Asthma Why We should Take it seriously
even ‘mild’ asthma can suddenly turn nasty. Make sure you know what to do
This chronic lung disease affects around one in 11 children and adults, and costs the NHS a billion pounds each year. But although many think their asthma control is ‘good enough’, two out of three daily deaths are preventable. Unfortunately, a recent national review showed that sufferers and even health professionals don’t always react quickly enough.
Asthma produces inflammation, mucus and narrowing/tightening in tiny airways. This can happen suddenly or be triggered by viruses, moulds, allergies to house dust, animals, or pollen, cold or damp air, exertion, cigarettes, emotions, foods, additives, pollution and many other irritants. It can also run in families, and improve with age, or start in adult life.
Getting the right diagnosis
Asthma symptoms vary between people and from time to time. You may have a persistent cough, or a dry, irritating cough at night, or when you exercise or catch a cold. You may notice wheezing (‘whistling’) when you breathe, feel breathless or that your chest is tight or restricted, cough up phlegm, or have linked symptoms such as sneezing, a blocked nose, and eczema. Symptoms overlap with other lung conditions, so you’ll need tests (see tips box). Asthma is still underdiagnosed and undertreated.
Gaining control
Identifying and avoiding (if possible) your personal triggers can make a big
difference. Not smoking, regular exercise and a healthy diet and weight help, too (see nhs.uk). Try to avoid crowds (infections), and ask about flu and ‘pneumo’ immunisations.
Always carry your ‘reliever’ (usually blue) inhaler. If you have symptoms several times a week, you’ll be offered a ‘preventer’ (usually brown) inhaler containing a small dose of steroids to reduce airway inflammation. Some people also need long-acting reliever inhalers, or tablets, such as montelukast, theophyllines or steroids. Possible new treatments include injections to suppress blood allergy cells and heat-treating sensitive airway muscles (bronchial thermoplasty).
Using your inhaler
Make sure you get the best device for you, that you know exactly how and when to use it, and what to do if it’s not effective. Asthma UK has demonstration videos at asthma.org.uk. Stopping treatment if you’re worried about side effects, or you’re feeling better, can be dangerous – discuss changing or stepping it down with your doctor. You also need regular medical reviews and specialist referral if symptoms can’t be controlled. NICE (the National Institute for Health and Care Excellence) is about to publish new guidelines.
Need urgent help?
Learn how to monitor your condition, recognise trouble, and take early action. You should have a personal action plan which may include pre-agreed treatment adjustments, phoning your GP surgery for advice, or even calling 999. Life-threatening attacks can develop rapidly without warning. You’re more at risk if your asthma is poorly controlled (that is, you have continuing symptoms, reduced peak-flow readings and/or find yourself needing extra treatment). Danger signs include your reliever inhaler not working or lasting four hours, not being able to speak a full sentence or walk, looking pale, feeling faint, blue lips and/or chest pain – call 999 as you’ll need oxygen and other emergency treatments.