Track your symptoms
Write down your symptoms in an asthma diary each day. Recording symptoms can help you recognize when you need to make treatment adjustments according to your asthma action plan. Use your asthma diary to record:
Shortness of breath or whistling sounds when you exhale (wheezing). Disturbed sleep caused by shortness of breath, coughing or wheezing. Chest tightness or pain. Quick-relief (rescue) inhaler use — record when you need to use your quick-relief inhaler, such as albuterol (Proventil HFA, Ventolin HFA), and write down how many puffs you take. Disruptions to work, school, exercise or other day-to-day activities caused by asthma symptoms. Asthma symptoms during exercise. Changes in color of phlegm you cough up. Hay fever symptoms such as sneezing and runny nose. Anything that seems to trigger asthma flare-ups.
Record how well your lungs are working
Your doctor may have you periodically record results of breathing tests (lung function tests). If your lungs aren’t working as well as they should be, your asthma may not be under control. There are two main lung function tests:
Peak flow. This test is done at home with a simple hand-held device called a peak flow meter. A peak expiratory flow measurement indicates how fast you can force air out of your lungs. Peak flow readings are sometimes gauged as a percentage of how your lungs work at their best. This is called your personal best peak flow. Spirometry. Spirometry tests can be done at your doctor's office with a machine called a spirometer. Some people use a hand-held spirometer to take measurements at home.
Spirometry tests measure how much air your lungs can hold and how much air you can exhale in one second after you’ve taken a deep breath. This measurement is called forced expiratory volume (FEV). Your FEV measurement is compared with the typical FEV for people who don’t have asthma. As with your peak flow reading, this comparison is often expressed as a percentage
Adjust treatment according to your asthma action plan
When your lungs aren’t working as well as they should be, you may need to adjust your medications according to the plan you made with your doctor ahead of time. Your written asthma action plan will let you know exactly when and how to make adjustments.
The chart below can help you determine if you’re doing a good job of keeping your asthma under control. A similar system should be included in your asthma action plan. Depending on where your asthma control falls on the chart, you may need to make adjustments to your medications.