How to Have Fewer Attacks

Before you read — 10 seconds: Which inhaler actually reduces how often you have attacks — the rescue one, or the daily one?

a) The rescue inhaler b) The daily controller inhaler

Most people with asthma think about attacks as bad luck. Some of it is. But a large share of it is preventable.

The daily inhaler is the one that prevents attacks

If you take one thing from this: the medicine that keeps you out of the emergency room is not the one you reach for when you cannot breathe.

The rescue inhaler opens your airways in the moment. It does nothing about the underlying swelling. The daily controller inhaler treats that swelling — and in studies it cuts meaningful asthma attacks by roughly half compared with using a rescue inhaler alone.

Half. From the inhaler that does not feel like it is doing anything.

3+ rescue inhaler canisters in a year is linked to a higher chance of a serious attack. Twelve or more — about one a month — is linked to a higher risk of dying from asthma.

Using your rescue inhaler a lot is information, not a solution

If that describes you, it is not a sign you need to be tougher or better organized. It is a sign that the underlying asthma is not controlled, and that the plan needs to change. Tell your care team. It is one of the most useful things you can report.

Quick check: If you are reaching for your rescue inhaler more and more often, what does that mean?

a) You need a stronger rescue inhaler b) It is a warning sign the asthma underneath is not controlled

Answer: A warning sign that the underlying asthma is not controlled — tell your care team rather than using more.

The unglamorous list

Stop smoking or vaping, and avoid secondhand smoke. Nothing else on this list comes close.

Keep up with immunizations — flu, RSV, COVID and pneumococcal. Respiratory infections are a common trigger.

Treat the other things — hay fever and sinus problems, reflux, weight, and sleep apnea all make asthma harder to control.

Know your triggers, and if you have specific allergies, reduce what you can at home.

Have your inhaler technique checked. It is worth doing more than once.

Ask for a written action plan. People with one manage attacks earlier and more confidently than people working from memory.

When it is worth seeing a specialist

Some asthma stays hard to control despite all of this. That is worth taking seriously rather than living with.

It is worth asking about a referral if you have been hospitalized for asthma, if you keep ending up in urgent care, if you need steroid tablets often, or if you are using your rescue inhaler at the levels above. There are treatments for severe asthma that target the specific cause of the inflammation, and identifying who they are right for takes a proper assessment.

Talk to us about an asthma review

Bring the number of rescue inhalers you have gone through this year, and any steroid courses. Those two numbers tell us most of what we need before you arrive.

Call (847) 860-7250.

Never change or stop a medication on your own. Talk to your care team first.

The answer

The daily controller inhaler. It treats the underlying swelling, and in studies it cuts meaningful asthma attacks by roughly half compared with using a rescue inhaler alone.

This article is for education only and isn't a substitute for medical care. Questions about your situation? Call the office — we're happy to help.