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Friday, July 11, 2014

Doc Talk: What asthma means for those who have it


Asthma is a term we commonly hear, but what does it really mean for the person who has it?

More than 24 million people in the United States have asthma. That number has climbed by 40 percent in the past decade. Each year there are 5,000 deaths caused by asthma, and a black, non-Hispanic person is twice as likely to die of asthma than a white person.

This disease is caused by heredity and the environment. It results in inflammation of the airways in the lung, called bronchi, which swell and fill up with mucus. As a result, the amount of oxygen getting to the lung tissue is decreased.

In the lung are tiny grapelike clusters called alveoli, which help get oxygen into the bloodstream. During an asthma attack, many of them are blocked by mucus and become useless. The alveoli can collapse, preventing oxygen from getting to the tissues of the body. The resulting low oxygen level affects many body functions.

Symptoms of asthma include a tight feeling in the chest, shortness of breath, labored breathing, persistent coughing, nighttime coughing and getting easily winded during exercise. These symptoms may commonly be triggered by allergies, cigarette smoke, smoke from a wood-burning stove, paint fumes, viruses, cold air, dust, cockroaches, animal dander and pollen.

Fortunately, there are medications that can reverse and control asthma attacks. Albuterol, which is inhaled into the lungs, is a "rescue" medication that helps dilate the swollen airways, making breathing easier.

Prednisone or a steroid taken orally helps decrease the inflammation and swelling. It's usually given for a period of three to five days, sometimes longer.

If the person requires oxygen or is in distress, he might be admitted to the hospital for more intensive care. This can include administration of oxygen and the use of other medications such as magnesium sulfate given intravenously or the use of heliox (helium and oxygen) for breathing. Once the distress has resolved and the person is recovering, inhaled steroids can be used to maintain the airways in a non-inflamed condition. Inhaled steroids are given on a daily basis, sometimes continuously, and are referred to as controllers because they help control the disease.

For individuals who are diagnosed with asthma, the health care provider can provide an Asthma Action Plan, which details what symptoms to be aware of and what to do when they occur.

If a person has symptoms of asthma, it is important to seek medical care. Uncontrolled asthma can in time cause permanent remodeling of the bronchi and lead to a decrease in lung function.

Asthma can be a serious disease with lifelong effects.

Doc Talk is a column about health issues written by Wichita-area physicians. This column was written by Rhonda Jeffries, pediatric hospitalist at Wesley Medical Center and University of Kansas School of Medicine-Wichita.

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