Changing symptoms over time

Asthma is a long-term condition. This means that it usually doesn’t go away, but using the correct medication can control symptoms very effectively. Sometimes children with asthma can ‘grow out of it’ but this is not always the case. In others there may be significant periods of time when they are symptom free, especially if the asthma is well managed.
Others also described the way their symptoms had changed over time. For some people, using the correct medication regularly meant that they now no longer, or rarely, experienced symptoms. Dee is frightened of having another serious asthma attack. so tries hard to keep her asthma well controlled. She said she can go for years now without needing to use her reliever inhaler and sometimes she forgets she has asthma. 

Some people noticed that their asthma improved for periods of time, but they had occasionally had flare ups, for example when they got a cold or chest infection or if they came into contact with known triggers, such as pollen. Sometimes people may discover a new trigger or react to something that has not bothered them before. Eve said it can sometimes "catch you out".
Margaret feels well most of the time but there can be times when she feels her asthma is starting to flare up and over the course of a couple of days it can get steadily worse. Usually she can calm things down by increasing her inhaler dose for a time. Alastair who has mild asthma said that although the perception of asthma is that of someone not being able to breathe at all, in his case it will gradually worsen to the point of being uncomfortable and when he uses his inhaler it stops it almost immediately. Alastair’s asthma is generally only triggered during the hay fever season. Charles said, "It’s been probably better since it was originally diagnosed, and I think that’s possibly due to the preventative treatment of Becotide …. I very seldom have the need to take Ventolin".
Sometimes people’s asthma had seemed to gradually worsen as they got older. That doesn’t necessarily mean they get symptoms all the time, but that when it does flare up it can be more severe. When Esther was first diagnosed with asthma in her 20’s she experienced occasional wheeziness, but she says it got progressively worse over time and began to be triggered more frequently by cold weather or if she exerted herself too much.
Some of the younger people we talked to wondered whether their asthma would become worse as they got older. Nicola asked the asthma nurse but was told it’s difficult to predict; she has decided to take things as they come and not worry too much about it. Similarly Tomas feels it’s best to concentrate on managing it as it is now and not to think about what may happen in the future.
Even when people have a good understanding of how to change the dose of their medication or how often they take it, they may still need to re-visit the GP or nurse to have their medication reviewed or fine- tuned. After a time of using an inhaler that has worked well symptoms sometimes start to reappear, suggesting it might be time to change medication.
A personal action plan helps people to vary their medication within agreed limits to gain better control when symptoms return. Some people find that they can manage changes just by using a plan that they have discussed in advance with the GP or asthma nurse. An ‘Asthma plan’ is intended to help people to know what to do to manage their condition and when they should seek further help.
(Also see ‘Triggers’, ‘Medication – inhalers’ and ‘Managing asthma –reviews and action plans’).


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