Many people believe their asthma attacks are completely unpredictable. Fortunately for most people this is untrue. This example highlights how monitoring with the Asthma Assistant could help you to spot the signs of an oncoming attack.

Case Study

Name: David
Age: 53 years

Background
David developed asthma for the first time when he was 51. Since then he has been in hospital three times with bad asthma attacks. In between these attacks he says he is very well and gets no warning. David. s doctor recommends he monitor his asthma at home just to see if his attacks are predictable in any way.

Monitoring With the Asthma Assistant
David monitored his asthma using the 'Basic Daily Card'. A section of his 'Monthly Basic Report' is shown below. It illustrates the run up to an asthma attack David suffered during the time he was monitoring his condition.



David has a bad asthma attack on 18^th May 1999. This is illustrated on his report shown above. His morning peak flow on this date is only 57% of his personal best value (yellow zone) and by the evening it is even worse at only 42% (red zone). In addition, he suffers breathlessness, wheezing and chest tightness and rates his asthma as 'Bad'. The five days before the attack, he notes no symptoms, rates his asthma as 'Good' and does not use his reliever medication. However, you can see from the peak flow bar chart and tabular data that his peak flow readings show a gradual decline for the two days preceding the attack of 18^th May: this was David. s warning.

David also monitored his medication in detail using the 'Additional Daily Card'. He then printed out the corresponding 'Monthly Additional Report'. A section of this is shown below.


David was taking his regular Becotide 100 preventer for the four days before the attack. On the 18^th May the doctor changed him to a stronger preventer inhaler, Becloforte 250 six puffs a day. In addition, the doctor prescribed him a short course of 10 steroid tablets daily. If you use these reports together as recommended, you can see that the preventer used in the 'Basic Daily Report' is 16 for each day 18^th to 22^nd May. This is calculated from the 6 puffs of becloforte and 10 steroid tablets each day as both are preventer medications. The program calculates this total automatically. Doses/puffs of reliever used each day as shown on the 'Basic Daily Report' are similarly calculated from the addition of the number of Ventolin 100 and Ventolin Nebules (both relievers) used each day.

Summary
This example shows how useful home monitoring with the Asthma Assistant could be in preventing a bad asthma attack. David's warning sign for this particular attack was a gradual decline in morning and evening peak flow for 2 days before the attack. By responding to this drop in peak flow (or any other warning signs), either by consulting his doctor or following his self-management plan, such an attack may be prevented in the future.