About Asthma
Asthma, the seventh-ranking chronic disease in
the United States, is a condition where a person's airways are
often inflamed or swollen, making breathing very difficult. Affecting
an estimated 20 million Americans, asthma is triggered by substances
or events which cause a person's airways to become more inflamed
or swollen than usual. This may cause a person to feel breathless,
wheeze, and/or cough.
Unfortunately, even with today's advanced medical
care, asthma can kill --- almost 5,000 Americans die from asthma
every year. And, asthma is on the rise, especially among children.
The annual direct health care cost of asthma is approximately
$11.5 billion; indirect costs (e.g. lost productivity) add another
$4.6 billion, for a total of $16.1 billion dollars. (Source: National
Heart, Lung and Blood Institute Chartbook, U.S. Department of
Health and Human Services, National Institute of Health, 2004.)
To combat this disease and its associated healthcare
costs, asthma specialists are taking a pro-active approach to
treating asthma. In the past, doctors focused on treating symptoms
and attacks when they occurred. Today's best medical advice is
to follow your doctor's asthma management plan to avoid attacks
before they start, to have more control over daily activities,
and to avoid costly trips to the emergency room or hospital.
Information for this section from: Facts in Brief About Lung
Disease, American Lung Association, June 1991; Lung Disease Data
1995, American Lung Association; Mayo Clinic Family Health Book,
William Morrow and Company, Inc., 1990, Asthma in Adults Fact
Sheet (June 2004 American Lung Association)
Signs
and symptoms of asthma
- wheezing
- difficulty breathing
- painless tightness in the chest
- coughing of excess mucus
Emergency
symptoms
- extreme difficulty in breathing
- bluish cast to face and lips
- severe anxiety
- increased pulse rate
- sweating
Asthma triggers
- allergy to pollen, mold spores, animal dander, house dust
mites
- respiratory infections
- exercise
- smoking
- cold, dry air
- household and industrial products
- air pollution
- anti-inflammatory drugs (including aspirin)
When caused by allergies, IgE antibodies react
with allergens to produce histamine and other chemicals, resulting
in a tightening of the lung muscles, swelling of the lining of
lung airways, and increasing production of mucus. Air flow through
the swollen bronchial tubes is restricted, causing wheezing that
is loudest during exhale of the breath.
Asthma
and children
- The prevalence of pediatric asthma rose 58 percent in the
last ten years.
- One-third of all asthmatics are under age 18.
- Asthma may remain chronic during childhood.
- It is the leading cause of chronic illness in children, and
the leading cause of school absenteeism attributed to chronic
conditions.
- Asthma is usually an inherited condition and is not contagious.
- Up to 10 percent of children have asthma, and only one-fourth
"outgrow" the disease.
- Asthma is twice as common among boys as girls.
- Children of smokers are twice as likely to develop asthma
as the children of nonsmokers.
- Apparently healthy babies born to women who smoked during
pregnancy have abnormally narrowed airways.
- Asthma is the most frequent reason for hospitalization due
to chronic disease in Americans under age 15.
Can
I exercise if I have asthma?
In some people, asthma attacks are induced by
exercise. However, this does not mean that asthmatics cannot exercise!
Well-known athletes such as Jackie Joyner-Kersee control their
asthma to achieve outstanding athletic accomplishments. In fact,
regular exercise does not harm your lungs and will help keep your
muscles toned, which is important to your overall health.
If you suspect you have exercise-induced asthma,
ask your physician for a body plethysmography test before and
after a cardiopulmonary exercise test. The body plethysmography
test will measure any changes in your airways before and after
the exercise test, which will measure your breathing during exercise.
Diagnosing
asthma
The primary symptom of asthma is shortness of
breath. This is usually accompanied by wheezing and coughing.
Symptoms of an asthma attack can occur within minutes after exposure
to a trigger, or may occur for no apparent reason.
Physicians use various tests to help diagnose
asthma, including pulmonary tests such as spirometry and plethysmography.
Spirometry is a technique in which your lung capacity is measured
by having you breathe as hard and as long as you can into a mouthpiece.
The mouthpiece is connected to a computer that will measure how
much air you exhaled and compare it to what a normal person your
age, weight, and height should have exhaled.
Plethysmography is a technique in which you sit
inside a clear acrylic chamber and breathe on a mouthpiece. Because
the chamber is enclosed, the system's computer can measure how
your chest wall changes the volume of gases inside the chamber
as you simply inhale and exhale. The computer then calculates
the amount of gas left in your lungs at the end of a normal exhalation.
For detecting asthma, pulmonary specialists utilize
plethysmography with a methacholine challenge to detect if your
symptoms are caused by your lungs' airways reacting to certain
triggers. This type of testing is more sensitive than spirometry
alone because the pulmonary specialist can detect even slight
changes in your airways. Sometimes, spirometry may not even show
a change at all. In fact, airways resistance testing can detect
three times as many people with reversible airways disease than
spirometry alone. If your doctor is using only spirometry,
he or she may not be getting the most complete picture of your
lung problems.
Asthma
Management
Asthma is a disease of the airways, and allergies
are often the trigger. Therefore, one of the most obvious ways
to remain in control of your asthma is to minimize exposure to
offending allergens. For example:
- avoiding smoke, smoking, and smokers
- avoiding aspirin, ibuprofen, and other nonsteriodal anti-inflammatory
drugs if you are sensitive to them
- staying away from dust
- using air conditioning - this allows doors and windows to
stay closed which may help keep some pollen and mold spores
outside.
- saying goodbye to the family pet
- eliminating certain foods from your diet if you are allergic
to them (4 to 8 percent of asthmatics, for example, are allergic
to sulfites used in wine, beer, and on fresh fruits and vegetables)
If you have been diagnosed with asthma by your
doctor, he or she may prescribe a medication to help control your
asthma. Several different types of medicines are used in asthma
treatment and come in many different forms. Based on your test
results, your doctor will determine what is appropriate for you.
No matter which medication you use, it is important
to take your medications as directed until your doctor advises
otherwise. Asthma is a chronic condition that doesn't go away,
even though you may be feeling fine. Even though an attack feels
like it happens suddenly, it can actually build up over a few
hours or days before you notice any symptoms. The goal is to gain
control over your asthma and prevent sudden attacks before they
happen.
Asthma
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