About Asthma Action Plans

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MountainReader

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Everyone who has asthma should work with their physician to have a written Asthma Action Plan. If you have been diagnosed with asthma and your doctor doesn't offer you one, you should be asking for one.

An Asthma Action Plan is a guideline for you that indicates what types of treatment you should initiate depending on what types of symptoms you are having.

Typical Asthma Action Plans include:

*Your doctor’s name and phone nuraber and a local emergency phone nuraber

*Lists of your long-term controler medications, dosages and how often you should use them.

*Lists of your quick relief medications, dosages and how often you should use them.

It should also provide you with information on monitoring your symptoms and provide instructions on how you should respond based upon your symptoms. They typically look something like this:

GREEN ZONE:
  • You feel good (no wheezing, cough, chest tightness, shortness of breath, etc...).
  • Use long-term controller medications as prescribed (if you have them).
  • Often directions to use your quick-relief medications prior to exercising.
  • A list of things to avoid.
  • Peak Flow nurabers you should watch for.

YELLOW ZONE:
  • Your asthma is getting worse. You do not feel good.
  • You may have chest tightness, coughing, difficulty breathing, wheezing, or other asthma early warning signs (there is a sticky at the top of the message board with a list of these items).
  • You may have difficulty doing some activities.
  • If prescribed, you may increase the dosage of your controller medication.
  • You will have increased use of your quick-relief inhaler.
  • You may add use of a home nebulizer.
  • If you don't find relief from your quick-relief medication, you should probably seek medical attention.
  • Your Peak Flow reading is probably 50-80% of your personal best.

RED ZONE:
  • Your asthma has gotten worse. You feel awful.
  • Your rescue inhaler is not working for you.
  • You should seek treatment from your doctor or call for emergency help depending on the severity of your symptoms.
  • You may find that it is getting harder and harder to breathe.
  • Many people in this zone often end up with steroid treatment to help get it back in control.
  • Your Peak Flow is typically below 50% of your personal best.
RED ZONE Danger Signs
  • You cannot talk without taking breaths between worRAB.
  • Your lips or fingernails are turning blue.
  • You are struggling to get a breath.
  • You may start to panic.
  • You should call for emergency help. If you are this bad, you should not try to take yourself to emergency. You may have an Epi-pen to use until help arrives.
  • This zone is serious, know your plan of action of what to do and educate those around you so they can help. You won't really be in a position to help yourself much in this zone.

There is a lot of information on Asthma Action Plans on the internet. Here are a couple of the websites which provide useful information on them:

An Asthma Action Plan form recommended on the National Heart, Lung and Blood Institute government website:

http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_actplan.pdf​

There is some good information on the WebMD website:

http://www.webmd.com/asthma/guide/developing-an-asthma-action-plan​
Hope you find this helpful! :)
 
MR: This is sooooo wonderful! This should be a sticky at the top of the asthma page! Anyone who's been told they have asthma and don't have such a plan in place shoudl print this out and take it to their pulmonologist ASAP. It can make living with asthma so much easier when you know what you need to know about the condition and how it applies to your individual case. Thank you, thank you, thank you.

And BTW, just had my 6 month check up last week. My doc has given me the go ahead to try cutting down to one puff of albuterol before jogging. My peak flows have really been good, no flares in over 2 years and I feel great. Of course, he reminded me to take the inhaler with me just in case I get 1/2 a mile from the house and can't breathe enough to get home. Just one more reason why I am so thankful to have this doctor and that he doesn't want to retire yet!
 
Titchou, that is great news!!! Do you use a special carrier for your inhaler? I've been thinking about getting a special marked one.

Any other suggestions for the lists above? We've referred to the plans so many times over the years and I realized that there weren't any comprehensive descriptions of one on this board.
 
If that is the case, then you should talk with your pulmonologist about giving you a standing scrip for steroiRAB that you can start on your own and/or a nebulizer. I had them in the beginning but never needed them as my asthma has been well controlled. The last flare I had was over 2 years ago and upping my daily Flovent and adding albuterol at night (per my plan) did the job. Now, 15 years after diagnosis, I don't even have a scrip for the steroiRAB and never got the nebulizer.

If your doctor doesn't do this, then you have no other alternative but to continue as you have been with the ER visit, etc.
 
No, I don't have a carrier as I never take it with me (I know, bad girl!) Since it's so cold here today, I'll have my wind jacket on so can put it in the pocket.

And I think you did a good job with the descriptions. I think it will help people understand that 1) these things happen sometimes and 2) don't panic! If you have a flare up or a little "blip" where breathing is a problem for even a short time (seconRAB) and you panic, then all sorts of bad things can happen. If you have a plan in place and you know what it is, then you tend to automatically follow it and panic does not ensue. And you get relief and go on about your business.
 
Bumped up in response to question on when to go to the emergency room. This asthma action plan summary is fairly standard for what most doctors give out. If you have asthma and don't have a plan, please ask for one next time you go to the doctor.
 
I'm on quite a bit of medication as well. Here is my Asthma Action Plan:

I've been on Advair 250/50, Singulair and Albuterol/ Albuterol Nebulizer (as needed).

When I'm in the "Green Zone", I take the Advair 250/50 twice per day and Singulair once per day. I use my Albuterol if I know I'm going to do something that might trigger my asthma.

When I'm in the "Yellow Zone", I change to Advair 500/50 twice per day and continue the Singulair. I also use my Albuterol about 4 times per day. This includes use of my home nebulizer.

When I'm way into the "Yellow Zone" or in the "Red Zone", I still take the Advair 500/50 twice per day, use the Sinulair, use my Albuterol about every 4 hours. I also fill my standing prescription for a heavy duty Prednisone taper. If it gets worse or isn't working, I'll go back to the doctor or seek emergency care. I carry an Epi-pen everywhere with me. If I have a bad asthma attack, using it will help open up my airway quickly and give me time to get emergency care. (I had ephinephrine used during a serious asthma attack 2 years ago and it did wonders.)

I have prescriptions for Advair 250/50 & Advair 500/50 (hoping to try the 100/50 this spring), Singulair, Albuterol in HFA and Albuterol for my Nebulizer, Prednisone and Levaquin from my Pulmonologist. I also take Kapidex because I have reflux that triggers my asthma as well. At this point, he is comfortable with the fact that I know my asthma and am capable of following my Asthma Action Plan. I'm able to treat myself without waiting for a doctor's appointment.

I will say that I had a lot of trouble getting a bad flare under control this winter. I was at the doctor's office about once a week for a couple months. It's frustrating, really really wears you out and hits the pocketbook as well.
 
Hi
I know action plans are good but I do not have much to add when I do find my breathing worse accept venatlin and then if that does not work I head to the doctor or the hospital.
I am on advair, spriva and alvesco daily and ventalin when needed. I have had to use many rounRAB of prednisone as well.
Can anyone relate to this??
 
Congratulations Titchou...that's fantastic!!!

My doctor added Singulair to my Syrabicort and things are much, much better now. I rarely have 4AM albuterol wake-up calls...sleeping through the entire night is such a wonderful thing :) I don't need my rescue inhaler during the day/evening very often, either :)

As far as asthma action plans are concerned...if you don't have one, ask your doctor about it. If you have one, follow it. They're very preventive in nature and will help prevent symptoms from become serious problems. If something becomes a serious problem, it has explicit instructions explaining what to do. (Then you don't do something stupid, like keep trying to use albuterol when you should have gone to the ER. Then get lectured by your doctor for being a complete moron who's lucky to be alive.)
 
You are a Great while writing this article ,it is awesome I liked it too much good and informative thanks for the sharing.
 
Yes, ahhchoo, we've all probably over done the albuterol at some point...and it isn't what you should be doing - too much or too little either. We've all probably gotten that lecture at some point in time!
 
Glad you found it helpful. It is good general knowledge, but for some reason most doctors don't provide it to people diagnosed with asthma. These boarRAB are great because they allow us to share what we learn.
 
thanks for reminding me... I have a new insurance/Doctor and my current action plan is from January 2009. I will be making an apt to talk to the new doctor to see if I need to make any changes.
 
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