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Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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Asthma

Asthma is a lung disease that affects your breathing. The airways that carry air in and out of your lungs become inflamed and constricted. Wheezing, cough, chest tightness and difficulty breathing are common symptoms.

Action Plan to Control your Asthma

Asthma does not stay the same all the time. Sometimes it will be in better control than at other times. Each person's asthma is different, so it is important that we work together and that you understand how to use your written asthma action plan. Most asthma action plans are based on three zones: green, yellow, and red. In general, the plan outlines which medicines to use when you are:

  • In good control, the green zone
  • Having a mild or moderate flare-up, the yellow zone
  • Having a severe flare-up, the red zone

You will be able to use your written asthma action plan to manage your asthma in each zone. You will know which zone you are in by paying attention to your symptoms, checking your peak flow readings, or both.

Green zone

In the green zone, you are breathing easily and feeling well. Your peak flow readings are 80 to 90 percent of your "personal best."

Personal best

Your personal best is your highest peak flow reading when your asthma is in good control. Find your personal best by checking your peak flow twice a day for 2 to 3 weeks when you are not having asthma symptoms. Take 3 peak flow readings each time you use your peak flow meter. The highest number you achieve is your personal best.

Your goal is to stay in the green zone by avoiding your asthma triggers and using your medicines as prescribed. This may mean using both your long-term controller or preventer medicines and your quick-relief medicines.

Yellow zone

You might be wheezing and coughing. Your peak flow readings are between 50 to 80 percent of your personal best. You may be taking your quick relief medication more than twice a week.

When you are in the yellow zone, take your asthma medicines according to your yellow zone plan. This may mean using more of your long-term control medicine and more quick relief medicine.

Yellow zone symptoms may seem mild at first, but a flare-up can get worse quickly if you don't take action. If you are in the yellow zone once a week or more, your asthma is not in good control. Be prepared to start using the yellow zone plan:

  • If your peak flow reading goes down even before you notice symptoms.
  • If you are in the yellow zone for 2 days without getting better, start your prednisone dose in your red zone plan and call our office.
  • Contact us to discuss your asthma plan and see what adjustments we need to make.
  • If you have a cold, flu, or allergy symptoms, check your peak flow at least twice a day.
Red zone

This can be a very dangerous condition. Your peak flow readings are less than 50 percent of your personal best. Other symptoms of the red zone can include:

  • Persistent coughing, wheezing, or chest tightness.
  • Waking up several times a night due to coughing or wheezing.
  • Taking longer to breathe out than to breathe in.

Manage asthma in the red zone by following these instructions, in this order:

  • Use quick-relief medicine immediately, taking 4 to 6 puffs from an inhaler or a nebulizer treatment. Repeat this every 20 minutes, but no more than 3 times.
  • Take your flare-up reversing ("burst") medicine and continue to take your controller medicine.
  • If you have followed these steps and you still have symptoms, call us or go to the Emergency Department.
  • If you have recently been in the red zone, it's important to contact us or go to the Emergency Department. Stay on your red zone plan until we let you know that it is all right to stop.
Danger signs in the red zone

It's important to watch for danger signs because you are at higher risk of dying from a severe asthma flare-up.

Call 911 or go to the nearest Emergency Department immediately if you have any of the following signs:

  • Difficulty talking, walking, or any signs of exertion due to breathing problems.
  • Severe shortness of breath.
  • Nostrils that flare (widen) with each breath.
  • Skin pulled tight between the ribs or at the base of your throat.
  • Wheezing when breathing in and when breathing out.
  • Lips or nails turn blue when you are having difficulty breathing.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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