Do you have the BEST asthma action plan?

Is your asthma action plan REALLY the best?

You deserve the BEST asthma action plan
You deserve the BEST asthma action plan

NOTE: This blog post kicks off 4 weeks of “preparing your health for winter.”  I’m going to spend some time to share all the tips and tricks that I have learned that can help you/your child:

  • Stay healthy with allergy, asthma, and eczema this winter
  • Reduce unnecessary doctor’s visits
  • Prevent ER/Urgent care visits


Do you have the best asthma action plan?

I’ll start this with a story from a friend a few years ago:

When I first met this family, they made an appointment to see me to help control their been to the ER or urgent care 3 times in 2 months due to their 8 year old son’s asthma attacks.

In each case, when they went to the ER they had long waiting times followed by the provider giving them a nebulizer treatment, steroids and then sending them back home.  They had seen their primary care provider after each ER visit (as they were told to do) who reviewed the ER’s notes and agreed with their care, told them to finish treatment and that was it.

My problem with this care:  this family’s doctors (in ER and primary care) had multiple opportunities to create an asthma action plan to help prevent this from happening again.  But it NEVER happened!

Their problem with this care:  $12,000!


The Problem with Uncontrolled Asthma

If this story resonates with you, you’re not alone.  I am continually astonished when I see the statistics on uncontrolled asthma considering how treatable and preventable asthma really is!  Consider these facts:

  • In 2009, 1 in 5 (20%) of KIDS with asthma had at least one ER visit (not urgent care or same day office visits)
  • 28% of ADULTS with asthma had at least one ER or Urgent Care visit per year!
  • Approximately HALF of kids with asthma miss at least one day of school each year due to uncontrolled asthma
  • ONE-THIRD of adults miss at least one day of work due to uncontrolled asthma
  • Each year, asthma causes more than 14 million doctor visits, 2 million ER visits and 439,000 hospital stays (the average hospital stay is 3.6 days)
  • The annual cost of asthma:  $56 billion dollars!

I don’t know why this doesn’t get more attention?  Maybe we need a better celebrity spokesperson?  A better hashtag?  Buzzfeed to write the clickbait titles for all asthma action plan articles so that more people will click it?  (4 tips to a great asthma action plan… #3 will shock you)?

I’m not sure what’s the best answer.

But my response is to write this article and give you what I do best:  create asthma action plans that are designed to keep you healthy, out of the ER and ultimately save you money on healthcare costs.

What’s special about this time of year for asthma action plans?

It is true, an asthma attack can happen at any time of year and with many different triggers.  But the MOST COMMON trigger for an asthma attack:  viral induced asthma attacks!

And the cold and flu season is upon us!

Think about what all happens this time of year:

  • Kids are all back in school (I believe kids CREATE viruses out of Elmers glue, intricate handshakes and shared pipecleaners just to spread to adults as some sort of retaliation against bedtimes)
  • The colder weather allows some viruses to cause more problems
  • The colder weather forces people to spend more time indoors and near each other

All this helps create a great environment for viral induced asthma attacks!  So how do you fight against this?  With asthma control and a great asthma action plan!

Step 1:  General Asthma Action Plan

The single BEST step toward having your best winter yet is to have your asthma controlled BEFORE winter hits!

This may seem obvious… but consider this fact from the REACT trial:  When both doctors and patients feel their asthma is under control, 55% are actually NOT controlled!

The REACT trial shows that as a medical community, we do not do a good job assessing your asthma.  It also shows that, overall, you personally might not know what good asthma control really mean!

The solution?  Check your asthma control!

The best tool to check whether or not your asthma is really under control is through the asthma control test.  I wrote a post about it here.  But if you want an even easier way:

Take my FREE “Asthma Control Test Quiz”

With it, I will be able to tell you, immediately, whether or not your asthma is controlled!

What if my asthma is not controlled?

If my quiz shows that your asthma is NOT well controlled, then there is good news:  we have time to fix it before the full cold and flu season!

To get better control of your asthma:

  1. Fill out my form and I will tell you the next steps!
  2. See your primary care provider and ask them to increase your therapy
  3. See an allergist and get a coordinated plan

Getting control of your underlying asthma is the single most important step to you having a winter free of asthma attacks!  That is why I placed it as a “General Asthma Action Plan” before anything else!

What if my asthma IS controlled?

If your asthma IS controlled already, then that is great news!  You are in the minority of people and you have fulfilled the first step of my general asthma action plan.

Your next steps:

  1. Share this article with anyone you know who has asthma!  Think about it this way:  if you have 2 friends with asthma (or 2 friends who’s kids have asthma), ONE of them is NOT well controlled!  You could be the hero for all your friends and family who have asthma!
  2. Make sure you have a perfect Emergency Asthma Action Plan (which I’ll help you get below)


Step 2:  Emergency Asthma Action Plan

Once you have good baseline control through the general asthma action plan, it is time to prepare for times when your asthma may get worse.  Again, these are fairly predictable triggers.

The most common triggers of an asthma attack are:

  • Viral induced asthma attacks
  • Allergen induced asthma attacks
  • Cold air induced asthma attacks
  • Exercise induced asthma attacks

So let’s make a plan for each of these common triggers:

Viral induced asthma action plan

We all know the signs and symptoms of a cold or flu.  If you are unsure, I am almost done with a good cold/flu article (but you can request an early copy here).

viral-induced-asthma-action-planFor a good viral induced asthma action plan, you should:

  1. Frequent hand washing (to help stop the spread of the virus).  Anyone who has had one child get sick, followed by a second child, then a parent, then back to the first child knows how this cycle can go on for months!
  2. Continue your daily “controller” asthma medications
  3. At the first sign or symptom of cold or flu:
    • Start your rescue inhaler 1-2 puffs every 4-6 hours as needed
    • For many people, I recommend they start the rescue inhaler 3 times a day starting as soon as the first sign or symptom of a cold/flu.
    • For some people, especially if you are on a low dose asthma controller medication, it is beneficial to increase your controller medication at the first sign of a cold/flu (if you are unsure whether or not you may benefit from this, feel free to ask me)!
  4. Continue this plan for 3-5 days AFTER the cold/flu has gone!
    • Most colds/flus last 7-10 days.
    • The biggest mistake I see from adults and kids is that they stop their emergency viral induced asthma action plan as soon as they start feeling better!


It is much better to continue to do your viral induced asthma action plan for a few days AFTER your cold is gone!  The reason is that while you may feel better, you could still have inflammation or low amounts of viruses that can still trigger an asthma attack!


Allergen induced asthma action plan

Colds and flus are the most common cause for an asthma attack.  But allergies are #2 (I review the 11 most common allergies here).

A lot of us think that as the weather gets cold and the plans stop pollenating, that the risk for allergen induced asthma attacks is gone.  Sorry, but that is not the case.

While it is true that outdoor pollen may be decreasing, the winter months mean that we need to worry about allergies due to dust mites, pets (both dogs and cats), cockroaches (insects are a major cause of allergies) and mold.

For a good allergen induced asthma action plan:

  1. Continue your daily “controller” asthma medications
  2. Continue to treat your allergies:
    • This may mean starting or increasing a nose spray
    • Continuing to use the best over the counter antihistamines
    • Reduce your exposure to pets if you have a pet allergy
    • Consider dust mite covers if you have a dust mite allergy
    • Look for evidence of cockroaches/insects and remove them if necessary
  3. Continue your rescue inhaler 1-2 puffs every 4-6 hours if needed
  4. Again, for some people it may be beneficial to increase your controller medication during these colder months to help prevent allergen induced asthma attacks.


Cold air and exercise are common triggers of asthmatic snowboarding attacks
Cold air and exercise are common triggers of asthmatic snowboarding attacks


Cold air asthma action plan

Cold air is another significant trigger of asthma attacks, and so a cold air asthma action plan would help prevent this trigger of asthma:

  1. Continue your daily “controller” asthma medications (seeing a trend yet?)
  2. Reduce your cold air exposure:
    • If you are able, do more activites indoors on the coldest days
    • Wear a scarf or other face cover to “warm” the air before it gets to your lungs
    • Breathe more through your nose on colder days (your nose will warm the air before it gets to your lungs… but you will have a cold nose and probably frozen boogers)
  3. Continue your rescue inhaler 1-2 puffs every 4-6 hours if needed


Exercise induced asthma action plan

Finally, there is exercise.  Exercise is definitely a cause of year round symptoms for many people, but the winter adds that colder element that often makes winter exercise “more of a risk” than warmer exercise.

The treatment is very similar to cold air induced asthma action plan:

  1. Continue your daily “controller” asthma medications (seeing a trend yet?)
  2. Reduce your cold air exposure:
    • If you are able, exercise indoors
    • Wear a scarf or other face cover to “warm” the air before it gets to your lungs
    • Breathe more through your nose on colder days (your nose will warm the air before it gets to your lungs… but you will have a cold nose and probably frozen boogers)
  3. Continue your rescue inhaler 1-2 puffs every 4-6 hours if needed
  4. In addition, taking your rescue inhaler 20-30 minutes BEFORE exercise can often keep your lungs open and prevent a lot of exercise induced asthma attacks.


Questions on your Asthma Action Plans?

The 4 sections above are some of the best general advice that I can give for preventing asthma attacks.

As you read through them, I bet a lot of them make sense and seem like common sense.  That’s good!  These solutions truly are simple, inexpensive and effective.  The problem is that people don’t know about them!

If you have questions, or want a more personalized plan, simply click here and fill out these 5 questions and I will get you a better plan as soon as possible!  (or, if you want a FULL winter-health plan, consider checking out this link here).

Warning Signs of an Asthma Attack

This entire article is about PREVENTING an asthma attack.  Again, the causes are predictable and usually fixed with an emergency asthma action plan.

However, there are still times when you may have an asthma attack despite these preventative steps.

So I wanted to take this last paragraph to list some of the warning signs that your asthma action plan is not working and that you may need to seek medical care:

Seek Medical Care If:

  • If you are needing your rescue inhaler more than 3 times a day
  • If your rescue inhaler is not helping any more
  • If your rescue inhaler seems to be less and less effective
  • If your symptoms are worsening despite following the asthma action plan
  • If symptoms last longer than 10-14 days
  • And, as always, if you think you should seek medical care than you probably should. Trust your instincts and if you are unsure, call your provider!  You can often get better results with fewer medications (and lower cost) if you see your provider sooner rather than later!


Next Steps:

This article is very important to me.  Every time I hear a story about someone spending $12,000 (or any dollars) for uncontrolled asthma I get sick to my stomach.  Asthma is able to be treated so well that with modern medications that, with very few exceptions, everyone should have great asthma control!

  • If you know someone with asthma then please SHARE this post on Facebook.
  • If you don’t know anyone with asthma, I still think you should share this post.  These are such easy steps that if we can help so many people this winter!

Also, consider tossing MyAllergyFriend a Facebook like!  That way, MyAllergyFriend will get more “authority” and more people will see these tips and tricks.

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