Topics on Asthma



Understanding Asthma

Asthma is a chronic respiratory disorder of the lungs in which there is inflammation (swelling) of the airways in our lungs. Due to this inflammation, the airways are narrowed and the lung becomes vulnerable to various allergens which act as triggers for an asthma attack. When a person comes in contact with a trigger*, the inflamed airways are irritated leading to tightening of the muscles and excess mucus production which further constricts the passages, thereby inhibiting normal breathing and this at times could even turn fatal.

The usual manifestations of asthma are repeated episodes of chest tightness, difficulty in breathing and cough. In children asthma often manifests through a single symptom like cough which is more severe at night or early in the morning and remains persistent despite intake of various cough syrups and medications. Asthma symptoms vary from person to person and it is important to watch them carefully for a correct diagnosis by the doctor.

Although asthma is not curable, it is possible to gain complete control over it and lead a normal active life. As asthma is predominantly characterized by inflammation of the lungs, the treatment is primarily aimed at controlling the inflammation and thereby prevent attacks. This is made possible by regular doses of ‘Controllers’, which are medicines available in inhalers. Controller therapy is generally used over a long period and should be continued even when there are no symptoms. However in case there is an attack the patient can get immediate relief by using rapidlyacting bronchodilator medicines whoch are called quick relief medicines.

There are several therapies and forms of treatment for asthma available in the market. However, it has now been accepted globally that the best and safest way to take asthma medication is by inhalation as it reaches your lungs directly and starts acting immediately. Infact, the inhalation technique dates back to the days of ayurveda when people used to burn datura leaves and inhale their smoke for relief from asthma. Besides, if you are on tablet or syrup the medication takes time to act as the medicine has to pass from the stomach to the blood and finally to the lungs. This could also result in several side effects. It is to be noted that in inhalation therapy, the dosage needed is up to 50 times lesser than syrups or tablets and far more effective.

Besides being more effective, inhalation therapy works out to be less expensive than using oral medication regularly. In addition, with regular inhalation therapy, your chance of hospitalization and missing work or school is reduced, resulting in substantial savings

Medication is not the only way to control asthma. It is also important to avoid asthma triggers - stimuli that irritate and inflame the airways. With medical support, each asthma patient must learn what triggers he or she should avoid. Early diagnosis and regular intake of medication along with a positive bent of mind goes a long way in reducing the threat of damage to your lungs.

A Peak-flow meter is a simple, affordable, hand-held device which helps diagnose breathing problems and asthma in children and adults. The patient blows into the mouthpiece of the device, and the reading can be taken to check the lung function. Most doctors have the device in their clinic but it is also available at most leading chemists for patients who want to keep their asthma in check. It is recommended that you use it twice a week to help keep your asthma under control and to predict and prevent an asthma attack.

If you have asthma and are checking your lung function with Peak-flow meter, and you notice a drop in the reading, it means that your asthma is not well controlled and you are likely to get an attack in the near future or within days. Therefore, like a thermometer and glucometer, asthmatics are now equipped with Peak-flow meter to measure the health of their lung, their progress with the treatment. A poor reading on the Peak-flow meter could motivate in getting a person back on track with adherence to prescribed medication.

A more detailed examination of the lung condition is achievable through Spirometer. This test gives you a printed graph of your reading like an ECG test.

* Dust, pollen, furry pets, cold and viruses, smoking and air pollutants, and even emotional agitation

The economic burden of Asthma

Asthma is a public health problem not just for high-income countries; it occurs in all countries regardless of the level of development. Infact, asthma in countries like the UK, Australia and New Zealand is higher than the global average, which could perhaps be attributed to the factor of ‘Hygiene Hypothesis.’ This means that those living in cleaner environments have greater chances of developing asthma than those living in less clean surroundings. This is because children with no exposure to infections leads to their immune system getting more provoked by allergens in the environment while those who have repated exposures to infections develeop an immunity towards the infections and not to allergens. However, most asthma-related deaths occur in low- and lower-middle income countries. This is due to the fact that asthma is under-diagnosed and under-treated in these countries. . It creates substantial burden to individuals and families and often restricts individuals’ activities for a lifetime.

Asthma is not a curable disease but because of newer medicines and newer delivery systems most people can lead an active and normal life in which the disease is well controlled. Unlike other chronic conditions such as hypertension and diabetes, there is minimum compromise and virtually no restriction on diet and lifestyle for an asthma patient.. Asthma is a silent condition and therefore even if there are no symptoms like wheezing, coughing or breathing trouble, regular use of ‘Controllers’ is mandatory. ‘Controllers’ are medicines available in inhalers and when used regularly over a long period of time, they help control asthma better. ‘Controller drugs improve symptoms, prevent attacks and help lead a good quality of life. However, in case there is an attack ‘Reliever’ medicines are available which when inhaled provide rapid relief. . Relievers act for a maximum of 4-6 hours.

Emergency treatment of asthma which needs a visit to the hospital is expensive and if hospitalization for a few days is required, the cost shoots up. In addition this elads to loss of work, and in some cases death. If asthma is treated as per guidelines provided by various national and international organizations, costs can be reduced tremendously both by the individual and government. In fact the cos of regular controller medication is as low as Rs 5 per day (less than a cup of tea). A year’s suup;y pf medication is less tham the cost of 1 night’s stay in a hospital.

Cost of treatment of asthma (Rs/case/year) as per Guidelines

Year

Chronic: Mild

Chronic: Moderate and severe

Acute cases

Hospitalization charges per episode

1996

277

1825

4,867

3042

2006

522

3447

9,163

5716

2011

644

4253

11,306

7053

2016

762

5060

13,454

8394


Additional cost for patients with acute asthma (Rs in crore/ year)

Year Urban  Rural Total
1996 27.72 76.71 104.42
2006 64.37 178.19 242.56
2011 87.55 242.36 329.91
2016 111.32 308.26 419.59

Economic burden to asthma (Rs in crore)

Year Chronic Acute Total
1996 960.05 167.07 1127.12
2006 2294.73 388.84 2683.57
2011 3197.60 528.84 3726.44
2016 4180.35 672.52 4852.86

Asthma is often incorrectly associated with considerable reduction in productivity and overall fitness, increased requirement for health care support, and morbidity in acute cases. However, the problem of asthma can be easily managed when it is in the mild stage. In fact, 90% of these cases are mild and can be successfully handled at primary healthcare centres. The prognosis of asthma remains good with as many as 60%–80% of patients being able to lead normal lives without much disruption.

Inhaler devices to control asthma

There are several therapies and forms of treatment for asthma available in the market. However, it has now been accepted globally that the best way to take asthma medication is by inhalation as it reaches your lungs directly and starts acting immediately. Infact, the inhalation technique dates back to the days of ayurveda when people used to burn datura leaves and inhale for relief from asthma. Modern medicines not very different from those inhaled in the old days are now available in easy-to-use and handy inhalers. Besides, if you are on tablet or syrup the medication takes time to act as the medicine has to pass from the stomach to the blood and finally to the lungs. This could also result in several side effects. It is to be noted that in inhalation therapy, the dosage entering your lungs is up to 40 times less and many more times more effective.

Besides being more effective, inhalation therapy works out to be less expensive than using oral medication regularly. In addition, with regular inhalation therapy, your chance of missing work or school is reduced, resulting in substantial savings

Medication is not the only way to control asthma. It is also important to avoid asthma triggers - stimuli that irritate and inflame the airways. With medical support, each asthma patient must learn what triggers he or she should avoid.

Peak Flow Meter - the thermometer for your lungs

A Peak Flow Meter is a simple, affordable, hand-held device which helps diagnose breathing problems and asthma in children and adults. The patient blows into the mouthpiece of the device, and the reading can be taken to check the lung function. Most doctors have the device in their clinic but it is also available at most leading chemists for patients who want to keep their asthma in check. The Peak Flow Meter also helpt to keep a check on the disease. Measurng your peak flow at least twice a week gives you an idea about the condition. A fall in the reading alerts you to the fact that there is some loss of control of asthma and that you may develop an attack in the near future. This helps in taking corrective steps.

Therefore, like a thermometer for keeoing a watch on fever and glucometer for keeoing a watch on the blood sugar levels, asthmatics are now equipped with Peak Flow Meter to measure the health of their lung, their progress and gets a person back on track with adherence to medication.

A more detailed examination of the lung condition is achievable through Spirometer. This test gives you a printed graph of your reading like an ECG test.

How to keep asthma under control in winters?

With the onset of winter, colds and flu also sets in. But for those with asthma, it can be an especially stressful time of year because even a simple cold virus can trigger a major asthma event.

In asthma, the lungs are already irritable and more reactive. Viral respiratory infections such as the common cold or flu can aggravate airway inflammation and trigger symptoms faster and easier than most people realise. Viral infections are the most frequent cause of severe asthma for infants and children under age ten.

While you or your child may not be able to avoid these exposures, there are ways to stay safe and healthy. Among the most important: A good way to gain control is to become more vigilant about taking your regular asthma medications. This is especially important in patients who have been noncompliant with their asthma regimens in the past.

Prevent your asthma from being triggered
• Keep warm if cold air triggers your asthma (As cold air can trigger asthma, you could try wearing a scarf around your mouth, and try to breathe through your nose, which warms and humidifies the air).
• Control germs by washing your hands (To prevent a cold or influenza attention to hygiene is important.)
• Stay at home if you feel unwell
• If you have severe asthma, check with you doctor if you need flu vaccination

Prepare an action plan for winters
• Your plan should include a list of asthma triggers you need to avoid and also specific symptoms that you need to be keep a lookout such as coughing, wheezing, shortness of breath, tightness of chest.
• You could set regular alerts and reminders on your cell phone or laptop to remind you of your or your child’s asthma medication.
• Keep the reliever medication handy, to be prepared for an attack. You could keep the gym instructor and your child’s teacher informed about the controller medicine.
• There is a device called peak-flow meter and you could keep this at home to keep a check on your lung health. This is a device designed to monitor how well your asthma is doing. It measures your ability to forcefully expel air from the lungs, and experts say using one regularly can help you head off a potential crisis regardless of the season.
• By remaining aware of your Peak Flow Meter readings on a regular basis, you will know when you are headed for trouble before you get there. And that means your doctor can prescribe additional medications, such as steroids, to offset any major asthma events before a cold or flu has a chance to take hold.

Never take OTC medicines to treat common cold or flu

While you may also find some relief from your cold through natural home remedies like drinking hot tea with honey, a bowl or two of hot soup, or plenty of fluids, and sleeping with your head elevated, you must always consult your doctor before taking any medicines for cold.
There are several over-the-counter medicines available to treat common cold and cough. However, asthma patients need to take extra care before popping a pill. It is important that the asthma patients talk to their doctor before taking cold medicines. This is because your asthma condition needs to be taken into account to treat your cold and cough.

But what is most important is that asthma patients should never depend on any cold or flu medicines to control asthma symptoms.

Could your persistent cough be asthma?

Cough is one of the most common symptoms prompting a visit to the primary care physician’s office. Some coughs persist for weeks to years, and cause patients to go from one physician to another seeking relief from incessant coughing which may rob them of sleep and interfere with work and their normal lifestyle and may indicate of something serious.

Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs. Asthma is not just constriction of airways in the lungs, but also inflammation of the airways. When a person with asthma comes into contact with an asthma trigger, the muscle around the walls of the airways tightens so that the airway becomes narrower. The lining of the airways becomes inflamed and starts to swell. Often sticky mucus or phlegm is produced. All these reactions cause the airways to become narrower and irritated – leading to the symptoms of asthma.

The symptoms of asthma vary from person to person. Though wheezing, breathlessness, chest tightness and coughing particularly at night or early morning are usually the symptoms of Asthma, it is possible to have only cough as the symptom and you could be diagnosed with Asthma. This is particularly common in young children. Asthma cough is usually dry and hacking and in some cases may not be accompanied with wheezing at all.

Asthma can start at any age. It is difficult to know what causes asthma, but we know if tends to run in families. People whose parents have asthma are more likely to develop asthma. The interaction between genetics, the environment and many aspects of our modern lifestyle have contributed to the rise in asthma

• smoking during pregnancy increases the chance of a child developing asthma
• second-hand smoke increases the chance of developing asthma
• irritants in the workplace may lead to a person developing asthma
• environmental pollution can make asthma symptoms worse
• indoor environment - centrally heated and poorly ventilated homes have led to an increased exposure to house-dust mites and mould spores, both asthma triggers
• poor diet and an increase in obesity have been linked to asthma

The usual symptoms of asthma are as follows
• Coughing: A cough that doesn’t go away and is often worse at night
• Wheezing: A whistling sound that is usually heard when breathing out
• Tightness in Chest: A constricted feeling in the chest, as if someone is squeezing or some heavy object is placed on it.
• Shortness of breath: Breathlessness – a feeling that you can’t get enough air in or out of your lungs which makes breathing especially tough.

Other symptoms:

Disturbed sleep due to coughing at night

Breathlessness which exercising

In India today the widest range of medicines and devices are available to control asthma and that too at a fraction of the cost at which it is sold internationally. With zero compromise in life, complete control over asthma is possible with inhalation therapy cost as low as Rs 1,000 a year. Use of inhalers ensures that the medicine reaches the lungs directly and is therefore most effective. Unlike some other chronic diseases, asthma is a condition which allows you to lead a normal active life with just a few puffs of inhalation everyday. However, the irony is that though, in India despite full availability of the drugs and devices at affordable prices majority of the cases remain undiagnosed and untreayted or suboptimally treated.

So even if your child has trouble sleeping, feels tired easily especially with exercise, or has persistent cough, it would be a good idea to visit your physician and ask for inhalation therapy.

80% of asthma patients also suffer from allergic rhinitis - PCJR

A recent study conducted by Primary Care Respiratory Journal (PCRJ) suggests that allergic rhinitis quadruples the likelihood of asthma patients having poor control over their symptoms, therefore increasing the chance of an asthma attack.

Frequently dismissed by patients and doctors as just a runny nose and itchy eyes, allergic rhinitis poses a serious health risk to the estimated 80% of asthma patients who also suffer from allergic rhinitis.

Despite the high prevalence of asthma and allergic rhinitis, two thirds of asthma patients have not discussed the impact of allergic rhinitis on their asthma with their doctor.

This study shows that smoking has a similar impact to allergic rhinitis on the poor control of asthma. Smoking is universally accepted as a trigger for asthma attacks and routine checks are in place to identify asthma patients who smoke.

Surprisingly, despite international guidelines recommending a combined approach to managing and treating asthma patients with allergic rhinitis, similar checks for allergic rhinitis are not common practice.

Environmental factors contributing to the rise in asthma

According to WHO, the strongest risk factors for developing asthma are inhaled substances and particles that may provoke allergic reactions or irritate the airways. Avoiding asthma triggers can also reduce the severity of asthma. Therefore, it is important for asthma sufferers and also their family members to understand what might trigger an asthma attack. It is now an established fact that smoking irritates the lungs and increases phlegm production and therefore and even with passive smoking you could trigger an asthma attack. Cigarette smoke and smoky places are triggers for 7 out of 10 people with asthma. House dust, feathers from pets, pollen, insecticides, paint fumes, cold air, viruses and emotional agitation are also other factors which could trigger your asthma.

In recent years, scientists have shown that air pollution from cars, factories and power plants is increasingly becoming a major cause of asthma attacks. And studies also suggest that air pollution may contribute to the development of asthma in previously healthy people ?

Air Pollutants that Trigger Asthma

It is therefore best to avoid travelling during peak hours when pollution is at its highest.

Asthma not a deterrent to pursue sports as a career

Asthma can be completely controlled and allows a person to lead a zero compromise life with adherence to prescribed medication. Asthma does not affect the fitness level of person or his intelligence quotient; however, the person may need medication in order to participate fully. Many asthma patients have gone on to win Olympic medals, like Jackie Joyner Kersee who won 6 Olympic Golds and Dennis Rodman, the great American basket ball player to name a few. Consider this: In the 1984 Los Angeles Olympic Games, there were 597 U.S team members and sixty seven of them had asthma. They won a total of 174 medals, 41 of which were won by athletes with asthma.

However, if you are prone to strenuous exercise induced asthma, do talk to your doctor to help you choose the sports which you could opt for. In most cases, the adaptability to activities like swimming, cycling, football and cricket is better and more comfortable as these sports do not involve continuous activity. It is also very important to carry a Reliever at all times and to inform you instructor or coach about your asthma and the Reliever medicine that has been prescribed to you. It is also a good idea to connect your coach to the doctor so that your condition has been medically explained to your coach. Asthma is no longer perceived to be a challenging condition for the

An asthma patient’s condition is extremely subjective and therefore triggers, treatment, dosage and activities vary from person to person.

>How to help a patient undergoing an asthma attack?

If an asthma patient takes his Controller medicine regularly and avoids triggers, the chances of a severe attack are low. It is also important to visit your doctor from time to time and check your lung power with the easy- to-use Peak Flow Meter . But in case of an emergency, make sure to follow the following steps:

1. The asthma patient must sit upright and not lie down. His clothing should be loosened. He should try to stay calm and relaxed. A relative or friend near him must not panic and help in whatever way to calm the patient and give him positive reassurance.
2. Without delay, the patient must take the Reliever medicine in the dosage recommended by the doctor.
3. Then wait for 5 minutes. If there is no improvement, additional doses of the Reliever medicine must be taken as advised by the doctor.
4. If the patient still gets no relief, call the doctor immediately. It is important to remember not to exceed the dose of the Reliever medicine without consulting the doctor.
5. If the doctor cannot reach the patient quickly he or she should be taken to the nearest hospital for emergency treatment.

As per the GINA update 2008, annual worldwide deaths from asthma have been estimated at 250,000. Most of these deaths are preventable and therefore it is imperative to take the management of asthma seriously.

Is Asthma a social taboo in India?

As per the World Health Organization (WHO), there are about 30 million asthmatics in India, of which most of them are either unaware, undiagnosed, undertreated or are getting only suboptimal treatment. This is despite the fact that India has the latest, most effective and the maximum number of medicines and device forms to control asthma, many of which are not even available in other parts of the world. And all these medicines are available at very affordable costs and your medication could cost you as low as Rs 2.00 – 3.00 per day.

Although asthma is not a curable disease, it is possible to lead a completely normal active life just with a daily dose of prescribed medication. There are several who have lost their childhood, lead a compromised life and even end up losing their lives due to asthma. If not controlled, asthma causes considerable reduction in productivity and overall fitness, increased requirement for health care support, irreversible damage to the lungs and morbidity in acute cases. However, the problem of asthma can be easily managed and in fact, 90% of these cases are mild. The prognosis of asthma remains good with as many as 60%–80% of patients being able to lead normal lives without much disruption.

However, in India Asthma in certain regions is perceived to be a social taboo. The level of acceptance of asthma is low and the patients diagnosed with asthma at times are in a state of denial. In several cases asthma is kept under wraps. This is because there are many who look upon asthmatics as people with life-long compromised condition and therefore asthma many a times is seen to become a barrier in the choice of career, arranging marriages and in some households creates domestic troubles and could affect a relationship. The behavior of some non-asthmatics towards asthmatics has been found to be crude and irresponsible and there are few who even subject asthmatics to mockery, ridicule and are ragged in colleges. The family members in few cases are unsupportive and could even go to the extent to forcing the patient to discontinue the treatment.

The prescribed medication in asthma in most cases is inhalation therapy and the patient could be prescribed a daily dose of inhaler medicines. These medicines are completely safe, help in preserving the condition of the lungs and could even prevent asthma attacks which cause 250,000 deaths worldwide each year, as per WHO. However, the public usage of inhalers instills social embarrassment and therefore there are some patients who try to avoid using inhalers in public.
There are several myths and misconceptions about asthma which has been nurtured through ages in India. These are as follows:

The most common myth is that asthma is a contagious disease. This belief has come into place primarily because people associate asthma with tuberculosis and tuberculosis is a contagious disease. However, the truth is that asthma is not contagious and you cannot catch asthma from anyone else and no one at home or work can get infected by it.

Though asthma is an inherited condition, not every child with an asthmatic parent is susceptible to asthma. There are several cases where children have asthma but the parents don’t have asthma. Therefore, it should not become a barrier in marriages as it is most likely that though either the bride or groom has asthma, it may not show up in their children.

It has also been found that many have the misconception that asthma could inhibit a sound congenial life as the fitness and stamina levels of the asthmatics are perceived to be low. However, contrary to the belief asthma is the only disease which allows a person to lead an uncompromised life and with proper medication and regular consultation with your doctor it is possible to participate fully. There are exercise induced asthma in which strenuous physical activity could act as a trigger, however, it is possible to keep it under control. Infact, many asthma patients have gone on to win Olympic medals like Joyner Kersee, Denis Rodman among others and famous sport stars like David Beckham, Saurav Ganguly also have asthma.

If your asthma is under control with regular medicines, you can have a normal safe delivery. In some cases however, asthma symptoms can worsen. It is important that you take care in the first trimester ie the first three months of your pregnancy. Contrary to popular belief, the use of inhaled drugs has no risk to the fetus. Asthma is not a transmitted disease and if you are on inhalation therapy only negligible amounts of asthma medication enters breast milk. In fact, lactating mothers all over the world who are on inhalation therapy breastfeed their babies without any adverse side affects.

The biggest barrier to acceptance of asthma can be broken if we all understand that asthma is a ‘lifestyle controlled disorder’ not a disease. The word disease has terrific negative impact on the patient’s psyche which is almost irreversible. Thus the process of instilling an affirmative thinking pattern among patients should be a growing ritual among medical practitioners. To build a modern & forward looking attitude towards the disorder is a requisite. Thus propagating an affirmative thinking pattern and supportive management techniques via patient literature is the need of the hour. The reason for the same being increasing number of patients are suffering from an emotional crisis and getting into depression when diagnosed with asthma.

However, the acceptance of asthma and inhalers has gone up in the past five years. The patients have benefitted from the use of inhalers which besides providing relief prevents loss of work and pay for them and reduces the chances of hospitalization considerably. With a minimum spend of as low as Rs 2-3 per day; it is possible to keep your asthma under control.

Adherence to prescribed medication reduces chances of future asthma attacks

Adherence to prescribed medication and treatment is crucial in managing any chronic disease. It has been found that adherence to asthma medication regime is very poor and tends to falter after few months in both children and adults and the rate of non-adherence has been estimated to be around 50%. Asthma is a chronic disease which requires long-term treatment and management. Improved patient adherence may lead to improvements in asthma control.

A number of factors can be associated with non-adherence to asthma treatment. There a few who drop-out once they benefit from the medicines and find initial temporary relief. Asthma also is an episodic condition where there would be days when the patient suffers from symptoms and this is generally followed by asymptomatic periods during which the patient might feel that he does not require medication. This is one of the primary time-periods in patient treatment when he discontinues treatment assuming that he may not require any more medication.

Medication related factors include difficulty with inhaler devices, unnecessary concerns about side effects and cost of medication. There are also several psychological barriers which lead to inhibitions such as dissatisfaction with health care professionals, inappropriate expectations, anger about one’s condition, underestimation of severity of the condition and complacent attitude towards health or even social stigma associated with asthma and inhalers.

Most people with asthma use their medication as prescribed only when they are symptomatic, as there is an immediate connection between taking medication and the relief of symptoms. For the same reason, adherence with reliever medication tends to be greater than adherence with preventive medication. Once symptoms resolve, continued adherence becomes increasingly difficult for many people with asthma. Asthma patients who take symptomatic treatment have their condition sub-optimally managed. This often leads to increased frequency of attacks, more doctor visits, faulty treatment and eventually an increased economic burden on the individual and society.

Communication and open-ended questioning are useful tools to discover a patient's attitudes to medications and medicine-taking, which will certainly influence their adherence to treatment. The medical practitioner should also try and counsel the patient from time to time to ensure that he understands the dangers of discontinuing medication. In some circumstances, non-adherence can be seen as an active attempt by the patient to reduce medication use. This could be because of the fear of getting addicted to the inhaler or an ‘anti-drug’ attitude.

Children, adolescents and even the elderly usually have a care giver who helps them in keep the asthma under control. However, lack of conviction in the care giver in the line of treatment could de-motivate the patient. Some people also experience social embarrassment in using the inhaler publicly and this could lead them into avoiding the regime.

However, the primary reason why people tend to fall-out of their asthma regimen is due to the fact that asthma is a silent disease and skipping doses of controller medicines does not manifest any prominent symptoms. But besides causing irreversible damage to your lungs, uncontrolled asthma can lead to hospitalization, loss of work and even death and several co-morbid diseases like heart diseases. Emergency treatment is more expensive as cost of one night of hospitalization is more than guideline determined asthma care which could cost as low as Rs 1,000 per year. In fact, the cost is rather intangible as it is not economic but the price you might have to pay for risking lungs which could even lead to death.

Asthma is not a curable disease but because of newer medicines and newer delivery systems most people can lead a normal healthy life and enjoy all kinds of social activities. In several cases there is minimum compromise and no restriction on diet and lifestyle. Asthma is a chronic condition with asymptomatic periods and therefore even if there are no symptoms like wheezing, coughing or breathing trouble, regular use of prescribed medicines is mandatory.

Inhalation therapy is now well-accepted globally as the best form of asthma treatment as it uses the technology to deliver the medication directly to the lungs. This is more effective, safer and has minimal side effects as the dosage is up to 40 times lesser than tablets or syrups. Besides being more effective, inhalation therapy works out to be less expensive than using oral medication regularly. In addition, with regular inhalation therapy, your chance of missing work or school is reduced, resulting in substantial savings.

Asthma in special situations

If you have asthma, it’s not the end of the world. It’s important to know that asthma can be controlled and you can lead a normal life. The following section will attempt to explain Asthma in special situations. Some of the topics we will touch upon are: asthma in pregnancy, asthma and lactating mothers, asthma and your job, asthma and travel, asthma and sports, asthma and smoking, asthma and complementary medicines, asthma and allergic rhinitis and so on.

Asthma in pregnancy:
Firstly, if you want to start a family, asthma shouldn’t stop you from getting pregnant. Secondly, if you are pregnant and have asthma, you can have a normal safe delivery. It is important that your asthma is under control with regular medication and that you take the normal precautions like any pregnant mother – your doctor will guide you best. In some cases, and if you do not take your medication regularly, asthma symptoms can worsen. The use of inhaled medicines have been proven to have no risk to the fetus.

Asthma in lactating mothers:
If you have asthma and you wish to breastfeed your baby, please do so. Asthma is not a transmitted disease. If you are already on inhalation therapy, only negligible amounts of asthma medication enter breast milk. In fact, lactating mothers all over the world who are on inhalation therapy, breastfeed their babies without any adverse side effects. Another point to note is that inhaled medication today is so safe, it can be safely used in pregnancy.

Asthma and your job:
You needn’t miss work, or suffer loss of pay, if your asthma is well under control. However, people working in the jewellery business, the printing, pesticide , quarries, painting and plastic industries, chefs and bakers, solderers and metal platers, foam workers and spray painters, hair dressers and carpenters, are known to be more prone to asthma. Perhaps, it is the smell of certain chemicals or the particulate matter that could be the cause of irritation in the lungs. These are called triggers.

It is important that you know your trigger, take appropriate precautions, take your Controller correctly and regularly, and of course see your Doctor who will be in the best position to advise you.

Asthma and travel:
Asthma needn’t come in the way of your work or your travel. If your work entails you to travel frequently, always keep a copy of your doctor’s prescription handy, written instructions and your emergency contact numbers with you. And most importantly, never travel without an adequate supply of your medication – both Controllers and Relievers. You should, as you know, take your Controller regularly. In fact, we advise you to keep a spare Reliever always at hand. Do check the weather conditions before you travel and be prepared for climate changes by taking suitable clothing.

Asthma and Sports:
Asthma is not a deterrent to being a winner in sports or in life. Top cricketers have asthma, basketball players have asthma, even swimmers and runners have asthma and they have gone on to win Olympic Golds.

If you have asthma and it is well controlled, you can by all means exercise and play sports actively. It is however important that you take your Controller medicine regularly, as prescribed by your doctor. Some asthmatics benefit by using a Reliever/ Rescuer before exercising. So always keep your Reliever handy too. Don’t forget to carry extra medication, just in case. Do inform your team members, your friends, your gym instructor or your coach about what they should do in case you have an attack.

The best exercises for asthma are yoga, and sports like swimming and sprinting, since they do not involve continuous running and allow you to have breaks in between. If you are serious about exercise and sports, please consult your Doctor regularly.

Asthma and Allergic Rhinitis:
There is a strong association of asthma and allergic rhinitis. People with allergic rhinitis complain of frequent bouts of colds with sneezing and runny nose. About 70% of patients who have asthma also have allergic rhinitis, since the nose is an extension of the respiratory tract. Usually, the nose gets affected first and then the lungs. Thus it is important to diagnose and treat allergic rhinitis in order to control asthma better.

Allergic rhinitis is a collection of symptoms which occur when one breathes in something that one is allergic to, like dust, pets, or pollen.

The symptoms are:
• Runny nose (persistent watery discharge from the nose)
• Sneezing
• Nasal obstruction
• Nasal itching ((Itching in the nose, eyes or on the roof of the mouth)

These symptoms can occur either during particular seasons of the year. This is called Seasonal Allergic Rhinitis (SAR). If it occurs all year round, it is termed as Perennial Allergic Rhinitis (PAR).

It is important that you take your allergic rhinitis seriously because if it is not treated on time the asthma could get worse and cause other complications like ear infections, sinusitis….Do visit your doctor to get the correct treatment.