Asthma dos and don’ts: A doctor’s lens on what every patient must follow

Asthma is one of the most common chronic diseases in India. In my practice, I see a pattern: most patients suffer not because asthma is untreatable, but because their everyday habits work quietly against them. I still remember a college student who had come to me with uncontrolled asthma. He was using his reliever inhaler 4-5 times daily and lived in constant fear of breathlessness. A few months later, with the right medications and simple lifestyle changes, he was back to living a normal life. His asthma hadn’t disappeared, he had just learnt how to control it.

The first step to controlling asthma begins with knowing that even on days when breathing feels normal, inflammation may be present in the lungs. That is why your controller medication containing inhaled corticosteroids is the foundation of treatment. It is important to use your inhalers exactly as prescribed by your doctor, even on days when there are no symptoms. The controller inhaler reduces inflammation, prevents asthma attacks and protects your lungs in the long-term. What you must avoid is the over-reliance on your reliever inhalers. It may give you quick relief from symptoms, but it is detrimental to your lung health in the long-run. Studies clearly show that overusing relievers is associated with increased risk of severe asthma attacks and even death. If you are reaching out for your blue reliever inhaler frequently, it’s a warning sign. Talk to your doctor to know about safer and more effective inhaled medications.

One of the most overlooked problems is incorrect inhaler technique. As a pulmonologist, I see many patients every day who believe they are using their inhaler correctly, but only about one in three actually do. Incorrect use means the medicine never reaches the lungs leading to poor control and frequent asthma attacks. A simple demonstration of technique and correction during each doctor visit can significantly change outcomes.
Asthma care is not just about medicines, it is also about lifestyle changes. In India, we are surrounded by triggers; dust, smoke, infections; that can worsen asthma symptoms. Keeping your surroundings clean is not optional, it is essential. Regularly cleaning the house, washing bed linens in hot water, keeping the house free of pet fur and cockroaches, avoiding heavy carpets and improving ventilation can reduce exposure to triggers. Even outdoor pollution may worsen asthma. Wearing a mask while stepping out on high pollution days can help.

Patients with asthma should not avoid physical activity. In fact, physical activity in moderation improves lung function and overall stamina. A balanced diet rich in fruits and vegetables helps support overall immunity while maintaining a healthy weight and reducing strain on the lungs. Good sleep and stress management are equally important. Simple practices like breathing exercises, yoga or meditation can make a noticeable difference in the overall quality of life.

A clear don’t that patients with asthma must remember is do not ignore early warning signs like night-time cough, breathlessness or wheezing. These may be signals that your asthma needs attention. Most importantly, do not smoke or allow exposure to second-hand smoke, it directly worsens inflammation in your lungs and may even reduce response to your treatment.

Here’s a simple message I give every patient: use your controller inhalers regularly and correctly, don’t depend on relievers, stay active, eat well, manage stress and follow-up with your doctor regularly. Importantly, talk to your doctor and understand the disease. The day you understand your disease better, asthma stops controlling you and you start controlling asthma.
Dr. Arjun Khanna Senior Consultant & Head, Amrita Hospital Faridabad