It is very important to try and identify those things which trigger your asthma symptoms. Contact with triggers should be avoided or minimised to help keep you well both now and in the future. Although there are a number of common triggers, people with asthma are not all affected by the same ones. This example will illustrate how monitoring with the Asthma Assistant might help you identify your triggers.

Case Study

Name: Karen
Age: 29 years

Background
Karen has had asthma since she was 28. She wants to track her suspected triggers so that she can confirm whether or not they are affecting her asthma. She uses the Asthma Assistant to help her.

Monitoring with the Asthma Assistant
Karen uses the 'Basic Daily Card' and the 'Additional Daily Card' to monitor her asthma. To help identify triggers it is essential to look at both the 'Monthly Basic Report' and 'Monthly Additional Report' together. For this reason, the relevant report sections are shown consecutively:





Information from the 'Basic Daily Overview' heads the 'Monthly Additional Report'. This is where the headers include '...Previous Day Comparison.' Karen has listed six possible asthma triggers when monitoring her asthma during this report period. These are listed under Triggers Encountered on the 'Monthly Additional Report'. In this section, she has confirmed red wine on 22^nd and 28^th July, and horse riding on 25^th July.

Notice that on 22^nd July when Karen confirms red wine she has no asthma symptoms or fall in peak flow on her 'Monthly Basic Report'. However, the next morning her peak flow has fallen significantly from her green zone to her yellow zone, she suffers coughing in the day and needs to use her reliever medication. We see a similar pattern following red wine on 28^th July. This is indicated on her 'Monthly Additional Report' where the 'Peak Flow Previous Day Comparison' shows a fall following 'red wine' days. Her symptoms and reliever use go up compared to the previous days entries. It is not unusual for symptoms to come on several hours after contact with a trigger. This is called the late response and is one of the reasons why some triggers can be difficult to identify. Red wine is an asthma trigger for Karen causing this characteristic late response i.e. her asthma does not worsen until several hours later and in this case, the following day.

In contrast to this response to red wine, we can see from the reports that when Karen goes horse riding on 25^th July, her sport is restricted, she suffers from coughing and chest tightness, uses her reliever medication twice and has a low evening peak flow. Going horse riding seems to have triggered Karen’s symptoms the same day. In addition, she coughs that night and the following day and her peak flow is also reduced. This illustrates that you can respond differently to different triggers and take a varying amount of time to recover following contact, from minutes, to hours, days or even months.

Summary
This example highlights the excellent program feature enabling you to customise your trigger search to meet your individual needs and situation. You can add in as many suspected triggers as you wish to help you determine which are making your asthma worse. Alternatively you can track the effect of known triggers on your asthma. These report sections suggest that Karen’s asthma is triggered by red wine and horse riding.