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Asthama Asthama Document Transcript

  • FAMILY HOME REMEDIES By Nadeem Y. MuftiASTHMA - 14 Ways to Breathe EasierIf you have asthma, you know the dreaded choking sensation, the faintness, the anxiety. Itsas if someone made you run around the block, then pinched your nose shut and forced you tobreathe through a straw. And you know all too well that once an asthma attack starts, it wontgo away by itself. Asthma sufferers make up an estimated five to ten percent of thepopulation. And while no two persons with asthma are alike in the subtle characteristics ofthe condition, they do have one thing in common: They have trouble breathing properly. Thereason is that their lungs are supersensitive and easily provoked into constriction by a widevariety of outside factors, called triggers. As you have probably discovered, perhaps the hardway, many things can set an asthma attack into motion--someones perfume, a smoke-filledroom, a friendly dog, a flowery garden, a strong wind, or even a good laugh. (Asthma,however, is a hereditary condition, so unless a person is genetically predisposed, nothing willmake asthma happen.) Triggers can be allergic or nonallergic, and reactions can beimmediate or delayed. While there is no cure for asthma, the good news is that asthma--whether mild, moderate, or severe--can be managed. Doctors who specialize in treatingasthma can be very helpful. Every patient with asthma should see a doctor to be sure anothercause of wheezing is not present and, if true atopic asthma is present, to develop a therapeuticprogram for managing the disorder. In addition to working with your doctor, you can takemeasures to help control your asthma. The key is to track down the triggers and, ascompletely as possible, eliminate them from your life. In short, you can help counter anasthma attack before it happens. Heres how: Smite the mite."Dust mites are microscopicinsects that thrive on food debris and high humidity," says Allan M. Weinstein, M.D., anasthma/allergy specialist in private practice in Washington, D.C. "Since they are among themost common allergic asthma triggers, dustproofing is a must." His suggestions:* Encloseyour mattress in an airtight, dustproof cover, then cover it with a washable mattress pad.Keep a bedspread on the bed during the day.* Wash your sheets in hot water every week,wash your mattress pads and synthetic blankets every two weeks, and wash your pillowsevery month.* Use polyester or dacron pillows, not those made of kapok or feathers, andenclose them in airtight, dustproof covers.* Avoid carpeting, which is difficult to clean; stickto bare floors with washable area rugs.* Choose washable curtains instead of draperies.* Trynot to do heavy cleaning, but if you must, use only a vacuum cleaner and damp cloth toclean; dust mops and brooms stir up the dust. Always use hot water. "Cold water is like a dayin the sun to a dust mite," says Weinstein.* Wear a mask over your mouth and nose whilecleaning, and leave the room when youre done.* Run an air conditioner or dehumidifier inwarm weather, especially in spring and fall when mites multiply. Aim to keep the humiditylevel in your home under 40 percent but above 25 percent.* Consider using an air purifier inthe bedroom to keep the room free from dust particles.Minimize mold."Fungus is a parasitethat can literally grow on you," says Stuart Young, M.D., an asthma/allergy specialist inNew York. "It can grow on nonliving organic material, too, in several forms--mold, dry rot,and downy mildew." Fungi reproduce by producing spores. The spores are the real problem,as millions of them float through the air to be inhaled in every breath, touching off an allergic
  • reaction that can contribute to asthma. To stave off the spores, Young advises you to:* Keepyour windows closed, because the mold spores can come right in through the windows evenif the windows have screens.* Stay out of attics, basements, and other dank, musty places.*Wear a face mask and give your bathroom a going-over for signs of mold. (Better yet, have anonallergic family member do this.) The most likely spots for mold growth: dark areas, suchas the backs of cabinets and under the sink.* Examine all closets regularly to see that moldshave not set up housekeeping in unused shoes and boots.* On a regular basis, have a familymember or friend investigate the inner workings of air conditioners, humidifiers, andvaporizers in your home where molds like to grow.* Periodically check houseplants for moldgrowth. In fact, getting rid of mold will help your plants, as well.Make peace withpollen.Pollen is released when plants are blooming--trees in the spring, grass in the latespring and early summer, ragweed from mid-August until the first frost. Plants that arepollinated by the wind are much more of a problem for asthmatics than are those pollinatedby insects. "The goal is to learn how to live with pollen, not hide away from it," says LoomisBell, M.D., chief of pulmonary--critical care medicine at St. Lukes--Roosevelt HospitalCenter in New York. He recommends that you avoid cutting grass or even being outsidewhile grass is being mowed. Keep your windows closed as much as possible--pollen can getthrough screens, too--and use an air conditioner to cool your home instead. Room airpurifiers are also available that can purify recirculated air, removing particles of all sorts thatare suspended in the air and further cleansing the air by passing it through a charcoal filter.After being outside in the midst of pollen, take off your clothes and wash them or at least runa vacuum over the articles of clothing. Wash yourself, too, and dont forget your hair.Dontpet a pet.The best approach is to not have a pet that can trigger your asthma, advises Young.The problem is not the hair of the animal but the dander--the dead, dry skin that flakes off.The animal licks the skin, and the dander remains in its saliva. "If giving up a pet isimpossible, the next logical step is to make very strict rules about living with an allergenicanimal," Young warns. Do not allow your pet into the bedroom--ever. If the animal is in thebedroom at any time during the day, the dander will remain for hours. Leave the pet home ifyou are going for a car ride that would necessitate very close contact with the animal. If youdo have direct contact with your pet (or any animal, for that matter), wash your hands rightaway. If you simply cannot keep your hands off your pet, at least keep your face away; kissthe air--your pet will still get the idea. In addition, try bathing your dog or cat once everyother week in warm water with no soap. Bathing the animal in this way significantly reducesthe amount of allergen on your pets fur, according to Clifton T. Furukawa, M.D., clinicalprofessor of pediatrics at the University of Washington School of Medicine in Seattle.Kickthe cigarette habit.Tobacco smoke can be an irritant that triggers asthma as well as anallergen that touches off an allergic response leading to asthma. Tobacco smoke is one of theworst irritants known: It paralyzes the tiny hairlike cilia along the mucous membranes of therespiratory tract. It also reduces immune response and leaves a smoker much moresusceptible to upper-respiratory infection. "There is not a single redeeming feature tocigarette smoking," cautions Weinstein. "Given the known health risks associated withsmoking, asthma patients should make every effort to stop smoking--either on their own orwith the help of a smoking-cessation program." Nonsmokers who live with a smoker are nobetter off. So if theres someone in your household who wont quit smoking, ask thatindividual to take his or her habit outdoors.Weather the weather.While each person respondsto weather conditions and weather variations differently, some general trends may be noted.
  • "Keep close watch on how the weather affects you," advises Young. (That means payingattention to factors including temperature, wind velocity, barometric pressure, and humidity.)"Then try to avoid conditions that cause you problems." For example, you should stayindoors when it is very cold, since a blast of cold air can cause a spasm in your bronchialtubes. Stay indoors if the wind is strong, too. While gusts of wind can blow pollution andsmog away, they can also blow pollen in your direction. If you enjoy walking in the rain,youre in luck, because rain tends to wash away roving allergens, pollutants, andirritants.Watch what you eat.The question of whether foods trigger chronic asthma has yet tobe answered. Some foods, such as nuts, shellfish, milk, eggs, and strawberries, can result inan array of allergic responses, including asthma symptoms. Sulfites in wine can have asimilar effect. "While the information available today suggests that the chances are small thatfood allergies are a trigger for chronic asthma in adults, it is still wise to reduce or eliminateyour consumption of certain foods that you notice make your asthma worse. But consult yourdoctor if you think the foods are nutritionally necessary," says Weinstein. Allergies tocertain types of food, especially milk and wheat, are more often a trigger of asthma inchildren. If milk and wheat seem to be causing problems for your asthmatic child, eliminatethese foods. Check labels, and avoid foods that list milk, milk solids, casein, whey, orcaseinate as ingredients. (Talk to your doctor about alternate dietary sources of nutrients suchas calcium.)Eating away from home can sometimes be a problem, says Weinstein. If you areinvited to dinner and dont know what dinner will be, eat something at home before you leaveso you wont be left hungry. If you are eating in a restaurant, inquire about the ingredients inthe dish you want to order as well as the method of preparation. No matter where you haveyour meal, common sense suggests that you avoid overeating, eating too fast, and talkingwhile you are eating. Steer clear of alcohol, too, especially if you are taking medications foryour asthma. One final reminder: Avoid so-called cytotoxicity tests and similar methods thatpromise to root out hidden food allergies and cure asthma (see Extra! Extra! - "The QuackComes Back").Stay healthy.A problem in the upper airways--such as a respiratory infection--can cause trouble in the lower airways--the bronchial tubes--and precipitate an asthma attack."Everybody wants to be in a state of good health," says Bell. "For a person with asthma,maintaining good health can mean a dramatic lessening of symptoms." Bell suggests that youstay away from people who have a cold or the flu, drink plenty of fluids, and avoid gettingovertired; otherwise, you will be more susceptible to infections. If, despite your best efforts,you do develop an infection, see your doctor; early use of antibiotics, when appropriate, canbe quite helpful.Exercise your options.For years, people with asthma have been told to avoidexercise because it would induce attacks. Research has shown, however, that the moreasthmatics exercise, the more exercise they can tolerate. "If you have asthma, you shouldpartake in regular aerobic exercise," says Bell. He recommends that you start by warming upwith light exercise before a more-vigorous workout. (Young recommends using cromolynsodium, a prescription medication, 15 to 20 minutes before aerobic exercise; discuss this withyour doctor.) Begin with short workouts and gradually increase them. At least at first, keep abronchodilator with you. If you feel tightness in your chest and cant work through it, use thedevice. If you are out in very cold or dry air, wear a scarf around your nose and mouth to heatthe air before breathing it in. Cool down with light exercise at the end of your workout. If onetype of exercise still brings on attacks, try another form of exercise. You may not be able totolerate running, for example, but you may be able to swim regularly.Avoid aspirin.Aspirinand certain products that contain aspirin can trigger asthma attacks in certain people. "Its just
  • wise to stay away from the whole family of aspirin products if you have asthma," saysWeinstein. "This is especially true for patients with nasal polyps, for whom aspirin ingestioncan be life threatening. Even if you have not experienced an asthma flare in the past, it couldoccur at any time." Weinstein encourages anyone with asthma to keep aspirin out of themedicine chest by checking labels on every over-the-counter drug that is purchased. (Avoidthose that list "aspirin" and those that contain the initials "ASA," "APC," or "PAC"; ask yourpharmacist if you are unsure whether the medication you want to purchase contains aspirin.)If you feel that you must take aspirin, get your doctors approval. According to an expertreport from the National Asthma Education Program, people with asthma should also stayaway from certain nonsteroidal anti-inflammatory agents (ibuprofen is one such medication)that have effects similar to aspirins. Opt instead for such "usually safe alternatives" asacetaminophen, sodium salicylate, or disalcid. You may also need to avoid tartrazine (yellowfood dye #5), which is found in a number of soft drinks, cake mixes, candies, and somemedications, if it aggravates your asthma.Take a deep breath.Breathing exercises provide aform of relaxation and can be of benefit to some patients during an asthma attack. However,it would be a mistake to rely on breathing exercises alone to control an asthma flare, saysWeinstein. As long as this rule is not broken, breathing exercises are fine for those patientswho find them beneficial. "You can practice controlled breathing, which concentrates onslow inhalations through the nose rather than panting breathing through the mouth," saysWeinstein. He suggests that before starting these breathing exercises, you blow your nose tomake sure that your air passages are clear of all foreign matter. Then sit in a chair in acomfortable position. Take a deep breath and feel your breath going as far down as possible.Your abdomen should expand as you do this exercise. Exhale slowly, feeling your abdomenrelax as your breath comes out of your nose. Repeat this exercise at least three times a day(but never right after eating).Keep your weight down."Unfortunately, some asthmamedications can result in weight gain. An overweight person has to breathe more heavily,and the heart works harder to pump blood all around the body. Weight reduction is veryimportant," says Bell. If you are overweight, you and your doctor should work together toestablish a diet plan that will reduce your calorie intake without depriving you of necessarynutrients.Mind your mind.The notion that asthma is "all in your head" has gone the way ofmany medical myths. Asthma is an illness with both physical and emotional aspects. Forexample, asthma attacks can be triggered by emotional changes, such as laughing or crying,or by stress. "The human body interacts with the mind," says Young, "so by putting yourmind at ease, you can dramatically reduce the panicky feeling that can make an alreadyexisting attack worse." He recommends developing an upbeat mind-set by committingyourself to feeling better. A positive attitude works wonders to enhance your other copingmethods. In addition, be forthright about your asthma; others will respect your directnessand, in most cases, try to make things easier for you.Learn to relax.Since stress andemotional upsets can trigger asthma attacks, it may be helpful to set aside time each day--preferably the same time--to practice some form of relaxation.