What is asthma?
Asthma is a lung condition that causes irritation and swelling (inflammation) of the lining of the airways in your lungs. The inflammation causes wheezing, coughing, and shortness of breath.
Asthma can be a chronic problem, which means you may have it the rest of your life.
You may start coughing or wheezing when you breathe in irritants or something you are allergic to.
· Examples of irritants are cold air, chemicals, perfume, and smoke.
· Examples of things you might be allergic to (called allergens) are dust, pollen, molds, foods (such as peanuts), and animal dander.
A cold or the flu might also bring on an asthma attack.
Some people have coughing or wheezing only when they are being physically active. This is called exercise-induced asthma.
Asthma may be mild, moderate, or severe. An asthma attack may last a few minutes or a few days. Attacks can happen anywhere and at any time. Severe asthma attacks can be life threatening. It is very important to get prompt treatment for asthma attacks and to learn to manage your asthma so you can live a healthy, active life.
Many Canadians have asthma, and the number of people who have asthma is increasing worldwide.
How does it occur?
If you have asthma, the airways in your lungs are always somewhat inflamed, even when you do not have any symptoms. When your airways are exposed to irritants or allergens, the airways become more swollen and make more mucus. The tiny muscles in the walls of the airways contract. These reactions cause the airway openings to get smaller. When the airways are smaller, it is harder for air to move in and out. Wheezing is the sound of air moving through the narrowed air passages. The extra mucus in the airways causes coughing.
Some of the factors that may increase the risk of developing asthma are:
· Low birth weight
· Having 1 or more close family members who have asthma
· Exposure to second-hand smoke or a lot of environmental pollutants (for example, smog in a large city)
· On-the-job exposure to chemicals used in the manufacturing industry, farming, and hairdressing
What are the symptoms?
Symptoms can be occasional or daily and include:
· Wheezing (a high-pitched whistling sound when you breathe in or out)
· Shortness of breath, or feeling like you cannot get enough air
· Chest tightness
You may find that there are things you used to do that you can no longer do because it is harder to breathe.
How is it diagnosed?
A single attack of wheezing does not mean you have asthma. Some infections and chemicals can cause wheezing that lasts for a brief time or a few days and then does not happen again.
Your personal healthcare provider will ask about your history of breathing problems. You will have a physical exam. You may have breathing tests called pulmonary function tests or spirometry. You may be tested before and after taking medicine to see how your symptoms respond to medicine.
How is it treated?
The goal of treatment is to allow you to live a normal, active life. With proper treatment, your asthma should be less of a problem day to day. It will also be less likely that you will have a bad asthma attack or more problems in the future. Treatment will probably include prescribed medicines. You may also need to remove allergy-causing substances or irritants from your home.
Three types of medicines are used to control asthma:
· quick-relief medicines
· steroid medicines
· long-term control medicines
Quick-relief medicines (also called reliever, rescue, or quick-acting medicines)
Ventolin or Salbutimol is the generic name of the most widely used quick-relief medicine. It is a type of medicine called a bronchodilator. Bronchodilators relax the muscles in the airways. When the muscles are relaxed, the airways become larger. This means that there is more space for air to move in and out.
You inhale the medicine by breathing it into your lungs as you spray it into your mouth. You use this medicine when you start to have an asthma attack. In some cases your personal healthcare provider may recommend that you use it on a regular daily schedule.
You should always carry a bronchodilator with you to use when you start to cough or wheeze. If you have exercise-induced asthma, you should use the medicine before exercise to prevent wheezing.
Steroid medicines for attacks that last several days
Steroids are another type of medicine that may be used to control asthma attacks. They are a type of anti-inflammatory medicine. The steroid medicine usually used for asthma is prednisone. You may need to take steroid tablets or use a steroid inhaler for several days with your other medicines to get your asthma back under control.
Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your personal healthcare provider prescribes. Don’t take more or less of it than prescribed by your personal healthcare provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your personal healthcare provider’s approval. You may have to lower your dosage slowly before stopping it.
Long-term control medicines (also called controller medicines)
Long-term control medicines are used to prevent asthma attacks and to keep you breathing as normally as possibly every day. Several types of medicines help prevent asthma attacks. They help reduce the inflammation in your airways. They are taken 1 or more times every day whether or not you are having symptoms. You may need only 1 of these medicines or you may need a combination. These medicines are now considered the best and safest way to have long-term control of asthma.
Long-term control medicine should be used all the time for year-round asthma. If you have asthma during just certain seasons of the year, your personal healthcare provider may instruct you to take the medicine just during the months when you usually have asthma symptoms. The medicine does not work well if you start and stop it frequently, for example, every week or two.
Long-term control medicines cannot stop attacks of wheezing after you have started wheezing. You must use a quick-relief medicine, such as Ventolin/Salbutimol, when you are wheezing.
The goals of long-term control medicines are to:
· prevent asthma attacks
· prevent chronic asthma symptoms, such as shortness of breath
· let you have a full active life, including playing sports and other physical activities
The medicines used most often for long-term control of asthma are:
· inhaled steroids, such as QVAR and Flovent
· a type of medicine called leukotriene modifiers, including zafirlukast (Accolate) and montelukast (Singulair) pills
· a long-acting, inhaled bronchodilator, such as salmeterol (Serevent) treatment)
Some of these medicines are available as combinations. For example, salmeterol is always used in combination with another type of controller medicine, usually an inhaled steroid.
One other, less often used controller medicine is theophylline. It is a pill usually taken at bedtime to prevent nighttime wheezing.
If you have severe persistent asthma and your asthma cannot be controlled with inhaled steroids, your personal healthcare provider may prescribe low-dose steroid tablets for long-term control of the asthma. However, steroid tablets have more long-term side effects than inhaled steroids. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your personal healthcare provider prescribes. Don’t take more or less of it than prescribed by your personal healthcare provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your personal healthcare provider’s approval. You may have to lower your dosage slowly before stopping it.
You need to work closely with your personal healthcare provider to find the treatment right for you. Make sure you understand how to use each of your medicines. Some are quick-acting and meant to be used when you have an asthma attack. Others are slow acting and help prevent attacks, but they do not help when you are having an attack.
Make sure you know how to use your inhaler correctly. Some inhalers work best if you hold them 2 inches in front of your mouth when you spray. This helps the medicine get to your lungs rather than getting stuck in your mouth. However, some inhalers need to be put in your mouth.
If you have an inhaler that should be used a couple of inches in front of your mouth and it is hard for you to hold the inhaler in the right position, ask your personal healthcare provider for an aerochamber. You can put one end of the spacer in your mouth and attach the inhaler to the other end. The spacer can help you inhale more of the asthma medicine.
Be sure you ask your personal healthcare provider or pharmacist the best way to use your inhalers. Read the directions that come with the inhalers. Also ask your pharmacist how you can know when your inhaler is empty so you can avoid getting caught without medicine.
Peak flow meter
Your breathing ability can change from day to day. For example, illness or seasonal allergies may make your airways more inflamed than usual. Your personal healthcare provider may prescribe a peak flow meter to measure how well air is moving out of your lungs. The peak flow meter can help you and your personal healthcare provider know if your asthma is in good control, if you need to take medicine to prevent an attack of wheezing, or if you need to get help right away.
Your peak flow measurement will often go down before you start having symptoms of asthma. When your peak flow reading is getting low it may mean that you’re about to have an asthma attack or that you need to adjust your medicines.
Ask your personal healthcare provider at what peak flow level you should call the office.
Uncontrolled or poorly controlled asthma increases the risk of problems during your pregnancy because not enough oxygen will get to your baby. Examples of problems that might happen are high blood pressure (preeclampsia), early delivery of your baby, or a small baby. By carefully following your personal healthcare provider’s recommended treatment, you should be able to avoid the pregnancy problems that can be caused by asthma.
See your asthma provider as soon as you know you are pregnant in case any changes need to be made to your medicines. Be sure to keep taking your asthma medicines as recommended by your asthma provider and have regular asthma checkups during your pregnancy. You may need changes in your asthma medicines to keep your lungs working well enough so that the baby gets the oxygen that it needs. Make sure that you talk to your personal healthcare provider about how you should treat an asthma attack while you are pregnant. Take only medicines that have been prescribed by your personal healthcare provider. If you have concerns about your medicines, talk with your personal healthcare provider about which medicines are safe for you and your baby.
How long will the effects last?
Asthma is a chronic condition, even though you might not have any symptoms for decades. It is more common in children than adults. People who had asthma as children often have no symptoms once they become adults. However, the symptoms may come back later in life. Asthma that develops for the first time in mid- or late life usually continues to be a problem for the rest of your life.
How can I take care of myself?
Learn about asthma and its treatment.
Learn to recognize signs and symptoms of an asthma attack. Many people with asthma either don’t recognize their asthma symptoms or don’t realize how quickly their symptoms can get severe. Pay attention to your symptoms and, if your personal healthcare provider recommends it, check your breathing with a peak flow meter. Ask at what peak flow reading you should call your personal healthcare provider.
Work with your personal healthcare provider to develop a written asthma action plan. Following the plan will help you manage your asthma every day. It will help you recognize and handle asthma problems and know when you need to see your personal healthcare provider.
Take your medicines exactly as prescribed. Always have your quick-relief medicine on hand and available. If you are taking a long-term control medicine, be sure to take it every day, just as your personal healthcare provider tells you. This prevents asthma attacks. If you are having wheezing even though you are using your controller medicine, let your personal healthcare provider know. Don’t just stop the medicine. If you are using both quick-relief and long-term control inhalers at the same time, use the quick relief inhaler first. Then wait several minutes before using the control inhaler.
Learn what things can trigger your symptoms and how to stay away from them. For example, you may need to cover your mattress, box springs, and pillows with zippered plastic covers. It may help to stay indoors when the humidity or pollen count is high. Avoid cigarette smoke.
You should also:
See your personal healthcare provider for regular checkups as often as recommended.
Ask your personal healthcare provider if it’s OK for you to take aspirin. Some people with asthma are allergic to aspirin and it causes them to wheeze. Aspirin is more likely to cause problems than other anti-inflammatory medicines, such as ibuprofen or naproxen, but sometimes these medicines can also cause wheezing. Acetaminophen does not cause wheezing.
Get a flu vaccine every October. When a new strain of flu appears, ask your personal healthcare provider if you should get vaccinated against the new strain.
If you often have problems with acid indigestion–a condition called gastroesophageal reflux disease, or GERD–you may have more asthma symptoms, especially at night. When you have GERD, stomach acid flows backward into the throat. The stomach acid irritates the upper airway and causes heartburn. If you have heartburn often, talk to your personal healthcare provider about it. Your personal healthcare provider may prescribe a medicine that reduces the acid in your stomach. This can help relieve GERD and asthma symptoms. You can also prevent or relieve symptoms of GERD by:
· losing weight if you are overweight.
· sleeping with your head elevated at least 4 inches
Asthma can be a life-threatening condition.
· If your medicines are not keeping you breathing comfortably, contact your personal healthcare provider.
· If you are having an asthma attack and you keep having symptoms after using your Ventolin/Salbutimol inhaler, you must get medical care right away. This may mean going to the emergency room or calling 911.
In most cases asthma is a controllable disease and you can live an active life. But it requires understanding your medicines, using them as directed, and working with your personal healthcare provider to find the best treatment plan for you. This plan may change as you get older, move to a different location, or start having other health problems.
Where can I get more information?
Asthma Society of Canada
Call toll-free at: 1-866-767-4050
Public Health Agency of Canada
The Lung Association of Nova Scotia
6331 Lady Hammond Road Suite#200
Halifax, NS B3K 2S2
Phone : 1-902-443-8141
Toll Free in NS : 1-888-566-5864