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What is Asthma?
ASTHMA is a chronic disorder of
the respiratory system that involves inflammation and
constriction of the airways. These factors cause recurring
episodes of wheezing, breathlessness, chest tightness, and
cough, especially at night and in the early morning. The
episodes sometimes pass on their own but often require
treatment with medication. A detailed medical history,
physical exam, and possibly additional medical testing
will allow a accurate diagnosis to be made. Proper clinical judgment is critical in the assessment of
asthma primarily due to the wide variety of signs and
symptoms seen from patient to patient and even within the
same patient over time.
What are some common signs and symptoms of Asthma?
ASTHMA should be considered as a possibility if there are any of the following indicators:
-History of cough especially if worse at night, recurrent wheeze or chest tightness.
-Colds often "go to your chest" and last for ten or more days.
-There is a reversible airflow limitation with diurnal (time of day) variations (Basically this means that breathing is easier in the afternoon after using an inhaler (such as albuterol) when compared to morning before using an inhaler.
-Symptoms begin or get worse with: seasonal changes, respiratory infections, exertion or exercise, excitement or anger, weather or temperature changes, contact with animals, smoke, molds, dust mites, chemicals, taking some drugs such as aspirin or beta blockers for blood pressure.
-There are other factors that may help a physician to make a diagnosis of asthma such as: family history of asthma or allergies, changes in the shape of the chest or hunching of the shoulders, sputum production, increased nasal secretions or nasal polyps, other allergies, and skin conditions such as eczema.
Note: Pulmonary function testing known at spirometry (not just peak flow testing) will help to confirm a suspected diagnosis of asthma. Many physicians that care for asthma patient are able to do spirometry testing right in their offices.
Asthma Statistics in the U.S.
ASTHMA is one of the most common chronic medical conditions in the United
States affecting at least 1 in 14 people.
ASTHMA therefore affects about 15 million Americans.
ASTHMA results in over 35,000 U.S. residents to miss school and work every day.
ASTHMA is responsible for about 1.5 million emergency room visits and
close to 500,000 hospital admissions.
ASTHMA affects children and blacks more than the rest of the population.
ASTHMA has been increasing in incidence over the last 20 years,
especially among children.
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Types (Classification) of Asthma
The classification of asthma is important because the treatment plan will vary based on the correct classification. Asthma is classified as: exercise induced, mild intermittent, or persistent. Persistent asthma is further classified as mild persistent, moderate persistent, or severe persistent.
Asthma Care not Asthma Cure
In 1991 the National Institutes of Health (NIH) first released their expert guidelines for asthma care. Few physicians properly follow these guidelines (or their updates) in fact even many "asthma specialists" do a less than perfect job of delivering appropriate care to control asthma. In a family care setting the situation usually becomes even worse. This might be due to a number of factors, the physician: may not know the guidelines, may not understand the guidelines or may feel the guidelines do not apply to their patients.
Appropriate asthma management involves a number of components primarily: preventing/controlling airway inflammation and preventing/controlling airway constriction. Historically only the second component was considered but since 1991 it has been well documented that controlling the inflammation is equally important in slowing the progression of the disease. In fact, the idea of asthma causing progressive changes to the lungs (airway remodeling) is foreign to many physicians.
Although short acting inhalers such as albuterol are needed by all levels of asthma patients for occasional symptomatic relief, patients that are only being treated with an albuterol inhaler probably are not receiving adequate therapy, an exception to this might be exercise induced asthma that often can be controlled with a short acting inhaler. The concept of "no wheeze means no disease" needs to be discarded once and for all! There are a variety of medications that can be used in many combinations for asthma control. A physician properly following the guidelines will be able to correctly identify the appropriate combination of asthma medications for you or your family member. Medications may need to be both increased and decreased over time to maximize asthma control and minimize side effects. Drug therapy for asthma is definitely not 'one size fits all' in fact it needs to be very specifically tailored to your specific condition at any given time. There may not be just one correct therapy choice for you but on the other hand there are certainly a lot of wrong choices that your health care provider can make. Learn as much as you can about what is currently considered 'state of the art' asthma care. There are a number of good links listed below to get you started. Knowledge is power!
Every asthmatic should have and know how to properly use a peak flow meter. Changes in the results when using a peak flow meter can occur many days prior to a patient being able to detect a worsening condition thereby allowing time to adjust the therapy to possibly prevent an exacerbation or attack. One problem that we have seen with peak flow meter training is that you must be standing (unless unable) to properly do the test. A sitting peak flow reading is going to be inaccurate!
You can find detailed information and instructions for correct peak flow meter use here.
Any patient that has ever had a serious asthma attack or is at risk for one also needs to have an oral corticosteroid such as prednisone available and be given instructions based on peak flow meter readings and symptoms as to when to begin taking this medications! This step can greatly reduce the risk of requiring hospitalization for many people and allow then to regain asthma control.
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The following are some of the best sites on the internet that
relate to asthma.
Asthma sites that are professional in
nature.
NHLBI National Heart Lung and Blood Institute lung disease information.
American Academy of Allergy, Asthma & Immunology "A driving force in the study and treatment of allergic diseases through education, research and cooperation since 1943."
Asthma in America Results of a survey funded by Glaxo Wellcome plus other resources.
Asthma sites that are patient oriented.
American Lung Association A great site with lots of information on asthma and other lung diseases.
MEDLINEplus: Asthma This site has very little content of its own but does provide links to over 50 of the finest asthma sites on the internet covering every aspect of the disease.
Lung Sounds This site has audio clips of various lung sounds both normal and abnormal. The clips are in both Real Audio and Windows Media Player formats.
Asthma Info- American Academy of Family Physicians Good site with lots of information for the whole family.
Asthma and Allergy Foundation of America An excellent site dedicated to "improving the quality of life for people with asthma and allergies through education, advocacy and research."
Mothers of Asthmatics- Allergy and Asthma Network "To eliminate suffering and death due to asthma and allergies through education, advocacy, community outreach, and research."
Related articles written by one of our team members (Martin Rossi)
We are excited to announce that in early 2007 this page will be expanding and moving to a new separate website dedicated specifically to appropriate asthma care for maximum asthma control. The team will be adding lots of information related to all aspects of state of the art asthma care including the newest drug therapies. Our goal is to enable you to become proactive in your treatment because you are a critical partner in your asthma control team!
For up to the minute news and information
from around the world about asthma from NewsNow
Visit Here
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Although as accurate as possible, the information on this page or provided to you by email from us, may not relate to your particular medical condition and is not intended to be used in the diagnosis or treatment of any medical condition. Always refer to your healthcare provider before making any changes in your treatment plan. In addition any sites to which we link may or may not contain information appropriate to your medical condition.
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