Asthma is a chronic condition of the lungs that affects how you feel and breathe. It’s not contagious – you can’t get asthma from someone else (like a cold), and you can’t pass it on to anyone else. You can have symptoms that occur every day, weekly, every few months, or hardly at all. Some children seem to outgrow it, but most teens with asthma will continue to have symptoms as an adult. Most importantly, with the proper treatment, people with asthma can have normal and active lives.

What exactly happens when I have asthma symptoms?

When you have asthma, the airways in your lungs (tubes that carry air in and out of your lungs) are swollen and inflamed. When you are exposed to something that irritates the airways, they start to narrow, getting smaller and leading to less air being able to move in and out. Muscles in and around the swollen airways get tight and more mucous is made. This causes you to have trouble breathing, with chest tightness, coughing, and/or sometimes “wheezing”, or a whistling sound when you breathe.

What are of the most common symptoms of asthma?

• Coughing, especially during the night, early morning, when outside in the cold air, or while exercising
• Wheezing that can be heard when you breathe
• Shortness of breath or trouble breathing
• Chest tightness or pain which may feel like someone is sitting on your chest or squeezing it

If you have any of these symptoms, talk to your health care provider!

Asthma symptoms can range from mild to severe – from being a little annoying to seriously affecting how you are feeling. When symptoms are severe, asthma can be life threatening.

Will I always have asthma?

Studies have shown that asthma usually does not go away, and that the swelling in your lungs actually stays there even when your asthma is not bothering you. This is important to know because you need to pay attention to how you feel and if your breathing changes.

It’s true that some people only have asthma as a child and never seem to have symptoms again. Others can have symptoms their whole lives. Finally, there are other people who have no symptoms for years and then have it bother them again, many years later. It’s important to remember that asthma is a chronic condition, which means it can keep coming back, unlike a common cold which is temporary. As a teen with asthma, you will probably have it as you grow into adulthood.

Causes

What causes asthma?

No one knows for sure what causes asthma, but doctors have found that certain things in the environment can irritate a person’s breathing and cause symptoms. Asthma often runs in families and teens who have elevated BMIs are more likely to have asthma. Most teens who are diagnosed with asthma also have allergies that can aggravate their breathing.

What are triggers?

Triggers are things in the environment that bring on asthma symptoms or “asthma flare-ups” (sometimes called asthma attacks). Some triggers, such as pollen, will only affect people with asthma during certain seasons and not throughout the year. Others may have symptoms only when they are around a cat, for example.

The following categories and list of “triggers” can cause asthma symptoms for some people.

Allergens (things that you’re sensitive to that cause a type of allergic reaction):

• Dust mites
• Animal dander – (which is from skin, fur or feathers of animals)
• Cockroach and rodent droppings
• Pollen from trees, grasses, weeds, and flowers
• Mold and mildew

Irritants (smells and other things that you might inhale (breathe in) through your nose, mouth and into your lungs):

• Cigarette smoke– both smoke from your own cigarette or someone else’s
• E-Cigarettes (Vaping) – can cause serious lung injuries on top of making your asthma worse
• Strong smells – perfumes, make up, cleaning products, scented candles, fresh paint, room deodorizers, gasoline
• Chalk dust, wood smoke
• Air pollutants – smog, diesel fuel and factory emissions

Weather:

• Cold air
• Hot temperatures, humidity or “sticky weather”

Exercise:

• Sports and other physical activities (such as running) that cause sudden and rapid breathing

Viral infections:

• Colds and flu or other infections of the nose, throat, lungs, etc. that can cause coughing, sore throat, and/or trouble breathing

Dealing with Triggers

The thing about triggers is that one type of trigger (let’s say dust mites) may cause your friend’s asthma symptoms, but another kind of trigger (such as dog dander) may bring on your symptoms. Triggers vary among people. While taking your medicine and avoiding your triggers is the best way to control asthma and prevent symptoms, you can’t always avoid triggers in the environment.

You can, however, be proactive about certain things such as:

• If you are allergic to dust, keep your bed and bedroom as dust free as possible. (Carpets, drapes, and stuffed animals collect dust and dust mites – get rid of these items if possible.)
• Cover your mattress with a protective zippered case to keep dust mites out.
• Wash your sheets in hot water at least once a week.
• Vacuum and dust your sleeping and living areas at least once a week.
• Don’t buy scented health and beauty products or cleaning products with strong scents.
• Quit if you smoke (this includes vaping).
• Stay in an air conditioned place if the air quality outside is especially bad (on humid/hot days).
• Get a yearly flu shot.
• WASH YOUR HANDS often – This is the #1 way to lower your risk of catching colds, the flu, or COVID-19.

Try keeping a symptom diary. Jot down what the weather was like, what you were doing, what time of day it was, etc. when you have asthma symptoms. This can be really helpful to bring to your health care provider too!

If I think I have asthma what should I do?

If you haven’t been to your health care provider yet and you think you might have asthma, call and make an appointment as soon as possible. Getting diagnosed and treated quickly will make a big difference in the way you feel.

How is asthma diagnosed?

Only your health care provider can tell if you have asthma. They will ask you questions about how you are feeling in general and also specific questions about your breathing. You will be asked about your past health, your family’s health, about any medications you take, and if you have any allergies. Your health care provider will likely give you a physical exam and check your nose, listen to your lungs and heart, etc. to make sure you don’t have any other problems. You might be asked to breathe into a tube (called a “peak flow meter”) that measures how much air your lungs can hold. If you are diagnosed with asthma you may be referred to a specialist.

What is exercise-induced asthma (EIA)?

Some people only have asthma symptoms when they exercise or play sports – called exercise-induced asthma (EIA). People with EIA have airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air during aerobic exercise. There are some things you can do to help control exercise-induced asthma.

• Take a quick-acting prescription inhaler (usually albuterol) 15 minutes before you exercise (to open up your airway)
• Do warm-up exercises for about 10-minutes before heavy physical activity
• Begin exercising slowly and work up to a faster pace – this has been found to prevent asthma symptoms during exercise
• If you have symptoms and need your albuterol more than twice a week, you probably need a medication you can take daily to control your symptoms. This daily controller medication may come as another type of inhaler, or as a pill. See your health care provider if you need your daily rescue medication (albuterol) more than twice a week when you are otherwise feeling well.

If you’re having trouble with your asthma while you are exercising, try the following:

• IMMEDIATELY STOP any activity you are doing and stay calm. Sometimes just taking a break helps
• Get out of the cold temperature and away from dust and dirt particles such as dust from a dry soccer field
• Take your quick-relief/albuterol inhaler (you should always carry one with you if you have asthma!)
• Slow and calm your breathing – breathing fast can make your asthma worse
• Get medical attention if you are not better

Treatment

How is asthma treated?

Asthma is treated by keeping track of how well your lungs are working (your health care provider will listen to your lungs), taking medications as directed, avoiding things that make it worse (triggers), controlling things in your environment, and learning how to manage it. Although there is currently no cure for asthma, it can be controlled extremely well.

Tips to control your asthma symptoms:

• See your health care provider regularly and talk about any concerns you might have
• Take medications as prescribed by your health care provider
• Use a spacer with all inhaled medication, unless it is a dry powder. (Your health care provider will tell you if your inhaler is a dry powder.)
• Use a “peak flow meter” if you have one, especially to check your numbers when you have a cold or flu
• Keep a “symptom diary” that describes time, date, severity (how bad you feel) and exposure activity (what were you doing when the symptoms got worse)
• Know your asthma “triggers” and try to avoid or eliminate them
• Pay attention to your asthma so you know when it is getting worse and when to get help
• Rest if your asthma is bothering you
• Don’t smoke, or quit if you do (this includes vaping)
• Learn as much as you can about asthma because the more you know, the better you can help care for yourself and feel good most of the time

What kinds of medicines are used to treat asthma?

Some people need to take one or more types of medication daily for their asthma and others may not need to take any except when their asthma is bothersome. Your health care provider will decide what medications you need to take.

The two main components of asthma are bronchoconstriction – tightening of the muscles around your airways, and inflammation or swelling inside your airways.

Albuterol – also known as your “rescue” or “quick reliever” medicine will relax the muscles around your airways. There are 3 brands of albuterol – ProAir®, Proventil®, and Ventolin®. They all have the same ingredients and work the same way. Controller medications are medicines that you need to take every day to decrease the swelling in your airways. Controller medications can be inhalers such as Flovent®, Pulmicort®, Asmanex®, QVAR®, Alvesco®, Aerospan®, Advair®, Dulera®, Arnuity™, Breo® or Symbicort® or perhaps a pill such as montelukast or Singulair. Your health care provider will teach you how and when to use your medicine.

Click here for video tutorials How to’s of Asthma Devices from Boston Children’s Hospital.

An asthma action plan is a proactive way to keep your asthma under control. It’s written with your health care provider (HCP) and it’s personalized (just for you). An asthma plan has 3 zones – green, yellow, and red.

• The green zone lists what medications you should take every day when you are feeling well.
• The yellow zone tells you what to do at the first sign of a cough, cold, or wheeze.
• The red zone tells you what to do if your albuterol isn’t helping, or if you are very short of breath.

The idea behind having a “plan” is having important information such as: steps you need to take to stay symptom-free, a list of your medicines – the doses and how often you take them, your health care provider’s phone number, and a list of your asthma triggers, so you can have all these facts in one central location. You should have a copy of your Asthma Action Plan at home and with the nurse at school. You can also make a copy of your action plan and keep it with you. An Asthma Action Plan also includes simple and clear instructions about how to identify early symptoms of an “asthma flare-up”, how to treat them, and when to go to the emergency room. You should feel comfortable talking with your HCP about your action plan and update it as things change.

Getting Help

It can be very scary if you have trouble breathing. Having a plan in mind and knowing when to go to the emergency room will help ease your worries.

What are the signs that I need to get help right away?

• You are feeling like you need to use your fast-acting (albuterol) inhaler more than once every 4 hours
• Your fast-acting inhaler (albuterol) does not start to work within 20 minutes of when you take it.
• You are having trouble talking or walking because you are out of breath
• You are not able to breathe – call an ambulance and go to the closest emergency room

What should I do in an emergency?

If you have been using your asthma medications and they aren’t working and you can’t breathe – call an ambulance right away! If you don’t feel it’s an “emergency”, contact your health care provider. Remember – many teens have reported feeling like they should have taken an ambulance instead of having a friend or family member take them to the hospital by car, as their breathing got worse during the drive. Whoever is taking you to the hospital will not know what to do if you suddenly can’t breathe – and it CAN happen.

Additional Resources