What are the less obvious symptoms of asthma. How can you distinguish asthma from other respiratory conditions. When should you seek medical attention for potential asthma symptoms. What lifestyle changes can help manage asthma symptoms.

Understanding Asthma: More Than Just Difficulty Breathing

Asthma is a chronic respiratory condition that affects millions of people worldwide. While many associate asthma primarily with shortness of breath, the reality is that this condition can manifest in various ways, some of which may surprise you. Understanding these diverse symptoms is crucial for early detection and proper management of asthma.

What Exactly Is Asthma?

Asthma is a condition characterized by inflammation and narrowing of the airways. This inflammation can be triggered by various factors, including allergens, exercise, cold air, and respiratory infections. When the airways become inflamed, they can swell, tighten, and produce excess mucus, making breathing difficult.

The Science Behind Asthma: Why It Occurs

The exact cause of asthma remains unclear, but researchers believe it results from a combination of genetic and environmental factors. If you have a family history of asthma, you’re more likely to develop the condition. However, environmental triggers play a significant role in the onset and exacerbation of symptoms.

Types of Asthma

• Exercise-induced asthma
• Occupational asthma
• Allergy-induced asthma
• Eosinophilic asthma

Each type of asthma has its unique triggers and may require different management strategies. For instance, exercise-induced asthma is more likely to flare up during physical activity, especially in cold, dry air. Occupational asthma, on the other hand, is triggered by workplace irritants such as chemical fumes or dust.

10 Surprising Signs of Asthma You Shouldn’t Ignore

While wheezing and shortness of breath are well-known symptoms of asthma, there are several other signs that people often overlook. Recognizing these symptoms can lead to earlier diagnosis and more effective treatment.

1. Persistent cough, especially at night
2. Chest tightness or pain
3. Fatigue or weakness during daily activities
4. Trouble sleeping due to coughing or wheezing
5. Rapid breathing or difficulty catching your breath
6. Frequent respiratory infections
7. Difficulty exercising or participating in sports
8. Increased mucus production
9. Feeling anxious or stressed about breathing
10. Difficulty concentrating due to breathing issues

Persistent Cough: A Common Overlooked Symptom

A chronic cough, especially one that worsens at night or in response to specific triggers, can be a sign of asthma. This cough is often dry and non-productive, meaning it doesn’t bring up mucus. Many people dismiss this symptom as allergies or a lingering cold, but if it persists, it’s worth discussing with a healthcare provider.

Fatigue and Asthma: An Unexpected Connection

Feeling unusually tired or weak during everyday activities could be a sign of asthma. When your airways are constricted, your body works harder to breathe, which can lead to exhaustion. If you find yourself winded after simple tasks like climbing stairs or doing household chores, it might be time to consider asthma as a potential cause.

Eosinophilic Asthma: A Unique Subtype

Eosinophilic asthma is a specific type of asthma characterized by high levels of white blood cells called eosinophils in the blood, lungs, and respiratory tract. This subtype often develops in adulthood and can be more severe and persistent than other forms of asthma.

Symptoms of Eosinophilic Asthma

• Intense wheezing
• Severe coughing
• Pronounced difficulty breathing
• Significant chest tightness
• Extreme fatigue

People with eosinophilic asthma often experience more intense symptoms that are harder to control with standard asthma medications. The fatigue associated with this type of asthma can be particularly debilitating, making even simple activities feel like strenuous exercise.

When to Seek Medical Attention for Asthma Symptoms

Recognizing when to consult a healthcare provider about potential asthma symptoms is crucial for proper diagnosis and management. If you experience any of the following, it’s time to schedule an appointment:

• Persistent cough lasting more than a few weeks
• Shortness of breath that interferes with daily activities
• Wheezing or whistling sound when breathing
• Chest tightness or pain
• Symptoms that worsen at night or in response to specific triggers

Early intervention can prevent asthma symptoms from worsening and help maintain better lung function over time.

Diagnosing Asthma: What to Expect

If you suspect you might have asthma, your healthcare provider will likely perform several tests to confirm the diagnosis. These may include:

Lung Function Tests

• Spirometry: Measures how much air you can exhale and how quickly
• Peak flow meter: Measures how hard you can breathe out
• Methacholine challenge test: Assesses airway responsiveness

Allergy Testing

Since allergies often trigger asthma symptoms, your doctor might recommend allergy testing to identify specific allergens that could be exacerbating your condition.

Imaging Tests

In some cases, chest X-rays or CT scans may be necessary to rule out other conditions that could be causing your symptoms.

Managing Asthma: Lifestyle Changes and Treatment Options

Once diagnosed, managing asthma typically involves a combination of medication and lifestyle modifications. Your healthcare provider will work with you to develop an asthma action plan tailored to your specific needs.

Medications for Asthma Control

• Quick-relief inhalers (bronchodilators)
• Long-term control medications (inhaled corticosteroids)
• Combination inhalers
• Oral medications
• Biologics for severe asthma

Lifestyle Changes to Manage Asthma

1. Identify and avoid triggers
2. Maintain a clean living environment to reduce allergens
3. Exercise regularly, but be mindful of exercise-induced symptoms
4. Quit smoking and avoid secondhand smoke
5. Manage stress through relaxation techniques
6. Get vaccinated against flu and pneumonia
7. Monitor your symptoms and peak flow regularly

By combining proper medication use with these lifestyle modifications, many people with asthma can effectively control their symptoms and lead active, healthy lives.

The Impact of Asthma on Daily Life

Living with asthma can affect various aspects of your daily routine, from work and school performance to social interactions and physical activities. Understanding these impacts can help you better manage your condition and improve your quality of life.

Asthma and Sleep

Nighttime asthma symptoms can significantly disrupt sleep patterns, leading to daytime fatigue and decreased productivity. Implementing good sleep hygiene practices and working with your healthcare provider to manage nocturnal symptoms can help improve sleep quality.

Asthma and Exercise

While exercise can trigger asthma symptoms in some people, regular physical activity is important for overall health and can actually improve asthma control over time. With proper management, most people with asthma can participate in their favorite sports and activities.

Asthma and Mental Health

Living with a chronic condition like asthma can sometimes lead to anxiety or depression. It’s important to address these mental health concerns as part of your overall asthma management plan. Cognitive-behavioral therapy and support groups can be helpful resources.

Innovative Approaches to Asthma Treatment

Research into asthma treatment is ongoing, with new therapies and management strategies emerging regularly. Some innovative approaches to asthma care include:

• Biologics for severe asthma
• Smart inhalers with digital tracking
• Bronchial thermoplasty for severe cases
• Personalized medicine based on genetic profiles
• Mindfulness and breathing exercises

These advancements offer hope for improved symptom control and quality of life for people living with asthma, especially those with severe or difficult-to-treat cases.

Asthma in Different Age Groups: Children vs. Adults

Asthma can affect people of all ages, but its presentation and management can vary significantly between children and adults. Understanding these differences is crucial for proper diagnosis and treatment.

Childhood Asthma

Asthma often first appears in childhood. Common triggers for children include:

• Respiratory infections
• Allergies
• Exercise
• Cold air

Children with asthma may experience more frequent respiratory infections and have trouble keeping up with peers during physical activities. Managing childhood asthma often involves educating both the child and caregivers about proper inhaler use and trigger avoidance.

Adult-Onset Asthma

When asthma develops in adulthood, it can be more challenging to diagnose as symptoms may be mistaken for other respiratory conditions. Adult-onset asthma is often associated with:

• Occupational exposures
• Hormonal changes (e.g., pregnancy, menopause)
• Weight gain
• Stress

Adults with newly diagnosed asthma may need to make significant lifestyle changes and learn new skills for managing their condition.

The Role of Allergies in Asthma

For many people with asthma, allergies play a significant role in triggering symptoms. Understanding the connection between allergies and asthma can help improve overall management of both conditions.

Common Allergens That Trigger Asthma

• Pollen
• Dust mites
• Pet dander
• Mold spores
• Cockroach droppings

Identifying your specific allergy triggers through testing can help you develop strategies to minimize exposure and reduce asthma flare-ups.

Allergy Management Strategies

1. Use air purifiers in your home
2. Wash bedding regularly in hot water
3. Keep pets out of bedrooms
4. Use allergen-proof mattress and pillow covers
5. Consider immunotherapy (allergy shots) for severe allergies

By effectively managing allergies, many people with asthma find that their overall symptom control improves significantly.

Asthma and Environmental Factors

The environment plays a crucial role in asthma management. Both indoor and outdoor air quality can significantly impact asthma symptoms. Understanding and mitigating these environmental factors can help reduce the frequency and severity of asthma attacks.

Indoor Air Quality

Improving indoor air quality is essential for managing asthma symptoms. Consider the following strategies:

• Use HEPA air filters
• Maintain proper ventilation
• Control humidity levels to prevent mold growth
• Avoid using harsh cleaning chemicals
• Keep indoor plants to naturally purify air

Outdoor Air Quality

Outdoor air pollution can exacerbate asthma symptoms. Stay informed about air quality in your area and take precautions on days with poor air quality:

• Check local air quality reports daily
• Limit outdoor activities during high pollution days
• Wear a mask when air quality is poor
• Keep windows closed on high pollen count days

By being mindful of both indoor and outdoor air quality, you can significantly reduce your exposure to asthma triggers and improve your overall symptom management.

The Future of Asthma Research and Treatment

As our understanding of asthma continues to evolve, so do the treatment options and management strategies. Researchers are constantly exploring new avenues to improve asthma care and potentially find a cure.

Emerging Research Areas

• Gene therapy to target specific asthma-related genes
• Microbiome studies to understand the role of gut bacteria in asthma
• Advanced imaging techniques for earlier diagnosis
• Artificial intelligence for personalized treatment plans
• Novel drug delivery systems for more efficient medication administration

These cutting-edge research areas offer hope for more targeted and effective asthma treatments in the future, potentially leading to better symptom control and improved quality of life for those living with asthma.

Participating in Asthma Research

If you’re interested in contributing to the advancement of asthma treatment, consider participating in clinical trials. Clinical trials offer access to new treatments and help researchers develop better therapies for future patients. Discuss with your healthcare provider about potential clinical trial opportunities that might be suitable for you.

As we continue to learn more about asthma and develop new treatments, the outlook for people living with this condition continues to improve. By staying informed about the latest research and working closely with healthcare providers, individuals with asthma can look forward to increasingly effective management strategies and a better quality of life.

10 Signs of Asthma Absolutely Everyone Should Know

You might think you know the signs of asthma because hey, it seems like one of those health conditions that is absolutely unmistakable. It’s kind of obvious if you just…can’t really breathe, right? Sure, but asthma symptoms can present with a lot more complexity and subtlety than that. “Many people do not realize they have asthma and deal with daily symptoms,” Purvi Parikh, M.D., an allergist and immunologist with Allergy & Asthma Network, tells SELF. Because of that, you should be aware of the signs of asthma so you don’t write them off for months or even years without realizing you have this persistent—and ultimately treatable—health condition.

What is asthma, anyway?

First up, a little anatomy refresher: Your airways, which extend between your nose and mouth and your lungs, have the very important job of carrying air in and out of your body, according to the National Heart, Lung, and Blood Institute (NHLBI). When you have asthma, triggers like animal fur, pollen, mold, cold air, cigarette smoke, exercise, and respiratory infections like colds cause your airways to get inflamed, according to the NHLBI. That inflammation can cause swelling, which in turn can prompt the muscles around your airways to tighten, making it hard to get air in and out. At the same time, your airways might also expel more mucus than they usually do, making it even harder to breathe.

Experts don’t know exactly what causes some people to get asthma when others don’t, but it’s pretty safe to assume that it’s probably a combination of environmental factors and genetic factors. For example, if someone in your immediate family has asthma, you’re more likely to have it too, according to the Centers for Disease Control and Prevention (CDC). Beyond that, the general cause is a stronger-than-normal response from your immune system to certain triggers, which is why you get all that inflammation when people without asthma don’t, says the NHLBI.

Speaking of triggers, everyone has different ones. For some people, asthma flares up in specific situations, according to the Mayo Clinic. For example, it’s possible to have exercise-induced asthma, occupational asthma, and allergy-induced asthma. Exercise-induced asthma is pretty much what it sounds like, and may be worse when the air is dry and cold. Your workplace might trigger occupational asthma if you’re around irritants like chemical fumes, gases, or dust. Allergy-induced asthma happens around airborne substances like pollen, mold spores, cockroach waste, or particles of skin and pet dander. You can learn more about these and the other different types of asthma here.

So, what are the symptoms you should watch out for?

Which signs of asthma you might experience differs from person to person and some are more common than others, Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF. It’s possible that you’ll have such a mild reaction to one of your personal asthma triggers that you don’t take much note of it. But if the effects get worse, they can turn into an asthma attack, which is a potentially life-threatening exacerbation of asthma symptoms. That’s why it’s so important to know the common signs of asthma, including the more subtle ones.

Common symptoms of asthma

These are classic asthma signs you should know:

Symptoms of Eosinophilic Asthma | Everyday Health

Eosinophilic asthma — a type of asthma that most often develops in adults — is marked by an increased number of white blood cells called eosinophils in the blood, lungs, and respiratory tract. High levels of eosinophils can cause inflammation and swelling in the airways and respiratory system.

When it comes to symptoms, eosiniphilic asthma isn’t that different from other types of asthma. “Symptoms are almost identical,” says Purvi S. Parikh, MD, an allergist and immunologist at NYU Langone Health in New York City.

That said, with eosinophilic asthma, symptoms may be more severe and persistent, and the usual asthma medications don’t provide relief. With this type of asthma, “it’s unfortunately much harder to get symptoms under control,” Dr. Parikh says.

RELATED: What Is Eosinophilic Esophagitis (EoE)? Symptoms, Causes, Diagnosis, and Treatment

According to the American Partnership for Eosinophilic Disorders (APED), intense wheezing, coughing, trouble breathing (shortness of breath), and chest tightness are all common with eosinophilic asthma.

Fatigue is also very common, Parikh says. “Patients get very tired or winded from doing simple activities, like walking a few blocks or doing household chores.” They may feel tired from breathing itself, she adds, especially if they’re not breathing effectively.

People with eosinophilic asthma tend to feel winded, as if they are doing heavy exercise. “It can feel like full-body fatigue that affects your lungs, heart, and whole body,” she says.

Your doctor may find inflamed and swollen nasal passages and benign polyps in the nose, all of which can cause a runny nose or a feeling of pressure in that area, the APED says.

When It Comes to Eosinophilic Asthma, Severity Varies

Symptoms of eosinophilic asthma can vary widely, according to Michael Peters, MD, an assistant professor of medicine in the division of pulmonary and critical care medicine at the University of California, San Francisco.

“Some patients describe an impact on daily life that’s relatively mild, with just a little cough,” Dr. Peters says. For others, “it’s extremely debilitating — where you’re being treated in the hospital with high doses of corticosteroids … and it’s completely changed your quality of life to the point that you can’t really function at all.”

According to Parikh, some people with eosinophilic asthma experience a squeezing sensation in the chest. Many have a hard time taking deep breaths, or even catching their breath. “Sometimes it’s so bad, people can’t even talk, or can’t talk in complete sentences.”

Other signs that point to eosinophilic asthma include “ending up in the emergency room more, in the doctor’s office more, requiring higher doses of medicines … requiring prednisone,” says Parikh. “People will say they’re unable to do simple household chores or play with their children, or they describe chest tightness like a squeezing pain that can sometimes be mistaken for a heart attack. They’re missing work or school [as a result].”

What’s more, “if you get woken up at night from your asthma,” Parikh says, “it’s a sign your asthma is uncontrolled.”

All of these are potential signs of severe eosinophilic asthma, Parikh says, and if you’re experiencing any of these signs, you need to be seen by your doctor.

When Eosinophilic Asthma Gets in the Way of Daily Life

“Sometimes people with eosinophilic asthma have this misconception that they are just getting old,” Parikh says. “They think they’re out of shape, and it’s actually dangerous because they downplay their symptoms. Nobody wants to be labelled with a chronic disease, so they’ll say it’s not that bad, and then we find out their symptoms are really limiting their life.”

In terms of lung function, experts still don’t know what the decline for people with this type of asthma will be over time, says Peters. “It’s been presumed that [lung function decline] happens,” he says, and that may be the case — “but it actually has never been shown or proven.”

If your asthma symptoms are severe or persistent, or in any way feel out of control to you, be sure to contact your doctor. New medications, such as biologics that target eosinophils directly, may be able to make a big difference in how you feel and function, according to the APED.

Asthma & Sleep: How to Get Better Sleep

Asthma is a condition in which a person’s bronchial tubes become swollen. The bronchial tubes are the body’s airways and allow air to move into and out of the lungs. As the airways swell, they lead to symptoms like wheezing, coughing, chest tightness, and shortness of breath. Swollen airways are also more sensitive to allergens and irritants. When asthma symptoms are worse than usual, it’s called an asthma attack, episode, or flare-up.

It’s estimated that asthma affects 1 out of 12 people in the United States, and unfortunately, the prevalence of asthma appears to be increasing. Over the past 40 years, the global prevalence of asthma has increased 50% every decade. While researchers don’t know why this increase is occurring, many researchers speculate that changes in hygiene practices, the use of certain medications in children, increasing rates of obesity, and vitamin D deficiencies may be to blame.

Asthma and Sleep

Whether it’s due to the symptoms of asthma or just staying up too late, missing sleep can make asthma worse. Sleep loss promotes inflammation in the body and affects lung function, increasing the chances of an asthma attack.

A recent study found that people who get fewer than six hours of sleep experience 1.5 times more asthma attacks and have a poorer health-related quality of life than those who sleep the recommended 7 to 9 hours each night. Poor sleep in people with asthma may also be related to the presence of other health conditions, including sleep disorders, and the stimulating effects of asthma medications.

The symptoms of asthma can flare up or get worse at night. Nighttime asthma, called nocturnal asthma, is an experience that can wreak havoc on a person’s sleep and may be a sign of more severe or poorly-controlled asthma.

Nocturnal Asthma

Nocturnal asthma is common, and about 75% of people with asthma are woken up by nighttime symptoms at least once per week. Around 40% of people with asthma experience nocturnal symptoms every night. Having poorly controlled or more severe asthma makes a person more likely to experience nocturnal symptoms.

The mechanisms behind asthma symptoms getting worse at night are not fully understood but may be related to normal hormonal changes in the evening. Many hormones — including epinephrine, cortisol, and melatonin — have circadian patterns, which are 24-hour cycles connected to the body’s internal clock. Changes in these hormones that occur in the evening may contribute to inflammation in the airways, increasing the risk of nocturnal asthma symptoms. Hormonal changes during pregnancy can also affect the symptoms of asthma.

Obesity can also increase the risk of nocturnal asthma and make asthma more difficult to manage. While this link is not fully understood, researchers have hypothesized that excess fat around the throat and increased systemic inflammation may contribute to nocturnal asthma in patients with obesity.

Acid reflux, also called gastroesophageal reflux disease (GERD), is another medical condition commonly associated with nocturnal asthma. As many as 80% of people with asthma also experience GERD symptoms like heartburn and regurgitation.

Nocturnal Asthma Triggers

In addition to obesity, GERD, and circadian hormonal changes, there are many environmental triggers that can provoke nocturnal asthma.

• Tobacco smoke: Smoking and exposure to secondhand tobacco smoke can weaken lung function and irritate the airways.
• Allergens in the bedroom: Many people with asthma are sensitive to dust mites, droppings from pests like cockroaches and rodents, animal dander, mold, and pollen. Even if people are exposed to these allergens during the day, a delayed allergic response can cause asthma to act up after getting into bed.
• Diet: Some people with asthma are sensitive to sulfites in foods and beverages like beer, wine, dried fruit, processed potatoes, and shrimp. If consumed too close to bedtime, these foods may trigger nocturnal asthma.
• Medications: Some medications, including certain cold medicines, aspirin, vitamins, and even eye drops can trigger nocturnal asthma when taken too close to bedtime.
• Cold air: Cold air is a common trigger during the day and can also trigger nighttime symptoms if the bedroom environment is too cold or a window is left open.
• Other medical issues: Viral infections like colds, the flu, and sinus infections are some of the most common triggers for nocturnal asthma attacks.

Nocturnal Asthma and Children

Asthma is more common in children than in adults and is the most common chronic disease in children worldwide. Accurately diagnosing and treating nocturnal asthma in children is especially important because the effects of nocturnal asthma, like loss of sleep and daytime sleepiness, are associated with behavioral and developmental difficulties.

Unfortunately, nocturnal asthma often goes undiagnosed in children because they tend to underestimate or not report their nighttime symptoms. For this reason, it’s helpful for parents to monitor and report back to the doctor any concerning symptoms in children. These symptoms may include wheezing, disturbed sleep, daytime sleepiness, and difficulties concentrating at school.

Asthma and Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a disorder in which the airways narrow or collapse during sleep. Asthma and OSA share similar symptoms and appear to have a bidirectional relationship. This means that having one of these respiratory conditions increases the likelihood of being diagnosed with the other. OSA is particularly common in people with asthma who also snore and those with poorly-controlled asthma symptoms.

People with asthma may find it helpful to talk to their doctors about obstructive sleep apnea. Because asthma puts a person at an increased risk of developing OSA, research suggests that periodic evaluations for OSA may help patients with asthma. Fortunately, treating OSA can often reduce asthma symptoms.

Controlling Asthma

Asthma symptoms can often be controlled by working with a doctor, allergist, or pulmonologist (lung specialist) to create a personalized Asthma Action Plan. Controlling asthma typically involves taking asthma medications and making a plan to avoid triggers that make asthma worse. Asthma medications come in two forms: quick-relief medicines that control asthma attacks and long-term control medicines that reduce the frequency and severity of future asthma attacks.

The American Lung Association recommends that people with asthma visit their doctor at least once a year to discuss their Asthma Action Plan. Yet even with the best plan, asthma can sometimes get out of control. If a person with asthma begins to experience new asthma symptoms or starts having trouble with routine activities — like cooking, cleaning, or bathing — it’s important to call a healthcare provider right away.

Avoiding Nighttime Asthma and Improving Sleep

Asthma can make it challenging to get quality sleep, so it’s helpful to cultivate habits that support sleep health. Focusing on improving sleep hygiene is a significant first step. By developing a regular sleep schedule and healthy daytime routines, people with asthma can reduce unnecessary daytime fatigue and focus on controlling their asthma symptoms.

Asthma triggers in the bedroom may increase the risk of nocturnal asthma and lost sleep. In addition to working with a doctor to find solutions for reducing or eliminating asthma triggers, below are a few tips specific to designing the ideal bedroom environment and avoiding nighttime asthma:

• Reducing bedroom allergens: Dust mites and pest residue in the bedroom can trigger nighttime asthma. Eliminating or reducing exposure to these triggers can make a huge difference. Wash bedding regularly and vacuum and dust weekly. Using allergen-proof bedding, like pillows and mattress covers, can help as well. For more information, the Centers for Disease Control and Prevention (CDC) offers a helpful guide to reducing asthma triggers at home.
• Keep pets outside the bedroom: Pet dander and saliva is a common asthma trigger. In addition to regular vacuuming and dusting, it’s helpful to keep pets out of the bedroom in general. For additional protection, consider changing clothes before sleep to prevent tracking pet’s dander into the bedding.
• Be careful with scented products: Strong scents from cleaning products, candles, and personal care products can be a trigger for some people with asthma. Consider making the bedroom an odor- and fragrance-free zone to reduce nighttime asthma.
• De-stress before bed: Stress is a common asthma trigger. Creating a nightly routine that incorporates relaxing activities, like soft music, a warm bath, or reading a book can help people fall asleep faster and reduce stress-related asthma attacks. Our guide to relaxation exercises to help fall asleep may be a helpful resource.
• Close the windows: Many people with asthma know that drastic changes in weather, temperature, and air quality can lead to asthma flare-ups. Reduce temperature changes, pollen, and air pollution in the bedroom by closing bedroom windows. Some people may also benefit from regulating the temperature and humidity in the bedroom environment or getting an air filter.
• Keep asthma medication nearby: Treating nighttime asthma attacks is an important part of controlling asthma. Keep asthma medications, along with a glass of water, near the bed so they are within reach if needed during the night.

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Uncontrolled Asthma vs. Severe Asthma: How to Get the Right Diagnosis

More than 25 million Americans struggle with asthma, a chronic condition that makes breathing difficult. Whether you have lived with asthma since childhood or developed it later in life, it is important to monitor your symptoms and avoid your triggers to manage the disease. Many times, regular flare-ups can be treated with a combination of quick-relief and controller medications. Unfortunately, this may not be enough to get your symptoms under control.

If you feel asthma is interfering with your life, it can be frustrating to know what to do next. This is when it may be time to talk to your doctor about the possibility of severe asthma.

Daily symptoms, such as chest tightness, shortness of breath, coughing and wheezing, are signs of uncontrolled asthma and may require the use of quick-relief medication a few times a week or even daily. In addition, you may commonly experience nighttime flare-ups and may even have to visit the emergency room. As you might expect, with these symptoms you may miss work, stop exercising, and have difficulty performing daily tasks. If you have signs of uncontrolled asthma as listed above, you will want to discuss this with you physician because you may be able to find a solution.

If you have mild to moderate asthma with uncontrolled symptoms, you may potentially be better controlled with adjustments to your treatment plan. Your doctor will want to evaluate the effectiveness of your current medication, as well as assess current lung function and determine your common triggers. This can be done by keeping an asthma diary or answering an asthma symptoms questionnaire. You may need to have a spirometry test, which is a simple, noninvasive breathing test to assess your current lung function.

In addition, your doctor may want to watch you use your inhaler to correct any errors in how you may be using it. They will most likely recommend that you avoid triggers and evaluate your current lifestyle for risk factors or other factors that cause increased symptoms or flareups. Smoking, beta-blocker medicines, allergen exposure, obesity, GERD, and depression or anxiety are just a few things that have been linked to contributing to asthma flare-ups. After evaluating all these factors, your doctor will likely want to adjust your medication to find something that is more effective, including adding an inhaled controller medicine if not already prescribed.

But what if you continue to struggle?

If after 3–6 months, your current treatment plan, which already includes a high-dose inhaled corticosteroid, a second controller medicine and/or an oral corticosteroid, is still ineffective, it may be severe asthma. Unlike uncontrolled asthma which improves with treatment changes, if you have severe asthma you will continue to have daily symptoms despite maximized optimal therapy. Other signals of severe asthma include waking every night due to asthma symptoms, two or more emergency department visits or hospitalizations in a year and the use of oral corticosteroids to manage symptoms.

At this point, your doctor will refer you to a specialist, either a pulmonologist or an allergist, to provide further testing to determine if you have severe asthma. They will be testing for biomarkers, which are identifiers in your immune system, blood, breath or mucus that cause Type 2 inflammation. Once a severe asthma diagnosis is confirmed they will help you find a personalized treatment plan that may include new medicines, such as biologics. When talking to your specialist, it may helpful to use our Severe Asthma Shared Decision-Making Worksheet to get the conversation started.

Think you may have severe asthma? Take our Asthma Control Assessment, to help identify if your asthma is uncontrolled and access a downloadable summary to take with you to your next doctor’s appointment.

9 Tips to Sleep Better with Asthma

Millions of people are affected by

nocturnal asthma,

or nighttime asthma. Symptoms include a tight chest, coughing, wheezing, and shortness of breath, and they can fragment and lighten sleep making life unbearable for many individuals. You end up feeling tired and irritable the next day and have difficulty controlling daytime asthma symptoms.

Asthma symptoms are stronger at night for a few reasons, including higher exposure to dust mites and other allergens. Plus, lying flat on your back increases post-nasal drip, which can trigger an asthma attack. These two things can make sleeping tough. But don’t worry—we’re here to help. In our article, we share 7 tips to sleep better with asthma so you can get undisturbed shuteye.

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1. Clean Your Bedroom

The bedroom can be a popular place for dust mites—a common asthma trigger—but cleaning your bedroom minimizes its effects. Picking up clutter and regular vacuuming and dusting improves indoor air quality and reduces the likelihood of an asthma attack.

2. Wash Your Bedding Weekly

If you can, wash your bed sheets and blankets in hot water once a week. A water temperature of at least 130 degrees Fahrenheit kills most allergens and bacteria. After bedding is washed, dry it on the hottest setting possible. The high heat kills any remaining allergens and sterilizes the material.

Don’t place the clean bedding back on the mattress unless it’s completely dry. Damp bedding can lead to mold and mildew growth, which are common triggers of nighttime asthma symptoms.

3. Keep Your Mattress Up Off of the Floor

While you technically can use some mattresses directly on the floor, we don’t suggest that for people with allergies (or in general, really.) Placing your mattress on the floor means you’re closer to dirt, dust, and other germs that can more easily make their way into your sleep space. Using a mattress foundation or bed frame limits your exposure to these irritants. A sterile mattress cover may also be helpful in keeping out the riff-raff.

4. Close the Windows

Outside air brings in pollen, dust mites, even animal dander, leading to inflammation in your lungs. This can trigger an asthma attack. When sleep is severely disrupted it can also have a negative impact on your circadian rhythm, causing you to wake up earlier or have difficulties falling asleep even when your asthma is controlled. Sleep expert Dr. Christopher Drake suggests, “Everyone should pay close attention to their sleep habits and keep a regularized schedule, especially getting up around the same time each day to avoid any circadian disruption to your sleep cycle. ”

5. Use Both a Humidifier

and an Air Purifier

Dry air can worsen asthma symptoms by irritating the throat and nasal passages, and allergens in the air can cause sneezing and morning congestion. Without humidifiers and air purifiers, you’re more likely to wake up with a sore throat or post-nasal drip, since the body overproduces mucus to protect passageways from debris. Investing in a humidifier and air purifier means more moisture in the air and less chance of irritation to the nose and throat.

Talk with a healthcare provider first before buying either of these devices. A humidifier can sometimes increase dust mites in the bedroom because it provides an ideal living environment. Air purifiers do balance those out, but some people, depending on the severity of their asthma, may want to avoid humidifiers entirely.

6. Invest in Dust-Proof Mattress and Pillow Covers

Zippered allergy covers for the mattress and pillows protect against dust and bacteria. Dust mites like to hide inside mattresses and can hinder your breathing as you sleep. Tightly-woven allergy covers make it impossible for dust mites to get inside your bed and pillows.

7. Elevate Your Upper Body

Lying flat on your back can worsen post nasal drip and trigger an asthma attack. Sleeping at an incline with a wedge pillow or an adjustable base makes it easier to breathe.

8. Get Tested for Sleep Apnea

People with asthma have a high risk of developing sleep apnea. Congestion from asthma causes snoring and may halt breathing for a few seconds at a time. If you wake up feeling tired, moody, and sore each morning, despite getting 7 to 9 hours of sleep, talk to your doctor about getting tested for sleep apnea.

If left untreated, sleep apnea can lead to long-term effects, like excessive daytime sleepiness and other serious medical conditions, like insomnia and acid reflux (also known as
gastroesophageal reflux

or GERD).

9. Keep Pets Out

Pet dander triggers asthma symptoms, making sleep difficult. It’s better to keep them out of the bedroom at night since dander sticks to bedding and carpet.

FAQs

Does asthma get worse at night?

Asthma is worse at night than during the day partly because the body is in a supine position, and you have a higher exposure to allergens than you would when walking around. Exacerbated symptoms make it difficult to sleep and cause coughing, wheezing, and sneezing. We recommend a humidifier, air purifier, and keeping your bedroom clean to reduce indoor allergens.

Is cold, fresh air good for asthma?

Cold, dry air is a common asthma trigger and causes bad flare-ups at night. Cold air irritates airways, leading to shortness of breath, coughing, and tightness in the chest. Try to keep the bedroom temperature between 60 to 67 degrees Fahrenheit to reduce flare-ups.

How do you calm an asthma attack?

A reliever inhaler is the best treatment for an asthma attack, but in case one isn’t on hand, sit upright and force yourself to take long, deep breaths. It improves lung function, won’t irritate airways, and slows your breathing, preventing hyperventilation. If symptoms worsen, seek emergency medical help immediately.

Does a hot shower help asthma?

Steam from a hot shower or bath clears out extra mucus in your airways, so you can breathe better. Less irritation reduces the likelihood of night-time asthma attacks. Keep in mind that heat can also worsen asthma, but it depends on your personal triggers. If you’re not sure, talk to your doctor.

Can I use my inhaler before bed?

You can use your inhaler before bed but keep it beside you if you have an attack. When you take your inhaler, sit up first so the medication can easily enter your throat and lungs. Wait a little bit before lying down and going back to sleep to ensure the medicine is working.

Conclusion

Nocturnal asthma symptoms lead to frequent sleep disturbances, affecting overall health. Taking steps like regularly washing your bedding or using a humidifier reduces asthma symptoms, so you can enjoy uninterrupted sleep.

Managing Your Asthma Flare-ups – American Family Physician

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

Am Fam Physician. 1998 Jul 1;58(1):109-113.

 
See related article on asthma.

To keep your asthma under control, you need to know what to do when you have a flare-up of symptoms (sometimes this is called an “exacerbation”). First, you need to know the symptoms that tell you your asthma is getting worse (flaring up). Second, you need to know how to treat your asthma when it gets worse. Early treatment of flare-ups works the best and will help get your asthma under control quickly.

What causes asthma symptoms to flare up?

Your asthma can flare up for different reasons. If you’re allergic to dust mites, pollens or molds, they can make your asthma symptoms get worse. Cold air, exercise, fumes from chemicals or perfume, tobacco or wood smoke, and weather changes can also make asthma symptoms worse. So can common colds and sinus infections. Gastroesophageal reflux (when stomach acid comes up into the back of the throat) can also cause flare-ups. You can help yourself by paying attention to the way these things affect your asthma. Your doctor might test you to find out if you’re allergic to something. Then your doctor can help you avoid the things that bother your asthma.

What are the symptoms of an asthma flare-up?

Common symptoms are coughing, shortness of breath (feeling breathless), a feeling of tightness in the chest and wheezing. (Wheezing is breathing that makes a hoarse, whistling sound.) It’s important to watch yourself every day for symptoms of asthma. You may have only one or two of these symptoms.

Another clue that your asthma is flaring up is that you have to take extra doses of your quick-relief asthma medicine (with an inhaler) more than twice a week because of these symptoms.

How do I know if a flare-up is serious?

Here’s a good way to see how bad a flare-up is: measure your peak expiratory flow (also called “PEF”) using a peak flow meter. Your doctor can show you how to use a peak flow meter to keep track of your asthma. A peak flow meter costs less than $30, and you only have to buy it one time. First, you find out your “personal best” peak flow. This is the highest reading you can get on the meter over a two-week period when your asthma is under good control.

Here are some general guidelines you can use to find out how serious an asthma flare-up is:

• During mild flare-ups, you may notice shortness of breath when you walk or exercise, but when you sit still, you feel okay. You can usually breathe well enough to talk in complete sentences. You may hear some wheezing, mostly at the end of exhaling (breathing out). Your peak flow readings will be 80 to 100 percent of your personal best.

• During moderate flare-ups, you may feel short of breath when you talk or lie down, but if you sit quietly, you feel better. You may talk in a few words rather than using whole sentences because you’re short of breath. You may feel anxious or tense. You may be using your neck muscles to help you take deeper breaths. You may hear loud wheezing, especially when you breathe out. Your peak flow readings will be about 50 percent to less than 80 percent of your personal best.

• During serious flare-ups, breathing will be very difficult and faster than usual. Even when you’re sitting still, you’ll feel short of breath. You might be able to talk only in a few words at a time because you’re so short of breath. You’ll feel anxious or tense. Your peak flow readings will be less than 50 percent of your personal best. If you feel sleepy and confused, and breathing is making you more and more tired, you may be having a life-threatening problem. Serious flare-ups mean you need to be treated right away, preferably in a hospital emergency room. Don’t wait to get medical help if you have the symptoms of a serious flare-up!

How is an asthma flare-up treated?

The best thing to do first if your asthma symptoms are getting worse is to use your rescue or quick-relief medicine. Ask your doctor if you’re not sure what to use for quick-relief medicine. The usual inhaler dose is two to four puffs every 20 minutes for a total of three doses, or one nebulizer treatment if you have a home nebulizer.

You should be able to tell how serious the flare-up is after you use your quick-relief medicine. If you have a peak flow meter, check your PEF again after you use the quick-relief medicine. If your PEF is still very low, your flare-up is serious.

Your doctor may have given you a written “Asthma Action Plan” with directions for treating mild, moderate and severe flare-ups. (A sample “Asthma Action Plan” appears at the end of this handout.) If you don’t have an action plan, ask your doctor for written directions about treating asthma flare-ups. If you have the symptoms of a serious flare-up or if your PEF is less than 50 percent of your personal best, call your doctor right away or go directly to the nearest hospital emergency room (by ambulance, if necessary).

Asthma Action Plan

Name ______________________________ Date __________________

To manage your asthma, you need to keep track of your symptoms, your medicine use and your peak expiratory flow (PEF). Using your PEF as a guide, here are some tips for treating your asthma symptoms:

• Green means Go—you’re feeling OK. Just keep using your preventive (anti-inflammatory) medicine.

• Yellow means Be Careful—you’re having some symptoms. It’s time to use your quick-relief (short-acting bronchodilator) medicine, in addition to the preventive medicine.

• Red means STOP—Your symptoms are serious. You need to get help from a doctor!

• Your green zone is _________, which is 80 to 100 percent of your personal best peak flow. Go! Breathing is good, with no cough, wheezing or chest tightness.

• ACTION:

• Keep taking your usual daily medicines.

Your yellow zone is __________, which is 50 to 80 percent of your best peak flow. Be careful! You may have symptoms like coughing, wheezing or chest tightness. Your peak flow level has dropped, or you notice that you need to use quick-relief medicine more often, or you have more asthma symptoms in the morning, or asthma symptoms are waking you up at night.

• ACTION:

• Take ______ puffs of _________________________ (your quick-relief medicine). Repeat this dose every 20 minutes, up to ____ more times. Use ____ puffs regularly every four to six hours for the next two days.

• Take ______ puffs of ___________________ (your anti-inflammatory medicine) ______ times per day.

• Start taking oral steroid medicines (or increase your dose): ________________ in a dose of ____ mg every a.m. ____ p.m. _____.

• Call your doctor or a hospital emergency room for advice today.

Your red zone is ___________, which is 50 percent or less of your best peak flow. Danger! Your peak flow number is very low, or you continue to feel worse after taking more medicines according to the directions for the yellow zone.

• ACTION:

• Take ______ puffs of your quick-relief medicine. Repeat this dose every 20 minutes, up to ____ more times.

• Start taking an oral steroid medicine (or increase the dose). Take _______ mg right now.

• Call your doctor now! If you can’t reach your doctor, go to a hospital emergency room.

Call your doctor at any time if you have any of the following problems:

or

or

Important telephone numbers:

• Doctor’s office _____________________________

• Doctor after hours _________________________

• Hospital emergency room __________________

Where can I find out more about asthma?

You can find out more about asthma by telephoning or writing to the following groups:

American Lung Association

Telephone (to find the local office nearest you):

1-800-LUNG-USA (1-800-586-4872), or check your local telephone directory

Internet address: www. lungusa.org

American Academy of Allergy, Asthma, and Immunology

611 East Wells St.

Milwaukee, WI 53202

Telephone: 1-800-822-ASTHMA (1-800-822-2762)

Internet address: www.aaaai.org

Allergy and Asthma Network/Mothers of Asthmatics, Inc.

3554 Chain Bridge Road, Suite 200

Fairfax, VA 22030-2709

Telephone: 1-800-878-4403

Internet address: www.aanma.org

National Asthma Education and Prevention Program,

National Heart, Lung, and Blood Institute Information Center

P.O. Box 30105

Bethesda, MD 20854-0105

Telephone: 1-301-251-1222

Internet address: www.nhlbi.nih.gov/about/naepp/

Asthma Flare-Ups (for Parents) – Nemours KidsHealth

What Are Asthma Flare-Ups?

An asthma flare-up is when asthma symptoms get worse, making kids wheeze, cough, or be short of breath. An asthma flare-up can happen even when asthma is controlled.

Asthma flare-ups are also called asthma attacks or exacerbations.

What Happens in an Asthma Flare-Up?

Asthma is a disease of the breathing tubes that deliver air in and out of the lungs. When someone has asthma, these airways (also called bronchial tubes) might be slightly inflamed or swollen, even when the person seems to be breathing fine.

During a flare-up:

• The inflammation gets worse. Sticky mucus clogs the airways and their walls get more swollen.
• The muscles around the airways get tight, further narrowing them (this is called bronchoconstriction).

These problems leave very little room in the airways for air to flow through — think of a straw that’s being pinched.

What Causes Asthma Flare-Ups?

People with asthma have airways that are overly sensitive to some things (called triggers). Being around triggers can bring on asthma symptoms.

The most common trigger in kids are viral respiratory infections, such as colds. Other common triggers include:

Many people with asthma also have allergies, which are another important flare-up trigger.

If not treated, a flare-up can last for several hours or even days. Quick-relief medicines (also called rescue medicines or fast-acting medicines) often stop the symptoms pretty quickly. A person should feel better once the flare-up ends, although this can take several days, especially if a viral infection was the trigger.

What Are the Signs of an Asthma Flare-Up?

Asthma flare-ups can vary in strength and length. They can happen without warning, causing sudden coughing, shortness of breath, and wheezing.

Flare-ups should be treated right away. So it’s important to know their early warning signs, including:

• coughing
• throat clearing
• fast or irregular breathing
• being very tired
• trouble doing everyday activities
• restless sleep or coughing that prevents sleep
• mild chest tightness or wheezing
• shortness of breath

If the flare-up is severe, a kid might:

• struggle to breathe or have fast breathing even when sitting still
• be unable to speak more than a few words at a time without pausing
• have retractions (sucking in of muscles in the neck and chest) while breathing in

Because they can be life-threatening, flare-ups demand attention. Your child might need to take quick-relief medicine (which acts quickly to relieve symptoms), visit the doctor, or even go to the hospital.

Following the instructions in your child’s asthma action plan can help you know what to do when a flare-up happens.

How Can Parents Help?

To help prevent flare-ups:

• Make sure your child always has quick-relief medicine and the spacer available.
• Teach your child how to avoid asthma triggers.
• Make sure your child takes the long-term control medicine (also called controller medicine or maintenance medicine) as the doctor directed. Even when your child feels well, it’s important not to skip it.
• Make sure your child gets a yearly flu vaccine, and washes his or her hands well and often to avoiding germs that lead to colds and other illnesses.
• Work with the doctor on an effective asthma action plan.

Ratatatat – Cosculluela lyrics te pueden borrar, y después que te caigan

No vira, y el tiempo

Ya yo he visto como muchos le dan cara a la tormenta

Sabiendo que no aguantan ni un viento

El Niño has returned

ver muerto

Yo sigo enfoca’o en lo mío

Me meto pa ” entro ‘el caserio

Y’ onde te pille, pa ‘

Cuando escuches “Clack-Clack”

Lo proximo que suene sera el Ratatatat

Muerto

Yo sigo enfoca’o en lo mío

Me meto pa ” entro ‘el caserio (Okay)

Y’ onde te pille, pa ‘

Cuando escu “Clack-Clack”

Lo proximo que suene sera el “Ratatatat”

Me mantengo e n esta música, la calle es la calle cuando se debe

Y no es con quién tú andes, es en verdad si tú te atreves

A enganchártela y salir a buscarme con los muchachos

Que fáde es decir “‘ pille te esparracho “

Pato ciego, fue como le dije en el day a Tego

Yo sigo vivo porque estos bobos me tienen miedo

Tuvieron su break el día en la Texaco, baján cuatro (j¿ ?¡ Qué)

Yo ando solo siempre, pero con el cubo y con el mapo

Mere Brenda, guardeme los Rolex en las tiendas (Okay)

Ya en este nivel no tengo que ponerme prendas

Los mahones, el Lacoste, telo piloste ‘onde tú’ tes

Sacamo los potes, y “Racatacata” con el tumba helicopter

It’s the Rotweilla Inc and the Street Kingz, nigga

Get more money man, we just gettin ‘bigger

Mueka, metele un cepillo al Forty-Five

Sacala a pasear, ba-ba-bye, ba-ba-bye 900 03

Me quieren ver muerto

Yo sigo enfoca’o en lo mío

Me meto pa ” entro ‘el caserio

Y’ onde te pille, pa ‘

Cuando escuches “Clack-Clack”

Lo proximo que suene sera el “Ratatatat” (Yeah!)

Muerto

Yo sigo enfoca’o en lo mío

Me meto pa ” entro ‘el caserio

Y’ onde te pille, pa ‘

Cuando escuches ” Clack-Clack “

Lo proximo que suene sera el” Ratatatat “

Tú eres de Guaynabo, mi hermana te conoce desde octavo (Okay)

¿Pa ‘qué tú’ tá rapeando si tus viejos tienen chavo ‘?

Y hablando de taquillas y de las cortas en los clavo ‘

Y yo te vi con una rubia solo por Condado

Eso no es calle, es claro, bo’, la calle es to’a de ustedes

De ustedes son los combos, las Forty y to’a las Nueve

Lo mío son los chavos, las rubias y las Mercedes

Y ahora con los cheques del publishing, alcancenme si pueden

It’s the rich mother-flower, con la SIG Sauer

En la guaga dando vuelta a ver si te pillo por Caguas

La subo en el expreso y la trepamo a 120

Ando con Holly, y Mueka va fumando al frente

En elre capsulequin, siempo

Tú sabe bien lo que va a pasar si te pillamo ‘

Andamo en la calle Los Insectos, y el combo del Doble Castillo

Con Charlie distribuyendo los ladrillo’ (¡Dracula!)

Me quieren3 ver muerto sigo enfoca’o en lo mío

Me meto pa ” entro ‘el caser io

Y ‘onde te pille pa’

Cuando escuches “Clack-Clack”

Lo proximo que suene sera el “Ratatatat” (Brru)

Muerto

Yo sigo enfoca’o en lo mío Me

pa ” entro ‘el caserio

Y’ onde te pille pa ‘

Cuando escuches “Clack-Clack” (I run the globe, my nigga)

Lo proximo que suene sera el “Ratatatat”

Lo de nosotros es caerle con 50, bajar con las 40 (Ajá)

Los peine 30, y darte en la cara a 190

‘Tán roncando de bichote y de que están bebiendo Blue (What?)

Y sólo me amenazan por YouTube (Pendejos)

Los conozco abajo, arriba, voy pa ‘PR y no hay quien lo consiga

Cuida’o corriendo que te me fatiga

Papi, si te explota el asma, te vo’a dejar plano como los plasmas

Y vas en caja pa’l país de los fantasmas, mere Jaime

Dame diez minutos en lo que rompo y los cocino (Yo, Jaime) 900 03

Yo a veces los miro de lejos y los examino

Dicen que son asesino, y tienen chavo pa’l casino

Compran Rhino, no hay Polaris, son to ‘chino

Ustedes no facturan, y ya en cuestión de orgullo está cabrón

Pero tumben el cuento que se montan de misión

Dizque sí son del callejón, ‘tán trabajando en Bayabon

Doblando las toallas en, I’m too strong, How nigga say you:

They , man? ”

I say: “I feel good!”

They say: “You feel like a champion?”

I say: “Yeah!”

They say: “Who put this together?”

I say: “Me!”

It’s Rotweilas Inc

lyricsRatatatat

lyrics

Let what is to happen happen.

This is no man’s land, there are no agreements on the street.

Take care of who it happens to.

That they can erase you and then fall.

Does not turn, and time

I have already seen how many turn to the storm

Knowing that they can not withstand the wind,

The child is back

They want to see me dead.

I’m still focused on mine.

I enter the caserio.

And ‘Onda caught you na’

When you hear “Clack-Clack”

The next sound will be “Ratatatat”

Dead

I’m still focused on mine.

I get pa ” inro ‘The caserio (good)

And’ Onda caught you pa ‘

When you hear “Clack-Clack”

The next sound will be “Ratatatat”

I stay in this music, the street is the street when it should

And it’s not who you walk with, but whether you dare. you are sparracho. ”

Blind duck, it was as I said on the day of That.

I’m still alive because these fools are afraid of me.

They had their break that day in Texaco, Bayan four (What a haystack !?)

I always walk alone, but with a cube and a mapo

Mere Brenda, keep a Rolex in stores (good)

Already at this level I do not need to wear clothes

Mahones, Lacoste, I am catching you.

I take out the pots, and Racatacata with the grave helicopter

This is Rottweil Inc. and Kings Street, nigga.

Get more money, man, we’ll just get a bigger.

Mueika, throw the brush at Forty Five.

Take a walk, ba-ba-ba, ba-ba-ba.

They want to see me dead.

I’m still focused on mine.

I enter the caserio.

And ‘Onda caught you na’

When you hear “Clack-Clack”

The next sound will be “Ratatatat” (yes!)

Dead

I’m still focused on mine

I enter the caseri

And ‘Onda caught you, na’

When you hear “Clack-Clack”

The next sound will be “Ratatatat”

You’re from Guaynabo, my sister has known you since the eighth (good)

What do you rap if your old people have a faq?

And speaking of lockers and short nails’

And I saw you with a blonde just around.

This is not a street, it’s clear, bo, the street is from you.

Of you, a combo, Forti and to’v nine.

My things are children, blondes and Mercedes.

Now with the publisher’s checks, catch up with me if you can.

This is a rich mother flower, with a Sauer whitefish

In La Guaga, turning to see if I catch you for Caguas

I take her onto the express train and raise her to 120

I walk with Holly and Mueica smokes in front.

In capsuleo, I’m always mechanically ‘

You know well what happens if I catch you.

Insects roam the street, and a double lock combo

With Charlie handing out bricks’ (Dracula!)

They want to see me dead.

I’m still focused on mine.

I enter the caserio.

And ‘Onda you caught na’

When you hear “Clack-Clack”

The next sound will be “Ratatatat” (Brru)

Dead

I am still focused on mine

I enter the caserio

And ‘Onda you caught na’

When you hear “Clack-Clack” (I run the globe, my nigga)

The next sound will be “Ratatatat”

We’re falling from 50, descending from 40 (Aha)

Comb 30 of them, and give you in your face 190

‘Tan snores from the whip and from the fact that they drink Blue (What?)

And they just threaten me YouTube (assholes)

I know them downstairs, upstairs, I I’m going na ‘OL and there is no one to get it.

Take care of running that tires me.

Daddy, if your asthma explodes, I’ll leave you flat as plasma.

And you’re in a box, Ghostland, just Jaime.

Give me ten minutes to break and cook them (me, Jaime)

Sometimes I look at them from afar and examine them.

They say they are murderers and they have a casino chavo pa’l

They buy a rhino, no Polaris, they are to ‘Chinese

You do not issue invoices, and already in a matter of pride you are a bastard

But drop the fairy tale that you collect on mission

Yes, they are from the alley, they work in Bayabon.

Folding towels I’m too strong nigga

They say: “How you feel, man?”

I say, “I feel good!”

They say “do you feel like a champion?”

I say: “Yes!”

They say: “Who put this together?”

I say: “I!”

This is Rottweilas Inc.

Boring, but positive post or hello, autumn mood .: evaevg – LiveJournal

Something I was missing. Along the way, the autumn blues caught up with me, albeit in a light version, but still.I didn’t want to. Moreover, everything is objectively good. Everywhere you spit – everything is wonderful everywhere, well, do not consider residual malaise after an untreated cold as a serious problem. As experience shows, now I will walk and cough for another week, like that same victim of the damned mines.

The worst thing is that you can’t write. Even today I would not have gathered, it just so happened that I have a theater in the evening, and I sit out alone at work (it makes no sense to call home), the whole tape has been re-read, and even the top is spilled.Here, from the top it really turns me out, as well as from politics. The further I listen and read about our political situation, the more scary and alarming I am. I have a son of military age, and although we have asthma and a military department, it is still restless.

I have no special news, everything is fine. Max returned, his son is actively involved in student life, everything is fine at work. Maybe this is the problem? Like writing in LJ is cool only when there are some problems or something annoying and infuriating. And I have no problems (pah-pah-pah) or endless situations.Probably in the common phrase that people with problems write in LJ, there is some sense … Although I have several friends who (well, at least it looks like that) everything in life is harmonious and good. They write about something. And for me, how everything works out, this is how problems begin with topics for posts and with a desire to write in general.

Well, for example – today I’m going to the theater. The event itself is about nothing, thanks to my dear friend Alena, I go to theaters quite often. And if I like the performance, then I will have nothing to write about.No, well, I’ll write, of course, that the theater is beautiful, the actors played great, the performance was simply beyond praise. Who cares? Well, such a sugary post will come out, which is difficult to comment on (“what a fine fellow, that I went”, “I didn’t watch, but I will keep in mind”, “and the last time I was in such and such a theater, I liked it too” – that’s all you can write about it), and it’s not interesting to read, because there is no intrigue. But if I don’t like it, and the performance will not be ice, here, by the way, there is a reason to joke.Well, for me, for example, such a post will be more interesting to write, I like neighing and criticizing, and for reading it is more fun, what really.

Or here are the usual sketches from life, the same everyday humor that I am very impressed with. You can’t write it out of the blue either. Here either mom should act as a permanent irritant, or Danya and Max should screw up, together or separately. And then yes – an interesting post. And so …

Or, for example, about emotions. Someone went on vacation – and the post came out so cute, with pictures of the beach, beautiful views and all kinds of cocktails with straws and palm trees in flowers.And the text is just as cute, like “Oh, how I had a great rest, how I don’t want to go back.” Well, no intrigue, again. You can overlook, breathe, be a little envious and comment with the same positive-neutral “What wonderful photos, it’s good that I rested. ” And now imagine that a person rested so-so – on the plane she got to “cheat” with several “children” who poisoned her all the way, the hotel staff was rude and stole, insolent beach macho tried to offer their services to gigolo and did not give a pass at all, without paying attention to her husband, who, however, would hardly have been able to prevent any kind of lewdness due to the complete merger with an olinclusive bar.Here is an interesting post, downright tasty. How many topics can be discussed, even eyes and hands run up.

In short, no matter how regrettable it is, but we must admit that positive posts lose out to negative ones. And it’s more interesting to write to me when I’m seething with indignation. And for reading it is also more attractive. So I will hope that at least the performance will not disappoint me, in the sense that I will not like it, even though I will write a devastating post, and that will be more interesting, honestly.

So I wrote seven paragraphs of tortured delirium and wondered, did I write this for a fig? What kind of person am I? Garbage happens in life – it’s bad, life has improved and entered the mainstream – it’s also bad. You will not please right at me. Okay, blame it on seasonal exacerbation and autumn melancholy.

fly off.ru – Rixos Premium Tekirova

We had a rest in Rixos from 9.07. until 20.07.2011 and we hope to return there more than once. I liked the hotel very much !!! Fully justifies its 5 *. Perhaps this is the only hotel about which I can say that. We gathered at this hotel spontaneously, literally 4 days before departure we bought a ticket there. Since this is a VIP-class hotel, the price for it was simply unaffordable for us, but we really wanted to get there, because it was not.Because we heard a lot of good reviews about this hotel, and when they saw the price for 11 nights, they immediately called the travel agency and made a reservation. Until the time of booking, we thought to go either to Orange Country or Kervensaray in Lara which. But both of these hotels somehow did not go to the soul. We were very happy that we would go to Rixos and began to get ready for the journey. Before that we had a rest 2 times in Egypt and 1 time in Thailand. In Turkey I am 6 times already. Before that I had a rest in the Delphin hotel chain: Botanic, Diva, De luxe. Club Ali Bey Belek and Silence Park Resort, all 5 * hotels.The ratio of vacationers is approximately the following: 70% of Russians and a little bit of Ukrainians, 30% of Germans and Turks. Territory. I’ll start in order. We arrived at the hotel at 7 a.m. resettlement was at 14 o’clock, I had to leave my suitcase at the reception and go for a walk around the hotel. Entering the hotel, we were pleasantly surprised by such a luxurious decoration: beautiful furniture, you can immediately see expensive, everything is very neat, clean, beautiful floor, there was a huge bouquet of flowers in a vase on the table near the elevator. Expensive mirrors hung in gold.There are carpets closer to the restaurant. On the sides there are shops with very high prices. There is also a Lobby Bar at the reception. While walking on the floor went to the toilet and were stunned. The feeling that I got into the toilet of the PLAZA hotel is serious. There is a picture on the wall and a huge mirror underneath a large comfortable armchair. The sinks themselves are made in marble, and the tap operates on a sensor. There are seats for children and a changing table. You go to the toilet and the sensor is triggered, the light comes on. Everything is neat and tidy. Between building A (it is more expensive and better, we lived there, a view of the mountains) and B there is a passage, you can not bypass, but go straight ahead.In general, we went for a walk further. We went outside to the central pool, took towels, occupied the sun loungers, changed clothes and lay down to sunbathe. The water is warm and very clean. The territory of the hotel itself is very clean and well-groomed. Many flowers are different, there is even a garden and greenhouses for plants, where they are looked after by a gardener. Good air. In general, the territory is very green, nothing more. The sea is clean only if there are no ships and yachts, because they dump waste from the sea. Of all the regions of Turkey in which I rested, the Kemer sea is the cleanest.The water was about 25 degrees, when entering it hurts to walk on pebbles, then you get used to it, because take a few steps and you can safely swim. The water is blue. There are 2 piers, 1 yachts are moored, 2 are sun beds, where we sunbathed. Every morning both piers are washed and sunbeds in particular. There are also 2 showers on the pier. On the territory there are 4 slides for children, 2 for children, 2 more or less normal. Sun beds, except for those that are on the sea, are all new, with cover and green rim, without mattresses. The central pool is 1.40 deep, and the one where the slides are 1.10, if an adult of normal dimensions slides down, it is possible to land not on his feet, but immediately on the bottom.The central pool is very large and warm, you can swim right from 8 in the morning, you won’t freeze. There are bridges made of dark wood above the pool, you can safely walk on them. There are also a lot of bars and cafes on the territory where you can eat during the day. The bartenders speak Russian, but weakly, they mostly ask with or without ice, with them or here, if they are with them, they give them a plastic cup. There was a real case: a child stepped on a glass glass near the lounger and ripped through his leg. There is also an open-air X-beach club on the territory, where on Tuesdays and Saturdays (it seems) there is a disco and animation, on other days the disco is held in the club from 12 am to 5 am.It is very fresh there and the music is honestly not very good, there were very few people there. There were also alcoholic and non-alcoholic drinks. There is also a vitamin sconce on the territory, which is located on the -1 floor of the A building, as you go down (to the pool) from the reception by the stairs, there are tennis tables to the left of the stairs, so you wrap up juices there too (there was orange and watermelon, very tasty) Number. In general, the situation was not very pleasant. We arrived in Turkey at 4 am. Naturally, while we were driving, we were strolling around the hotel, tired from the road, we wanted to check in faster, but the reception staff stubbornly stuck, they say, there are no free rooms, wait until 2. As a result, at 10 o’clock we went to the Guest Relation and asked her to arrange for any money to settle us. As a result, after half an hour of abuse, they said that they had found a room (despite the fact that they said that there were no vacant rooms), and we could move in without any additional financial expenses. Hurray! Here are the arrogant! In our room we had plasma, there was a minibar, a safe, a balcony, a table, bedside tables, an air conditioner, a wardrobe, a normal-sized bedroom with 2 single beds and a bathroom (toilet, bath – shower, sink, hairdryer, toiletries).RTelik shows about 12 Russian channels (3 music and many of our popular Russian ones, such as DTV and STS, very well). We lived in building A with a view of the mountains (of course, it was difficult to call it mountains, because the balcony overlooked the bungalow, and the whole view was obscured by trees under 3 meters, but it was quiet, calm, the music did not scream, the mosquitoes did not torment) , central, more expensive than B, because this 3-storey building was built quite recently, and building B remained from the previous owner. The room is excellent, always clean, the air is fresh, everything worked properly, no complaints.Room for 5. Was in the room of building B (7-storey). This is, as they say, “hug and cry” … Quiet horror compared to rooms A. The air conditioner is thundering, the room itself is 1.5 times smaller, which struck me: you open the door to the bathroom, and it rests against the sink, a little effort and you can go further pass the. The bathroom is so small, just horror, probably the whole bath is 4 squares, but no more, moreover, the bath in “A” is about 7 square meters. m., 5 people can freely enter and even dance, at least what to do, there is enough space for everyone.To the left is a toilet, in the center is a sink, to the right is a bath. Do not turn around at all. 2 people are unlikely to fit in there. The interior is naturally poorer, the room itself is dark, a small TV with a picture tube from the Cold War. I did not regret at all that I overpaid for the room. Nutrition. For food I put 5 +++++, just can’t describe in words how tasty and varied everything is !!! We got straight for breakfast as we arrived. I have not seen such a variety anywhere and never, although I always rested in expensive hotels. You will definitely not stay hungry for breakfast, several types of sausages, meat, boiled potatoes in seasoning and mashed potatoes, omelet porridge, various pastries, but everything is so delicious that you will lick your fingers.There was always freshly squeezed orange juice (also it was until 7 pm at the vitamin bar). And they make latte coffees well. Lots of vegetables and fruits around the clock, for breakfast, for lunch, for dinner. There were: peaches (very juicy and sweet), apples, melons, watermelons, cherries (very tasty and sweet), apricots, bananas, kiwi, pears (small). All fruits are delicious, have tasted everything. To be honest, I’ve seen better sweets. Lunches and dinners at the hotel are very varied and satisfying. Several types of meat, chicken, turkey.There were boiled, and fried, and grilled, and like shawarma meat. The kebab meat is very tasty, there was almost every dinner. Everything is deliciously prepared. Full of side dishes, delicious baked potatoes, much tastier than our Russian. The fries are also very tasty, although I’m not a fan of them, but I ate it sometimes. Excellent mixed salads, which usually no one eats, there was 1 salad, which was taken by almost everyone, without exception, this is a salad with fresh cabbage and something else with sour cream. Very tasty. =) =) And for lunch and dinner there were several types of noodles, they cooked it, honestly, not very much, it was kind of bland, and for this reason I did not eat it! The ice cream is delicious, not gelatinous, and for lunch and dinner there was a fountain with hot chocolate, sometimes white, then black.Great. In general, the food is the best, a separate respect to the cook of Rixos! You are just a magician! Animation for 5-. The imported animation is amazing, there are no dumb dances, where the dancers have grandmother-sized panties, everything is very cultural and civil (except for Africa). I was struck by the synchronicity of the dancers, I was very happy. Todes came, was at their performance for the first time, I liked it very much! Such positive guys, lively ones, all slender and fit, real lighters. Throughout the dance, the guys smiled and looked at the audience, so they charged the people with their positive energy that everyone applauded while standing, there was a storm of avats addressed to them! Africans or Ethiopians came several times, I don’t know who, but I didn’t like it, there were hefty men, half-naked, with rags instead of panties and the girls were the same, all the dances were shaking their asses, that all the linen was visible, as a result, after 10 minutes, half of the hall left …There are several good and funny animators, such as Rada and Gillette, who are always friendly, they dined and danced with us at the disco, but there are frankly unpleasant animators, I didn’t remember their names. Some are all sluggish, at least it seemed to me so. The circus came with animals, very nice, the dogs are great, they were well trained, the trainers themselves are very funny, pleasant. During the day there was boccia, darts and beach volleyball. There were contests, such as Miss and Mister (humorous competition), judging for Miss kapets in general, “3” was given for the girls’ perfect gait and a beautiful smile, 1 girl performed such an amazing dance, plastic … an excellent figure … everything is with her, and at the end she sat down on a split, and the audience burst into a storm of applause, as a result she was given a “3”, the audience was indignant, but the managers who gave the marks did not even pay attention.“5” was given 1 time and then to the 42-year-old aunt, who all came out so pompously, the fat hangs from the sides and the gait is generally zero. Well … everyone made their own conclusions … The daytime animation is excellent, except that quite often no one called for it, but cool, funny and varied games, no one was bored =) for drinks themselves, there is enough space for everyone, dofiga halls. On the beach for 5 service including bartenders. In the morning we washed the urns with soap !!! The ashtrays were changed quickly, everything was clean, there were no stains or dirt in principle.