taking care of your asthma - emblemhealth/media/files/pdf/asthma_toolkit.pdf• lack of sleep due to...

TAKING CARE OF YOUR ASTHMA

WHAT IS ASTHMA?

Asthma is a disease that affects the lungs. If you have asthma, you have it all the time, but will have an asthma attack only when some-thing, known as a trigger, bothers your lungs. Here’s how it happens:• When your airways come into

contact with a trigger, they become inflamed, narrow and fill with mucus.

• This prevents air from passing through your lungs easily, making it hard to breathe.

• This causes an asthma attack.

In most cases, we don’t know what causes asthma; nor do we know how

to cure it. We do know that if someone in your family has asthma,

you are more likely to have it as well.

We also know it can be kept under control by taking medicine and avoiding triggers. Many people with asthma live active,

full lives.

What are some common triggers of an asthma attack?Some of the most common asthma triggers are listed below:

•Tobacco smoke•Dust mites•Air pollution•Cockroaches •Pets•Mold•Being sick•Windy and cold weather

What are the signs and symptoms of asthma?

•Coughing that won’t stop, mostly at night•Wheezing when breathing both in and out•Shortness of breath or very rapid breathing•Chest tightness, pain or pressure•Feeling weak or very tired when exercising•Feeling tired, easily upset, grouchy or moody•Having symptoms similar to a cold or

allergies (i.e., sneezing, runny or stuffed nose, cough, sore throat or headache)

•Trouble sleeping

How do I know I am having an asthma attack?In addition to the symptoms described above, you may have:

•Tightening of your neck and chest muscles•Trouble talking•Feelings of worry or panic•Pale, sweaty face•Blue lips or fingernails

How is asthma treated?Asthma is most often treated by taking medicine. It is important that you have a good understanding of how asthma medicines work so you know under what conditions to take the different types of medicines that your doctor may prescribe.

Asthma medicines come in two types: long-term controller medicines and quick-relief rescue medicines: •Long-term controller medicines are taken

each day to prevent an asthma attack.

•Quick-relief rescue medicines are taken for fast relief at the first signs of an asthma attack. This type of medicine will not prevent an attack.

Is it OK to skip a dose of asthma medicine?You need to take your controller medicine each day to help lower your chance of having an asthma attack. If you are finding it hard to take your medicine on time, see the Hints to Help You Take Your Medicine section in this brochure or talk to your doctor.

What other tests are needed?Your doctor may perform the tests below to see how asthma is affecting your breathing: •Spirometry: This lung function test for asthma

is a simple breathing test that measures how much air you can take into your lungs and how quickly you can blow it out. It is often used to find out the amount of blockage in your airways.

•Peak flow meter: This portable, easy-to-use tool measures how well your lungs are working. Lower than usual readings are a sign that your lungs may not be working as well which may mean that your asthma is getting worse.

What can happen if asthma is not controlled?If you are skipping doses of your medicine or do not follow your doctor’s treatment plan, you may raise your chance of:

•Frequent asthma attacks•Visits to the emergency room•Hospitalizations •Missed work/school days•Trouble exercising and taking part in

other activities•Lack of sleep due to nighttime symptoms•Lungs not working as well for the rest of your life•Cough that doesn’t go away•Needing a machine to help you breathe

(e.g., a ventilator)•Death

The medicine your doctor prescribed can help control your asthma and its symptoms. But if you don’t take your medicine exactly as your doctor orders, you increase your chance of having an asthma attack.

This brochure can help you get the most out of your medicine. Read the hints below and go over the Questions for Your Doctor section during your next office visit.

An Asthma Action Plan can help you take charge of your asthma. You should develop your plan with your doctor. The plan will:

• List the medicines you are taking and when to take them.

• Describe how to control asthma long-term and handle your asthma if it gets worse.

• Explain when you need to call the doctor or go to the emergency room.

You can download an Asthma Action Plan that you can fill out with your doctor at www.emblemhealth.com/asthmaactionplan.

HINTS TO HELP YOU TAKE YOUR MEDICINE

•Make taking your asthma controller medicine part of your daily routine. Leave your medicine where you brush your teeth to help you remember to take it.

•Set the alarm on your watch, clock or cell phone to help remind you to take your medicine at the right time.

•Some medicines work better when taken with food while others do not. If your medicine should be taken with food, keep it on the kitchen counter as a reminder to take it with your meal.

•Ask a friend or family member to call you to help remind you to take your medicine. It’s a great way to stay in touch, too!

http://www.emblemhealth.com/asthmaactionplan

http://www.emblemhealth.com/asthmaactionplan

TAKING CARE OF YOUR ASTHMA

The medicine your doctor prescribed can help control your asthma and its symptoms. But if you don’t take your medicine exactly as your doctor orders, you increase your chance of having an asthma attack.

This brochure can help you get the most out of your medicine. Read the hints below and go over the Questions for Your Doctor section during your next office visit.

An Asthma Action Plan can help you take charge of your asthma. You should develop your plan with your doctor. The plan will:

• List the medicines you are taking and when to take them.

• Describe how to control asthma long-term and handle your asthma if it gets worse.

• Explain when you need to call the doctor or go to the emergency room.

You can download an Asthma Action Plan that you can fill out with your doctor at www.emblemhealth.com/asthmaactionplan.

HINTS TO HELP YOU TAKE YOUR MEDICINE

•Maketakingyourasthmacontrollermedicinepartofyourdailyroutine.Leaveyourmedicinewhereyoubrushyourteethtohelpyouremembertotakeit.

•Setthealarmonyourwatch,clockorcellphonetohelpremindyoutotakeyourmedicineattherighttime.

•Somemedicinesworkbetterwhentakenwithfoodwhileothersdonot.Ifyourmedicineshouldbetakenwithfood,keepitonthekitchencounterasaremindertotakeitwithyourmeal.

•Askafriendorfamilymembertocallyoutohelpremindyoutotakeyourmedicine.It’sagreatwaytostayintouch,too!

QUESTIONS FOR YOUR DOCTOR1.WhyamItakingthismedicineandhowwillithelpcontrolmyasthma? ________________________

________________________________________________________________________________

2.HowoftenandatwhattimesofthedayshouldItakethismedicine?___________________________

________________________________________________________________________________

3.WhatshouldIdoifImissadose?______________________________________________________

________________________________________________________________________________

4.ShouldItakeallthemedicineeventhoughIfeelfine? ______________________________________

________________________________________________________________________________

5.HowcanItellifthismedicineisworking?ArethereanytestsIneedwhiletakingthismedicine?______________

________________________________________________________________________________

6.Arethereanysideeffectsfromthismedicine?_____________________________________________

________________________________________________________________________________

7.HowlongwillIneedtotakethismedicine?DoIneedarefill?________________________________

________________________________________________________________________________

8.Doesmyprescriptiondrugplancoverthismedicine?Isthereagenericoptionavailable?____________

________________________________________________________________________________

9.CanIgeta90-daysupply?*CanIorderthismedicinethroughthemail?________________________

________________________________________________________________________________

* You may be able to get a 90-day supply and/or order your medicine through the mail!Ifyouhavequestionsaboutyourprescriptiondrugcoverage,visitwww.emblemhealth.comorcallCustomerServiceatthephonenumberonthebackofyourmemberIDcard.

GroupHealthIncorporated(GHI),GHIHMOSelect,Inc.(GHIHMO),HIPHealthPlanofNewYork(HIP),HIPInsuranceCompanyofNewYorkandEmblemHealthServicesCompany,LLCareEmblemHealthcompanies.EmblemHealthServicesCompany,LLCprovidesadministrativeservicestotheEmblem-Healthcompanies. EMB_MB_BRO_13870_Asthma_Medication_Tips6/13

USING YOUR INHALERA Guide to Getting the Most Out of Your Medicine

• Using a calendar, count forward that many days to see when your medicine will run out. Choose a day to have your prescription refilled that is a few days before this date.

• Using a permanent marker, write this refill date on the canister, and on your calendar.

How to Clean Your InhalerThe way you clean your inhaler is determined by the type of inhaler you use:

Metered-Dose Inhaler

The mouthpiece of your inhaler must be cleaned regularly to prevent medicine buildup and blockages. Most manufacturers suggest cleaning the mouthpiece once per week.

• Remove the medicine canister and cap from the mouthpiece. Do not wash the canister or put it in water.

• Run warm tap water through the top and bottom of the plastic mouthpiece for 30 to 60 seconds.

• Shake off extra water and let the mouthpiece dry completely (overnight is recommended).

• If you need the inhaler before the mouthpiece is dry, shake off extra water, replace the canister, and test spray two times (holding away from the face).

Dry Powder Inhaler

Dry powder inhalers should not be washed with soap and water. The mouthpiece can be cleaned with a clean, dry cloth. See the instructions that came with your inhaler for more information.

Group Health Incorporated (GHI), HIP Health Plan of New York (HIP), HIP Insurance Company of New York and EmblemHealth Services Company, LLC are EmblemHealth companies. EmblemHealth Services Company, LLC provides administrative services to the EmblemHealth companies.

EMB_MB_BRO_14185_InhalerGuide 9/13

55 Water Street, New York, New York 10041-8190

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AbOUt YOUR INHALERIf you have a disease that affects the lungs such as asthma, emphysema, chronic bronchitis or chronic obstructive pulmonary disease (COPD), your doctor may prescribe a medicine for you that requires the use of an inhaler. An inhaler is a device that helps deliver a set amount of medicine to your lungs.

Each inhaler is made up of two pieces: a pressurized canister of medicine and

a mouthpiece. When you press down on the

inhaler, it releases medicine

that you then breathe into your lungs. It is important to use your inhaler correctly so your lungs get the right amount of medicine.

This brochure includes general instructions and tips on how to use and care for your inhaler. It is important to also review the directions that come with your medicine.

How to Use Your Inhaler*1. Remove the cap and hold the inhaler upright.

2. Shake the inhaler. If the inhaler is new or you have not used it in a while, you may need

to get it started by spraying once or twice away from your face.

3. Tilt your head back slightly and breathe out.

4. Hold the inhaler about one to two inches away from your mouth or place the mouthpiece

fully into your mouth and close your lips around it. Spacers are useful for some people. See the section about spacers to learn more.

5. Press down on the inhaler to release the medicine as you start to slowly breathe in for three to five seconds.

6. Hold your breath for 10 seconds to allow medicine to reach deep in your lungs.

7. Repeat as directed. Wait one minute between puffs to allow the second puff to get into the lungs better.

8. Replace the cap of your inhaler.

9. After using your inhaler, rinse your mouth with water, gargle and spit out. This will help reduce side effects from your medicine.

*These instructions are for a metered-dose inhaler. For a dry powder inhaler, close your mouth tightly around the mouthpiece of the inhaler and breathe in quickly. Talk to your doctor or pharmacist if you have any questions about which type of inhaler you have and how to use your medicine.

Do you know about spacers?

A spacer is a tube that attaches to the

inhaler and holds the medicine until

you can breathe it. This makes using

the inhaler easier and helps to get the

medicine into the lungs.

To use a spacer, place the mouthpiece of the

spacer between your teeth and seal your lips

tightly around it. Press the canister of the inhaler

and the medicine will be released and trapped

in the spacer. Then, when you are ready, breathe

in slowly and fully through your mouth. Talk to

your doctor or pharmacist to find out if a spacer

would help you get more from your medicine.

How to Keep track of Your MedicineTo get the most from your medicine, make sure to take it exactly as your doctor ordered. Also, keep your inhaler in a place that will remind you to use it, such as on the nightstand.

It’s very important to keep track of how much medicine you’ve used so you can plan ahead and get a refill before you run out of medicine. One way to do this is to write the refill date on the canister itself. Use this method to figure out when you’ll need to get a refill:

• Start with a brand new inhaler. Divide the number of puffs in the canister (the canister will often have this number printed on it) by the number of puffs you take each day. The number you get will be the number of days the canister should last. (For example, if you take 4 puffs each day from a 200-puff canister, you will need to have a new canister every 50 days.)

USING YOUR INHALERA Guide to Getting the Most Out of Your Medicine

• Using a calendar, count forward that many days to see when your medicine will run out. Choose a day to have your prescription refilled that is a few days before this date.

• Using a permanent marker, write this refill date on the canister, and on your calendar.

How to Clean Your InhalerThe way you clean your inhaler is determined by the type of inhaler you use:

Metered-Dose Inhaler

The mouthpiece of your inhaler must be cleaned regularly to prevent medicine buildup and blockages. Most manufacturers suggest cleaning the mouthpiece once per week.

• Remove the medicine canister and cap from the mouthpiece. Do not wash the canister or put it in water.

• Run warm tap water through the top and bottom of the plastic mouthpiece for 30 to 60 seconds.

• Shake off extra water and let the mouthpiece dry completely (overnight is recommended).

• If you need the inhaler before the mouthpiece is dry, shake off extra water, replace the canister, and test spray two times (holding away from the face).

Dry Powder Inhaler

Dry powder inhalers should not be washed with soap and water. The mouthpiece can be cleaned with a clean, dry cloth. See the instructions that came with your inhaler for more information.


EMB_MB_BRO_14185_InhalerGuide 9/13

55 Water Street, New York, New York 10041-8190

www.emblemhealth.com

Urgent Care CentersWhen the doctor’s office is closed and you need medical help, go to an urgent care center. To see a list of urgent care centers:

You do not need a referral to visit an urgent care center in our network. Going to an in-network urgent care center will lower your copays and wait time compared to a hospital emergency room.

If you think you or your child are having a medical emergency, such as bleeding that will not stop, coughing up or vomiting blood, severe chest pain, or loss of consciousness, call 911 or go to the nearest emergency room.

Scan this code with your smartphone or go to www.emblemhealth.com/ucc to see a list of our urgent care centers.

1. Visit www.emblemhealth.com/ucc.

2. Click on the urgent care center link next

to the name of your insurance plan.

Home Delivery of Your asthma Controller

Medicine through Mail Order

If you are not already taking an asthma controller medicine, talk to your doctor about the benefits. If your doctor orders one for you, make sure to take it exactly as prescribed. Also, ask your doctor if a 90-day supply of an asthma controller medicine is right for you.

When you order a 90-day supply of medicine through our home delivery vendor, Express Scripts, Inc. (ESI), you will enjoy:

• Convenience — no more running to the pharmacy every month to refill prescriptions.

• Free standard shipping on every order.

• You can talk to an ESI pharmacist 24 hours a day, seven days a week.

There are three easy ways to order your 90-day supply of controller medicine through ESI:

• Option 1: Visit www.StartHomeDelivery.com and fill out the form online.

• Option 2: Call EmblemHealth Pharmacy Benefit Services at the number listed on the back of your ID card or ESI at 1-877-866-5798 (TTY: 1-800-899-2114) to ask that a home delivery order form be mailed to you. Fill out the form and mail it back.

• Option 3: Your doctor can fax a new prescription to ESI and should call 1-800-305-5287 for instructions.

If you are already on a 90-day supply of medicine through ESI, you can download the free Express RX application to your mobile device from your app store to order refills, check order status, find a pharmacy and more. Note that data charges may apply. Please see your individual carrier plan for details.


EMB_MB_OTH_15057_UrgentCareCenters_Insert 1/14

Medical Alert!n Very short of breath, orn Quick-relief medicines have not helped, orn Cannot do usual activities, orn Symptoms are same or get worse after 24 hours in Yellow Zone

-Or-

Peak flow: less than (50 percent of my best peak flow)

Take this medicine:

p p 4 or p 6 puffs or p Nebulizer (short-acting beta

2-agonist)

p mg (oral steroid)

Then call your doctor NOW. Go to the hospital or call an ambulance if: n You are still in the red zone after 15 minutes AND n You have not reached your doctor.

RE

D Z

ON

E

For: Doctor: Date:

Doctor’s Phone Number Hospital/Emergency Department Phone Number

See the reverse side for things you can do to avoid your asthma triggers.

p 2 or p 4 puffs, every 20 minutes for up to 1 hourp Nebulizer, once

Add: quick-relief medicine—and keep taking your GREEN ZONE medicine.

If your symptoms (and peak flow, if used) return to GREEN ZONE after 1 hour of above treatment: p Continue monitoring to be sure you stay in the green zone.-Or-If your symptoms (and peak flow, if used) do not return to GREEN ZONE after 1 hour of above treatment: p Take: p 2 or p 4 puffs or p Nebulizer (short-acting beta

2-agonist)

p Add: mg per day For (3–10) days (oral steroid) p Call the doctor p before/ p within hours after taking the oral steroid.

Asthma Is Getting Worsen Cough, wheeze, chest tightness, or shortness of breath, orn Waking at night due to asthma, orn Can do some, but not all, usual activities

-Or-

Peak flow: to (50 to 79 percent of my best peak flow)

(short-acting beta2-agonist)

YE

LLOW

ZO

NE

First

Second

n Trouble walking and talking due to shortness of breath n Take p 4 or p 6 puffs of your quick-relief medicine AND

n Lips or fingernails are blue n Go to the hospital or call for an ambulance NOW! (phone)

DANGER SIGNS

Asthma Action Plan

Doing Welln No cough, wheeze, chest tightness, or shortness of breath during the day or nightn Can do usual activities

And, if a peak flow meter is used,

Peak flow: more than (80 percent or more of my best peak flow)

My best peak flow is:

Before exercise

Take these long-term-control medicines each day (include an anti-inflammatory).

Medicine How much to take When to take it

GR

EE

N Z

ON

E

p p 2 or p 4 puffs 5 to 60 minutes before exercise

Allergensp Animal Dander

Some people are allergic to the flakes of skin or dried saliva from animals with fur or feathers.The best thing to do:

• Keep furred or feathered pets out of your home.If you can’t keep the pet outdoors, then:

• Keep the pet out of your bedroom and other sleeping areas at all times, and keep the door closed.

• Remove carpets and furniture covered with cloth from your home. If that is not possible, keep the pet away from fabric-covered furniture and carpets.

p Dust MitesMany people with asthma are allergic to dust mites. Dust mites are tiny bugs that are found in every home—in mattresses, pillows, carpets, upholstered furniture, bedcovers, clothes, stuffed toys, and fabric or other fabric-covered items.Things that can help:

• Encase your mattress in a special dust-proof cover. • Encase your pillow in a special dust-proof cover or wash the pillow each

week in hot water. Water must be hotter than 130º F to kill the mites. Cold or warm water used with detergent and bleach can also be effective.

• Wash the sheets and blankets on your bed each week in hot water. • Reduce indoor humidity to below 60 percent (ideally between

30–50 percent). Dehumidifiers or central air conditioners can do this. • Try not to sleep or lie on cloth-covered cushions. • Remove carpets from your bedroom and those laid on concrete, if you can. • Keep stuffed toys out of the bed or wash the toys weekly in hot water or

cooler water with detergent and bleach.

p Cockroaches Many people with asthma are allergic to the dried droppings and remains

of cockroaches.The best thing to do:

• Keep food and garbage in closed containers. Never leave food out. • Use poison baits, powders, gels, or paste (for example, boric acid).

You can also use traps. • If a spray is used to kill roaches, stay out of the room until the odor

goes away.

p Indoor Mold • Fix leaky faucets, pipes, or other sources of water that have mold

around them. • Clean moldy surfaces with a cleaner that has bleach in it.

p Pollen and Outdoor MoldWhat to do during your allergy season (when pollen or mold spore counts are high):

• Try to keep your windows closed. • Stay indoors with windows closed from late morning to afternoon,

if you can. Pollen and some mold spore counts are highest at that time. • Ask your doctor whether you need to take or increase anti-inflammatory

medicine before your allergy season starts.

Irritantsp Tobacco Smoke • If you smoke, ask your doctor for ways to help you quit. Ask family

members to quit smoking, too. • Do not allow smoking in your home or car.

p Smoke, Strong Odors, and Sprays • If possible, do not use a wood-burning stove, kerosene heater, or fireplace. • Try to stay away from strong odors and sprays, such as perfume, talcum

powder, hair spray, and paints.

Other things that bring on asthma symptoms in some people include:p Vacuum Cleaning • Try to get someone else to vacuum for you once or twice a week,

if you can. Stay out of rooms while they are being vacuumed and for a short while afterward.

• If you vacuum, use a dust mask (from a hardware store), a double-layered or microfilter vacuum cleaner bag, or a vacuum cleaner with a HEPA filter.

p Other Things That Can Make Asthma Worse • Sulfites in foods and beverages: Do not drink beer or wine or eat dried

fruit, processed potatoes, or shrimp if they cause asthma symptoms. • Cold air: Cover your nose and mouth with a scarf on cold or windy days. • Other medicines: Tell your doctor about all the medicines you take.

Include cold medicines, aspirin, vitamins and other supplements, and nonselective beta-blockers (including those in eye drops).

This guide suggests things you can do to avoid your asthma triggers. Put a check next to the triggers that you know make your asthma worse and ask your doctor to help you find out if you have other triggers as well. Then decide with your doctor what steps you will take.

How To Control Things That Make Your Asthma Worse

EmblemHealth, Inc. insurance plans are underwritten by Group Health Incorporated (GHI), HIP Health Plan of New York (HIP) and HIP Insurance Company of New York (HIPIC).

For More Information, go to: www.nhlbi.nih.gov

NIH Publication No. 07-5251April 2007

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