As I write this article, I am toasting by our fireplace after grabbing some wood from outside where the temperature is a brisk 29 degrees. The colder fall temperatures have rolled into East Tennessee like a freight train and winter feels close on its heels. I don’t mind it a bit, but for those with asthma, it carries a level of threat. With the colder weather and more time spent indoors being exposed to other sick folks, comes an increase in colds and flu. Those are no fun, but when a person has asthma those infections can trigger a more serious response with wheezing, coughing and shortness of breath. For that matter, even the wood smoke from my fire would be a problem for some.
Asthma is a common chronic airway disease characterized by periods of reversible airflow obstruction (asthma attacks). Airflow is obstructed by inflammation and swelling in the airways along with contraction of the small muscles surrounding the airways that causes them to constrict.
There are a host of possible triggers for asthma attacks. Sixty percent of asthma has an allergy trigger. Other exposures include exercise, viral infections, pollutants (especially cigarette smoke), emotional stress, exposure to cold, sinusitis, gastroesophageal reflux (GERD), and aspirin and other medication sensitivities.
Asthma affects 5-10% of the population or an estimated 25 million persons, including 7 million children. Fortunately about half of all children diagnosed with asthma have a decrease or disappearance of symptoms by early adulthood. There are approximately a half million hospitalizations yearly from asthma and it is the number one chronic cause of missed school days. Unfortunately, the incidence of asthma has been steadily increasing in the U.S. over the last decade for reasons which are not clear. Despite this, the death rate from asthma has been declining, though slowly, with about 3300 deaths per year currently.
There are certainly a ton of treatments available for asthma. The key is to not let the readily available treatments lull you into not taking asthma as seriously or responding to it as promptly as we should. The earlier you jump on an asthma flare-up the better.
What kind of treatments are we talking about?
• Treating the triggers such as underlying sinus infections
• Aggressively treating allergy, possibly with allergy shots (immunotherapy)
• Using maintenance asthma meds daily (if needed) to keep the need for rescue inhaler use down to no more than two times per week
• Pre-treating with an asthma med prior to exercise if you have exercise-induced asthma
• Not smoking, and avoiding second hand smoke and other inhaled irritants as much as possible
If a flare-up occurs, get in to see your doctor as soon as possible so that you have a plan in place to nip the problem in the bud. This can keep you out of the Emergency Department and hospital. Aggressive treatment can usually allow an asthmatic to participate fully in sports and other exertional activities. Don’t buy into the myth that aggressive treatment will somehow weaken your lungs – it’s quite the opposite. So, if you wrestle with asthma, go after it early and vigorously so you can still enjoy these colder fall and winter months here in East Tennessee.
Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville. Contact him at 982-0835