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Doctor Discussion Guide: Questions to Ask When Your Severe Asthma Can’t Be Controlled

Medically reviewed by Suzanne Falck, MD on October 16, 2017Written by Kristeen Cherney on October 16, 2017
questions for the doctor

The nature of severe asthma can be unpredictable. While your symptoms may be manageable, severe asthma can significantly impact your daily activities. Instead of putting up with asthma symptoms, know that there are solutions available that can help you control them.

If you feel like your severe asthma is out of control, it’s time to talk to your doctor. Use the following questions as a discussion guide at your next appointment.

1. What’s triggering my severe asthma?

Severe asthma can have a variety of triggers. Some of the possibilities include seasonal allergies, animal fur, and chemical smells. Not everyone with severe asthma has the same triggers. Plus, triggers can change over time.

If your doctor has identified some of your asthma triggers before and you’re experiencing a new wave of symptoms, it’s worth investigating other possibilities. Your doctor can help you determine the best way to learn what these new triggers are, whether via allergy testing or by keeping a symptom-tracking journal at home.

2. Do I need more testing?

Your doctor might suggest more tests from the get-go. But if your severe asthma feels uncontrollable, it’s worth checking with your doctor upfront. Test results can take time to process, so it may be helpful to ask your doctor before your appointment. This is a good idea in case there’s a chance you can complete both your evaluation and testing on the same day.

Some of the possible tests include:

  • allergy (skin prick) testing
  • chest X-ray
  • eosinophil exam via a blood test
  • peak flow measurement
  • spirometry to check the amount of air you can breathe out (and how quickly)
  • fraction of exhaled nitric oxide
  • sputum sample

3. What types of medications do I need?

The exact medication you need depends on the severity of your symptoms. If your symptoms can’t be controlled, then your doctor will likely prescribe stronger medications to decrease lung inflammation. By controlling inflammation, your airways are also less likely to constrict and lead to breathing complications.

Considering these facts, you’ll need an effective long-term control medication for your asthma. If you have severe asthma, you’ll usually be using an inhaled corticosteroid and long-acting bronchodilator. If you’re already taking a leukotriene modifier, your doctor may have you try a different brand. You’ll still need a quick-relief medication on hand, such as a rescue inhaler.

If your severe asthma is triggered by allergies, your doctor may prescribe a stronger antihistamine. These types of medications work by blocking the body’s ability to make histamine — which causes allergy symptoms — whenever you encounter certain allergens.

There are newer biologic medications that work on the immune system. These are used by doctors specializing in specific types of severe asthma. Bronchial thermoplasty is also sometimes offered for those with severe asthma.

Keep in mind that it could be several weeks before a long-term medication takes full effect. Finding the right medications that control your severe asthma may involve a trial-and-error process.

4. Are there any alternative options for treatment?

Due to the dangers of severe asthma, your doctor will likely have you stick with a conventional treatment plan.

You should never try any herbs or other alternative options for your asthma without first checking with your doctor. But it’s worth asking about any options you’ve researched that you’re interested in knowing more about.

Caffeine, choline, and breathing exercises are a few of the alternative asthma methods currently being studied.

5. How can I treat other conditions I have besides severe asthma?

It’s not uncommon to have more than one medical condition besides severe asthma. You should certainly disclose any other conditions you have with your doctor.

It’s especially important for your doctor to know about any other medications you take for such conditions so that they can help prevent any drug interactions.

6. Will my severe asthma last forever?

Asthma itself is a lifelong condition, and there’s no cure for it. But asthma often goes through cycles. There may be points in your life that you have worse symptoms than others. This can be related to your age, environment, or stress levels.

The key here, though, is that you shouldn’t assume severe asthma symptoms are just a part of your current cycle. Even if you have severe asthma for the rest of your life, you should still be able to control your symptoms.

Call your doctor if your new severe asthma treatment plan fails to offer any relief. You should also seek emergency medical care if you experience significant breathing difficulties along with chest pain, blue skin, or faintness. These could be signs of an asthma attack.

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