YOU CAN WIN OVER ASTHMA

SK Jindal

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AKSHAY (14) had been having repeated attacks of breathlessness, bouts of severe cough and wheezing, waking up at night or early morning almost every day. This would happen every year during the change of season. My diagnosis of ‘bronchial asthma’ came as a shock to his mother. I explained that it is a kind of respiratory allergy that commonly starts during childhood. Like any other allergy, asthma is an abnormal reaction to an inhaled environmental antigen. It is different from common cold, usually a viral infection, with symptoms such as cough, fever and nasal congestion.

I told her that asthma is not a stigma and many asthmatics, even sportspersons, have excelled in their careers, proving that this respiratory condition can never be a hindrance in leading a normal life. Akshay was feeling well by the evening, and his mother was much relieved.

Asthma is an allergic disease which is partly hereditary and partly environmental in origin. It is neither auto-immune, nor infectious. It is a chronic respiratory condition that causes inflammation and tightening of the muscles around the small airways in the lungs, leading to narrow air passages. This makes the airways produce extra mucus, causing difficulty in breathing. The symptoms include cough, wheezing, shortness of breath and tightness in the chest.

Asthma is more common in children but can affect individuals of any age. India has an estimated 3.43 crore asthma patients. Every year, 1.98 lakh Indians die of asthma. Over the last few decades, both the incidence and severity of asthma have increased. This can be partly attributed to the increasing levels of air pollution.

Characteristically, asthma can lead to:

• Acute episodes of cough, breathlessness and wheezing, more frequently at night or in the early hours of morning. Sleep is frequently disturbed.
• In more severe forms, the patient may remain symptomatic continuously for several weeks or months.
• Asthma gets worse during the months of seasonal change, generally attributed to the heavy load of pollens and dust in the air, along with changes in environmental temperature and humidity. Almost three out of four patients start with the symptoms following an episode of common cold, or a viral infection of the upper respiratory tract.
• Typically, the patient starts with fever, running nose, sneezing and sore throat, followed by asthma symptoms. Persistence of symptoms for more than a few days or presence of wheezing, chest congestion, heaviness and breathlessness should warrant immediate medical intervention.

Asthma symptoms are sometimes confused with chronic bronchitis due to similarity in nature — cough, often called smoker’s cough, coughing up mucus, wheezing, chest discomfort, etc. A progressive condition, bronchitis is usually seen in the elderly, among smokers, and is continuous, with more of sputum production (for at least three months a year, for two years in a row). On the other hand, asthma is usually reversible and treatable even though it may require regular treatment.

Asthma patients may develop worsening or additional symptoms on exposure to a trigger. Some triggers include dust mites in hot and humid conditions, exposure to smoke from combustion, strong perfumes, air pollution, fur or feathers from pets, fumes and paints. An acute attack can sometimes be serious. Family education and doctor-guided self-management are important.

While there is no cure for this life-long condition, asthma can be effectively controlled with inhaled medications and avoidance of exposure to triggers. Regular cleaning of beddings, pillows and their exposure to sunlight reduce the burden of mites. Educate yourself with asthma-management plans in discussion with your doctor. One must not allow asthma to control one’s life. Live a normal and active life with appropriate disease management.

— The writer is Professor Emeritus, Pulmonology, PGI, Chandigarh