Asthma is a chronic disease that affects your airways. The airways are the tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways are inflamed (swollen). The inflammation makes the airways very sensitive, and they tend to react strongly to things that you are allergic to or find irritating. When the airways react, they get narrower, and less air flows through to your lung tissue. This causes symptoms like wheezing (a whistling sound when you breathe), coughing, chest tightness, and trouble breathing, especially at night and in the early morning.
Asthma in adults is frequently present since childhood, but can start later in life with no history of prior lung problems. During evaluation a detailed history of the types and patterns of symptoms along with noted precipitators or aggravators is taken. Additionally, a detailed medical history of other conditions that can aggravate asthma or even be mistaken for asthma will be obtained. Present and prior breathing medications, as well as other medications, will be assessed and previous x-rays, blood tests, and breathing studies will be reviewed, if available.
A work history relating to possible adverse lung effects will be taken as well as a detailed home and work environmental history. Your family history specifically relating to allergic, respiratory, cardiac, and gastrointestinal diseases will be obtained. This information along with a physical examination will then direct further evaluation. This often includes pulmonary function testing often before and after a bronchodilator and if appropriate allergy skin testing and/or other blood tests or x-ray studies are obtained. Certain patients might also need specific “challenge” breathing studies.
Once the initial evaluation is completed, recommendations as to a course of treatment will be discussed and agreed upon by the patient and doctor. There will also be a plan for evaluating and, if necessary, adjusting this treatment. Regular return visits will be discussed and scheduled with the realization that a flair-up of symptoms may require an acute visit. The treatment plan will be discussed in detail, if appropriate, the nursing staff will instruct you in the proper techniques for using medications and information about environmental considerations and life style alterations will be discussed. Allergy injections, if appropriate, will be discussed. Peak flow determinations may be instructed.