Asthma Action Plans. . .

September 25, 2009

as much as I believe in asthma action plans professionally, I’m not really going to preach them from that angle, other than to say that they are a really good thing. . . duh! (Although I do believe I’d see alot less asthmatics in the ER if AAP’s were used and followed more)

what is an asthma action plan: its a guideline that you as the patient and your asthma doc work on together, this guideline tells you how and when to take your meds, when to increase your meds, and when you should call your doctor or go to the ER. it generally consists of “Zones” color coded like a traffic light, alot of times there are peak flow numbers and symptoms for each zone, and sometimes its just based on symptoms, each zone has its own list of medications and instructions to follow that tell you when to change zones and when to call the dr or go to the ER.

why are they a really good thing? well, I’ll explain from experience. . . when I was first diagnosed with asthma I didnt have an action plan, every move I made with my asthma treatment I had to call my Dr’s office and either talk to someone or go in to be seen, leading to delays in treatment, and ending up on oral steroids a few times, and lots and lots of frustration that comes from trying to get appts and make phonecalls to increase or change my meds to get things under control. and on top of that I was always wondering when I should call my doc, and dealing with the stress of not knowing what I should do, and not having any control of the situation. . .

Since I’ve had my action plan I have used it once, my asthma doc says that its hard to tell how it works till its been in place 6 months to a year, the one time I did use it I loved it, it made life alot easier, and best yet, I got ahead of things before they got bad, and only needed to “yellow zone” for 2 days. . . it could have been much worse, I’ve ended up on prednisone a few times for letting things stew too long. . .

So, whats my asthma action plan?
I have moderate persistant asthma, my triggers are upper respiratory infections, smoke (cigarette and other) fumes like paint or chemical, construction dust and stuff like that, and exercise and stress.

Green: PF of 400 and up
Symptoms: NO symptoms (coughing, tight chest, shortness of breath {I dont really wheeze unless I am really bad off})

Meds: Symbicort 160/4.5 2 puffs twice a day, singulair 10 mg daily, and xopenex inhaler 2 puffs or neb 1.25 mg neb every 4 hours as needed

Yellow: PF 250-400
Symptoms: any symptoms what so ever, first sign of cold or upper respiratory infection

Meds: symbicort 160/4.5 2 puffs twice daily, singulair 10 mg daily, xopenex inhaler 2 puffs or neb 1.25 mg every 4 hrs scheduled, and either pulmicort flexhaler 180 mcg 2 puffs 4 times a day or 1 mg pulmicort nebulized twice a day

Red: PF<250
Symptoms: worsening symptoms dispite treatment or symptoms staying the same after 24-48 hours of treatment

Meds: Yellow Zone Meds plus 60 mg prednisone daily x 5 days
Call MD, go to ER if need be

so, whats your action plan? any success stories? any advice? any questions?


One Response to “Asthma Action Plans. . .”

  1. kerri said

    Great post!

    I can agree. Before I had my action plan and was able to increase my meds, I’d basically just be in the Ventolin/flare cycle and not really be doing anything much about it until it went away. Not a good move, but when you don’t really know what your doctor WANTS you to do, it’s hard to make guesses (and, you should never have to make guesses!)

    My asthma action plan:

    Mild persistent asthma; triggered by exercise, respiratory tract infections, smoke, pollen, dust, fragrances and chemicals.

    Green Zone (Peak flow 296-370 lpm)
    No symptoms.
    -Advair MDI 250/25 – 2 puffs twice daily
    -Singulair 10 mg – 1 tablet daily at bedtime
    -Ventolin 100 mcg – 2 puffs before exercise (and as needed

    Yellow Zone (Peak flow 185-296 lpm)
    (Coughing, chest tightness, dyspnea.)
    -Advair MDI 250/25 – 3-4 puffs twice daily
    -Singulair 10 mg – 1 tablet daily at bedtime
    -Ventolin 100 mcg – 2 puffs every 4 hours as needed

    Red Zone (Peak flow under 185 lpm)
    -If Ventolin is not helping, or peak flow drops below 50%, go directly to the emergency room.

    Advice regarding an action plan? GET ONE! And get it filled out properly! My primary care doc had never seen an action plan before I presented her with one! (At this point, I knew I need to get in with a lung doctor . . .) And, on it, all she wrote was if I was yellow zoning, to take my Ventolin every 4 hours . . . Finally, she gave me the go-ahead to increase the control meds if I was flaring (however, she never told me for how long–thanks Morgan!)

    Because I’d never been instructed to increase my control meds before, my asthma would flare up frequently/continuously whenever I got a cold. After getting a cold right after starting school, I dropped into the yellow zone and knew to increase my Advair. I still needed the Ventolin throughout the day, but usually only once or twice, and I was actually able to function like a human being. One of my last colds in the spring had me out of school for two days, and flaring for a bunch more. In my first couple weeks of university, not really an option to miss out unless I was basically dead or something.

    You sound like you’ve got a great action plan going on–mine’s pretty unclear at times (something I’ll be working at with the respirologist, I hope)! Fortunately, I’ve never been in the red zone, but, the whole point of the action plan is ’cause you just never know!

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