Chances are if you do not have asthma you probably know someone who does. In New Zealand asthma is a prevalent health condition affecting both children and adults. Some children grow out of asthma by their teens, although it may return later, while a third of adults who have asthma did not have it as a child.
Asthma is a serious and potentially life threatening lung disease. Most people who develop asthma will always have asthma. The actual cause of this disease is uncertain. What is known is that people who have asthma have sensitive airways in their lungs, which react to ‘environmental triggers’ that do not affect other people. These triggers cause their airways to tighten, swell up and produce mucus. These reactions cause the airways to narrow and this is the reason that the typical symptoms of asthma include coughing, wheezing, chest tightness and shortness of breath. Over time people who have asthma learn to identify their triggers and try to avoid or lessen their exposure to them. Common triggers include cigarette smoke, colds and the flu, perfume, cats and other furry animals, weather changes, dust mites that are found in all homes, strong emotions, physical activity and some medications including Aspirin and non steroidal anti-inflammatory preparations including Voltaren, Mefenamic Acid and Nurofen.
Asthma has the potential to control peoples lives by restricting their activity, waking them at night, increasing the number of visits they need to make to their medical centre or to the emergency department and occasionally making them critically ill. The good news is that it doesn’t have to be this way. By the avoidance of triggers, the use of asthma medication (a preventer and when necessary a reliever) and regular contact with your doctor and asthma nurse you will be able to control your asthma and become symptom free most of the time. This means that people with asthma will be able to participate in all levels of physical activity.
Medications are prescribed to help control the symptoms of asthma because at this stage it is not possible to provide a cure. If a person has asthma it means that their airways are inflamed all of the time, not just when they experience symptoms.
Preventers, including Flixotide, Beclazone and Pulmicort. These inhalers help to reduce the inflammation in the airways. This is very important because if you are able to reduce the amount of inflammation it will help to lessen the risk of an asthma attack. It is important to remember that peventer medication works slowly. It will take from two weeks to three months for a person prescribed this medication to notice a difference. Preventer medication needs to be taken everyday, usually morning and night. It is not to be used in an emergency.
Relievers including Salamol, Ventolin and Bricanyl. These inhalers are also called short acting relievers and they help to relax a person’s airways, making it easier for them to breathe. Relievers are the types of inhalers that a person with asthma always needs to have with them because these inhalers are necessary to treat an asthma attack.
Symptom controllers are long acting relievers including Foradil, Oxis and Serevent. These inhalers help to relax the airways for twelve hours at a time. This type of inhaler is for people who despite the regular use of a preventer still wake at night or have to limit their physical activity because of asthma. Symptom controllers should not be used for emergency use because they take too long to work.
Combination inhalers including Seretide and Symbicort contain a preventer and a symptom controller, they need to be taken every day, usually morning and night and they should not be used in a emergency situation.
It is recommended that you review your asthma with a doctor at least twice a year, more frequently if you still experience symptoms despite using your asthma medication as prescribed.
Other things that people with asthma can do to help control their symptoms include monitoring their peak flow readings, using a spacer and working with your doctor to devise an asthma management plan.
Peak flow meters are available free of charge at the Student Health Service (SHS) and they are used to see how fast you can blow air out of your lungs. When a person’s airways are swollen their peak flow reading will be lower than when they are not. After a person is diagnosed with asthma it is recommended that once their symptoms settle down that they check and record their peak flow readings morning and night for two weeks. Readings need to be checked before the person takes their asthma medication. This information is extremely helpful as it can assist the doctor to either increase or decrease the amount of medication required. Once peak flow readings are steady and the person feels well they do not need to use their meter everyday. However, people with asthma should take readings if they have a respiratory infection, they do not feel as well as usual, they have had a recent asthma attack, their medication has been changed or they have been exposed to one of their triggers.
Spacers are also available free of charge at the SHS. Spacers are clear plastic tubes, which are used with meter dose inhalers. Research has shown the when people use their inhaler with a spacer they are able to get 50% more medication into their lungs where the medication is needed compared to people who do not use a spacer.
Spacers are potentially a life saving device as they have been shown to be as effective as nebulisers when caring for people with acute asthma. If you have asthma and use a reliever such as Salamol or Ventolin you should have a spacer. The other great thing about them is that they are portable and they do not require electricity to work. The doctor will also be able to work with you to produce an asthma management plan. Doing this will enable you to work out ways to reduce the frequency and severity of symptoms you may experience and will provide you with information about how to control your asthma if your symptoms worsen.
A key message for students who have asthma is if you need to use your blue reliever inhaler more than three to four times a week, or if symptoms of asthma are causing you to wake during the night, or limiting the things you need to do, like walking up the hill from the city to the Kelburn campus it means that your asthma is not under control. The doctors and nurses at the SHS are eager to work with you to help you control your asthma and reduce the impact this disease has on your life.