In the old days, people with asthma were at the mercy of their disease. Some medications helped, but often people would end up in the hospital because they simply couldn’t breathe. Today, we know much more about the causes and effective management of asthma, which can help make hospitalization unnecessary.

Asthma is a chronic lung disease in which the airways are inflamed. People with asthma have airways that are very sensitive to triggers such as colds, cigarette smoke, perfumes and other airborne allergens, and exercise.

During an asthma flare-up, the lining of the airways becomes inflamed, swells and produces more mucus. This makes the opening in the airways smaller. The muscles around the airways also tighten, making the opening even smaller and decreasing the amount of air going in and out of the lungs.

Signs of asthma flare-ups are:

. Cough – worse at night, after exercise, in a smoky room or in cold air.

. Wheezing – a whistling or twanging noise heard best when breathing in and out.

. Breathing faster than usual – count your breathing rate for 30 seconds. How does this compare with your normal rate?

. Sucking in at the breastbone as well as other sites – look for this in between the ribs and at the front of the neck. This is a much more important sign for infants and young children than it is for others.

With appropriate management, those with asthma can be fully active and able to play any sport. At this time of year, when the sun is shining and temperatures are warming up, asthma should not keep you indoors and inactive. With the right plan, you should be able to walk, run and jump just as fast and as long as anyone else.

Here are some ways to control asthma and lead a more active life.

. Identify your triggers. Knowing your triggers and how to avoid them is an important way to guard against unwanted asthma flare-up. Common household triggers include cleaning chemicals, insecticides, strong perfume, scented candles, plug-in deodorizers, auto deodorizers and powders such as carpet fresheners.

Many of our homes have been super-insulated – if a building doesn’t breathe properly, “it will hold in irritants that can affect the lungs,” said Jan Thompson, registered nurse and pediatric asthma educator for Eastern Maine Medical Center.

Exercise is the most common asthma trigger, but it is one you should not avoid as long as you work out safely. With good control of other triggers, exercise should be possible. Your asthma management plan is not working if exercise causes coughing, wheezing or tightness in the chest.

. Use medications correctly.

Being educated about medications and how to use them correctly can make the difference in controlling asthma. Inhaled medications treat asthma faster by going directly into the airways, allowing smaller doses and fewer side effects than oral medication.

There are two categories of inhaled asthma medication – “rescue” inhaled medication to relieve symptoms as they occur, and controlling medications which are taken every day for those with more mild or very occasional symptoms.

“Even people with mild asthma can have a severe, life-threatening episode,” Thompson said. “Taking a rescue-inhaled medication gives temporary relief because it stops broncho-spasms. Unfortunately, it does not reverse the root of the problem, which is inflammation of the airways. If your rescue inhaler does not stop asthma symptoms for four hours, or if you need it regularly – more than two days a week or two nights a month – then you may be headed for an asthma flare-up.”

. Monitor your asthma with a peak-flow meter. You can monitor your asthma with a peak-flow meter that indicates how much air you can exhale from your lungs at a given time. People age 5 and older are most able to learn how to use a peak flow meter properly. Since the airways narrow during asthma flare-up, the peak flow meter can detect an early flare-up and decrease your chance of needing emergency care.

. Work with your health professional. Your health care provider is the best person to help you organize your asthma management tool bag. With these tools, those with good awareness and control can use a peak-flow meter, check the weather, think about where they will be and what they will be doing that day, and even check the EMMC allergy index for up-to-date pollen counts. Planning every day will help keep you as healthy as possible and out of the doctor’s office or emergency department.

The EMMC allergy index details the presence of pollen and mold in our area and is updated three times a week in the Bangor Daily News. The information is available by calling 973-7750 or by logging on EMMC’s Web site. To obtain more information on asthma or to access the EMMC allergy index, go to www. emmc.org.

Dr. Linda Austin hosts “What’s On Your Mind?” at 1 p.m. Thursdays on Maine Public Radio, and EMMC’s “HealthTalk” throughout the week.