Alan Frischer, MD, MPH
Updated: Sep 26, 2021
Breathing is such a natural and innate reflex that most of us don’t give it a second thought. It is, however, a struggle for the 27 million Americans (one-third of whom are children) suffering from asthma.
Every year, asthma causes 1.7 million visits to doctor’s offices, 1.3 million emergency room visits, some 400,000 hospitalizations, and more than 3,500 deaths. The estimated annual cost due to loss of productivity comes to about $56 billion.
Asthma is a life-threatening, incurable, chronic inflammation of the lung airways. An asthma attack starts with a bronchospasm (a tightening of muscles around the airways). The lining of the airways becomes swollen or inflamed and thicker mucous is produced. The bronchospasm, inflammation, and mucous production all lead to wheezing, coughing, and shortness of breath. Other symptoms include rapid breathing, chest tightness or pressure, difficulty talking, feelings of anxiety and panic, a pale and sweaty face, and in severe attacks, blue lips and fingernails from lack of oxygen.
There are many triggers for asthma attacks:
Allergies play a major role. Common allergens include ragweed, pollen, mold, animal dander, and dust mites. 80% of children with asthma also suffer from allergies.
Environmental allergens trigger asthma attacks. They include cigarette and other types of smoke, chemical fumes, strong odors, and extreme weather.
Exercise can induce an asthma attack, even in people who don’t otherwise experience asthma. Those with exercise-induced asthma are likely more sensitive to changes in the temperature and humidity of the air. When at rest, we breathe through our nose, which warms, humidifies, and cleanses the air we inhale. When we exercise, we breathe faster and through our mouths, so that the air that enters our lungs is colder, drier, and not cleansed.
Respiratory infections affect the lungs and may inflame and narrow the airways, triggering an asthma attack.
Asthma is an inherited disease. If one parent has asthma, there is a 30% chance that the child will as well, and the odds rise to 70% if both parents have asthma. It is more common among boys than girls. It is a lifelong condition. Although some feel that that they grow out of their childhood asthma, it is, in fact, a chronic ailment. One in five children go into remission by age 19, but later in life asthma may well reappear.
Treatment for asthma focuses on prevention and control of the symptoms:
Use a peak flow meter to detect the narrowing of airways even before symptoms appear. This can provide time to adjust medications or take other steps before symptoms get worse.
Identify allergen triggers, and avoid them.
Become familiar with available rescue medicines or maintenance medicines, such as bronchodilators and anti-inflammatories.
Develop an emergency plan for severe attacks. If you are having an asthma attack and have already used your rescue medicines, quickly see your doctor or head for the nearest emergency room. Delays can be fatal.
Fortunately, treatments for asthma have grown more effective through the years. Although we continue to see deaths, many can be avoidable with proper treatment and care. If you are an asthmatic, it is critical that you have a close and ongoing relationship with your doctor.