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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.
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Please Note:
This is just an hypothetical example. Asthma can be very different
from one person to another and even in one person at different
times. Always get to know your own asthma. Always work closely
with your doctor and nurse who are essential in educating
you about your condition.
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