Asthma: Living well with asthma

Asthma is a chronic pulmonary disease that affects over 2.7 million persons in Canada alone. With an appropriate treatment, asthma can be controlled and sufferers can lead a normal life.

What is asthma? Asthma is an incurable, chronic pulmonary disease that can result in death. It is estimated that in Canada alone, 2.7 million adults and children between the ages of 4 and above, suffer from asthma.

Asthma is triggered by an inflammation and constriction of the bronchial tubes, the main airways that carry air in and out of the lungs.

Typical asthma symptoms include coughing, shortness of breath, a feeling of tightness in the chest, and wheezing. Symptoms and acute exacerbations, commonly known as asthma attacks, generally occur when an asthma sufferer is exposed to asthma triggers (triggers). The most common of these are allergens, viral respiratory infections such as colds and flu, physical exercise, as well as smog, fumes and irritating gases. The intensity of asthma attacks varies tremendously from one individual to another, and can range from the occasional and relatively mild shortness of breath, to very severe respiratory problems that can become life threatening.

What is the therapeutic objective? Optimal control of the symptoms The primary goal of any asthma treatment is for a patient to attain optimal asthma control. Asthma is considered well controlled if a sufferer: experiences few diurnal (daily) symptoms (less than 4 times per week), and no nocturnal symptoms; uses their reliever medication (rescue inhaler) less than four times per week, excluding the doses before exercising; and has not had to miss school or work.

To achieve optimal asthma control, it is important for sufferers to truly understand their condition. It is particularly important for asthma sufferers to identify the exact triggers that induce their symptoms in order to avoid being exposed to them. They must also adhere to their asthma treatment and take their medications exactly as prescribed. With the help of their healthcare providers, asthma sufferers must also develop a personalised action plan to really take charge of their condition.

Taking your medications correctly There are two main types of medications used to manage and relieve asthma symptoms. Controller medication, also known as maintenance therapy (corticosteroids), is used to treat inflammation, and is to be taken regularly. Reliever medication, better known as a rescue inhaler (bronchodilators), is used to achieve rapid relief at the first sign of an attack.

Inhaled corticosteroids are the basis of any asthma treatment, as they directly reduce airway inflammation. However, because they do not work immediately and only act over the long term, many patients tend to abandon them, relying instead on their bronchodilator. Yet, inhaled corticosteroids are the most important medications in the treatment of asthma. For a sufferer to achieve optimal and long-lasting control of their asthma symptoms, it is essential they take their inhaled corticosteroids on a regular basis, even when the symptoms become rarer.

Bronchodilators are used to relieve asthma symptoms quickly, and for a few hours. They quickly facilitate the airflow by dilating the bronchial tubes, but are not meant to reduce inflammation. These medications should not be used more than four times per week, not including the doses that must be taken prior to physical exercise. If you need to take these medications more often, it may be a sign that your asthma is becoming uncontrolled, and that it may be time to revise your controller medication or maintenance therapy. You should discuss any changes in your symptoms or frequency of attacks with your physician.

Has your physician prescribed a spacing device, also known as a spacer? If so, you should know they are worth using, because they serve in increasing the concentration of medication that is deposited in the lungs, while decreasing that which stays in the mouth and throat. This reduces your chances of having to contend with the localized adverse effects of certain inhaled medications.

It is important to remember that asthma is a disease that changes. A period of adjustment will likely be required before you and your physician are able to determine the exact combination of medications that will control your symptoms effectively. You should also know that your medication requirements may also change over time.

Preventing attacks The very best way to avoid asthma attacks is to identify and avoid triggers (allergens and irritants). However, this is easier said than done, as there are hundreds of substances that can trigger attacks such as environmental pollution, dust, dust mites, and cigarette smoke.

For individuals who have pollen allergies, installing an air conditioning unit in the house and in the car can help decrease the quantity of pollen present in your immediate environment, as you will be able to keep the windows closed. For those who cannot afford such luxury, the best solution is to keep the windows closed during the pollen season.

Many asthma sufferers will notice an exacerbation of their nocturnal symptoms due to dust. To decrease the amount of dust in the bedroom, you should remove all carpeting, choose drapes or blinds that are easy to wash, and wash the bedding in hot water every week. The level of humidity in the house should also be kept below 50% to prevent the excessive proliferation of dust mites and moulds.

Separation from a beloved pet to which we are allergic is the most effective way to achieve optimal control of our asthma. While many individuals think they are allergic to their animal’s fur or feathers, they are in fact allergic to the saliva, oily secretions, skin particles, also known as animal dander, and excrements. Consequently, there is no such thing as an animal that does not cause allergies, because all animals lose skin particles.

Physical exercise Just as is recommended for individuals who do not suffer from asthma, asthma sufferers should engage in moderate physical activity for approximately one hour, most days of the week. If your asthma symptoms limit your ability to be physically active, it is a sign that your asthma is not at all well controlled. It is important to keep in mind however that cold air and other irritants such as environmental pollution can trigger asthma symptoms. For asthma sufferers, a warm-up period is particularly important to prepare the body for more intense exercise. In addition, it is recommended that most asthma sufferers take a dose (puff) of their bronchodilator before starting any sustained physical activity to help prevent symptoms.

Action plan All asthma sufferers should establish a written plan of action with their healthcare providers. This will allow them to react quickly and adequately in case of a respiratory infection and/or asthma attack. It is important to react at the very first sign of any degradation in your breathing to avoid the onset of an asthma attack.

In conclusion Do not let asthma govern your life. You will be able to attain optimal control of your symptoms and consequently live a truly active life if you educate yourself on the disease and take charge of your health, if you take your medications judiciously, particularly your inhaled corticosteroids. The quality of your life rests in your hands!

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