Quiz: Identify Your Asthma Attack Type

When you breathe, the muscles around your airways should relax and enable air to pass through quietly. An asthma attack can narrow your breathing passage, inflame its lining, and increase mucus production.

Discovering your specific asthma attack type is essential to keep symptoms from flaring.

If you answered ‘yes’ to questions 1, 2, 3, 4 and 5 

You’re likely stricken with allergic or occupational asthma. To determine if an allergy provoked asthma onset, a healthcare provider will choose to do a blood or skin test. A skin test will involve allergens being applied to small areas of skin to see its reaction.

Other diagnostic tests can also be performed to identify if you have allergic asthma. These include:  

• Spirometry – Requires you to take a deep breath and exhale into a tube that’ll collect information about air movement when you breathe  
• Bronchoprovocation test – Requires you to breathe in allergens in a controlled environment 
• Exhaled nitric oxide test (FeNO test) – Requires a healthcare provider to measure the amount of nitric oxide in your breath when you exhale 

Upon diagnosis, your healthcare provider may prescribe a preventer inhaler for daily use and a reliever inhaler to ease symptoms of an asthma attack. 

Your medical history and a clinical examination will establish if your asthma is related to your occupation. Pulmonary function tests can help detect a narrowing of the airways, while a chest X-ray and blood and sputum tests may rule out other lung diseases.

Preventive actions at the workplace can help reduce the risk of asthma. The workflow process should be amended to manage staff exposure to irritants. It’ll include industry-standard hygiene techniques specific to certain chemicals or substances, keeping exposure to a minimum. Regular medical check-ups may also reveal possible lung damage or other clinical disorders.

However, if you have advanced occupational asthma, a healthcare provider will propose a combination of physical therapy, medications, and breathing aids to control symptoms. 

If you answered ‘yes’ to questions 6, 7, 8 and 9 

Initially, the perception was that exercise-induced asthma has only one symptom – a chronic cough. In recent times, this asthma type also appears with: 

• Airway hyperresponsiveness – a narrowing of the airways in response to stimuli 
• Eosinophilic inflammation – a worsening of disease due to biological mechanism-enabled white blood cells 

• Bronchodilator responsive coughing – a recurring cough that presents with an increase in exhaled air after using the medication 

Because of this, exercise-induced asthma can be considered a variant of the disease, a phase at the beginning of the diseases’ onset, or a precursor of classic asthma. Spirometry tests before and after exercise can show if you have this asthma type.

A reliever inhaler can fend off or calm disease symptoms. Montelukast – an oral medication and a long-acting bronchodilator – can be an option too. 

Separately, the reasons behind nocturnal asthma are unclear. These few factors relate directly to its occurrence: 

• Cold air inhalation 
• Poor control of daytime asthma 

• Sleeping face down or on your side 
• Hormone and lung function changes 
• Exposure to evening or night-time allergens 

To lower the incidence of an asthma attack at night, you should adhere to steps such as:  

• Changing your sleeping position 
• Keeping the bedroom environment clean  
• Keeping an inhaler on your bedside table 
• Maintaining an ideal body weight 

• Practising breathing techniques 
• Regulating your room’s temperature 

How Traditional Chinese Medicine Perceives Asthma Onset

In Traditional Chinese Medicine (TCM), the condition arises in the Lung, and links to the Heart, Kidney, Liver, and Spleen. It can also be categorised as Deficiency or Excess-type asthma. Several Excess types which make you vulnerable to the disease are:  

• Wind-Cold attacking the Lungs, which has symptoms like chest swelling, shortness of breath, sensitivity to cold, coughs, and thin, clear-white sputum
• Wind-Heat attacking the Lungs. Symptoms include fever, chest swelling, shortness of breath, yellow and sticky sputum, sensitivity to wind, and a red tongue with a thin, yellow coating
• External Cold and internal Heat. Symptoms include fever, lung swelling or pain, shortness of breath, cough with sticky sputum, dry stools, dark yellow urine, and a red tongue with a thin, white coating
• Phlegm-turbidity obstructing the Lungs, which has symptoms like nausea, vomiting, severe shortness of breath, coughs, and a pale tongue with a thick and greasy white coating

• Phlegm-Heat accumulating in the Lungs. Symptoms are constipation, mild fever, shortness of breath, yellow and sticky or blood-streaked sputum, dark yellow urine, and a red tongue with a yellow and greasy coating
• Liver qi affecting the Lungs. Symptoms are anxiety, depression, insomnia, shortness of breath due to emotional stimulation, loose stools, and a pale tongue with a thin and white or yellow coating

Addressing an Asthma Attack with Herbal Formulas  

Real Health Medical’s Chief Physician Chu I Ta says that you can correct these disorders with herbal formulas:

1. Wind-Cold attacking the Lungs: Ma Huang Tang (麻黄汤)
2. Wind-Heat attacking the Lungs: San Ju Yin (桑菊饮)
3. External Cold and internal Heat: Ma Xin Shi Gan Tang (麻杏石甘汤)
4. Phlegm-turbidity obstructing the Lungs: Er Chen Tang (二陈汤) and San Zi Yang Qin Tang (三子养亲汤)
5. Phlegm-Heat accumulating in the Lungs: Sang Bai Pi Tang (桑白皮汤)
6. Lung Qi affecting the Lungs: Wo Mo Yin Zi (五磨饮子)
7. Lung Deficiencies: Bu Fei Tang (补肺汤) with Yu Ping Feng San (玉屏风散)
8. Kidney Deficiencies: Jin Kui Shen Qi Wan (金匮肾气丸) with Shen Ha San (参蛤散)

Stimulation of acupressure points like tian tu (CV22, 天突), yong quan (KI1, 湧泉), he gu (LI4, 合谷), qu chi (LI11, 曲池), and zu san li (ST36, 足三里) can also help.

Early intervention is necessary for ensuring the right treatment for each asthma attack type. You can also use herbal formulas with the advice of a licensed TCM practitioner. If this quiz has helped you, share it with your loved ones!