ABOUT ASTHMA

As a Respiratory Therapist, I created this page

in an attempt to inform all of you,

about the lung disease known as ASTHMA.

Asthma is on the rise throughout the world,

especially here in Hawai'i. This disease still

kills many people every year, and it should not.

Asthma can be controlled and those who have it,

can lead a normal life.

I will try to explain what Asthma actually is,

what triggers asthmatic attacks,

and what can be done to monitor and control it.

What is asthma?

Asthma is a chronic breathing problem that

can last a long time, sometimes forever.

About 14 to 15 million people in the United States have it.

What Are The Signs Of Asthma

The signs of asthma are a cough, either when you

are resting or after you exercise, shortness of

breath, wheezing and a tight feeling in your chest.

These signs are caused by inflammation (swelling)

of the lining (narrowing) of the airways and

constriction of the airways. (Airways are

breathing tubes that carry air in your lungs.)

Inflammation and constriction can stop air

from moving easily through the airways.

Is asthma a serious health problem?

Yes. Asthma is a serious problem. It can be

life-threatening if it isn't taken

care of in the right way. However, with proper care,

people with asthma can live normal lives.

Who gets asthma?

People of all ages, races and economic levels can get asthma.

The total number of people with asthma is growing.

In the United States, more than 4.8 million children

have asthma. Most of them will have it all their lives.

Although it seems like some people "outgrow" it,

the signs of asthma can come back years later.

Sometimes adults get asthma even though

they didn't have it as children.

What are the warning signs of an asthma attack?

When an allergen or an irritant affects

your airways and triggers an asthma attack,

you will usually feel an increase in some

signs such as chest tightness, shortness of breath,

cough, wheezing and, sometimes, a feeling of chest congestion

caused by increased mucus in your airways.

Other signs to watch out for are these:

needing to use more medicine more often

to relieve the signs of asthma,

waking at night with asthma problems and a decrease

in your ability to participate in your usual daily activities.

If you are measuring your peak flow rate

every day, watch for a drop in the

morning measurement from your usual value.

Asthma attacks can be mild or severe.

They may develop suddenly or more slowly.

Severe signs suggest a severe attack.

This requires medical care right away.

It's important not to wait to get emergency care,

because a severe asthma attack can be life-threatening.

Sometimes a mild attack that seems to go

away can come back several hours later.

This is called a late-phase attack.

It can be more severe than the first attack.

It makes your airways more sensitive to asthma triggers,

and this sensitivity can last for days or weeks.

What causes an asthma attack?

Asthma attacks are triggered by allergens

and by airway irritants. Here are some examples

of things that may trigger an asthma attack:

� Animal dander � Dust mites � Cold viruses � Perfumes

� Cold air � Paint fumes � Cigarette smoke � Household cleaners

� Heavy exercise

Can asthma be controlled?

Yes. To get the right care for asthma,

you must see a doctor. People with asthma

and their families can learn how to control asthma.

Your doctor is ready to help you learn.

Here are some tips to help you

avoid problems with your asthma:

� Stay away from substances and fumes

that can irritate your airways. Avoid them as much as you can.

It's especially important to avoid cigarette and cigar smoke.

� Don't use household cleaning

products that cause breathing problems.

� Reduce allergens in your home. The bedroom,

because you spend so much time there during sleep,

should be cleaned carefully every week.

� If you're allergic to cats and dogs,

don't keep them in your house.

At least keep them out of your bedroom

at all times. Cat dander and cat saliva

are highly allergic. Dander and saliva

stay in the house for months after a cat is removed.

(Dander is bits of dried skin in the animal's fur;

saliva is the liquid in the animal's mouth.)

� If dust bothers you, put special covers

over your mattress and bed pillows.

Wash all the bedding, sheets, blankets

and covers in very hot water every week.

This washing kills many of the dust

mites that live in the bedding.

Dust mites can trigger asthma attacks.

� Have someone else vacuum your carpets

once or twice a week. This cleaning cuts

down on house dust and kills dust mites that

live in the carpets. You shouldn't go into the room

for several hours after the vacuuming is done.

If you can, take out the carpeting altogether.

Bare floors are easier to keep clean.

� Humidity makes dust mites and mold grow.

If you can keep the humidity indoors

at less than 50 percent, you'll have less

trouble with dust mites and mold.

What medicines are used to treat asthma?

Two kinds of medicine are used to treat asthma:

anti-inflammatory medicines and bronchodilators.

Asthma medicines have to be prescribed for each

individual person's needs, because every person

with asthma is different. At every office visit,

tell your doctor how well your medicine is working.

Be sure to tell about all the side

effects you have from the medicine.

Don't stop taking your medicine without

talking to your doctor first.

Anti-inflammatory and long-term control medicines:

These prescription medicines work to keep

the lining of the airways from becoming inflamed.

They prevent asthma attacks from happening

and make them less severe when they do happen.

They don't do a good job of stopping

an asthma attack once it starts

(you should use bronchodilators for that).

Some anti-inflammatory medicines are inhaled medicines like

cromolyn (brand name: Intal) and nedocromil

(brand name: Tilade). Others are inhaled steroid medicines

(brand names: Beclovent, Vanceril, Azmacort,

AeroBid, Flovent, Pulmocort). You don't have to worry about using

these steroids. Inhaled steroids are not dangerous.

Almost all the medicine goes right into your lungs.

Inhaled steroids don't cause the problems

that some people have with steroids in pills.

Long-term control medicines include oral

medicines like zafirlukast (brand name: Accolate)

and zileuton (brand name: Zyflo). All of these

medicines must be taken every day, just the way

your doctor tells you, or they can't help you.

Bronchodilator medicines: These medicines work

by relaxing the muscles in the airways so they don't

constrict. There are two kinds of inhaled bronchodilator medicines:

� Short-acting (quick relief). These medicines

quickly stop asthma symptoms. Short-acting inhaled

bronchodilators include these brand names:

Proventil, Ventolin, Brethaire, Tornalate, Maxair and Alupent.

� Long-acting (long-term control). This medicine

can prevent symptoms from starting.

It can't stop symptoms once they start.

There is only one inhaled long-acting bronchodilator right now,

called salmeterol (brand name: Serevent).

Other bronchodilators your doctor may

prescribe for you include ipratropium

(brand name: Atrovent) and theophylline, which

does have some anti-inflammatory effects.

Are asthma medicines safe?

Asthma medicines are safe if you take them

the way your doctor tells you. You can't get

addicted to asthma medicine. Some people worry

that if medicine is taken all the time,

after a while it will no longer work. This isn't generally

true. Tips for using your asthma medicine the right way:

Take anti-inflammatory medicine regularly,

exactly the way your doctor tells you,

even if you don't have any signs of asthma.

This approach reduces airway swelling and

helps keep asthma attacks from starting.

� Take bronchodilator medicine at the first

sign that your asthma is starting to get worse.

Watch for early signs, like cough,

chest tightness, wheezing and shortness of breath.

Start taking the bronchodilator medicine right

away to make these asthma problems go away.

� Remember that bronchodilators can make signs

of asthma go away, but they can't reduce

or prevent airway swelling (inflammation).

If you have to use a bronchodilator more than

three or four times a day, your asthma may

be getting worse. Your airways may be swollen.

You should talk to your doctor right away.

� Remember that if you need quick help for signs of asthma,

you can use a short-acting bronchodilator,

like Proventil, Ventolin or Maxair.

Don't expect the long-acting bronchodilator (Serevent)

to give you quick relief of symptoms.

� Remember that inhaled medicine doesn't

work unless it's inhaled the right way.

At each visit to your doctor, ask

someone to watch you use the inhaler

to make sure you're taking the medicine the right way.

What is a daily treatment plan?

A daily treatment plan is a written guide.

Your doctor gives it to you so

you can manage your asthma by yourself at home.

You and your doctor should develop it together.

Your plan will include this information:

� How you take your medicines. For example,

people with mild asthma may use a bronchodilator

only when they have symptoms.

� How much of each medicine to take.

� How to check (monitor) your asthma at

home using symptoms and/or peak flow measurements.

If your doctor wants you to monitor your

asthma with a peak flow meter,

use the meter to measure your breath every

morning before you take your asthma medicine.

Blow as hard as you can, one short BLAST,

into the peak flow meter, three times in a row.

After three tries, write down the highest number

in your asthma record book. Repeat the measurements

again during the day, as your doctor tells you to.

What is an asthma action plan?

An asthma action plan tells you what to do

if you have a serious asthma attack.

Your doctor will tell you what medicine to take

and when to call for advice.

Be sure to write down emergency telephone numbers

for your doctor and the nearest hospital emergency

department. Keep these numbers with you at

all times and next to your telephones.

Plan in advance how you would get to the

doctor's office or an emergency department if you need help.

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