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Asthma

Breathing Difficulties in Cold Weather

12/14/2007

Question:

I have asthma and am taking spiriva in the morning, singulair at bedtime and albuteral 4 times a day or as needed. When I go outside I cover my nose and mouth with a scarf. The other day I went out and had a hard time breathing, I went back into the house and took albuteral. Took 15 to 20 minutes before I felt better. That was scary as I couldn`t breath. Is there nanything that I should be doing or some medication that would work better? I`m almost scared to even go outside.

Answer:

Cold air is a trigger for many people with lung disease.  It is important the air is warm before it enters the lungs.  When you breathe through your nose the air is warmed as it passes over the turbinates and upper airways.  As you become more active in the cold it is hard to continue breathing through your nose - using a scarf or mask over your mouth can be helpful.  People with asthma who are sensitive to cold air, may find it helpful to take 2 puffs from their rescue albuterol inhaler before being active in the cold.

You ask about if you should be on different medicines.  The 2007 asthma guidelines have been published and are very clear about medications to use with asthma depending on severity.  Your asthma is considered out of control if you have breathing problems more than twice a week during the day or twice a month at night or you need to use your albuterol more than 2 days per week (preventive before exercise does not count).  The results of your breathing test - spirometry is also considered.  At this time, inhaled steroids is considered the best therapy for persistent asthma but there are a few alternative medications that can be used.  It is important to discuss these things with your doctor.  If you still have concerns, ask to see an asthma specialist or pulmonologist. 

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Response by:

Cathy   Benninger, RN, MS, APRN, C-AE Cathy Benninger, RN, MS, APRN, C-AE
Clinical Assistant Professor
Director, OSU Asthma Center Educational Program
College of Medicine
The Ohio State University