Asthma

There are more than 25 Million individuals in the United States diagnosed with asthma, 7 Million of which are children.  Asthma is a chronic disease that affects the lungs.  Specifically, it affects the airways, called bronchial tubes, in the lungs.  When triggered, the bronchial airways become inflammed causing them to narrow.  This means that not enough air is allowed into the lungs.  Mucous may also be secreted into the airways which further impairs airflow into the lungs.  These occur due to what is called airway hyper-responsiveness which is basically when the bronchial tubes "overreact" to triggers.  Triggers may be such things as:

• Allergies
• Exercise
• Irritants (chemicals, smoke)
• Respiratory infections
• Medications
• Gastroesophageal Reflux Disease (GERD)
• Cold air
• Sulfites and preservatives (Mayo Clinic, n.d.).

Signs and symptoms of asthma include:

• Shortness of breath
• Chest tightness
• Coughing  
• Wheezing.  

Individuals will have these symptoms in varying degrees.  For some, it may be minor, others serious, and in some cases, it may be fatal.  In 2013, 3,630 people in the United States died due to asthma (Xu, 2016).  This figure was essentially the same in 2015 with 3,615 deaths due to Asthma (AAFA, 2020).  Ways to know your asthma is worsening include signs and symptoms occurring more frequently, breathing becoming more difficult, or relief inhaler needed more often.

There are several risk factors that predispose individuals to asthma. 

• Having a blood relative with asthma, 
• being overweight, 
• smoking, 
• being around secondhand smoke and 
• being exposed to pollution or chemicals (Mayo Clinic, n.d.).  

Asthma, Eczema and Allergic Rhinitis make up what is called the Allergic Triad.  Having one of these conditions increases the chances of having the other two.  Chronic inflammation is the basis of all three conditions.

In order to diagnose asthma, other conditions should be ruled out through a physical exam.  Tests should also be done to check lung function.  Spirometry checks for the amount of bronchial tube narrowing by looking at how much air can be exhaled and how fast it can be exhaled after a deep breath.  Peak Flow meters measure how hard someone can exhale.  Other tests include Metacholine challenge, Nitric Oxide test, chest x-ray, allergy testing and sputum eosinophils test (Mayo Clinic, n.d.).

When determining how severe an individuals asthma is, a classification system is used.  Mild Intermittent refers to mild symptoms up to two days per week and up to two nights per month.  Mild Persistent refers to symptoms more than two days per week, but no more than once per day.  Moderate Persistent refers to symptoms once a day and more than one night a week.  Severe Persistent refers to symptoms throughout most of the day and frequently at night (Mayo Clinic, n.d.).

There are medications and treatments available.  When an individual is having acute difficulty breathing, what is referred to as rescue medications are needed.  Long term medications are used to control asthma symptoms. 

 Short acting beta agonists include:

• bronchodialators:  inhaler that rapidly relieve asthma symptoms.
• Ipratropium 

Long Term Medications include:

• Inhaled Corticosteriods, 
• Leukotriene modifiers, 
• Long acting Beta Agonists and 
• Theophylline
• Oral or IV corticosteroids: can relieve inflammation in cases of severe asthma, but are only used for a short term.  

 Other treatments:

• Bronchial thermoplasty is a treatment that heats the airways with an electrode.  This treatment is not used often and is usually done with severe asthma that generally has not improved with inhaled corticosteroids and long term medications.  

Asthma action plans are usually written based on what treatments are being used.  These outlines which medications to take, when to take them and when to increase or decrease the amount of medication.  What the individual's triggers are should also be listed and how to avoid them (Mayo Clinic, n.d).

There are lifestyle changes individuals can make to help alleviate asthma symptoms including:

• Using air conditioners, 
• Minimizing dust, 
• Dehumidifiers, 
• Preventing mold spores, 
• Decreasing pet dander and 
• Cleaning regularly can all help keep asthma to a minimum.

Watch Youtube video below. 

https://www.youtube.com/watch?v=_SZVAj_2-4k&t=12s

UPDATED MAY 18, 2020


AAFA. (2020) Asthma Capitals 2019: Asthma-Related Mortality.  Asthma and Allergy Foundation of America.  Retrieved from https://www.aafa.org/asthma-capitals-asthma-related-mortality/.

Mayo Clinic.  (n.d.) Asthma.  Mayo Clinic.  Retrieved from http://www.mayoclinic.org/diseases-conditions/asthma/basics/definition/con-20026992

Wheeler, S.  (2009)  The Allergic Triad: Asthma, Eczema and Allergic Rhinitis.  The Orchard and Pea Patch Preschool's Blog.  Retrieved from https://theorchardandpeapatchpreschools.wordpress.com/2009/12/15/the-allergic-triad-asthma-eczema-and-allergic-rhinitis/

Xu, J.  (2016)  Deaths:Final Data for 2013.  CDC.  Retrieved from https://www/cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf