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Wednesday, February 8, 2012

Rules of 2's

Rules of 2's

I listened to a "telehealth" yesterday from the Utah Asthma Program. (They broadcast a speaker live over the internet once every 3 months.) They also record the telehealth presentations so you can watch them later. To see some of the programs they have done in the past, click here. (This last presentation isn't on there yet, but give them a little time and they will add it.)

Each speaker is very smart, I learn something new every time-even though I've been dealing with asthma for 12 years with my 3 kids. This program was by David Gourley, who talked about Diagnosing Asthma. He talked about the "Rules of 2." There are many people who are sure that their asthma is under control, but this is how to tell.

Your asthma is NOT under control if you are:

  • Using your inhaler more than 2 times per week
  • Waking up at night (due to asthma) more than 2 times per month
  • Refilling your Albuterol canister more than 2 times per year
Does this sound like you? What should you do if it does? A visit to your doctor or asthma specialist would be in order. Dr. Gourley said that if any of those things sound like you (or one of your loved ones) that you need to do more to control your (or their) asthma. He talked about the need to be on a controller or maintenance medication. (That's a medication that you take EVERY day, whether you feel sick or not! )

There are a lot of different medications that they can use to control asthma. You can work with your doctor until you find one that works for you. All 3 of my kids and I use different medications, different strengths of medication, etc. Asthma is a very individual disease.

Some people are afraid of side effects of using controller medication. But it is better to have your asthma under control and not be using your inhaler so often. What if you forget your inhaler? Run out? Can't find it? Controller medication can help control the swelling in your lungs that happens with asthma. If the swelling is already there, and you get sick on top of that, it can be too much for your lungs to handle. (As we found out with our kid's 12 hospitalizations!)

Asthma can and should be under control. But it takes a little experimenting with medications and doses to get it right. If you have any problems under the Rules of 2's, talk to your doctor pronto! You should be able to enjoy life with asthma once it's under control.

And I intend to enjoy life and live long enough to annoy my kids. Ha!


  1. Does using the nebulizer count as a rescue inhaler use? I'm confused about that. For me, it's the same medicine. I'm not sure if I'm supposed to just see that as part of the treatment or a sign the asthma is out of control.

    1. Hi Loraine,

      Yes, using a nebulizer does count as rescue use if it is your rescue medication (albuterol, proventil, xopenex, etc.)

      Some people use their nebulizer for their controller medication too. We did that when my daughter was little. She would use Pulmicort in the nebulizer every morning. But it was okay but it was her daily, controller medication.

      If you feel like you are having a hard time breathing/having asthma attacks more than twice a week, National Guidelines suggest "stepping up" treatment to include a controller medication.

      It's important to get to the root of the problem-what is causing the asthma symptoms?

      Allergies? Cold weather? Perfumes? Animals? Air pollution?

      It's not good to have swelling in the lungs, and that's what happens if your asthma isn't in control. Then if you have an asthma attack on top of that, it's hard for the lungs to recover.

      I would keep track of how many times a week you use your inhaler. You may need to call your doctor and have him look at what medication you are on. He may need to add a daily, controller medication.

      Here's a link to Allergy and Asthma Foundation of America

      They explain the different treatments for asthma.

      Good luck!

      Your doctor will assess whether you need a maintenance medication