Asthma

Get help straight away if

These are uncommon, but they need same-day care — go to an emergency department, do not wait for an appointment.

• Too breathless to speak in full sentencesCall 911. Do not drive yourself.
• Your reliever is not lasting, or you need it far more often than usualA reliever that wears off quickly means the attack is not under control — get help now rather than repeating the dose and waiting.

Contact us promptly if

Not an emergency, but worth being seen sooner rather than waiting it out.

• Waking at night with cough, wheeze or tightnessNight symptoms are one of the earliest signs that control is slipping. Worth an appointment before it becomes an attack.
• Using your reliever more than about twice a weekUsually means the preventer needs review, not that you need more reliever.

What usually happens

The reliever treats the moment; the preventer treats the disease. The reliever works instantly and so feels like the important one — which is exactly why people drift onto it and away from the preventer. That drift is the pattern behind most severe attacks.

The preventer works only while you take it, and it does nothing you can feel. Taking it daily when you feel perfectly well is the entire point of it.

How much reliever you use is the best measure of control we have. More than roughly twice a week is a signal, not a habit.

Technique matters as much as the prescription. A large share of inhalers deliver very little because of how they are used, and a spacer often helps more than a stronger drug.

At your appointment

We will ask how often you use the reliever, whether symptoms wake you, and what you have had to stop doing — those three answer the control question.

We will almost certainly ask you to show us your inhaler technique. It is not a test; it is the commonest fixable problem.

We may check your breathing with a simple blowing test, and go through triggers — including smoking, vaping and workplace exposures.

You should leave with a written plan for what to do when things worsen, and a review point.

Worth asking

• —Can you watch my inhaler technique?
• —Should I be using a spacer?
• —What exactly should I do on a bad day, and at what point do I seek help?
• —Is my current preventer the right one for how I am doing?