Asthma:

 


What is Asthma?

Asthma is a chronic inflammatory disease of the lungs and airways affecting more than 15 million Americans.  It is a long term condition that affects your airways.  When asthma flares up, your airways swell and tighten.  This causes your airways to narrow so less air gets into your lungs, making it hard to breathe.

Asthma is characterized by inflammation that occurs when your bronchi come in contact with irritants or “triggers”.  The lining of the bronchial tubes becomes inflamed and swollen, reducing the space available for airflow and excess mucous to build up which in turn causes it to become difficult to breathe.

Another component of asthma is bronchoconstriction. This occurs when bands of muscles surrounding your bronchial tubes tighten causing your airways to narrow. This results in chest tightness, wheezing, and shortness of breath.


Symptoms of Asthma:

If you have asthma, you might not have all of these symptoms.  And, your symptoms may change over time.

  • Wheezing.  This is a whistling or squeaky sound when you breathe.
  • Coughing. It may be worse at night or early in the morning.
  • Tightness in your chest. This may feel like someone is squeezing your chest.
  • Fast or noisy breathing.
  • Shortness of breath. You may feel short of breath, or feel like you can’t catch your breath.

Diagnosing and Treating Asthma Symptoms:

 

  • Physical exam from your doctor that includes listening to your breathing
  • Review of your family’s health history
  • Pulmonary Function Testing that shows total lung capacity and also any inflammation that could be present.
  • Possibly a bronchodilator treatment and then a post pulmonary function test to observe clinically the change in the values.
  • Allergy testing to determine possible triggers.


Causes and Triggers of Asthma:

While the exact cause of asthma is unknown; it does seem to run in families.  People who suffer from asthma find that many different things may bring on an episode:


Outdoor Triggers:

  • Pollen – if pollen counts are high on a particular day, stay indoors and use your air conditioner.  You can find pollen counts for your area in your local newspaper or online.  If you have to be outside, take a shower to wash off pollen and change clothes when you come inside.
  • Outdoor Mold – Mold can grown on rotting logs, fallen leaves, compost piles and mulches, hay and commercial peat moss.  Avoid these if possible and have someone else do the yard work.
  • Pollutants – Stay indoors if air pollution and smog levels are high.  If you are sitting in traffic, keep your windows rolled up.
  • Cold Air – Wear a scarf over your nose and mouth when you’re outside in winter months.


Indoor Triggers: 

  • Dust Mites – These are microscopic bugs (you can’t see them) that live in dust and fibers of fabrics like curtains, mattresses and carpets.  Dust weekly and wear a mask when you do.  Also, consider making small changes in your home to limit dust mites, such as replacing carpet with hardwood floors and buying a vacuum cleaner with a HEPA filter.  To reduce dust mites in your bedroom, wash sheets weekly in hot water (at least 130 degrees F), and cover mattresses and pillows with special dust-mite proof covers.
  • Mold – make sure mold doesn’t grow in the damp areas of your house, such as basements, bathrooms or kitchens.  Keep humidity levels at less than 50 percent.  To keep the air in your home clean, change your heating and cooling system filter regularly.
  • Cockroaches – take out your garbage often, and don’t leave food sitting out.
  • Pets – if you have an indoor pet, wash it weekly to limit exposure to pet dander.  Also, vacuum weekly and keep pets out of your bedroom.


Other Triggers:

  • Smoke – if you smoke, quit.  Also, avoid being around secondhand smoke or other types of smoke, such as campfires.
  • Infections – talk to your doctor about getting an annual flu shot since respiratory infections can cause flare-ups.  Also, wash your hands frequently if you’re around other people who are sick.
  • Exercise or physical activity – asthma shouldn’t be an excuse to avoid exercise.  In fact, it can even help strengthen your lungs.  If physical activity does trigger flare-ups, talk to your doctor.  There are ways you can be active and avoid flare-ups.  Your doctor may suggest taking medicine before you exercise to prevent symptoms.
  • Acid Reflux Disease (GERD) – if you have frequent heartburn because of acid reflux disease, tell your doctor.  Although, experts aren’t sure why, there is a connection between asthma and acid reflux disease.
  • Stress – take steps to reduce stress, such as exercising, talking to a counselor, or making time for your favorite hobby

Foods & Medications:

Many processed food and drinks contain chemicals (sulfites) that are added as a preservative, but can cause an asthma episode.  The most common are dried fruits, fruit juices, vegetables and wines.

Cheese and other dairy products, citrus fruits, tomatoes, seafood and corn are also foods that can sometimes initiate an asthma episode.

Some medications, even the ones you buy over the counter, may also be asthma triggers.  Aspirin and aspirin-like products may cause symptoms in people who have chronic sinus problems or nasal polyps.  Beta-adrenergic blocking agents (used to treat migraine, rapid heart rate, congestive heart failure, tremor and glaucoma) are also known to cause asthma episodes

Avoiding Asthma Triggers

Although it is not reasonable to think you can completely eliminate asthma triggers, removing as many as possible from your home and work surroundings can help you enjoy a healthier life with fewer asthma episodes.

IN YOUR HOME:

While it may be impossible to remove every trigger from your home, there are many things you can do to give yourself “breathing room”.

  • Air conditioning - Many airborne triggers can be captured in the filter of an air conditioning unit.  If air conditioning every room is not an option for you, a single changed regularly.
  • Heating - If your home or apartment has forced-air heating, put a filter or a piece of cheesecloth over each vent to help trap airborne particles. Change filters frequently.
  • Dust Control - Heavy drapes, upholstered furniture, thick rugs, and decorative items are major dust collectors.  Try to choose furnishings that can be cleaned easily; vinyl, or leather couches, washable lampshades, mini-blinds, and wood or vinyl flooring.  Avoid stuffed animals in kids rooms.
  • Bedding - Choose pillows with dacron, foam or other synthetic filling. Cover your mattress and box spring with allergen-proof covers, and use washable cotton or synthetic bedding.  Wash bedding at least once a week in 130°F water, which is the “HOT” button on most washers.  Avoid dust ruffles, which, as their name applies, tend to collect dust and dust mites.
  • Prevent Mold - Keep bathrooms clean and dry; use a fan or dehumidifier.  Check foods regularly for spoilage.  Dry fresly laundered clothes promptly.  Remove houseplants, since moist potting soil is a haven for mold.
  • Pets - Unfortunately, animal dander and saliva are potent allergens.  Therefore, at least make your bedroom a “pet-free zone”.
  • Pest Control - Pest, particularly dust mites and cockroaches, can represent significant asthma triggers.
  • Strong odors - Cigarette smoke and strong odors from perfumes, air fresheners, household cleaners, and other sources can be severely irritating.  Limit smoking to the outdoors.

IN YOUR WORKPLACE:

Help your coworkers and supervisors understand your asthma; the will be willing to help control the triggers in your workplace.  It may be possible to change your work area, or make other changes in your work environment.

  • Minimize your exposure to smoke, heavy scents, and fumes.
  • Air conditioners or air filtration systems can be good if they are maintained regularly.
  • Avoid potted plants, which can harbor mold.
  • Take steps to manage tension and stress that can contribute to asthma episodes.

Once you and your doctor know what kind of asthma you have, and what your triggers are, you can work together to develop a treatment plan that meets your specific needs.  This plan may include medication, lifestyle changes, and avoidance of triggers. 

There are two kinds of medicines that are prescribed to treat asthma:

Long-term (preventative) medicines

  • Anti-inflammatories (inhaled corticosteroids) – A corticosteroid is an asthma control medication used to prevent and control the swelling (inflammation) that causes your airways to narrow and produce more mucus; may be used in combination with long-term bronchodilators. They are an important part for long term management and prevention of asthma symptoms. (Asmanex, Pulmicort, QVAR, Flovent). Some common side effects of using inhaled corticosteroids include sore throat, hoarseness and yeast in the mouth.  These symptoms can be avoided by rinsing your mouth with water and brushing teeth after each dose.
  • Long Acting Bronchodilators – A long-acting beta2-agonists is an asthma prevention medication used for long term control of daytime symptoms, nocturnal asthma, and exercise-induced bronchospasm.  They relax and widen narrowed airways.  These medications are never used alone for treatment; typically used as combination therapy with an inhaled steroid.
  • Combination Medications - combine both an anti-inflammatory drug and a long acting bronchodilator drug.  These medications are also used for prevention of symptoms and must be used daily to be effective.   Be sure to rinse mouth after using to avoid getting yeast in the back of the mouth. (Examples of these meds are:  Advair Diskus, Advair MDI, Symbicort MDI, Dulera MDI)
  • Quick relief or “rescue” medications - An asthma rescue medication is a short acting bronchodilator that helps provide rapid relief to relax muscles around the airways.  These medications act almost immediately to relieve symptoms of asthma and usually only last 2 to 4 hours.(Albuterol Inhaler or nebulizer, Pro Air MDI, Ventolin MDI, Xopenex MDI) 
  • Leukotrienes - (Singulair, Zyflo) are chemical substances that promote the inflammatory response seen during exposure to allergens. By keeping these chemicals from producing swelling, leukotriene inhibitors reduce inflammation.
  • Systemic (oral steroids) – used to treat moderate to severe asthma episodes.  They have anti-inflammatory action, which helps reduce inflammation and speed your recovery from an episode.  These medications have significant side effects and must be used only when absolutely necessary.  Side effects include, water retention, increased appetite, weight gain, osteoporosis and insomnia. (Prednisone, Prelone, Orapred, Medrol Dose Pack)





To Learn More, you can also visit these websites:
• American Academy of Allergy, Asthma and Immunology (AAAAI)
www.aaaai.org
En Espanol:  www.aaaai.org/espanol/
• American Lung Association
www.lungusa.org
1-800-LUNGUSA
• National Heart, Lung, and Blood Institute (NHLBI)
www.nhlbi.nih.gov