ASTHMA- SYMPTOMS, DIAGNOSIS, TRIGGERS

WHAT IS ASTHMA?

Asthma is a condition that affects the airways of your lungs, i.e. the tubes that carry air in and out of your lungs. In asthma, the muscles around the airways tighten and become narrow. This makes it difficult to breathe. There is also an inflammation (a swelling), in the lining of your airways, and sometimes, a sticky mucus or phlegm builds up that blocks the airways, making breathing difficult. Often, there is a wheezing sound. In asthma, your airways are thus very sensitive and react to many irritants called triggers, like cigarette smoke, pollen or cold air.

Now if you have asthma or know of anyone who does, the first thing you do is:Don't worry. You are not alone. According to the World Health Organisation (WHO), around 300 million people currently suffer from asthma. It is the most common chronic (long duration) disease among children. The WHO report also states that asthma affects about 25-30 million in India alone. 

While earlier, asthma had a lot of stigma attached to it, today, thanks to more information about the disease and modern medicine, you can live normal, active life despite your asthma. Film stars have asthma, cricketers have asthma, prominent business people have asthma and they have not allowed it to come in the way of their success. So there's no reason why you should let asthma stop you or your loved one from making the most of life.

SYMPTOMS OF ASTHMA 

The usual symptoms of asthma are:

 Tightness in chest: A constricted feeling in the chest, like someone is squeezing or sitting on it.

Shortness of breath: Breathlessness i.e. you can't get enough air in or out of your lungs. Breathing out is especially tough.

Recurrent or persistent Coughing: A cough that doesn't go away. Coughing often occurs at night or after exercise.

 
Wheezing: A whistling sound that's usually heard when breathing out.

Other symptoms:

Disturbed sleep due to coughing at night
 Breathlessness while exercising
Please note: Asthma symptoms vary from person to person. Someone may have all the symptoms while another may have only coughing or wheezing. Do keep a close watch on your symptoms and discuss them with your doctor to help diagnose your condition correctly. And remember that with the proper treatment you can control your asthma symptoms.

How is Asthma Diagnosed? 

If you or your loved one has been diagnosed with asthma, there's absolutely no need to worry. There's no need to panic, or change your job or your city. Olympic athletes have asthma, top cricketers have asthma, actors have asthma, politicians have asthma, but they have not let it interfere with their normal life. 

The key to getting your asthma under control is to understand your triggers, watch out for your symptoms, and to take your medication correctly. But first it must be diagnosed correctly.

In India, many parents do not want to accept that their child has asthma. They would prefer to hear that their child has 'wheezing bronchitis' or 'allergic bronchitis' rather than the word 'asthma'. They go from doctor to doctor thus causing hardship for the child and immense stress for themselves, when in actuality if asthma is detected early and treated on time, their child could lead a normal life, faster. Children should be children and an asthmatic child if treated properly can do everything a normal child does - from going to school regularly, playing sports and yes, even eating ice cream!

Asthma is easy to detect but sometimes it is mistaken as a recurrent cough and thus not taken seriously or treated on time or treated with cough syrups. Often, asthma runs in the family. To help your doctor diagnose your asthma or your child's asthma, you will have to answer your doctor's questions as correctly as possible. The questions will be regarding your symptoms, your family history, the medications you are taking, the allergies you have and so on. This is called medical history. Most diagnosis is based on medical history. The doctor will also conduct a physical examination and recommend that you take some tests like the Peak Flow Meter (Breathe-o meter) and Spirometry tests. To know more, read on.


Peak Flow Meter 

A Peak Flow Meter is a simple, affordable, hand held device which helps diagnose breathing problems and asthma in children and adults. 

Just as you have a BP instrument to check blood pressure and the Glucometer for diabetics, the Peak Flow Meter is like a thermometer for asthma. As a patient, you will have to blow into the mouthpiece of the device, and the reading will be taken to check your lung power. Most doctors have the device in their clinic but it is also available at most leading chemists if you want to keep your asthma in check.

If you have asthma and are checking your lung power with the Peak Flow Meter , and you notice a drop in the reading, it means that your asthma is not well controlled and you are likely to get an attack in the near future or within days. This is like an early warning signal to increase the dosage or the number of times you should take your medication. When the Peak Flow Meter reading is normal, it suggests that your asthma is under control.


Spirometry Test

A Spirometry Test is a more sensitive and sophisticated test which detects the signs of asthma early. The Spirometer is used to measure how much air your lungs can hold and how efficiently the air moves into and out of your lungs. In other words, it gives a good indication of your lung power and gives you accurate details about your breathing capacity. The lab or the doctor conducting the test will give you a printed graph of your reading, just as you get a graph when you do your ECG test.

Both the Peak Flow Meter (Breathe-o meter) and Spirometry tests are used to diagnose asthma and also help you measure your progress when your asthma is under control.

However, since these tests are not recommended for children below six years of age, you as a parent have to work together with your pediatrician, to make sure that your child's asthma is diagnosed early and correctly, by paying close attention to your family history and triggers. You will also be required to visit your doctor regularly so that together you can monitor your child's progress.

TRIGGERS OF ASTHMA.

A trigger is anything that irritates the airways of the lungs and causes the symptoms of asthma. Everyone's asthma is different and it is likely that there will be more than one trigger that causes your asthma. Your trigger could be anything from dust mites and pets to pollution and pollen. It is important that you know your triggers and then do your best to avoid them. Because asthma can be controlled and you can live a normal life. 

It may be difficult to identify your particular trigger but sometimes the clues are obvious. For eg: when your symptoms start within minutes of coming in contact with a cat or dog or bird. Or when your symptoms start when the air is polluted with the smoke of fireworks. You could possibly be allergic to something in the air which irritates your airways and brings about the attack.

The most common risk factors for developing asthma is environmental exposure to inhaled substances and particles that may cause allergic reactions or irritate the airways like house dust mites, tobacco smoke, chemical irritants in the workplace (in industries like coal, cement, paint, asbestos, mining, sugar, pesticides to name a few), air pollution and outdoor allergens like pollens. The risk is also high for those who live in congested areas, are exposed to damp walls, and the fumes of wood fire cooking.

Here are some common triggers and helpful tips to avoid an asthma attack.

House dust mites Pets Smoking and air pollutants Your occupation/ workplace Colds and viruses Emotions Exercise Food Hormones Medicines Molds, fungus and pollen Weather Mosquito coils, room fresheners, cleaning products

	House dust mites: Dust mites are the most common trigger. They are tiny creatures that live and thrive in dust in carpets, mattresses, sofas, curtains, and yes, even in soft toys. Helpful tips: Avoid carpets if you can and get someone to vacuum regularly. If you have asthma, get someone else to do the cleaning or get it done when you are not home. If your child has asthma, get the house cleaned when they are at school. Remove all soft toys from beds. Wash soft toys and dry them in the sun every 2 weeks.
	Pets:  Pets are a common trigger of asthma symptoms. Their fur, feathers, saliva, flakes of skin, or urine can cause asthma symptoms. Helpful tips: Avoid keeping furry and feathered pets. Keep them away from your main living and sleeping areas. If you must keep a pet, keep fish instead.
	Smoking and air pollutants:  Most of the time, we breathe in polluted air that can trigger asthma symptoms. Cigarette smoke, fumes from car exhausts, smoke from fireworks, smoke from wood fire cooking...contain lots of different particles that could irritate the airways. Helpful tips: If you have asthma, stop smoking. It is injurious to your health. Politely request smokers to stop smoking since even passive smoking is not good for you. If your family members smoke, request them to smoke outdoors, since cigarette smoke gets trapped and lingers in the curtains, carpets and upholstery for a long time. Avoid travelling during peak hours when pollution is at its highest.
	Your occupation/workplace:  Your job or your place of work could sometimes be a trigger. People working in the jewellery business, the printing, pesticide , quarries, painting and plastic industries, chefs and bakers, solderers and metal platers, foam workers and spray painters, hair dressers and carpenters, are known to be more prone to asthma. Perhaps, it is the smell of certain chemicals or the particulate matter that could be the cause of irritation in the lungs. Helpful tips: Take appropriate precautions, take your Controller correctly and regularly, and of course see your Doctor who is in the best position to advise you.
	Colds and viruses:  Colds and viral infections are very common triggers of asthma. Since everybody at some time or the other suffers from a cold, these are impossible to completely avoid. Helpful tips: Eat healthy, stay fit. Wash your hands as often as possible. Avoid touching your face with your fingers.
	Emotions:  Strong emotions, stress or even laughing too much can trigger asthma symptoms. Helpful tips: Take care of your stress and have a balanced attitude to life.
	Exercise:  Exercise is good for everyone including those with asthma. But some people get more breathless than others during or after exercising. If your asthma is under control, you should have no problem exercising. However if the symptoms get worse, please consult your doctor. Helpful tips: The best exercises for asthma are yoga, and sports like swimming, hockey, cricket, football, since they do not involve continuous running and allow you to have breaks in between. Consult your family doctor before you exercise or join a gym. Tell your gym instructor, or the sports coach in school about your asthma and tell them aboutyour Reliever or Rescuer medicines.
	Food: Most people with asthma do not have to follow a strict diet but some people could be allergic to nuts, eggs, fish, cow's milk, shell fish, yeast products, some food colourings and preservatives, wines, fizzy drinks, processed foods. Click here to see how parents have no fear that asthma might harm their children Helpful tips: Avoid foods with preservatives and packaged artificial foods. Also check if your allergens are nuts, eggs, cow's milk, shell fish and yeast products. Do read the fine print on packaged foods carefully. Check with your doctor about doing an Allergy Test.
	Hormones:  Yes, hormones can be an asthma trigger, particularly in women. Some may experience asthma symptoms during puberty, before their periods, during pregnancy, and during menopause. Helpful tips: Consult your doctor, if you feel that hormones could trigger your symptoms.
	Medicines:  Some medicines may trigger symptoms. These include medicines for flu, heart problems, glaucoma to name a few. Helpful tips: Consult your doctor and always tell him the medication you are on.
	Molds, fungus and pollen:  Flowering plants which release pollen can trigger symptoms. You should also watch out for fungus on damp walls, damp clothes, wet bathrooms and piles of rotting leaves in the garden. Helpful tips: Keep your home well ventilated. Make sure your walls at home are not damp.
	Weather:  A sudden change in temperature, windy days, hot humid days are also known to act as triggers for some. Helpful tips: Try to avoid going for early morning walks when foggy. Wear a scarf over your face when it's windy. Avoid going in and out of areas that have extreme temperatures ...from an air conditioned room to hot humid conditions outside.
	Mosquito coils, room fresheners, cleaning products: The chemicals in these products could be triggers for some people. In fact, in an independent research conducted by the Chest Research Foundation, Pune, India, burning one mosquito repellent exposes you to particulate matter air pollutants equal to 75 to 137 cigarettes! Helpful tips: Install wire mesh mosquito nets in your windows to keep mosquitoes away. Avoid strong smelling cleaning products and keep your rooms well ventilated rather than using artificial room fresheners.

Please note: There is wisdom in the old saying, 'Prevention is better.'. If you have asthma, it is best to keep a close watch on your triggers and avoid them.Always consult your doctor about any doubts you may have about your triggers, your symptoms and treatment.