Nearly 26 million Americans are living with asthma, and you might be surprised to learn that of those, 19 million are adults. Asthma symptoms can be controlled and should not hold a person back from living a full and healthy life. However, close to four in ten adults living with asthma reported poor asthma control. Frequent asthma episodes (or asthma attacks) can occur when asthma is not maintained appropriately. With each asthma episode, the lungs can become damaged, and over time, the structure of the lungs can change, making breathing even more difficult. So learning more about how to properly manage asthma and even something as simple as properly using asthma medicines can improve your health today and well into the future.

What Causes an Asthma Episode?

According to Nicola Hanania, M.D., M.S., associate professor of medicine in the Section of Pulmonary and Critical Care Medicine and director of the American Lung Association Airways Clinical Research Center at Baylor College of Medicine, people with asthma may experience symptoms like wheezing or coughing. However, those who have ongoing symptoms are at higher risk of an asthma episode, and if they do not use their medication at the right time and as prescribed, may also be at risk of being hospitalized.

"Managing an asthma attack is not hard but has to be done quickly," Hanania said.

Asthma Episodes Cause Changes in Your Lung Anatomy

As we get older, our breathing ability tends to decline gradually. However, people with asthma lose lung function at a quicker pace, especially if they suffer multiple asthma episodes over a long period of time. This stress on the lungs can lead to airway remodeling, when a person's airway is scarred and is not as flexible or responsive to treatment. Airway remodeling can lead to more swelling, muscles tightening around the airways and more mucus production.

"If we treat patients early we may be able to reduce this occurrence," Hanania said. "Even though we still don't have a cure for asthma, we can achieve and maintain good control over it most of the time."

Proper Inhalation Techniques

There are a few different types of inhaled medication delivery systems: metered-dose inhalers (MDIs), dry-powder inhalers (DPIs) and nebulizers. Taking the right medicine,at the right time and in the right way helps people better control their asthma so they can be active and healthy.

"It is unfortunate that approximately 70 percent of people living with asthma do not have proper inhalation technique," Hanania said.

MDIs are most common but are the most difficult to master. Correct use of MDIs requires good hand-breath coordination. Also, patients should be mindful not to breathe in the medicine too fast. If patient cannot manage the steps to breathe in the medicine correctly, doctors can prescribe a tube that attaches to their MDI (a valve-holding chamber or spacer) to hold the medicine while allowing them time between activating the device and a taking in a slow, deep breath of medicine. DPIs require patients to take a deep breath in to disperse the powder deep into their lungs; however, for weaker and older patients, this is very challenging.

"It's very important for the inhalation technique to be accurate because we want the asthma medicine to go to the right place," Hanania said. "Many times patients exhale the drug back out the nose or mouth, wasting their time and money, and, above all, they don't get better."

Important Advice for Adults with Asthma

If people with asthma need to use their quick-relief medicine twice a week or more, it is a sign that their asthma management could use some fine tuning.

"We don't want them to wait until they are sick and go to the emergency room," Hanania said. "Managing asthma is really a partnership between the patient and their healthcare team."

The American Lung Association has tools and resources to help adults manage their asthma.

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