What is Asthma?
Asthma is a long-term condition in which the airways of those affected are extra sensitive and can become inflamed. During an attack, the muscles around the airways tighten and the airways become narrower. There is usually also a build-up of mucus. This causes wheezing and shortness of breath.
Asthma is often diagnosed during childhood although some people experience their first attack as adults. Worryingly, and for reasons that are not really known, the condition appears to be on the increase, particularly in the more developed parts of the world. Estimates indicate that between 6 and 10% of the population are affected. An asthma attack can be a serious medical emergency. Studies show that most of the hospital admissions and deaths caused by asthma would have been prevented had the condition been better managed. It is therefore vital that those diagnosed, or their parents, must speak to their doctor about good management of the condition, and always ensure that appropriate medication, usually in the form of inhalers, is at hand.
Causes of Asthma
Some studies suggest that increased hygiene over the last 30-40 years is one of the reasons why the condition is on the increase.
If your parents have asthma or there is otherwise a family history of allergies such as eczema or hay fever, there is a greater risk. The risk is also higher in those who smoke or whose parents smoked during pregnancy or early childhood.
Many sufferers find that an asthma attack can be triggered by certain outside agents. These triggers will not be the same for everybody. Examples of triggers include house dust mites, colds and flu, cockroaches, exercise (particularly for some in cold air); sudden changes in weather conditions for example thunder storms, mold spores, some foods, car fumes, animal dander and pollen. Some sufferers find that products made with royal jelly can trigger an attack.
Symptoms include shortness of breath, wheezing, a persistent cough which is often worse at night or early in the morning, and tightening of the chest.
Anyone suspected of having asthma should visit their doctor. The doctor will ask about symptoms and about how long they have been going on. A child with asthma may sometimes have a “barrel” chest or a “shadow” visible to a doctor on visual examination of the chest. The doctor may also listen to the person’s chest with a stethoscope to see if wheezing is present.
A diagnosis may be difficult in infants younger than 2 years old because children of this age often have some degree of wheeziness which is not related to asthma.
For older children and adults doctors often use a peak-flow meter to help make the diagnosis. This is a small plastic tube with a mouth-piece. The patient is asked to blow into the mouthpiece and the device measures the force of the out breath. You may be asked to keep a chart of peak-flow meter readings over several days or weeks.
Good asthma management
It is important that anybody diagnosed cooperates fully with their doctor in managing the condition. Good management will allow you to carry on leading a normal life, and will help prevent severe attacks.
Use of a reliever inhaler
Your doctor is likely to prescribe an asthma reliever inhaler, which you should take with you everywhere and use whenever the first symptoms of an attack appear. The effect of the reliever is often immediate and usually lasts around 4 hours. Speak to your doctor about whether it might be a good idea for you to take a puff of the reliever before doing exercise, as well as to relieve symptoms when they appear. For babies and infants, your doctor might recommend use of a spacer, to attach to the inhaler, with a face mask to ensure the correct dose of reliever is given.
Use of a preventer inhaler
Where the reliever inhaler needs to be used more than twice a week or in any case where your doctor decides that it is appropriate, you may be diagnosed with a preventer inhaler in addition to your reliever. This must be used as often as prescribed, often once or twice daily. Do not stop use just because your symptoms have gone away, and you have no further attacks. This just means that the preventer is working.
It is important to try to work out what triggers an attack so that these can be avoided. Try to keep the home as free from dust mites as possible. Try to avoid soft-furnishings or use ones with washable covers. Regularly air mattresses, pillows and duvets. Wood floors are easier to wipe clean than carpets or rugs. Keep the house well ventilated.
Speak to your doctor or asthma nurse about whether it is a good idea for you to have an annual flu jab. Some individuals find that attacks are more likely in times of stress or hormonal change.
If your asthma is being well managed, provided your doctor has not advised otherwise, there is no reason why you should not exercise. Exercise is good for your general health and some people with asthma find that sports such as regular swimming actually decreases the overall likelihood of an attack.
Know the signs of a severe attack
Be aware of the signs of a severe asthma attack for which immediate medical attention must be sought. Symptoms of a severe attack include breathlessness which makes walking, talking or sleeping difficult, lips or fingers turning blue, drowsiness, dizziness and weakness. If use of the reliever does not immediately alleviate symptoms an ambulance should be called. Even if the reliever causes the patient to feel better straight away they should still be seen by a doctor.
Management of childhood asthma
If a child has been diagnosed with asthma ensure that their school and all carers and close relatives are aware of what symptoms to look out for and how to treat an attack. Ensure that suitable medication is kept at school or anywhere else where the child attends regularly, and that it is easy to access and has not passed its expiry date. Do not allow anybody to smoke around the child or in the home.
Your written asthma action plan and regular reviews
It is a good idea for any adult or child with a diagnosis of asthma to agree a written action plan with their doctor or asthma clinic. This might include a list of known triggers, contact numbers for general advice and in case of emergency, written instructions on how to use reliever and/or preventer inhalers and expiry dates of inhalers.
Your asthma plan should be reviewed every 6-12 months, or as often as your health professional advises.
Remember, good asthma management helps you or your child to lead a normal life and saves lives.