|
. | Asthma
Although asthma has been recognized for 2,000 years, it is only in the past 50 years that major strides have been made in the understanding and management of this condition. As a result of these developments, it is now possible to treat 95% of all asthmatics so well that they are hardly aware of having the condition. Unfortunately, many of the advances in the treatment of asthma have not yet reached the majority of people who suffer from it. Many asthmatics still require emergency room care and/or admittance to hospital, and deaths from asthma continue to occur. Education and the encouragement of asthmatics to take an active role in their own care have proven to be beneficial techniques and are expected to result in an improvement in their quality of life and a reduced death rate.
Asthma is not really a single disease, but a reaction of the air passages in the lungs to irritants such as cold air, dust, fumes and animals. The symptoms of asthma result from inflammation and spasm of the air passages. This inflammation makes the airways more sensitive to irritants and the symptoms of asthma appear. A unique feature of asthma is the 'twitchiness' or sensitivity of the airways to irritants such as cold air, dust, pollens and moulds. Muscle spasms occur in the airways, causing a narrowing of the airway so that air cannot easily pass in and out of the lungs. Inflammation and muscle spasm produce the wheezing sounds characteristic of asthma.
The three symptoms most typical of asthma are:
1. Wheezing - the high-pitched or hoarse whistling sound that can occur as air moves in or out of the lungs of a person with asthma.
2. Cough - the cough associated with asthma may come and go, but it is most noticeable at night after exertion, when breathing cold air, or during and after a bout of cold or the flu.
3. Breathlessness - or shortness of breath is often worse at night and during or after exertion. The breathlessness may come and go and may vary in intensity.
The symptoms of asthma are often made worse by exercise; having a cold or flu; exposure to cold air, dust, fumes, or animals; and during seasons when pollens, ragweed and moulds are most abundant. It is important for you to identify those things that are asthma 'triggers' for you and try to avoid them. Eliminating the source of the trouble can help in clearing up the symptoms.
The treatment of asthma in adults is similar to treating asthma in children. Often, though not always, medication is used in the treatment of asthma. The medication may be in the form of an inhaler or pill, or may be given intravenously in hospital to treat an acute attack. Asthma medications generally fall into two main groups:
1. Bronchodilators that open up the airways by decreasing or stopping the muscle spasms.
2. Anti-inflammatory medications that prevent and reduce the inflammation of the airways.
When using inhalers, it is important that they be used properly to ensure the medication goes directly to the lungs. Be sure to ask your doctor about the proper use of inhalers.
Other treatments may include getting a preventative flu shot, getting allergy shots, taking antihistamines and sometimes, the use of antibiotics. One cannot stress enough, however, that apart from the wise use of medications, the most important part of the treatment plan is for you to take an active role in the management of your asthma.
The 3 main goals in the effective treatment of asthma are:
1. Reducing the number of asthma attacks by avoiding, removing or limiting exposure to the things that tend to irritate your airways. Some asthmatics find they need little or no medication to manage their asthma when they successfully eliminate the 'triggers' for asthma attacks. While exercise can be a trigger for an asthma attack in some people, avoiding exercise should not be part of the treatment plan of a well-controlled asthmatic. Wise use of asthma medications most often results in the ability to exercise without problems, even if this is an asthma trigger for you. Often wise medication use means taking medication to prevent an attack rather than using medication to treat an attack once it has started.
2. Achieving and maintaining control of asthma through the regular use of medication may be required if a specific triggering agent cannot be found and eliminated. The principle is that the regular use of medication can be effective in controlling the underlying inflammation of the airways so they will be less prone to irritation and spasm.
3. Preventing severe flare-ups by vigorously treating the first signs of an asthma attack. This is an important goal of effective treatment. Asthma is considered to be under control if you are virtually free of coughing, wheezing and shortness of breath most of the time. In a well-controlled asthmatic, symptoms, if they occur, should be mild, infrequent and readily treated by using a bronchodilator.
Everyone who suffers from asthma should have an action plan in mind for dealing with a sudden flare-up or worsening of their condition. This plan should be discussed ahead of time with your doctor, friends and family. Your asthma needs immediate medical attention if you experience:
- severe shortness of breath;
- air hunger;
- difficulty speaking because of breathlessness;
- little relief from your bronchodilators;
- an increasing sense of fear or panic;
- cold clamminess;
- a feeling of weakness or exhaustion;
- a bluish appearance to the lips.
In these situations, it is essential to call 9-1-1 for an ambulance (or have someone call 9-1-1 for you). It is unwise to try to predict the severity of an asthma attack by judging the severity of wheezing, because the airways may be so blocked that little or no wheezing sound is produced.
The daily maintenance of good asthma control is key to the prevention of severe, debilitating and potentially life-threatening asthma attacks. It is important to have a good relationship with your doctor and pharmacist. Keeping your asthma under control now may prevent permanent damage to your lungs in the future.
For more information, contact the Canadian Lung Association.
Back to Information Centre
| |
