Being told you have asthma can feel strange — especially if you've been managing symptoms on your own for a while (many people with asthma go years without a diagnosis, using a "blue pump" borrowed from someone else). Or it may have come out of the blue after an episode that scared you. Either way, you now have a diagnosis. And with that comes a plan.
What to Do Right Now
1. Get two things from your doctor before you leave: a controller inhaler and a written asthma action plan. An asthma action plan is a personalised guide that tells you what to do when your asthma is well-controlled, when it's worsening, and when to go to hospital. If your doctor hasn't given you one, ask for it specifically.
2. Understand the difference between your controller and your reliever. Your reliever inhaler (usually a blue salbutamol pump) opens your airways fast when you're struggling to breathe. Your controller inhaler (usually an ICS — inhaled corticosteroid) reduces the chronic inflammation that causes asthma. The controller is what prevents the attacks. The reliever treats them.
Using only the reliever and not the controller is the most common asthma management mistake in South Africa. It works short-term but leaves you vulnerable to attacks. Both inhalers have different jobs.
3. Learn your triggers. Common asthma triggers: dust mites, pollen, pet dander, mould, cold air, exercise, respiratory infections (colds, flu), smoke (cigarettes, braai), strong chemical smells, and some medications (aspirin, beta-blockers in some patients). Identifying your specific triggers helps you manage your environment.
4. Register for CDL 001 with your medical scheme. Your asthma qualifies you for the Chronic Disease List (CDL 001) benefit. Once registered, your scheme must fund your controller and reliever inhalers and GP visits from the risk benefit — not from your savings or day-to-day limits. This is a legal requirement for all registered schemes. Ask your doctor to assist with registration.
5. Learn the correct inhaler technique. Today. Up to 70–80% of people use their MDI (metered-dose inhaler) incorrectly — which means the medication misses the airways and goes into the mouth or is swallowed. Your pharmacist or doctor can demonstrate proper technique. Using a spacer device with an MDI dramatically improves drug delivery and is especially important for children.
Your Questions, Answered
"Will I always have asthma?" Asthma in children sometimes improves with age (though it can return in adulthood). Asthma diagnosed in adulthood is generally a lifelong condition, though many people have long periods of complete control with minimal treatment. Well-controlled asthma should not limit your activities.
"Can I exercise with asthma?" Yes. Many elite athletes have asthma. Exercise-induced bronchoconstriction is common and manageable. Your doctor may recommend using your reliever 15 minutes before exercise. Regular cardiovascular fitness actually improves asthma control over time.
"Is the steroid inhaler safe for long-term use?" Inhaled corticosteroids (ICS) are very different from anabolic steroids or high-dose oral steroids. The doses in asthma inhalers are tiny and mostly stay in the lungs. Long-term ICS at low doses is very safe. Potential concerns (mild growth effect in children at high doses; oral thrush if you don't rinse your mouth after use) are manageable and vastly outweighed by the benefit.
"My asthma seems controlled on just the blue pump. Do I really need the controller?" GINA 2024 guidelines no longer recommend using a SABA reliever without a controller inhaler, even for mild asthma. If you're using your reliever more than twice a week for symptoms (not counting pre-exercise use), your asthma is not as controlled as it might feel. The controller prevents the worsening that leads to hospitalisations.
What the Next 3 Months Look Like
4–6 weeks: Follow-up with your doctor for asthma control assessment. Use the ACQ (Asthma Control Questionnaire) or similar tool. Spirometry (lung function test) to confirm diagnosis and baseline.
3 months: Reassess control. If well-controlled, maintain. If not, step up therapy (increase ICS dose or add a second agent).
After stability: 6-monthly GP reviews; annual spirometry; flu vaccination annually.
What Your Medical Aid Should Cover
Registered under CDL 001: - Controller inhaler (generic ICS) — from risk benefit - Reliever inhaler (generic SABA) — from risk benefit - GP management visits - Spirometry (lung function test) - Spacer device (if clinically indicated)
Check with your scheme about: - Combination ICS-LABA inhalers (some schemes require step-through on separate inhalers first) - Allergy testing (skin prick/sIgE) — usually day-to-day benefit - Flu vaccination funding
One Last Thing
Asthma is one of the most manageable chronic conditions in medicine. Millions of people with asthma live full, active, unrestricted lives — including professional athletes. The tool to get there is not complicated: a controller inhaler taken daily, a reliever kept on hand, and knowing your triggers.
The fear after an acute asthma attack is real. Let that fear motivate consistent adherence to your controller inhaler, not anxiety about the condition itself. Most attacks are preventable with good management.
What does your scheme cover for asthma? Check on AURA →
This article is for educational purposes. Speak to your doctor or pharmacist about your inhaler technique and action plan.