Severe asthma is a chronic respiratory condition in which your symptoms are more intense and difficult to control than mild-to-moderate cases.
Asthma that isn’t well-controlled can affect your ability to complete daily tasks. It can even lead to life-threatening asthma attacks. If you’re experiencing side effects from a medication or don’t think it’s working, it’s important to see your doctor. They can review your medical history and adjust your treatment accordingly.
Here are some questions you can bring to your next medical appointment to get the conversation started.
Start by asking your doctor to explain the signs and symptoms of severe asthma. Mild-to-moderate asthma can typically be controlled with prescription medication. People with severe asthma require higher doses of these medications and may still find themselves in the emergency room due to asthma attacks.
Severe asthma can cause debilitating symptoms that lead to missed school or work. You may also be unable to take part in physical activities like going to the gym or playing sports.
Severe asthma is also more likely to be accompanied by other medical conditions, such as obesity, sleep apnea, and gastroesophageal reflux disease.
Your doctor may prescribe inhaled corticosteroids for severe asthma to prevent your symptoms and manage the inflammation in your airways. With regular use, inhaled corticosteroids can reduce the frequency and intensity of asthma attacks. They won’t prevent or stop an attack once it has started.
Inhaled corticosteroids may cause local side effects, which are limited to a specific part of the body. They can also lead to systemic side effects, which affect the whole body.
Possible side effects include:
- oral candidiasis, a fungal infection of the mouth
- sore mouth or throat
- spasms of the trachea
- slight reduction of growth in children
- decreased bone density in adults
- easy bruising
Oral corticosteroids may be prescribed in addition to inhaled corticosteroids if you’re at risk of a serious asthma attack, or if you’ve already had one in the past. They work by relaxing the muscles around your airways. They also reduce symptoms like coughing, wheezing, and shortness of breath.
These can carry similar side effects to inhaled corticosteroids, although they’re more common and can be more serious. Side effects may include:
- fluid retention
- high blood pressure
- suppressed growth in children
- osteoporosis in adults
- muscle weakness
Biologic drugs are often taken by injection and help to control symptoms of severe asthma. Biologics tend to be more expensive than other asthma medications. But they’re being used more and more as an alternative to oral steroids, which can sometimes lead to serious side effects.
Biologics are typically safe to use. The side effects are generally minor, including:
- pain around the injection site
- aching muscles and joints
- sore throat
In rare cases, severe allergic reactions to biologics are possible. If you think you’re experiencing an allergic reaction, contact your doctor right away.
Short-acting beta agonists (SABAs) are sometimes used as rescue medications for the rapid relief of asthma symptoms. Long-acting beta agonists (LABAs) work in a similar manner but continue to provide relief for 12 hours or more.
These both carry the same side effects, as they work in very similar ways. But the side effects of SABAs usually resolve quickly. With LABAs, side effects may persist for extended periods of time. Side effects may include:
- increased heart rate
- hives or rash
Leukotriene modifiers work by blocking an inflammatory chemical in the body called leukotriene. This chemical causes your airway muscles to tighten when you come into contact with an allergen or asthma trigger.
Leukotriene modifiersare usually well-tolerated in people with severe asthma, but they do carry a number of minor side effects, including:
- upset stomach
- nausea or vomiting
- nasal congestion
- flu-like symptoms
Managing your symptoms is a vital part of living with severe asthma. Your doctor can advise you on strategies to help minimize the effect of asthma on your daily life.
See your doctor on a regular basis to check on how well your medications are working. Let your doctor know immediately if you feel as though any of your medications aren’t functioning like they’re supposed to.
Your doctor can also help to identify which pollutants and irritants are triggering your asthma. Once you know what your triggers are, you can take steps to avoid them.
If you’re a smoker, you should make an effort to quit as soon as possible. Smoking can exacerbate your symptoms and increase your chances of other life-threatening conditions like cancer and heart disease. Talk to your doctor about programs or medications that can help you stop smoking.
You’re probably curious about your long-term outlook with severe asthma. If so, consider asking your doctor about this.
Severe asthma can be unpredictable, so the long-term outlook is different for everyone. Some people’s symptoms improve, some experience ups and downs, and some find that their symptoms worsen over time.
Your doctor can give you the most accurate prediction based on your medical history and how well you’ve been responding to treatment so far.
Maintaining a dialogue with your doctor is key to finding the right treatment for you. The questions above are a good place to start, but they are by no means the only things you should ask.
Don’t be afraid to contact your doctor’s office whenever you have other questions or concerns. The more you know about your severe asthma, the easier it will be for you to manage your symptoms and lead a normal, healthy life.