How can a 42-year-old woman manage uncontrolled asthma?

Question

Hello doctor,

My wife, who is 42, was recently told she has something called uncontrolled asthma. I’m trying to understand what that means. She’s been prescribed an inhaler, but to be honest, I don’t see her using it much. I always thought asthma was something you just handled when it flared up, but now I’m starting to worry since her doctor seemed pretty concerned.

She’s been coughing a lot, especially at night, and she gets out of breath doing simple things like walking up the stairs.

Could this be because she’s not managing her asthma properly?
What exactly does uncontrolled asthma mean?
Can it lead to more serious problems if it’s not treated correctly?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

From what you've shared, it sounds like your wife is dealing with bronchial asthma, and more specifically, it may be uncontrolled asthma. The cornerstone of effective asthma management is regular use of inhaled medications. To get asthma under control, it’s critical to use the right inhaler at the correct dose, with proper technique, and consistently every day, not just during flare-ups.

For someone newly diagnosed or showing signs of poor control, I would recommend the following baseline investigations:

Complete blood count (CBC).
Serum total IgE (to check for allergies).
Chest X-ray.
Pulmonary function test (PFT or Spirometry) is to be done before and after using a bronchodilator.

Some common reasons for frequent flare-ups include:

Underlying issues like allergic rhinitis, acid reflux (GERD or gastroesophageal reflux disease), or obesity.
Not using the inhaler regularly or using incorrect technique.
Being prescribed the wrong type or dose of inhaled medications.

If asthma is confirmed, here are some key treatment recommendations:

Start daily use of a combination inhaler that contains Formoterol and Budesonide (200/6), two puffs twice daily using a spacer (always follow with mouth rinsing). Unless your pulmonologist advises otherwise, this should be continued daily for at least six months.
To ensure proper medication delivery, use a spacer device with the inhaler. The spacer usage technique can be easily learned online.
Follow up with a pulmonologist regularly, whether in person or via telehealth, ideally once a month.
Make sure all age-appropriate vaccinations are up to date.
Identify and treat any comorbid conditions (like allergies, reflux, or obesity) that could be worsening her asthma.

Please complete the investigations listed above and follow up after one week with the results. That will help determine how well her asthma is currently being managed and if any adjustments are needed.

Please don’t hesitate to reach out with any further questions. We’re here to help.

Thank you.