Asthma FAQs  
 
 
 

 

     

Asthma FAQs

     
 
 

1. What is Asthma?
2.
How can I tell if I have asthma?
3.
What are the things that can set off asthma attack?
4.
Is there a cure for asthma?
5.
What do I do if I have an asthma attack?
6.
How is asthma treated?
7.
Are steroids safe for me to take?
8.
Where is the best place on earth for asthmatics?
9.
Can I do exercise and play games like football and cricket?
10.
Can I take pain killers like Aspirin?
11.
What about vacuum cleaners or air purifiers?
12.
What are the jobs to avoid? Can I apply in all the jobs?
13.
Can I smoke or sit near a smoking person?
14.
Are pets like cats and dogs safe for me?
15.
How Can I Control Things That Make My Asthma Worse?
16.
What to do when pollen or mold spore counts are high?
17.
What are other things that Can Make Asthma Worse?
18.
What is the difference in asthma of male and female child?
19.
I have asthma. Will my child also suffer from asthma?
20.
What are the other disease that mimic asthma?
21.
Is asthma more common in premature child?
22.
What is the role of alternative medicine in asthma?
   (a)
Acupuncture.
   (b)
Immunotherapy (allergy shots).
   (c)
Homeopathy.
   (d)
Air ionisers.
   (e)
Herbal and traditional Chinese medicines.
   (f)
Hypnosis.
   (i)
Manual therapy including massage & spinal manipulation.
   (j)
Physical exercise training.
   (k)
Breathing exercise including yoga and buteyko?
   (l)
High altitude and speleotherapy.
23.
Role of fish oil and fatty acid in asthma treatment.
24.
Is the risk of getting asthma more in obese people?
25.
Role of weight reduction in asthma control?

26. What are the complications/ risks of surgery in Asthma patient?
27.
What are the actions to be taken before surgery in asthma patients?
28.
What is Bronchial thermoplasty?
29. What are emergency phone numbers or asthma helpline numbers in UK?

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What is Asthma?

Asthma of any severity is chronic inflammatory disease of airways. To simplify Asthma is a condition that affects the airways ( the small tubes that carry air in and out of the lungs). People with asthma have airways that are almost always red and sensitive (inflamed). Their airways can react badly when they have a cold or other viral infection, or when they come into contact with an asthma trigger (something that sets off their symptoms). When this happens the muscles around the walls of the airways tighten and they become narrower. The lining of the airways swell and often produce a sticky mucus. As the airways narrow, the air has to squeeze in and out, and this is what causes the person with asthma to find it difficult to breathe. Asthma symptoms can include coughing, wheezing, shortness of breath or a tight feeling in the chest.
With the correct treatment, support and advice, most people with asthma can lead full and active lives.


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How can I tell if I have asthma?

There is no hard and fast way of telling if you have asthma or not. This is partly because the symptoms can vary and may be similar to other respiratory conditions like COPD. Asthma symptoms include shortness of breath, wheezing (a whistling noise in the chest), cough and chest tightness. Not everybody will have all these symptoms. A history of asthma, eczema or hay fever in the family may mean that your chances of developing asthma are slightly higher than those without.
If you have breathlessness and you think that you may be suffering from asthma, see your doctor. He will discuss your medical history and your current symptoms. He may measure your peak flow using a peak flow meter or do Spirometry.
The doctor may decide to give you your own peak flow meter on prescription and ask you to keep a diary of readings before seeing him or her again.

Are you suffering from asthma: Visit Am I asthmatic and know.


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What are the things that can set off asthma attack?

A trigger is anything that irritates the airways and sets off the symptoms of asthma. Common triggers include colds or flu, cigarette smoke, exercise and allergies to things like pollen, furry or feathery animals or house-dust mite.
Everyone's asthma is different and you will probably have several triggers. Asthma, like its related allergic conditions eczema and hay fever, often runs in the family and may be inherited.
There are probably a number of other, environmental, factors that contribute to someone developing asthma , many aspects of modern lifestyles, such as housing and diet, might be responsible. We also know that smoking during pregnancy increases the chance of a child developing asthma. There is currently no evidence that traffic pollution causes asthma, although poor air quality can make your asthma worse.


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Is there a cure for asthma?

There isn't a permanent cure for asthma. Scientists and Doctors world over are actively doing research in asthma causes and treatment. (like indoor and outdoor pollution, allergies, gene therapy, cell biology and chemical structures to name but a few). The results of their work will help us understand much more about how and why this common condition develops. It might also lead to even more effective asthma treatment and may be a permanent cure some day.
Current research is suggesting that taking certain preventative measures in the home can lessen your chances of developing asthma, or reduce your symptoms.

READ MORE: > HOW TO CONTROL ASTHMA TRIGGERS? <


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What do I do if I have an asthma attack?

Take your reliever inhaler (blue one) immediately.
If the reliever has no effect after five to ten minutes, call your doctor or an ambulance or Asthma Helpline if available.
Continue to take reliever medication every few minutes until help arrives.


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How is asthma treated?

Medication can come in the form of inhalers and tablets, although currently inhalers are more common. An inhaler ensures that very small amounts of medication are delivered directly into the lungs. There are a variety of inhalers available. It is important that you use a device that you are comfortable with and can use properly. Your doctor or nurse will advise you on the most appropriate device and should demonstrate how to use it correctly.
There are two main types of asthma medication:

1.Reliever medication

Reliever inhalers are usually blue colored.
They act by opening up the airways causing the muscles to relax and therefore allowing you to breathe more easily.
The reliever should only be used when the symptoms of asthma appear or, if recommended, before exercise. They do not reduce the inflammation in the airways. If you need to use your reliever more than once a day or 3-4 times per week this suggests that there is a degree of inflammation in your airways that requires preventer treatment.

2.Preventer medication

Preventers usually come in brown, red or orange colors inhalers.
They work over a period of time to calm inflammation in the airways and make them less likely to react badly when you come across an asthma trigger. They need to be taken regularly. Most preventers are inhaled corticosteroids. It is important to understand that corticosteroids are not the same as anabolic steroids used by athletes to improve their performance.
There are other types of medication that can be added to your reliever and preventer treatment if needed, such as preventer tablets and long-acting relievers.


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Are steroids safe for me to take?

Steroid inhalers are the mainstay of asthma treatment today. Inhalers give very low doses of steroids per puff. There are very few side effects from inhaled steroids when used in proper doses and especially if used with a spacer. One may experience local side effects such as a hoarse voice or sore throat. It is possible that at higher doses of inhaled steroid (more than 1000mcg of budesonide or beclomethasone) some steroid may be absorbed. This is still a much smaller dose than from a steroid tablet. Occasionally if asthma symptoms are severe your doctor may prescribe a short course of steroid tablets. These should not cause any long-term side effects.
However, if you have very severe asthma and need to take steroid tablets for a long period of time there may be some side effects such as thinning of the bones or weight gain. It is important to discuss your concerns with your doctor.


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Where is the best place on earth for asthmatics?

There is no evidence that moving to some other house will improve your asthma symptoms. Many people associate asthma with bad air quality and presume that somewhere with better air quality will improve their asthma.
Pollution is only one of many things that can affect asthma but there are many other trigger factors. Even in the least polluted parts , the percentage of people with asthma is about the same as that elsewhere (including cities).
Asthma triggers varies from one person to another. A place that's good for one person may not be so good for another. Your own personal experience will give you clues as to what triggers your asthma. Some triggers will be found indoors, where we spend most of our time. House-dust mite, for example, is a common trigger which will be found wherever you live. Most people with asthma have more than one trigger, it is possible that by moving house you may be exchanging one trigger for another. Sometimes people feel better in a new area for a short while and then become sensitive to triggers they find there. Except in a few circumstances, such as living in damp housing, there seems little to be gained from moving house.


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Can I do exercise and play games like football and cricket?

As long as your asthma is well controlled you should be able to take part in most exercise. Some forms of exercise that people with asthma can find particularly beneficial are yoga as it teaches proper breathing techniques swimming (where the damp atmosphere can be of benefit, though chlorine can set some people's asthma symptoms off) and aerobic exercises. Team sports that allow you to have a rest can also be good.
If exercise makes your asthma worse (Exercise induced Asthma), warming up properly for a minimum of five minutes and taking a couple of puffs of reliever inhaler before you begin. It usually help. If your symptoms continue, talk to your doctor or practice nurse as this could be a sign that your medication needs to be reviewed.
There are a few sports such as diving, parachuting and mountaineering where restrictions may be imposed if you have asthma. If your asthma is well controlled you should be able to take part in these sports.


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Can I take pain killers like Aspirin?

Although most people with asthma have aeroallergen-induced symptoms, some individuals manifest symptoms with non allergic triggers. As many as 10 % to 20 % of people with asthma are sensitive to non steroidal anti-inflammatory drugs. So it is better to avoid these drugs. Its best to consult your doctor before taking any medicine.
But 100 mg aspirin taken every other day may reduce asthma risk in women by 10 percent according to the results of a large trial. (Reuters Health reported on March 13)
Still, the researchers emphasize that more studies are needed before aspirin can be recommended solely for this purpose. The findings, which are reported in the medical journal Thorax, indicate a 10 percent reduction in asthma risk with aspirin use, although this beneficial effect was not seen in obese women.


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What about vacuum cleaners or air purifiers? Will they make my asthma better?

No single product is likely to improve your symptoms on its own. However, there are several simple measures that you can take to reduce dust or improve the air quality in your home and these might help to reduce your symptoms. In fact, recent research is suggesting that by removing the common things that set off asthma in the home, you may lessen the chances of a child developing asthma.
You might like to try damp dusting, having fewer or no carpets and soft furnishings (where house-dust mites like to live), avoiding smoking in the house and keeping the house well ventilated to reduce humidity. Special bedding covers, which usually cover the whole mattress and protect against house dust mites, have been shown to have some benefit for people with asthma. Close the windows during windy season or when there excessive smog or pollution outside.
Regular vacuuming with an efficient vacuum cleaner that has strong suction power and does not blow dust out of the exhaust will help to reduce dust in your house. But try to avoid cleaning by yourself. There are some products, such as specialized vacuum cleaners, that are advertised as being especially good for people with asthma. These products may be efficient in removing levels of dust mite allergen from the home. Good ventilation is also essential for reducing humidity, and therefore allergen levels in the home. Although air purifiers will help to filter out fine dust particles and revitalize stale air, there is no clear evidence to suggest they reduce asthma symptoms.


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What are the jobs to avoid? Can I apply in all the jobs?

As long as your asthma is well controlled, you will be able to apply for most jobs, in fact. However, a few jobs; in the armed services, the fire brigade, the police, and the prison service, do have restrictions for people with asthma. The army, police force, navy and prison service all require applicants to be physically fit and will assess your application on an individual basis. The fire and ambulance services will not accept applications from people with asthma as workers commonly come in to contact with smoke and toxic fumes, which can commonly set off asthma symptoms. You will not be able to join the air force as a pilot if you have ever had asthma, although you can work as part of the ground crew.
You can find out more from your local careers service, or from the organization concerned.
Some other jobs involve working closely with things that set your asthma off, for example chemicals in engineering, photocopier toner in the office, dust from flour in a bakery. If you feel that your job is aggravating your asthma it is important to discuss it with your doctor or nurse.


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Can I smoke or sit near a smoking person?

Smoking is a real enemy and can make your asthma worse. If you smoke, you will be increasing your chances of developing many health problems and your asthma symptoms will become worse and difficult to control. Your lungs may also suffer from irreversible damage. Many people are also affected by breathing other people's cigarette smoke (passive smoking). Smoking while pregnant also increases the risk that your baby will have asthma, and may cause other health problems.


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Are pets like cats and dogs safe for asthma patients?

Animals are one of the things that can set off, or trigger asthma symptoms. In particular many people with asthma will have their symptoms set off by cats and dogs. There are minute particles called allergens found in the animal's fur, saliva and urine, which get into the air and are breathed in. This does not affect most people, but people with asthma have sensitive airways and breathing in allergens can cause an increase in symptoms. You can become sensitive to a pet even if you have had the pet for a long period of time. There are measures that can help:

1. If you have a furry or feathery pet, then keep the pet outdoors wherever possible.
2. Always keep your pets out of your bedroom.
3. Always wash your hands after handling the pet.
4. Also find out whether your vet can advise about products you could use to wash the animal once a week, in order to reduce the amount of allergens you are exposed to.


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How Can I Control Things That Make My Asthma Worse?

You can help prevent asthma attacks by staying away from things that make your asthma worse.
You need to find out what makes your asthma worse. Some things that make asthma worse for some people are not a problem for others. You do not need to do all of the things listed below.
Ask your doctor to help you find out what makes your asthma worse. Then, decide with your doctor what steps you will take. Start looking at your bed room for triggers and start controlling them.
 Click: How to control asthma triggers?


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What to do during allergy season (when pollen or mold spore counts are high)?

Try to keep your windows closed.
Stay indoors with windows closed during the midday and afternoon, if you can.
Pollen and some mold spore counts are highest at that time.
Ask your doctor whether you need to take or increase anti-inflammatory medicine before your allergy season starts.


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What are other things that Can Make Asthma Worse?

Flu: Get a flu shot.
Sulfites in foods: Do not drink beer or wine or eat shrimp, dried fruit, or processed potatoes if they cause asthma symptoms.
Cold air: Cover your nose and mouth with a scarf on cold or windy days.
Other medicines: Tell your doctor about all the medicines you are take. Include cold medicines, aspirin, and even eye drops.


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What is the difference in asthma of male and female child?

Male sex is a risk factor for asthma in prepubertal children and female sex is a risk factor for persistence of asthma in the transition from childhood to adulthood. Male children with asthma are more likely to "grow out" of their asthma in the transition to adulthood.


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I have asthma. Will my child also suffer from asthma?

In Arizona, a study was conducted where researchers examined 344 families to see if asthma runs in families. It was found that:

  • Families with neither parent having asthma 6% of the children had asthma


  • Families with one parent having asthma 20% of the children had asthma.


  • Families with both parents having asthma 60% of the children had asthma.

  • This reveals a strong correlation between asthma and genetics.
    When studying the relationship between genetics and anything, twins are excellent candidates for research. Identical twins have the same genetic makeup while fraternal twins (non identical) do not. In 1995 Sarafino and Goldfedder conducted research to prove that both genetics and the environment play a role in the appearance of asthma.
    In this study 325 pairs of twins were examined. Among these twins, 84 pairs were found where at least one of the twins had asthma (these were the subject of this study). Of the 84 pairs, 39 were identical and 55 were fraternal. The data collected is as follows:
    Twin pairs where both twins had asthma:
    Identical Twins > among 39 twins, in 59% (23 of 39 pairs) cases both twins had asthma
    Non-Identical Twins > among 55 twins, in  24% (13 of 55 pairs) cases both twins had asthma.
    This experiment proves the interrelationships between the environment and asthma. If asthma was solely a genetic condition, identical twins (who have the same genes) would have the same chances of developing asthma. But this study shows that in 41% of cases only one identical twin will develop the condition. Similarly, if asthma was solely governed by environmental factors, identical twins would have the same chances of developing asthma as non-identical twins – but this study shows that the chances of developing asthma are more than twice as high if twins are identical.
    These research findings imply that rather than inheriting asthma itself, we inherit a tendency to develop asthma. And this inherited tendency will only come to fruition if we are also exposed to the environmental stimuli that trigger asthma.
    Conclusions:
    When asthma runs in families, genes are a stronger contributor than the environment.
    When asthma does not run in families, genes are not as strong and the environment plays a stronger role.
    As more research is being conducted, more researchers are agreeing with the above statements and arising to the conclusion that your genetic code may predispose you to being susceptible to asthma. Therefore nature and environment, both play role in the development of asthma.


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    What are the other disease that mimic asthma?

    Disease in infant and children mimicking asthma:

    Upper airway diseases

  • Allergic rhinitis and sinusitis

    Obstructions involving large airways

  • Foreign body in trachea or bronchus

  • Vocal cord dysfunction

  • Vascular rings or laryngeal webs

  • Laryngotracheomalacia, tracheal stenosis, or bronchostenosis

  • Enlarged lymph nodes or tumor

    Obstructions involving small airways

  • Viral bronchiolitis or obliterative bronchiolitis

  • Cystic fibrosis

  • Bronchopulmonary dysplasia

    Heart disease

    Other causes

  • Recurrent cough not due to asthma

  • Aspiration from swallowing mechanism dysfunction or gastroesophageal reflux

    Disease in adult mimicking asthma:

  • COPD (e.g., chronic bronchitis or emphysema)

  • Congestive heart failure

  • Pulmonary embolism

  • Mechanical obstruction of the airways (benign and malignant tumors)

  • Pulmonary infiltration with eosinophilia

  • Cough secondary to drugs (e.g., angiotensin-converting enzyme (ACE) inhibitors)

  • Vocal cord dysfunction
     


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    Is asthma more common in premature child?

    Wheezing is more common in young children who were born prematurely. In adulthood there are no consistent relationships between asthma and birth weight.


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    What is the role of alternative medicine in asthma?

    There are many types of alternative therapies for asthma treatment. But none is as effective as the modern allopathic treatment. Below are the different types of treatment and their recommendation according to the "British Guideline on the Management of Asthma revised edition July 2007"

    Acupuncture in asthma

    A Cochrane review138 of 21 trials raised many methodological concerns. Only seven trials (174 patients) achieved randomisation to active (i.e. recognised in traditional Chinese medicine to be of benefit in asthma) or sham acupuncture (i.e. points with no recognised activity) for the treatment of persistent or chronic asthma. Blinding was a common problem, and only achieved for those making the observations. The difficulty in making sham acupuncture convincing and part of the holistic approach of traditional Chinese medicine was emphasised. There was wide inconsistency in methodology. Acute trials show that acupuncture has a beneficial effect, but this is less in magnitude than that achieved by inhaled bronchodilators or cromones. Demonstrating that this effect can be transferred to persistent asthma using regular treatment was achieved in one RCT reported in the Cochrane review.
    The Cochrane review found no evidence for a clinically valuable benefit from acupuncture, with no statistically significant improvement in lung function being demonstrated. More rigorous research methodology and attention to outcomes other than lung function are required.
    Ref: Linde K, Jobst K, Panton J. Acupuncture for chronic asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update Software.


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    Immunotherapy (allergy shots)

    Three observational studies, in over 8,000 patients, have shown that immunotherapy in individuals with a single allergy reduces the numbers subsequently developing new allergies over a three to four year follow up compared with contemporaneous untreated controls.89, 90, 91 No double blind placebo controlled trials of immunotherapy as primary prevention have been conducted, and at present immunotherapy cannot be recommended for primary prevention. Preliminary results from an ongoing parallel group study using contemporaneous untreated children as the control group for pollen immunotherapy in children with allergic rhinitis suggest a lower rate of onset of asthma in the treated group..
    Ref: (a). Des Roches A, Paradis L, Menardo JL, et al. Immunotherapy with standardized dermatophagoides pteronyssinus extract. VI. Specific immunotherapy prevents the onset of new sensitizations in children. J Allergy Clin Immunol 1997;99:450-3.
    (b). Purello-D'Ambrosio F, Gangemi S, Merendino RA, et al. Prevention of new sensitizations in monosensitized subjects submitted to specific immunotherapy or not. A retrospective study. Clin Exp Allergy 2001;31:1295-302.
    (c). Pajno GB, Barberio G, de Luca F, et al. Prevention of new sensitizations in asthmatic children monosensitized to house dust mite by specific
    immunotherapy. A six-year follow-up study. Clin Exp Allergy 2001;31:1392-7


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    Homeopathy in asthma

    A Cochrane Review140 identified only three methodologically sound RCTs. In the first trial (24 patients), homeopathy improved symptom scores and forced vital capacity (FVC) but had no effect on FEV1 or bronchial reactivity. The second study demonstrated improvements in both active and placebo groups. The third, poorly reported, trial demonstrated an increase in lung function in patients receiving the active preparation.
    There is insufficient information regarding the value of homeopathy in the treatment of asthma. Large, well designed trials using defined remedies and a spectrum of patients are warranted.
    Ref: Linde K, Jobst KA. Homeopathy for chronic asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update Software.


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    Air ionisers in asthma

    Ionisers are widely advertised and marketed as being of benefit to patients with asthma, however there is no evidence that they are of value in ameliorating the symptoms of asthma or improving lung function. They do reduce mite allergen levels in the room in which they are used, and could be incorporated into a coordinated allergen avoidance program, but this has not been formally tested.
    One study has raised concerns that ionization may produce an increase in nocturnal cough. The use of ionisers cannot be encouraged, as there is no evidence of benefit and a suggestion of adverse effect.
    Ref:Warner JA, Marchant JL, Warner JO. A double blind trial of ionisers in children with asthma sensitive to the house dustmite. Thorax 1993;48:330-3


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    Herbal and traditional Chinese medicines in asthma

    Currently available evidence does not allow any firm judgement to be made on herbal remedies in general or individual preparations in particular. Seventeen trials were identified, but the combined results are inconclusive. Nine of the 17 trials reported some improvement in lung function, but it is not clear that the results reported would be generalisable to a UK population.
    Ref: Huntley A, Ernst E. Herbal medicines for asthma: a systematic review. Thorax 2000;55:925-9.


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    Hypnosis in asthma

    Studies of hypnosis in patients with asthma are generally poorly controlled and patient characteristics and outcome measures vary enormously. The conclusions from a critical review141 were that hypnosis may be effective for asthma with the biggest effect in susceptible subjects, but more randomised and appropriately controlled studies are required.
    Ref: Hackman RM, Stern JS, Gershwin ME. Hypnosis and asthma: a critical review. J Asthma 2000;37:1-15.


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    Manual therapy including massage & spinal manipulation in asthma

    A Cochrane review identified four relevant RCTs.142 The two trials of chiropractice suggest that there is no place for this modality of treatment in the management of asthma. No conclusions can be drawn on massage therapy.
    Ref: Hondras MA, Linde K, Jones AP. Manual therapy for asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update Software.


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    Physical exercise training in asthma

    A Cochrane review143 has shown no effect of physical training on PEF, FEV1, FVC or VEmax. However oxygen consumption, maximum heart rate, and work capacity all increased significantly. Most studies discussed the potential problems of exercise-induced asthma, but none made any observations on this phenomenon. As physical training improves indices of cardiopulmonary efficiency, it should be seen as part of a general approach to improving lifestyle and rehabilitation in asthma, with appropriate precautions advised about exercise-induced asthma.
    Ref: Ram FSF, Robinson SM, Black PN. Physical training for asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update Software.


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    Breathing exercise including yoga and buteyko in asthma

    The underlying principle of yoga and Buteyko is to reduce hyperventilation by lowering respiratory frequency. A Cochrane review144 found no change in routine measures of lung function. Two studies reported a reduction in use of medication, and two a reduced frequency of attacks. At present it is not possible to make an evidence-based recommendation about breathing exercises for asthma.
    Ref:
    Holloway E, Ram FSF. Breathing exercises for asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update Software.


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    High altitude and speleotherapy

    Speleotherapy involves the use of subterranean environments as a therapeutic measure. A Cochrane review of the available evidence does not permit reliable conclusions to be drawn, although in two out of three studies, a total of 124 asthmatic children showed some short-term benefit. Randomised controlled trials with longer term follow up are required.
    Moving children to high altitude environments with low allergen and pollutant exposure has been reported to be associated with clinical improvements, but there are no published controlled trials and no long-term follow up data available.
    Ref: Beamon S, Falkenbach A, Fainburg G, et al. Speleotherapy for asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update Software.


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    Are fish oil and fatty acid useful in asthma treatment?

    In vitro studies suggest that supplementing diet with the omega n-3 fatty acids found predominantly in fish oils might reduce the inflammation associated with asthma. Controlled clinical studies in small numbers have on the whole been negative, with a Cochrane review concluding that there was little evidence to recommend fish oil supplements in asthma.
    Ref: Arm JP, Horton CE, Spur BW, et al. The effects of dietary supplementation with fish oil lipids on the airways response to inhaled allergen in bronchial asthma. Am Rev Respir Dis 1989;139:1395-400.
    Woods RK, Thien FC, Abramson MJ. Dietary marine fatty acids (fish oil) for asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford:
    Update Software.


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    Is the risk of getting asthma more in obese people?

    People who are overweight have a 50% higher risk of developing asthma, scientists have said.
    US researchers reviewed seven studies involving over 330,000 adult patients, the American Journal of Respiratory and Critical Care Medicine reported.
    The study, by a joint team from the US National Jewish Medical and Research Center and University of Colorado, classed showed that for every normal weight person with asthma, there were 1.5 people with asthma who were overweight or obese.
    The risk of having asthma for those who were obese was twice that of someone with normal weight.


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    What is the role of weight reduction in asthma control?

    A small randomized parallel group study has shown improved asthma control following weight reduction in obese patients with asthma. Other studies have also shown that losing weight and getting fitter can help in both managing asthma and improving lung function.

    Ref: Stenius-Aarniala B, Poussa T, Kvarnstrom J, et al. Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ 2000;320:827-32.


    What are the complications/ risks of surgery in Asthma patient?

    Patients who have asthma are at risk for specific complications during and after surgery. These
    complications include:

  • Acute bronchoconstriction triggered by intubation

  • Hypoxemia and

  • Possible hypercapnia

  • Impaired effectiveness of cough

  • Atelectasis, and

  • Respiratory infection

  • Latex exposure (allergy)

  • Allergy to some anesthetic agents

    The likelihood of these complications depends on the severity of the patient’s airway hyperresponsiveness, airflow obstruction, mucus hypersecretions, latex sensitivity, and history of prior surgeries, because the latter is a risk factor for both latex and anesthetic agent sensitivities.


    What are the actions to be taken before surgery in asthma patients:

    Patients who have asthma should have an evaluation before surgery that includes a review of symptoms, medication use (particularly the use of oral systemic corticosteroids for longer than 2 weeks in the past 6 months), and measurement of pulmonary function.

    If possible, attempts should be made to improve lung function preoperatively (FEV1 or peak expiratory flow rate [PEFR]) to either their predicted values or their personal best level. A short course of oral systemic corticosteroids may be necessary to optimize lung function.

    For patients who have received oral systemic corticosteroids during the past 6 months and for selected patients on a long-term high dose of an ICS, give 100 mg hydrocortisone every 8 hours intravenously during the surgical period and reduce the dose rapidly within 24 hours after surgery. Stress doses of
    corticosteroids may be considered for select patients treated with prior high-dose ICS therapy as well, because clinically important adrenal suppression has been reported in such patients, particularly children.

     


    What is Bronchial thermoplasty?

    Bronchial thermoplasty is used to reverse the airway remodeling seen in asthma.

    Bronchial thermoplasty can directly target the muscle component of the bronchial airway. The technique involves the use of the Alair(R) system, under development as Asthmatx, to deliver energy through a catheter which has an expandable basket of 4 electrodes at the distal end. During bronchoscopy, the electrodes are expanded to contract the airway wall and a controlled bolus of energy is supplied over 10 seconds.

    In the randomized Asthma Intervention Research trial in patients with poor asthma control, mild exacerbations were reduced for 4 months. Adverse events were increased early after treatment but did not differ compared to controls between 6 weeks and 12 months.

    In the Research in Severe Asthma trial, an early increase in moderate-to-severe adverse events was also seen with the technique, but again the rates of these events were equal at later time points. Bronchial thermoplasty was associated with improved FEV1, a reduction in rescue therapy and a reduction in oral steroid use.


    What are emergency phone numbers or asthma helpline numbers in UK?

    In an emergency, you can dial 999 (or 112) and ask for an ambulance. 112 is the European emergency phone number and it's a good idea to make a note of this if you are visiting another European Community member state.
    Generally, you should treat the situation as an emergency in asthma, for example, if:
    * someone has stopped breathing or is too breathless to talk,
    * the person is experiencing severe chest pain or is having trouble breathing,
    * the person is, or has been, unconscious,
    * the person has a severe allergic reaction.
    If you are not sure if it is an emergency, you can call NHS Direct on 0845 46 47 for advice on what to do.
    Good UK websites and there phone no. besides http://www.asthmahelpline.com are:
    1. http://www.asthma.org.uk/how_we_help/adviceline/index.html.
     There Helpline number is - 0800 121 62 44
    2. http://www.patient.co.uk/support/British-Lung-Foundation.htm
    3. http://www.lunguk.org/supporting-you/helpline-advice-service/index.htm
    others are:
    http://www.ukhealthcare.uky.edu/allergy/index.asp
    http://www.asthmarelief.co.uk/contact-us.php

    Last edited 18-8-2010

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