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What does Asthma feel like?
- You suffer from cough that is worse at night or early in the morning
- You don't sleep well at night due to difficulty breathing and you are unable to enjoy your daily activities the next day.
- You can't breathe normally and your feel chest tightness upon exposure to perfume or any strong fragrance
- Your chest becomes tight in the cold weather and you begin wheezing
What is asthma?
- Asthma is usually triggered by environmental factors and is directly related to allergies.
- Asthma differs from COPD in symptoms, treatment and effect on lungs.
- Asthma can be a reversible condition and effective treatment is available
Asthma is a chronic inflammatory disorder that affects airways causing cough, chest tightness, breathlessness and wheezing. Asthma takes the form of recurrent episodes especially at night or early in the morning.
When diagnosing asthma, other serious pulmonary condition (COPD: Chronic Obstructive Pulmonary Disease) should be excluded. Therefore, we need to know the difference between the two conditions as each one needs different treatment.
4 Types of asthma:
Asthma is classified according to:
- The frequency of these symptoms
- Night time awakening
- Drugs used to control symptoms (mainly SABA; Short-Acting Beta Agonists like Ventolin or Salbutamol inhalers)
- Interference with normal daily activities and exacerbations
- The age of the patient
According to the above items, asthma has four types:
- Intermittent asthma.
- Mild persistent.
- Moderate persistent.
- Severe persistent.
Causes of asthma
Unfortunately, the exact cause of asthma is still unknown. Many factors may contribute to the occurrence of asthma often early in life. These factors include genetic factors (an inherited tendency to develop allergies), respiratory infections during childhood and contact with airborne allergens or exposure to viral infection in early childhood while the immune system is developing.
Mechanism of Asthma
Upon exposure to asthma triggers, the airways become inflamed, narrow, and filled with mucus. Once an asthma attack begins, spam of muscles around those narrow inflamed airways occurs, causing difficulty in breathing, chest tightness and other asthma symptoms.
Triggers of Asthma
If you are diagnosed with asthma, you have to know asthma triggers to avoid them as much as you can to enjoy a high-quality life. It is important to know that triggers are different from one person to another. Every asthmatic patient should be aware of triggers that cause asthma attack to him to avoid.
The most common asthma triggers are:
- Tobacco smoke.
- Dust mites(tiny bugs that are present in most homes).
- Outdoor air pollution due to cars and factories.
- Furry pets.
- Smoke from burning wood or grass.
- High humidity in weather.
- Some foods or medicines.
- Physical exercises (This is known as Exercise-induced Bronchospasm, and controlled effectively by some inhalers like Ventolin or Salbutamol).
- For some people, strong emotions may fasten breathing causing hyperventilation that can also cause an asthma attack.
- Acid reflux can trigger an attack.
- Breathing in mould may trigger an asthma attack.
- Fragrances can also trigger an asthma attack.
Diagnosis of asthma
Diagnosis of asthma does not depend only on symptoms, because not all asthmatic patients experience all these symptoms together. In addition, having these symptoms does not always mean that the diagnosis is asthma. Therefore, depending only on symptoms and physical examination is not enough in all cases. The doctor may perform diagnostic tests known as Pulmonary Function Tests to check how lungs are working.
Two tests to diagnose Asthma
- Spirometry that measures the amount of air you can breathe in and out and how fast you can blow air out.
- Lung testing that measures how your airways react to specific exposures. Repeated measures of your lung function by spirometry are done under each exposure.
Your doctor may perform other tests to find which allergens affect you. The severity of asthma may vary from episode to another for the same patient. Sometimes symptoms just annoy the asthmatic patient, other times symptoms are severe that can affect the quality of life.
Treatments for asthma
Pharmacologic treatment of asthma - 2 types of medicines are used in asthma:
- Short-acting "Quick-relief or rescue medicines" that relieve symptoms at asthma attack.
- Long-term medicines that treat airway inflammation and prevent exacerbations.
The pharmacological treatment of asthma is of stepwise approach, the initial treatment of asthma depends on the severity of asthma flare, and then, follow up treatment is decided according to response to the initial treatment and success of your asthma action plan (management plan) to control symptoms and prevent asthma attacks.
Dosages are adjusted according to your responsiveness. If your asthma is not well control, your doctor may increase the medicines you take. On the other hand, if your asthma is well controlled for several months, your doctor may decrease the medicines.
Quick-relief medicines for asthma
Salbutamol or its branded version Ventolin and other inhaled short-acting beta-2 agonists (known as SABA) are the first choices for quick relief of asthma symptoms. They work by actingquickly to relax muscles around airways during asthmaattacks, so air can flow through them.
Quick-relief means once you feel asthma symptoms you should take the medicine. Therefore, you should carry the inhaler with you allthetime. However, if you find yourself in a need to use it more than twice per week, you should consult your physician as you may need to add a long-term asthma control medicine.
Long-term control medicines for asthma
Inhaled corticosteroids are the preferred and most effective option for long-term relief of inflammation and airways swelling.
In severe asthma, the patient may need to take a corticosteroid in oral form.
Inhaled long-acting beta-2 agonists: these medicines open airways. The may be added to corticosteroids in the same inhaler like
Anti-inflammatory medicines: which is taken by a device called nebulizer and helps prevent airway inflammation.
Leukotriene modifiers: which blocks the chain reaction that increases inflammation in the airway.
Immunomodulators: prevents your body from responding to asthma triggers.
Theophylline: helps open airways.
How long do I have to be monitored?
At the beginning of treatment, you need to visit your doctor every 2-6 weeks. Once your asthma is well controlled, you will need to pay your physician a visit only once every year.
Goals for an Asthma sufferers
- Minimal or no day or night symptoms.
- Minimal or no exacerbations.
- No limitation for daily activities.
- Maintain normal lung function as much as we can.
- Minimum need to the gold treatment of asthma (SABA; Short-Acting Beta Agonists, like VENTOLIN INHALER and SALBUTAMOL INHALER).
How to prevent an asthma trigger/Attack
Some notes to be taken into consideration to be lower chances for asthma flares as possible:
Keep away from smokers as much as you can, especially in the days you do not feel well
Protect yourself against dust mites: change filters on heaters and air conditioners regularly, wash all beddings in hot water at least once a week. Remover dust everywhere with a damp cloth. If you can keep the floor without carpets, do it
If pets trigger your asthma, it is important not to have any at home and avoid long visits to places that have pets
Try not to use cleaning chemicals, aerosol sprays and paints that have heavy odours
Don’t use strong smelling products and perfumes
Stay indoors in highly polluted areas
Symptoms of asthma
The main symptom is coughing that is often worse at night causing sleep disturbances, as well as early in the morning.
Wheezing; as a result of narrowing in the air passages, whistling or rattling sound occurs while breathing.
Chest tightness; a patient feels like that there is something is sitting on his chest and that he cannot breathe normally.
Patients may feel that the air is trapped and they cannot get air away from their lung.
What is the difference in symptoms between asthma and COPD?
In COPD: Cough is productive (wet or chesty cough: that produces mucus or phlegm)
In Asthma: cough is non-productive (dry cough).
In COPD: Cough occurs throughout the day
In Asthma: cough is worse at night and early in the morning.
In COPD: patients are “smokers”
In Asthma: may have allergies and symptoms are triggered by many environmental factors, (including smoke)
In COPD: Lung damage in COPD is irreversible
In Asthma: airway obstruction is reversible in asthma.
If a mother has asthma, will her baby get asthma?
It is not a rule. However, the baby is more likely to have asthma.
All that the mother can do is keeping her child away from any smoking areas, since smoking puts the baby at higher risk to develop asthma.
The most important advice for any pregnant woman is “DO NOT SMOKE”.
Does asthma go away?
Asthma is a chronic condition. Nevertheless, if you stick well to your asthma action plan, you will live a high quality life away from annoying symptoms, as long as you keep yourself away from triggers.
What should I do if I experience an asthma attack?
Try to keep calm. Take one puff from your quick-reliever inhaler (Ventolin or Salbutamol for example). You can take up to 10 puffs over 10 minutes. If you do not feel better, call the ambulance.
Do asthma inhalers like Ventolin or Salbutamol have side effects?
There are mild side effects for the inhalers like increased heart rate or feeling shaky after inhalation. However, these side effects last only for a few minutes and not everyone will experience them.
Can I exercise with asthma?
If you are controlling your asthma well, then you can exercise safely.