Asthma Symptoms Not Always Recognized and Treated
When it comes to asthma, experts say there is a huge knowledge gap between what patients believe they must endure as part of their illness and what they spare themselves by managing their disease properly.
"We have known for a long time that asthma can be controlled better, that it is not being controlled as well as it can be, and that we ought to do something about it," says Dr. Norman Edelman, a professor of medicine at the State University of New York at Stony Brook and a medical consultant to the American Lung Association.
About 20 million Americans have asthma and at least half are not as controlled as they could be - suffering needlessly from interrupted sleep, lost days at work or school, and inability to exercise, says Dr. Edelman.
A recent poll taken by the Asthma and Allergy Foundation of America (AAFA) found that 88 percent of nearly 600 adults who have asthma reported managing their symptoms well.
But that may not be the case: In that same group, 61 percent said they had to catch their breath while running up the stairs, 48 percent have been awakened during the night as a result of asthma symptoms, and 50 percent have had to stop exercising in the middle of their regimens.
Among 118 respondents whose children have asthma, 89 percent felt their children's symptoms were being well-controlled, yet half of the children had missed days of school and or work, half were unable to complete their exercise programs, and 45 percent were awakened in the night because of asthma symptoms.
"This was an interesting study of perception versus reality," says AAFA spokesperson Mike Tringale. "These people have learned to live with compromised lives."
He adds, "Now, however, because of better understanding of the disease, better preventive education and better medicines, most people with asthma don't have to have any symptoms."
The implications of poorly managed asthma are numerous, including physical problems such as weight gain from not exercising.
"Weight gain is terrible for asthma, because it exacerbates the symptoms," he notes.
And there are more subtle psychological changes.
"People's personalities are affected," Dr. Edelman says. "Even though you are going about your daily activities, like going to work, you are still disabled because you are not functioning at your maximum. It changes who you are."
To close the knowledge gap, both the American Lung Association and AAFA have started programs to alert asthma sufferers that most can control their asthma more effectively.
Last spring the American Lung Association introduced a five-question online test on its Web site for asthma sufferers over the age of 12.
Questions include asking if and how seriously within the last four weeks asthma symptoms prevented asthmatics from completing work at school or in the office, if those with asthma are kept awake at night because of their illness, and how often asthmatics have experienced shortness of breath.
"About 100,000 people have taken the test online, and two-thirds of them have found that they don't have their asthma under control," notes Dr. Edelman.
The test's success has spurred the Lung Association to develop another quiz designed for children under 12, to be answered by their parents.
The AAFA's program called Sleep Work Play also helps asthma patients better recognize their symptoms so they can talk to their doctors about controlling them.
"People haven't been talking in the same language," says AAFA's Tringale. "Doctors don't probe deeply enough in patients' symptoms, parents don't question their kids."
The program includes a Web site questionnaire that asks asthma patients about their sleep, work, and play habits. It also encourages users to take the completed questionnaire to their physician, so that the two of them can discuss how to better manage asthma symptoms.
The questions - for example, "Do you have to stop and do things differently because of your asthma? Please be specific: even little things like walking through a park, petting a dog, going on vacation, etc." - help people to think about how asthma symptoms are really affecting their lives, Tringale says.
Always consult your physician for more information.
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According to the American Lung Association, asthma is a lung disease which can be life threatening.
Asthma is chronic. In other words, a person lives with it every day, states the American Lung Association.
Asthma causes breathing problems. These breathing problems are called attacks or episodes of asthma.
Asthma may resemble other respiratory problems such as emphysema, bronchitis, and lower respiratory infections.
It is under-diagnosed - many people with the disease do not know they have it.
Sometimes the only symptom is a chronic cough, especially at night, or coughing or wheezing that occurs only with exercise.
Some persons think they have recurrent bronchitis, since respiratory infections usually settle in the chest in a person predisposed to asthma.
Often symptoms get started or "triggered" by something that bothers your lungs, American Lung Association experts say. These things are called asthma triggers.
There are many kinds of triggers. They can range from viruses (such as colds) to allergies, to gases and particles in the air.
Given this range, a person may find it hard to figure out what starts an asthma attack.
Physicians are not exactly certain how you get asthma. But they do know that once a person has it, lungs react to things that can start an asthma attack.
For instance, with asthma a person might get an asthma attack with a cold (or some other kind of respiratory infection). Or, it might occur when something is breathed in that bothers the lungs (such as cigarette smoke, dust, or feathers).
When this happens, three changes take place in a person's lungs:
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Cells in the air tubes make more mucus than normal. This mucus is very thick and sticky. It tends to clog up the tubes.
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The air tubes tend to swell, just as skin swells when one gets a scrape.
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The muscles in the air tubes tighten.
These changes cause the air tubes to narrow, making it hard to breathe.
Asthma attacks may start suddenly, the American Lung Association states, or they may take a long time, even days, to develop. Attacks can be severe, moderate, or mild.
Always consult your physician for more information.
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