Dr. M.J. Bazos,
Why do I need to worry about flare-ups?
To keep your asthma under control, you need to
know what to do when you have a flare-up of symptoms (sometimes called an
“exacerbation” or an “asthma attack”). First, you need
to know the warning signs of a flare-up. Second, you need to know what to do
when your asthma gets worse so you can get it under control
What causes asthma symptoms to flare
Your asthma can flare up for different reasons.
Allergies can make your asthma symptoms get worse. Viral infections (such as a
cold), tobacco, pollutants (such as wood smoke), cold air, exercise, fumes from
chemicals or perfume, sinus infections and heartburn can all cause a flare-up.
For some people, strong emotions or stress can trigger an asthma attack. Pay
attention to the way these things affect your asthma. If you and your doctor
figure out which things bother your asthma, you can start trying to address
What are the symptoms of an asthma
Common symptoms are coughing, feeling
breathless, a feeling of tightness in the chest and wheezing (breathing that
makes a hoarse, squeaky, musical or whistling sound). Watch yourself every day
for any of these symptoms.
How do I know how serious a flare-up is?
Your doctor will show you how to keep track of
your asthma by using a peak flow meter. This device measures your peak
expiratory flow rate (PEFR). First, you find out your “personal
best” peak flow. This is the highest reading you can get on the meter over
a 2-week period when your asthma is under good control.
Here are some guidelines on using a peak flow
meter to find out how serious an asthma flare-up is:
- During mild flare-ups, you may feel
breathless when you walk or exercise, but feel OK when you sit still. You can
usually breathe well enough to talk in complete sentences. You may hear some
wheezing, mostly when you breathe out. Your peak flow readings will be 80% to
100% of your personal best.
- During moderate flare-ups, you may feel
breathless when you talk or walk around, but feel better when you sit quietly.
You may not be able to finish whole sentences without taking a breath. You may
find yourself needing more quick-acting medicine to treat your asthma symptoms
as they get worse, or awakening more often at night with asthma symptoms. You
may hear loud wheezing, especially when you breathe out. Your peak flow readings
will likely be between 50% and 80% of your personal best.
- During serious flare-ups, breathing will
be very difficult. You’ll feel breathless even when you’re sitting
still. You might only use a few words at a time because you’re so short of
breath. You’ll feel anxious or tense. You continue to get worse even when
using your quick-acting medicine to treat your worsening asthma symptoms. Your
peak flow readings will likely be less than 50% of your personal best. If you
feel very tired and confused, you may be having a life-threatening attack.
Serious flare-ups mean you need to be treated right away, preferably in an
How is an
asthma flare-up treated?
If you feel like you’re having a flare-up,
use your quick-acting medicine or quick-relief inhaler right away. Be sure you
and your doctor talk beforehand about how much medicine to take during a
To figure out how serious the flare-up is, use
your peak flow meter after you use the quick-acting medicine. If your peak flow
is less than 50% of your personal best, your flare-up is
Ask your doctor for written directions about
treating asthma flare-ups. (Your doctor may have a form to give you, or you can
print out this
one.) If you have the symptoms of a serious
flare-up or if your peak flow is less than 50% of your personal best, call your
doctor right away or go directly to the nearest emergency room (by ambulance, if