Breathe easy: It’s manageable

Dr Ashok Mahashur

Asthma is a chronic, non-communicable disease with no cure. Common among children and elderly people, nearly 3, 83,000 people in 2015 died because of this problem. 

According to WHO estimates, India has one of the largest numbers of deaths due to chronic respiratory diseases in the world, coming second after China. Asthma is a major public health concern in India, which has nearly 15 to 20 million asthmatics. 

While it affects people all over the globe, it tends to claim more victims in the lower-income countries, mainly because lower-income countries do not have human resources, trained in coping mechanisms and prevention strategies required to effectively manage asthma attacks. 

Asthma, genetic or environmentally induced, has multiple causes, ranging from exercise-induced asthma, occupational asthma (workplace irritants such as chemical fumes and gases) and allergy-induced asthma (airborne substances like pollen, mould spores, cockroach waste and pet dander). Air pollution, especially particulate matter is the most common cause for asthma. It consists of solid and liquid particles suspended in air that penetrate into the gas exchange regions of the lung (alveolus). In addition to this, tiny particles may pass through the lungs to affect other organs.

 If any of these foreign particles are inhaled, the airways begin to constrict. This is the body’s natural response to the entry of any unwanted irritant or foreign body. This is done in an effort to prevent the foreign particles from gaining further entry into the respiratory system. However, the constriction of airways leads to the onset of an asthma attack. 

When an attack occurs, the lining of the bronchial tubes swells up. This causes the airways to narrow, which leads to a reduced flow of oxygen in and out of the lungs. This leads to a complete shutdown of oxygen circulation in the system. The person begins to gasp for air and his breathing becomes extremely heavy. Psychologically at this point, s/he begins to panic. This causes them to expend more energy in gulping for air as a result of which their system weakens and they may lose consciousness. The heart begins to beat faster; the muscles begin to tense up and one feels their chest tightening. A terrifying experience, an asthma attack can last for a few minutes to several hours. The only way to control such a situation is to ensure immediate medical intervention. 

Regular screening of the lungs can ensure that asthma is diagnosed at an early stage. However, it is important to keep monitoring oneself post the diagnosis. This is imperative for two reasons. The first is to ensure that there are no other infections affecting the lungs, such as chronic obstructive pulmonary disease. The second is to ensure that a person’s lung capacity remains the same and doesn’t worsen. 

Symptoms range from mildly intermittent to severely persistent. When symptoms occur multiple times in a short span of time, causing discomfort while doing simple activities like sleeping, walking or even sitting, it is time to visit the doctor. 

Asthma is a difficult condition to live with. While it can hamper one’s quality of life and affect one’s productivity, it is also one of the few conditions which can be managed effectively. Therefore, one should not lose hope. Rather be grateful that they can still lead a normal life. Their disease does not encompass them; it is just a smaller part of them that can be handled. 

— The writer is senior chest consultant, Hinduja Hospital, Mumbai 

Dealing with it

There are a few coping mechanisms and strategies that can be adopted to check or handle asthma attack. 

• Controlling the moisture in one’s home.
• Wearing masks while venturing out whenever air pollution is high, to control aggravation of asthma.
• Having necessary appliances such as furnaces, heat pumps and central air to remove excess particulate matter.
• Controlling the dust in the house by keeping the carpets, mattresses, cushions, pillows and bedding clean. 
•  Ideally, chronic asthma patients should keep a safe distance from pets. Care should be taken to ensure they are cleaned more frequently; homes should be kept as allergen-free as possible.
• Ensuring ventilation by cleaning, painting, installing new carpets and furniture which does not collect dust.
• Ensuring that there is no gasoline, solvents, or other volatile hazardous chemicals stored inside the house or garage. Other psychological prevention strategies which can be adopted to prevent asthma due to stress 
• Take regular breaks and pace yourself between activities so that symptoms do not get worse.
• Talk to others and build a support system.
• Making a daily list of tasks which can prevent an asthmatic patient from feeling overwhelmed and panicked (this anxiousness could lead to an attack).
• Doing breathing exercises and using herbal remedies which can actively supplement the treatment process.