Diagnosing and Managing Your Condition
How Asthma is Diagnosed
Tips for Working with Your Doctor
Your Asthma Team

Diagnosing and Managing Your Condition

The best way to manage asthma is to develop an effective working partnership with your doctor. Your doctor's role in this partnership is to provide medical advice, suggest treatment options and recommend resources. Your role is to monitor your symptoms, report them accurately, and do what you can to manage your illness on a day-to-day basis.

How Asthma is Diagnosed

If you have difficulty breathing, your doctor will need to conduct a number of tests in order to determine whether your symptoms are actually signs of asthma.

First, your doctor will ask you about your symptoms and whether you have a family history of asthma or allergies, and determine if you have any allergies. Your doctor will also perform a physical exam to rule out that something other than asthma is causing your symptoms. Your doctor will also check how well your heart and lungs are working.

Your doctor may also request the following diagnostic tests:

• Pulmonary (lung) function test. This test measures the volume and force with which you can push air out of your lungs. The results of this test will help your doctor determine if you have asthma. If you do have asthma, the test will determine whether you have a mild, moderate or severe case of asthma.
• Skin tests. Skin tests are used to find out if you are allergic to airborne substances such as pet dander, dust, or pollen.
• Methacholine challenge test. Sometimes the above tests may not provide enough information for your doctor to say for sure whether or not you have asthma. A methacholine challenge is the next step. Methacholine is a drug that causes your airways to tighten. You will be asked to inhale methacholine, and if your lung performance drops by 20 per cent, then you are likely to have asthma. To open up your airways so that you can breathe properly again, you will then be given a drug called a bronchodilator.
• Blood and sputum tests. Blood tests may be used to determine whether you have any allergies.
• Chest x-rays. This test will rule out other conditions that have the similar symptoms as asthma (for example, pneumonia).
• Exercise challenge test. This test evaluates the responsiveness of the airways.
• Trial use of asthma medication. Asthma medications are taken, and any improvement in symptoms are observed.

The results of these tests will enable your physician to determine if you have asthma and which treatment is best for you.

Tips for Working with Your Doctor

• Choose your family doctor carefully. Look for someone who is knowledgeable about asthma and who is interested in working cooperatively with you. Your doctor should be familiar with the latest clinical guidelines and standards for asthma care.
• Learn as much as you can about asthma so you can ask questions and identify problems that may need extra attention.
• Be your own advocate. Understand what type of care is recommended for people with asthma, and ask your doctor about it.
• Work with your doctor to set goals for better management of your condition.
• Meet with a B.C. Lung Association asthma educator to learn more about all aspects of asthma including how to self manage your illness.
• Work with your doctor to develop your own asthma Action Plan. An Action Plan will clearly spell out how you should be taking your medications, and what you should do when your asthma symptoms worsen.
• Your family doctor will manage most of your asthma care, but you may be referred to other medical specialists when necessary. For instance, you may be referred to a respirologist. Your family doctor and other medical specialists work together as a team. Don't hesitate to ask for a referral if you think it necessary.
• Make sure you understand what medicines you should be taking, what they are for, how they work, how to take them, and possible problems/side-effects.
• If you find it difficult to follow your doctor's instructions or are reluctant to take a prescription medicine because of side effects, be sure to tell your doctor.
• Keep a health diary or logbook to record your symptoms, the medications you use, the amount of medication you use, your peak flow readings and any changes in your condition.
• Take responsibility for your own health. This may include making necessary lifestyle changes, taking your medications properly, and/or quitting smoking.
• Don't hesitate to express your concerns or ask questions about your asthma care. Active involvement in your own care is critical. You can and should be involved in decisions about your treatment.

Your Asthma Team

Asthma management a team effort. Members of your 'asthma team' might include:

• Doctor - prescribes medication and manages medical problems
• Pharmacist - provides information about your medications and how to use them
• Asthma educator - teaches self-management skills either one-on-one or in a group program
• Respiratory therapist
• Asthma clinic
• Stop smoking program

Remember: You are the key player on this team.

Last Revised: December 17, 2007