“Don’t fool around with this. Asthma kills. It could kill you.”
Those were the words of my doctor, in reply to my refusal to start a course of oral steroids for my asthma. Quite honestly, I was shocked to hear them. He’s not the type of doctor who will scare you just because scary things MIGHT happen. He was quite serious.
I’ve had asthma my whole life. It wasn’t diagnosed until I was a young adult because my childhood symptoms were not the typical “wheezing” associated with asthma. Instead, every fall and winter, I would begin to cough. At times, it sounded like a dog barking. Five months of bronchitis is no fun!! It even got me kicked out of school for a few days because my coughing became so disruptive, no one could stand it.
If my mom had taken me to a pulmonologist, instead of our back-woods family doctor, we might have discovered the problem earlier and spared me a lot of hacking and coughing.
It’s important for you to note that this article is presented from the perspective of an asthma patient. I am not a doctor – cannot diagnose, treat, or recommend a course of treatment. However, patients often must become educated and advocate for themselves with their doctors. Hopefully this article will prepare you to ask the right questions and get the right answers from your doctor.
Symptoms of asthma include wheezing, coughing, and feeling “tight” – like you can’t take a breath. Some people report that their asthma causes a scratchy throat, hoarse voice, or dizzyness. In a severe asthma attack, the fingernails, lips and toenails can turn grayish or even blue from lack of oxygen. The patient may feel confused or have a hard time coordinating motions, like walking and talking. In a desperate fight for air, their nostrils may flare or their neck and chest suck in – but unfortunately, no air is able to get into the lungs. Some severe attacks can be managed at home using special equipment to deliver medicine straight to the lungs. If an asthmatic doesn’t have access to this, or if treatment does not bring immediate relief, they MUST get to an emergency room. As my doctor implied, this is a life-or-death situation.
The symptoms of asthma can vary from person to person. So can the severity – today, my asthma is usually mild and my symptoms go away (almost) completely from time to time. However, if I am exposed to certain chemicals, smells, or air pollution, it can become severe very quickly. Like mine, some people’s asthma is triggered by something in my environment. There are also people who have exercise-induced asthma. They do just fine until they must exert themselves – in a gym or doing yard work are two common ways for this to turn up. There are also many patients who wheeze a lot of the time. Almost all people with asthma (even very mild asthma) will develop stronger symptoms during times of extreme stress or respiratory illness.
Living well with asthma can be challenging, but it’s certainly possible. You, your doctor, and your family must form a team.
A correct diagnosis is important. There are a few other respiratory illnesses which produce symptoms quite similar to asthma. Therefore, misdiagnosis is possible. In fact, if your asthma does not respond well to beta agonists (the stuff in an inhaler) or to steroids, it’s probably time for a second opinion.
Your doctor will likely start you out with an inhaler that you are supposed to carry everywhere with you. It’s a good idea to get a prescription for two of them, and stash one in your desk drawer at work (or wherever you hang out away from home). Trust me – if you have an attack and don’t have your inhaler, it’s terrifying! Many doctors will prescribe “two puffs every four to six hours” and never tell you what they mean by that. Some asthma warrants inhaler use that often. Other people just need those two puffs if and when they have an attack. Over-using an inhaler can have serious consequences. Patients can become jittery and nervous, and it can even set the heart into arrythmia.
Your doctor will also probably test something called “Peak Flow”. They’ll have you breathe as hard as you can into a small tube-like device called a Peak Flow Meter. A tiny arrow shifts as you breathe. This measures how much capacity your lungs have. It can be used at home to measure the progression of asthma, to test certain substances or environmental conditions, or to help you know when to use your inhaler. Your doctor may also prescribe breathing exercises for you to try at home, followed up by the meter to measure your progress.
If your asthma is chronic and you’re needing that inhaler more often, your doctor may prescribe maintenance medicine for you. There are several excellent drugs on the market. Some come in pill form, others must be inhaled. It’s important to note that what works for one person may not work for another. Side effects and risks can vary from person to person as well. Don’t become discouraged if a drug does not alleviate your symptoms. Call your doctor to discuss the problem.
Another common treatment for more severe asthma is a medical device called a nebulizer. This machine delivers a pre-measured dose of the same kind of medicine that’s found in inhalers. The medicine is turned into a vapor by the machine, and the patient inhales it through a small tube. Nebulizers come in many shapes and sizes, from larger “at-home” units to tiny portable ones that can be carried in a purse or backpack.
Steroids are very effective in treating asthma. Some people need a small dose of steroids on a maintenance basis. Others need a higher dose of them when they experience a flare-up. A few patients may need ongoing steroid treatments, which has many side effects – however, for them, it’s a matter of life and death.
Since asthma is often environmentally caused, it’s worth checking into allergies and airborne irritants. Certain foods are known to cause attacks in susceptible individuals. One ingredient high on the list is sulfites. Dried fruits, salad bars, wine, and juices like lemon and grape all contain sulfites. Canned white tuna may also contain sulfites, even if it’s not on the label. Many people are allergic to pets, dust mites, and even cockroaches! Environmental irritants such as paint, new carpeting, kitchen cupboards, mold, and insect sprays can cause asthma attacks. Cigarette smoke definitely can aggravate asthma – whether you smoke, or are just exposed to it. Air pollution is, of course, a huge concern. You may have heard the weatherman saying that the air quality is “code orange” or even “code red” – that means that the air pollution in your area is high enough that people with respiratory illnesses may be affected. Oh – the cause of my childhood asthma? Wood smoke. We burned wood for heat during the winter, and so did everyone in our neighborhood. My symptoms improved greatly when we moved to a new area where no one burned wood.
Treatment involves more than just medication and managing your allergies! The better you take care of your body, the better your asthma will be. Eating right, getting exercise (even if you have exercise-induced asthma), and getting good-quality sleep are all important, too. Alleviate as much stress as you can from your life. If you have other illnesses or take certain medications, be aware that they can impact your asthma as well. It’s important to have one primary doctor overseeing your total care. This person can coordinate the specialists you see, and ensure that medications you are prescribed will not aggravate your symptoms.
Asthma can indeed kill. Thousands die every year in the United States. However, with proper treatment, patient compliance, and awareness of environmental factors, most people with asthma live full and happy lives.
Reference:
- Foundation for Better Health Care’s Asthma Page
