Frequently asked questions about asthma - what is it, how is it treated and how to prevent it.
What is Asthma?
For air to get deep into the lungs, it needs to travel through a series of branching tubes, or airways. In asthma, these airways become oversensitive and react to things that would normally cause no problem, such as cold air, secondhand cigarette smoke or dust. The muscle around the wall of the airways tightens up, making them narrow. The lining of the airways gets swollen (like your nose during a cold) and thick mucus is produced, clogging up the airways. The narrowing makes it difficult for air to move in and out, and this is why the chest has to work so hard.
Tightening of the muscle around the airways can happen quickly – the most common cause of mild asthma. This can be relieved quickly with the right inhaler. The swelling and mucus happen more slowly and need different treatment. These take longer to clear and are a particular problem in serious episodes of asthma.
How likely is it to affect me?
One in six New Zealanders has asthma. It can start at any age, but it most often begins in childhood. As many as a quarter of all children will wheeze at some time.
Conditions like hayfever, eczema or hives, which are usually the result of allergy, may occur along with asthma. Having these makes it more likely that you might get asthma too. Asthma can affect anyone, but if other family members have it, you are more likely to get it yourself.
These complaints may occur in episodes, perhaps brought on by colds, exercise, change of temperature, dust or other irritants in the air, or by an allergy (eg. Mould in damp houses, pollen or animals). Episodes at night are common, and a few people have them all the time.
Do I have Asthma?
Usual complaints of someone with asthma include:
- Difficulty breathing
- A tight feeling in the chest
- Wheezing (a whistling noise in the chest)
- Cough – especially at night or in the morning
You need to see your doctor to check there is no other explanation. By examining your chest, doing breathing tests and listening to your description,your doctor can usually decide if you have asthma and can prescribe suitable treatment. Diagnosis can be uncertain in some people, so you may have to accept your doctor cannot always be definite.
How can I monitor my asthma?
You can measure how open or narrow your airways are using a small device that you blow into, called a “peak flow metre”. The measurement, when used with an Asthma Self Management Plan from your doctor, can guide you in treating yourself and help you decide when to get help.
Isn’t it all in the mind?
No, asthma is caused by physical changes and requires treatment as a physical condition. Many people, however, find their asthma is worse if they are worried, anxious or under stress.
What can be done to help?
We do not yet know how to cure asthma but we can usually control it. The aims of treatment are to:
- Make the lungs and airways as normal as possible
- Stay free of symptoms
- Have as little interruption to ordinary life as possible.
To keep your asthma under control
- Get an Asthma Self Management Plan or Child Asthma Plan from your doctor – so you will always know what to do if your asthma worsens or changes.
- Avoid tobacco and smokey places
- Keep fit
- Use a peak flow meter or a Symptom Diary
- Take inhalers/medicines as agreed with your doctor – the preventer medication is especially important
- If you use a metered dose-type inhaler (MDI) using a “spacer is recommended to help more medication reach your lungs – especially important with your preventer and during an acute attack.
With good medical advice and a motivated patient, these aims can mostly be reached. It is exceptional for asthma not to be able to be kept under good control.
Some common sense things you can do are keeping fit, not smoking, trying to avoid things that trigger your asthma and using your medication correctly.
To prevent or reduce asthma episodes may require regular treatment. The medicine used soothes the airways, making them less irritable. Preventer medication used regularly (even when you feel well) can make a huge different to the amount of asthma you have. Long acting medications for difficult-to-control symptoms are also available for some patients.
To treat wheezing when it occurs, you can use a reliever medicine, or “bronchodilator”, which relaxes the tight muscle around the airways. The quickest and most convenient way to take it is through an inhaler, taking a puff of it when you need to. Tablets or liquid forms of reliever medicines are also available, but these take longer to work and have more side effects.
If asthma becomes bad despite your usual treatment, something extra will be needed. It may mean increasing your inhalers, taking a course of steroid tablets or maybe having an injected medication. Know what to do, who to call and where to go if your asthma is bad.
Can I manage without taking medicines?
Anyone considering using a complementary therapy should discuss it with their doctor initially. There are some complementary medicines which are potentially harmful for people with asthma. In general, complementary medicines and therapies have not been studied as extensively as conventional medicines. Often little is known about how effective they are, or of any possible harm effects.
If you have asthma, it is important to continue using treatments prescribed by your doctor, while undertaking complementary therapies.
Will it go away or will it get worse?
Many children seem to lose asthma by their teens; however, it may return as they get older. In adults it tends to remain. It is hard to predict for any one person, but asthma is not bound to get worse by any means. However, smoking is very likely to make asthma worse.
Is it dangerous?
For most people asthma is a nuisance only. But some get severe attacks and a few people do die of asthma. Most people with asthma can control their condition well and can be in a good position to avoid/deal with serious attacks if they occur.