You Can Control Your Asthma

4^th May 2010 is the World Asthma Day. The theme of World Asthma Day 2010 is "You Can Control Your Asthma". On this occasion it is important for all of us to be well informed about the various aspects of asthma and spread awareness about the same.

A very important fact about asthma is that it cannot be cured but can definitely be controlled. People with asthma can live normal active life provided their asthma is controlled. Thus asthma does not have to necessarily limit one’s life.

Nowadays we have specialist doctors who specialize in treatment of respiratory diseases (Chest Physicians) and it’s better to have a specialist opinion right at the onset before the disease progresses.

People have asthma for many years. The main complaint an asthmatic faces is trouble in breathing. During asthmatic attacks (Acute severe asthma) chest tightness, coughing and wheezing episodes are the main clinical complaints. Patients might be absolutely normal in between two asthmatic attacks. Asthmatic attacks vary in severity from mild to very severe cases which can turn out to be fatal. Most of the times these patients wake up at night due to coughing or breathlessness.

What is asthma?

Asthma is a disease involving the airways in the lungs. The main function of the airways is to carry air in and out of the lungs. In asthma airways become smaller and smaller and also more thickened (Airway remodeling). When asthma is under control, the airways are clear and air flows easily in and out. When asthma is not under control, the sides of the airways in the lungs are always thick and swollen. In such a situation, an asthma attack can happen easily. During an attack, the airways get squeezed and also make mucus. Thus during an asthma attack, less amount of air can get in and out of the lungs. This is manifested coughing and wheezing in asthmatic patients.  The chest feels tight during such attack.

The airway function is measured objectively by spirometry or the so called pulmonary function test which helps in the diagnosis of asthma.

You can get asthma at any age however you cannot catch asthma from other people. Many times it runs in families.

How to control your asthma and keep asthma attacks from starting:

1. Take asthma medicines regularly and as per the instructions of your doctor.

2. Stay away from things that start your asthma attacks (triggers).

3. Go to the doctor 2 or 3 times in a year for check-ups. Go even when you feel fine and have no breathing problems.

4. Know the signs to predict your asthma is getting worse and how to respond (consult your doctor).

Medications:

Most people with asthma need two kinds of medicine.

1. Quick-relief medicines (“relievers”) are used to stop asthma attacks.

2. Preventive medicines (“controllers”) are used every day to protect the lungs and keep asthma attacks from starting.

Now a days SMART therapy is available and both type of medicines are available in the same inhaler. Ask  the doctor to write down what asthma medicines to take and when to take them.

The medicine plan provided by your doctor helps you :

• to know what quick-relief medicines to take when you have an asthma attack.

• to help remember what preventive medicines to take every day.

• to see if you should take asthma medicine just before sports or working hard.

It is important to stress that preventive medicines for asthma are safe to use every day.

• You do not become addicted to preventive medicines for asthma even if you use them for many years.

• Preventive medicine makes the swelling of the airways in the lungs go away.

The doctor may tell you to take preventive medicine every day:

• If you cough, wheeze, or have a tight chest more than twice a week

• If you wake up at night because of asthma

• If you have many asthma attacks

• If you have to use quick-relief medicine more than twice a week to stop asthma attacks.

Asthma medicine can be taken in different ways. When asthma medicine is breathed in, it goes right to the airways in the lungs where it is needed.

Inhalers for asthma come in many shapes. Most are sprays (Metered Dose Inhalers) and some use powder (Dry Powder Inhalers). A spacer or a holding chamber makes it easier to use a spray inhaler. Asthma medicine also comes as pills and syrups.

The important points which need to be stressed are that, always have asthma medicines, always keep a part of your monthly budget for your medicines and buy medicine well in advance before you run out of medicines. Always carry your quick-relief asthma medicine with you when you leave home.

Risk factors:

Many things can start asthma attacks. These things are called “ risk  factors”: Animals ,Cigarette ,Smoke, Dust in beds with fur, Dust from Strong Pollen from the weather, sweeping smells and trees and  sprays ,flowers ,Colds ,Running, sports, and working hard.

Different people with asthma respond to different risk factors. Know which ones start asthma attacks for you. Keep risk factors that start your asthma attacks out of your home.

The following are some household measures that could help the asthmatic patients.

• Many people with asthma are allergic to animals with fur.  Keep animals outside. Give away pets.

• No smoking inside. Get help to quit smoking.

• Keep strong smells out of the home.  No soap, shampoo, or lotion that smells like perfume. No incense. Make special changes to the room where the person with asthma sleeps.

• Take out rugs and carpets. They get dusty and moldy.

• Take out soft chairs, cushions and extra pillows. They collect dust.

• Do not let animals on the bed or in the bedroom.

• No smoking or strong smells in the bedroom.

•Keep the bed simple. 

Dust collects in the mattress, blankets and pillows. This dust bothers most people with asthma.

• Put special dust-proof covers with zippers on the mattress and pillow.

• Do not use a pillow or a mattress made of straw.

• A simple sleeping mat may be better than a mattress.

• Wash sheets and blankets often in very hot water.  Dry them in the sun.

Use windows to keep the air fresh and clean.

• Open windows wide when it is hot or stuffy, when there is smoke from cooking, and when there are strong smells.

• If you heat with wood or kerosene, keep a window open a little to get rid of fumes.

• Close windows when the air outside is full of exhaust from cars, pollution from factories, dust, or pollen from flowers and trees.

Plan to do these chores when the person with asthma is not there:

• Sweep, vacuum, or dust

• Paint

• Spray for insects

• Use strong cleaners

• Cook strong smelling foods.

• Air out the house before the person with asthma returns.

• If there is no one to help, people with asthma can use a mask or scarf when they sweep or dust.

Running, sports, or working hard can also cause asthma symptoms. But these activities are good for you and need not be stopped. Your doctor may tell you to take asthma medicine before doing these activities. Thus the quality of life need not be affected.

When you know there is asthma in the family, you may be able to keep your baby from getting asthma.

• When you are pregnant, do not smoke.

• Keep tobacco smoke away from the baby and out of your home.

• Put a special dust-proof cover on the baby’s mattress. 

• Keep cats and other animals with fur out of your home.

Health check ups:

Go to the doctor 2 or 3 times a year for check- ups. Go even if you feel fine and have no breathing problems.

• Tell the doctor about any problems with your asthma medicines. The doctor can change the asthma medicine or change how much you take. There are many asthma medicines.

• Ask questions. Your doctor is your partner in controlling your asthma.

• Asthma may get better or it may get worse over the years. Your doctor may need to change your asthma medicines.

Know the signs that your asthma is getting worse and how to respond.

• Be alert for asthma symptoms: Cough, wheeze, tight chest and waking up at night. Act fast if an asthma attack starts.

• Move away from the risk factor that started the attack.

• Take a quick-relief asthma medicine.

• Stay calm for 1 hour to be sure breathing gets better.

Get emergency help from a doctor if you do not get better. Get help if you see any of these asthma danger signs.

• Your quick-relief medicine does not help for very long or it does not help at all. Breathing is still fast and hard.  

• It is hard to talk.

• Lips or fingernails turn grey or blue.

• The nose opens wide when the person breathes.

• Skin is pulled in around the ribs and neck when the person breathes.

• The heartbeat or pulse is very fast.

• It is hard to walk.

Be careful!  Using too much quick- relief medicine for asthma attacks can hurt you.

Quick-relief medicine for asthma makes you feel better for a little while.  It may stop the attack. With some attacks, you may think you are getting better but the airways are getting more and more swollen. Then you are in danger of having a very bad asthma attack that could kill you. A bad asthma attack may be recognized;

• If you use quick-relief medicine more than twice a week to stop asthma attacks, this means you need a preventive medicine for asthma. 

• If you need quick-relief medicine more than 4 times in 1 day to stop asthma attacks, you need help from a doctor today.

Monitoring asthma:

A peak flow meter can be used at a clinic or at home to measure how well a person is breathing.

• It helps the doctor decide if someone has asthma.

• It helps to see how bad an asthma attack is.

• It helps the doctor see how well asthma is controlled over time.

If a peak flow meter is used every day at home, people can find breathing problems even before they start to wheeze or cough.  Then people know when more asthma medicine is needed. There are many kinds of peak flow meters (Consult your doctor for details on this).

Thus on this world asthma day let us all resolve to spread this awareness about asthma and let everyone know that "You Can Control Your Asthma".