Asthma is a variable condition. This means if you are very well for some time you may be able to decrease your medication and likewise if your asthma becomes troublesome you may need to increase your medication. Monitoring your asthma when any change is made to your medication helps confirm it has achieved the desired effect.

Case Study

Name: Jo
Age:15 years

Background
Jo usually takes two puffs of her reliever inhaler before morning sport to prevent her asthma symptoms from coming on. Recently she has noticed her asthma is restricting her. She is out of breath when at the end of her sports session and needs to use her reliever. She also feels much more tired after finishing. Jo's Basic Daily Report indicates her asthma has worsened. As a result her doctor recommends she double her preventer inhaler from two to four puffs a day, continues monitoring her asthma and returns for a follow-up in two weeks.

Monitoring With The Asthma Assistant
Jo monitors her asthma using the Basic Daily Card. She also keeps track of her sporting activities using the triggers section of the Additional Daily Card. Ten days of the Basic Daily Report and a section from the corresponding Additional Daily Report are shown below:


On days when Jo does not do any sport and is taking her preventer inhaler 2 puffs daily her asthma shows signs of good control. However we can see that when she goes canoeing or swimming (6th and 7th of February) she shows signs of poor asthma control. She notes breathlessness in the day, increased use of her reliever inhaler, and a drop of evening peak flow to her yellow zone. Her diurnal variation also increased above 20% and she notes that her sport is restricted. These changes validate that sport is making her asthma worse.

Jo increases her preventer therapy to 4 puffs daily on 9th February. Notice that she still shows signs of poor control both that day and the next after sport. However, on 13th and 14th of February although she notes swimming and canoeing respectively on her Additional Daily Card, her peak flow is stable and she notes no symptoms or restriction on sport. The increase in her preventer inhaler appears to have had the desired effect in ensuring her asthma does not interfere with her sporting activities. This example also illustrates that it can take a couple of days before you notice the benefit of increased medication.

Summary
Monitoring illustrated how much Jo's asthma was being affected by sport. Not only did she have symptoms with sport, but the effects lasted into the evening causing her peak flow to drop into her yellow zone that indicates poor underlying control. Her asthma is much more stable after increasing her preventer inhaler.