Dr. Anelise Engel
Asthma
The word "asthma" is derived from a Greek word meaning "breathlessness" or "panting," both of which describe symptoms present during an asthma attack.
- More than 15 million people in the United States have asthma.Asthma is the nation's leading cause of chronic Illness in children. It affects about 5 million children under the age of 16
- More than 1 million Americans over the age of 65 have been diagnosed with asthma.
Understanding ASTHMA
When you Breathe air moves through your nose or mouth down to your windpipe (trachea). just as the windpipe meets the lungs, it branches off into two large airways (bronchi), one to each lung. Within the lungs, the large airways branch off into smaller airways (bronchi-oles) leading to many small air sacs (alveoli). These air sacs do two very important jobs. First, they transport oxygen from the air you breathe into your bloodstream. Second, they remove carbon dioxide from your blood so it can be removed from your body when you exhale.
Asthma interferes with normal breathing by narrowing the airways both within and leading to the lungs. When the airways are narrowed, the amount of carbon dioxide leaving the body and the amount of oxygen entering the body are both restricted. With asthma, one or more of the following situations cause the airways to narrow:
Tightening of the muscles that wrap around the airways. For people with asthma, the airways sometimes overreact to triggers. The result is spasms of the muscles encircling the airways. When these muscles become "twitchy" with spasms, called bronchospasm, the space inside the airways narrows, and less air is able to pass in and out of the lungs. Bronchospasm makes it particularly hard to breathe out.
Inflammation of the airways lining. The same triggers that cause bronchospasm can also cause ongoing (chronic) swelling and inflammation in the inner lining of the airways. Like bronchospasm, inflammation of the lining narrows the space available for air to pass through. When the lining of the airways is irritated and inflamed, bronchospasm is more likely to occur.
Overproduction of mucus. Mucus normally lubricates the airways and cleans away small particles of foreign matter, such as dust and dirt, from the air passages. When the airways become inflamed during an asthma episode, too much mucus may be produced. The excess mucus takes up space in the airways, blocking the free flow of air. It may also become dry and sticky, further gumming up the airways. When this happens, it is more difficult to clear away by coughing and may even lead to bacterial infection.
Many people with asthma experience times when they have more problems breathing and times when they feel perfectly normal. The times of greater difficulty are called "asthma episodes." During an asthma episode, you may have sudden coughing or wheezing that can cause you to feel short of breath. Asthma episodes can last from a few minutes to several hours or days.
Fortunately, the airflow obstruction caused by asthma can be reversed, often rapidly. This is one of the key ways in which asthma is different from other diseases, such as emphysema. Sometimes, bronchospasm will simply stop on its own. More often, however, medications are needed to prevent and treat asthma episodes. Although there is no cure for asthma, with the help of your doctor, you can learn to manage this disease so it doesn't interfere with your daily life.
HOW IS ASTHMA DIAGNOSED?
Asthma symptoms can be different from person to person. For some, the main symptom
is a persistent cough. Others may experience wheezing, chest tightness, shortness of breath or any combination of the above.
Asthma tends to run in families, and most people who have asthma develop their first symptoms while still young. About half of those with asthma show symptoms before age 10, and another third develop the condition before age 40. However, anyone can develop asthma at any age.
Because other illnesses and diseases can cause similar symptoms and difficult breathing, you should see your doctor to determine whether the problem is asthma or something else. Be prepared to give specific information about when and under what circumstances your symptoms tend to occur.
TESTING FOR ASTHMA
Tests your doctor may order include chest X-rays and spirometry. The X-rays help rule out other possible causes for your symptoms. If no other lung disease is present, chest X-rays will be fairly normal in a person who has asthma.
Spirometry is a test that involves blowing into a device called a spirometer. The spirometer measures the amount and speed of air that is breathed out, indicating how open or narrow the air passages are. When the passages narrow during an asthma episode, the force of exhaled air measured by the spirometer is lower than normal. Some people who have asthma, however, may have normal spirometry results during times when they are symptom free. This is one way your doctor can tell that the problem is asthma and not emphysema or chronic bronchitis, both of which are diseases that cause irreversible damage to the lungs.
THE ASTHMA SPECTRUM
Asthma can range from very mild and intermittent to severe and persistent, with a wide spectrum in between. The severity of your asthma can change over time, depending on how your body reacts to different triggers at different times in your life. You may have periods when your asthma flares frequently; at other times in your life, you may have few problems.
The key to managing asthma is understanding your symptoms and what triggers and relieves them.
WHY ME?
Many people think asthma is a disabling disease - something that makes you unable to participate in sports, be active or enjoy life. Though asthma has had this reputation in years past, it just isn't true today. With medications, asthma can be controlled so it doesn't interfere with leading a normal, active lifestyle.
This is not to say it will be easy to adjust to having asthma and to the things you need to do to take care of it. Learning that you have a chronic disease such as asthma can raise a variety of emotions - some not so pleasant. You may feel angry, frustrated or worried about what your future will be like living with asthma. You may wonder why this had to happen to you.
Just remember that all the are perfectly normal. These feelings usualy pass as time goes by and you become more comfortable and confident that you really can manage this disease and prevent and treat asthma episodes. If you continue to struggle with feelings of frustration, anger, worry or fear, or if these feelings are interfering with your daily life or relationships, talk with your doctor. He or she may be able to recommend a counselor or other mental health professional who can help you.
Family, friends, co-workers, teachers and coaches can also provide valuable support if they understand asthma. Share what you know about asthma with the people who care about you, and let them know how they can help you if you have an asthma episode.