Guest Author - Amy Anaruk

Maintenance is one of the most important words you�ll encounter in the battle to gain control of asthma. Developing a maintenance plan involves reducing lung inflammation, avoiding triggers, working with a general practictioner and/or specialist to figure out the best treatment meds, and composing an Asthma Action Plan. This article is part one of the series Asthma Maintenance 101.

An absolutely crucial first step in achieving asthma maintenance is identifying triggers--foods, substances, allergens, situations that cause asthma flares. If you recognize your triggers you can avoid them, and good preventative care can reduce dependence on emergency inhalers.

How do you determine what your triggers are? Rule number one is simply to pay attention. This step seems like a simple one, but think about how many times we ignore little health warnings while dealing with all the other details of our busy lives. Paying attention sometimes takes a conscious effort:

�Okay, for the next few weeks I�m going to notice whatever I�m doing/eating/breathing right before I have a coughing fit or feel short of breath.�

Keep track of the patterns, not the one-time occurrences. If, for example, one winter day you step outside and immediately start coughing but it doesn�t happen again, then that one time was probably a fluke. On the other hand, if you notice that every single time you step outside and walk to your car in the frigid air your chest tightens up and your breaths don�t come as easily, chances are pretty good that the transition from warm air to cold is one of your triggers. Each trigger you identify is a chance to change your life. Avoiding a blast of cold air by simply wrapping a scarf around your nose and mouth may completely solve this particular problem and keep you from needing your bronchodilator.

Keeping a journal to track down triggers makes a lot of sense for asthmatics, especially since an unexpected substance or activity can start causing flares with no warning. Not until I kept a journal for my daughter�s symptoms did I realize that very cold beverages will give her coughing fits if she drinks them too quickly. Because I had written all her activities down, I noticed that three times in one week�once when she gulped an entire can of cold tea, once when she drank a milkshake, and once when she had a glass of ice water�she started coughing and couldn�t stop after drinking. Once we recognized the problem she started taking smaller, slower sips and made sure not to gulp without breathing. She hasn�t had a flare from drinking since.

Allergy testing is another good tool for trigger identification. Because allergy and asthma go hand-in-hand, you frequently find one when you find the other. The most common ways to check for allergies are with a skin test or a blood test.

Allergists can perform skin tests by either the intradermal method, which involves injecting an allergen under the surface of the skin, or the more common prick or �scratch� method, which entails lightly scratching the surface of the skin with allergens. In both methods, doctors can test many different common allergens at once, since your skin will only react at the site of the scratch. The test only takes about thirty minutes total, and you get results on the same day.

When a patient has a severe skin issue or is on medications that can affect the results of an intradermal or prick test, an allergist may choose to perform a RAST (radioallergosorbent) blood test. During a RAST test, the doctor draws a blood sample from the patient and sends it along to a lab, where technicians test the sample for immunoglobulin E (IgE) response to various allergens. IgE is the antibody that causes allergic reactions. A blood sample that shows a high level of IgE in reaction to a specific substance indicates a probable allergy to that substance.

Allergists also prefer to use the RAST method if they suspect a patient is dangerously allergic since a blood test introduces allergens to a sample in a lab and not to the actual patient. The main disadvantages to blood testing are that it costs more than the skin tests and the results take longer because they come from a lab.

Plenty of treatment options exist that you can use in combination with your asthma meds to limit allergy-induced flares. Prescription and over-the-counter antihistamines and low-steroid nasal sprays can help, and asthmatics with mild allergies can often simply avoid flares by avoiding exposure to problematic allergens. Check out the links below for information on how to limit your exposure to the very common dust mite trigger and for more details on allergy testing.