Dear Doc: Breathe easy with asthma control techniques | VailDaily.com
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Dear Doc: Breathe easy with asthma control techniques

Dr. Drew WernerVail, CO, Colorado

Dear Doc,School sports are upon us and some of my runners have asthma. How can I help them run their best and be safe, too?CoachDear Coach,Great question and perfect timing. As they say, Tis the season. September is the peak time for asthma attacks in the United States and most asthma related hospitalizations also occur this month. The term asthma originally came from a Greek word meaning difficult breathing. Our modern use of the word encompasses a variety of conditions in which there is narrowing of the airways as a result of either spasms of the smooth muscles surrounding them or swelling and mucus in the lining of these airways. In any case, it is a problem of air exchange. Unlike a smokers emphysema, asthmatics do not have a problem getting air into their lungs as much as getting air out. When breathing out is prolonged or slowed, the next breath cannot get in as quickly as is needed.Asthma can occur spontaneously or may be triggered by something specific. Often several factors act at once to make the problem even worse. Common things that may trigger asthma include allergies, infections, exertion, cold exposure and high altitude.When we breathe, air enters our trachea and passes down through an increasingly smaller set of airways to the alveoli or air sacs, which take in oxygen (O2) and expel carbon dioxide (CO2). It is in these small airways that the spasm, swelling & excessive mucus production occurs setting into motion an asthma attack. The end result is shortness of breath despite being surrounded by air. It can be very frightening to breathe fine one minute and suddenly be struggling the next. I think the ancient Greeks had it right. No matter how much we have learned about asthma, those who suffer from it simply have difficult breathing.Fortunately, there are things we can do to treat and prevent asthma. First and foremost is prevention. That sounds so obvious, but can be so difficult. My first rule is (for asthma and almost every other medical problem and illness), DONT SMOKE! Other preventive measures include avoiding triggers:oDress warmly in the cold & breathe through a neck gater or mask in frigid temperatures.oAvoid allergies including foods, animals and other environmental triggers both indoors and outdoors .oUse a vacuum with a HEPA filter to minimize indoor allergies.oConsider seeing an allergist such as Dr. Robert McDermott who recently came to our valley and has a full time practice here in Eagle and in Glenwood Springs at Valley View Hospital. Allergists are physicians who are expert at treating allergies and asthma which often go hand in hand.Sometimes people get so used to difficult breathing they forget what it feels like to get in a full breath of air. If you think you have asthma or arent sure how bad it is, then spirometry, a special breathing test, can be used to measure the overall health of your breathing. It is a very important test not only for making the correct diagnosis of asthma, but also in monitoring the effectiveness of treatment. A Peak Flow Meter is a device for personal use and measures the force of air a person can breathe out. This simple meter is small, portable, inexpensive and easy to use. It is a helpful device for most asthma sufferers to use for monitoring their condition. For athletes with asthma, peak flow meters are a vital part of achieving their best performance. They guide therapy and the use of rescue medications as well as help tell the difference between a potentially serious asthma attack and shortness of breath from normal conditioning and aerobic stress. Peak flow meters can be used before participation in practice or competition as well as during or after sports to help you and your doctor best manage your condition.Only recently, it was felt that if you had reactive airways then your asthma was only a problem in certain situations or with certain exposures. Your treatment was only for those bad days. On the other hand, if you had asthma daily or persistently abnormal spirometry then you needed a maintenance medication. Now we know differently. Asthma attacks are damaging to our lungs and airways. The more we have, the worse it gets. After many years, the recurrent asthma attacks add up and may lead up to chronic breathing problems. Most asthmatics then need maintenance or preventive medications.Asthma is treated using two types of medications rescue medicines and preventive medicines. The rescue medication used most often is an albuterol inhaler. This drug rapidly dilates constricted airways in just a few minutes, rescuing you from your asthma attack. The benefit however, is brief, lasting from on to four hours and over use actually results in decreased effectiveness. Preventive medications dont work quickly, but rather improve our airways over time and actually minimize the damage recurrent asthma attacks cause. A simple way to think about it is this: If you need to use a rescue medication more than two or three times per week, you should talk to your doctor about going on a preventive medication. On the other hand, preventive medications should not be used during an acute asthma attack. They simply do not work quickly enough to provide the needed urgent relief.Preventive medications include inhaled steroids, long acting beta agonists (such as long acting Albuterol), and leukotriene receptor antagonists. Thats a complicated name for a class of oral medications that help reverse the process that causes asthma. Dont worry about using the inhaled steroids they wont give you big muscles or the other side effects people think of with steroids. They are actually similar to topical steroids commonly used for rashes. They are breathed in, work topically in our lungs, and then are exhaled. They are not absorbed into our blood streams and as a result are remarkably safe. Finally, there are mast cell stabilizers that dont really affect the asthma process but rather block the allergic response in people with inhaled allergies.So remember, information is power and you can take control of your asthma. Talk to your doctor and you can work together to find the best solution for you.Please keep your questions coming in! The only bad question is the unanswered one!Let me know whats on your mind at editor@vaildaily.com.Remember your health is your responsibility! Health is our greatest asset & it doesnt happen by accident. If something doesnt seem right, or questions are left unanswered dont wait, call your doctor.


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