look into severe asthma and get you up to speed on everything you need to know in just 10 minutes.
You will learn:
- The symptoms that define this condition
- The triggers that make it worse
- The most effective options for treatment.
Table of Contents
Introduction - Understanding Severe Asthma
Severe asthma can be hard to live with. It may affect all aspects of your daily life.
But what is severe asthma?
Severe asthma can affect you in many ways, often with more frequent and severe symptoms than just the shortness of breath that many get with milder forms of asthma. You are likely to have frequent asthma flare-ups that affect your ability to do day-to-day things.
How many people live with Severe Asthma in Canada?
Asthma Canada estimates that between 230,000 and 465,000 Canadians are living with this condition. This represents about 5-10% of all individuals diagnosed with asthma. The impact of severe asthma is more serious compared to those with milder forms of the disease, with a higher rate of death.
Asthma causes the deaths of over 250 Canadians a year. That is why it is so important that this condition be managed effectively.
What is the Main Difference Between Mild-to-Moderate Asthma and Severe Asthma?
The main difference between mild-to-moderate asthma and severe asthma is the frequency and intensity of symptoms, the level of medication required to control symptoms, and the affect of these symptoms on daily life.
Here are the key differences:
- Frequency and degree of symptoms: in patients with mild-to-moderate disease, symptoms are less frequent and less severe, and can be controlled with as-needed medication. Patients with severe asthma experience more frequent and severe symptoms, which can impact daily living and quality of life.
- Medication and Control: People with mild-to-moderate asthma usually manage it with low doses of medication that may or may not be needed on a daily basis. But people with severe asthma generally need to be on much higher daily doses of medication, often with other types of advanced therapies to maintain good control of their asthma.
- Risk of Exacerbations (flare-ups): People with severe asthma are at higher risk of frequent and serious exacerbations, which can be life-threatening and might require urgent medical care or hospitalization. In people with mild-to-moderate asthma, exacerbations are generally less severe and happen less often.
- Lifestyle impact: Mild-to-moderate asthma can sometimes be a small annoyance, but severe asthma can be life changing. It might limit physical activity, involve a lot of trips to the doctor, missing work or school and involve constant adjustments to medications to prevent serious symptoms and exacerbations.
- Treatment Response: Patients with mild/moderate asthma have a good response to asthma treatments. Those with severe asthma usually have a less predictable response to treatments and may need more medications and specialized therapies.
These differences show the need for a precise diagnosis and an individualized treatment plan, especially for those with severe asthma, to help their wellbeing quality of life.
What are the symptoms of Severe Asthma?
Identifying and controlling the symptoms of severe asthma is key to managing it properly.
Symptoms of severe asthma include:
- Severe shortness of breath that your usual inhalers do not relieve
- Persistent cough or wheeze that your usual treatments do not relieve
- Chest tightness or pain that stops you doing day-to-day things
- Use of quick-relief (rescue) inhalers frequently, suggesting an asthma attack is about to happen
- Inability to do physical activities – such as playing sport or walking – due to your breathing
- Poor sleep due to your breathing problems.
Identifying Triggers of Severe Asthma
To effectively manage your severe asthma, it’s important to know what triggers it. Common triggers include:
- Alergens
- Irritants
- Exercise
- Cold Air
- Occupational Factors
- Emotional Stress
1. Allergens:
- Pollen: high levels of tree, grass, and weed pollen can produce some of the worst flare-ups of the year. Tracking local pollen counts, and staying indoors during high counts, can reduce the impact of pollen on your asthma.
- Dust Mites: These bugs are attracted to warm, humid environments. Avoid exposure by using allergen-proof mattress and pillow covers, and washing bedding in hot water at least once a week.
- Pet Dander: Animals, including dogs, cats, and birds, can be important sources of house dust. Keeping animals out of bedrooms and bathing them frequently can limit exposure to dander.
- Mold Spores: Mold grows in damp places. Some things you can do to prevent mold from growing in your home: reduce indoor humidity, fix leaks, find and clean mold with the right solutions.
2. Irritants:
- Smoke: Whether from cigarettes or wildfires, smoke causes lung irritation and can cause lung cancer. Even short-term exposure is bad news.
- Pollution: Air-borne impurities can aggravate someone who already has asthma. Staying indoors when air quality is bad and using air purifiers are good solutions.
- Chemicals and Fragrances: Strong odors from perfumes, household cleaners, or painting materials may set off symptoms. Use fragrance-free or naturally scented products and make sure to keep windows or doors open when using chemicals.
3. Exercise
- Exercise-Induced Bronchospasm (EIB): This condition is sometimes worsened when an asthmatic inhales cold, dry air and can make physical activity very difficult. Warming up slowly over 20 minutes and covering your mouth and nose in cold air can help prevent an attack.
4. Cold Air:
- Airway constriction: Cold air can tighten the airways quickly. Use a scarf or mask on your face during cold months – to warm the air before it goes into your lungs.
5. Occupational Factors:
- Job highlights: Woodworking, baking, and jobs in the chemical industry may trigger your asthma from powdered materials, food vapors, fumes or dust. Wearing protective equipment and maintaining good ventilation can reduce exposure to some triggers.
6. Emotional Stress
- Stress and Anxiety: These can lead to worsening symptoms, and they can make it more difficult to properly manage asthma. Simply learning to breathe deeply for a few minutes at a time, practicing meditation, or speaking with a counsellor about feelings of stress or anxiety can help a lot.
- Anxiety Symptoms: Anxiety about a possible attack can cause more symptoms. Developing a good action plan to deal with attacks helps reduce anxiety.
How to identify severe asthma triggers?
In order to have control over severe asthma, you should be able to identify what causes your asthma symptoms.
You can try monitoring your symptoms over period of time, or getting a professional assessment of your triggers. Here are some examples:
- Symptom Monitoring: If you can, keep a diary of your day-to-day activities, the environments in which you spend your time, the weather, the foods you eat, or anything else you think is important, and note whether there are any patterns that might provide clues to particular triggers. For example, if you notice you feel worse on days when the pollen count is higher, or if your symptoms develop during exercise.
- Manage Asthma With Digital Tools: Use an app built to track asthma symptoms, to monitor your condition in real time, record the use of your rescue and controller medications, and to alert you to poor air quality (pollution) or changing weather conditions that could trigger your asthma.
- Allergy Testing: a small amount of a suspected allergen is placed on the skin (forearm, back, upper arm) and then scratched on the skin with a lancet. The allergen will then pass through the skin. A small red reaction – (like a mosquito bite) will appear if you are allergic.
How We Treat Severe Asthma: Simplified
Severe asthma can be treated both through medications and changes in lifestyle that will help you control your symptoms and avoid flare-ups. Here is what’s usually included in a treatment for severe asthma:
- Daily Maintenance Medication
- Rescue Inhalers
- Other Medications
- Biologic therapies
1. Daily Maintenance Medication
The medicines help reduce swelling in your airways and improve your breathing over time. These usually contain:
- Inhaled steroids (also called inhaled corticosteroids): Help keep your asthma under control by reducing inflammation.
- Long-acting Beta-agonists (LABA): Often combined with corticosteroids in the same inhaler. They work by helping to keep your airways open, making breathing easier.
2. Rescue Inhalers
You take rescue inhalers when you have a sudden worsening of asthma symptoms. They work quickly to relax the muscles around your airways and help you breathe. They can also be used before exercise to prevent symptoms.
3. Other Medications
Some people might need extra treatments, like:
- Oral Corticosteroids: Pills used to manage severe symptoms of asthma, but they are only used short-term because of their side effects.
- Leukotriene Modifiers: These help prevent asthma symptoms for up to 24 hours.
4. Biologic therapies
These are newer asthma treatments for people whose asthma is not controlled by other medications. Biologics target the specific parts of the immune system that cause inflammation in your lungs. This treatment is given as injections or infusions and can reduce symptoms and improve your quality of life if you have certain types of severe asthma.
It’s important that you stick with your treatment plan and check in with your doctor regularly. You should monitor how well your treatment is working, follow your medication schedule, and regularly check your lung function throughout the treatment.
With a good strategy, treatment and management for asthma with an asthma action plan is the key to keeping the condition under control and living a productive and healthy life.
Conclusion
Severe asthma is a chronic disease. Lifestyle changes, recognition of triggers, following medical treatment plans, and communication with your physicians are all very important to achieve the best outcomes and lead a full and active life.
Join our Living Well With Severe Asthma Program
Severe Asthma is difficult to manage, and it can affect every part of your life. That’s why we created the ‘Living Well with Severe Asthma’ program – to provide you with education and resources designed specifically for you.
By joining our free educational program, you will gain a deeper understanding of your severe asthma and learn how to improve your day-to-day life.
Visit our website Living Well with Severe Asthma to register for free today and start your journey to better asthma control.
