Asthma is a condition that just doesn't get the respect it deserves.
The reason I say asthma doesn't get enough respect is that, because it's so common and because we have such excellent medications to treat it, most people, even people with asthma, significantly underestimate what asthma can do. In short, asthma can kill. In fact, over 4000 Americans die of asthma every year, and the sad reality is that many of those deaths could be prevented if asthma were accorded the respect it deserved.
Asthma is a chronic lung condition that affects at least 20 million Americans. Asthma is a particular problem in kids in that it is not only a common cause of absenteeism from school, but in an era when many American kids are fast threatening to become Michelin Man stand-ins, asthma is also a very common cause of non-participation in sports and exercise, although in reality, most kids with asthma can - and, more important, should - stay active in sports.
Asthma produces shortness of breath, wheezing, coughing, and tightness in the chest. It used to be thought that these symptoms were entirely due to reversible spasm in the airways, but we now know that airway inflammation is at least equally important in producing asthma symptoms, and that insight has had a dramatic impact on how we now treat this disorder.
The list of asthma-provoking factors is huge and includes: dust and dust mites (scary to know, isn't it, that there are live things in those dust balls under your bed?), pollution, exercise, smoking, stress, respiratory infections (the worst asthma attacks I've had coincided with bouts of the flu, which is why I now get an annual flu shot, as should everyone with asthma), animal dander, pollens, molds, laughing, GERD (stomach acid washing back into the esophagus is a commonly overlooked cause of asthma attacks, especially during the night), and many others (although, despite popular belief, foods rarely cause asthma).
Asthma is often diagnosed from the individual's history, although that leads to both underdiagnosis (when the pattern of symptoms is not typical) and overdiagnosis (everything that coughs or wheezes is not asthma, especially in kids). The definitive way to confirm that it's actually asthma causing those symptoms is with pulmonary function tests.
Besides respect, asthma is best treated with prevention. Thus, people with asthma should, as much as possible, avoid exposure to factors they know they're sensitive to. But as an asthmatic who shares his abode with a huge, symptom-provoking malamute, I can attest to the fact that it's not always easy to avoid what you know you should avoid, especially since Big Louie keeps tripping me any time he thinks I'm going out without him. It is important, however, to try to avoid asthma provokers as much as possible, so dust, wash, clean, kick the cat out, etc., as much as you can fit those into your life.
Even with the best avoidance measures, however, most people with asthma still need at least occasional medication. The most commonly used medications have long been symptom relievers known as short-acting bronchodilators (medications that open airways) or short-acting beta-agonists (those puffers you often see kids use when they get wheezy), but we now know that these should only be used occasionally or in special circumstances, such as before exercise. Just as important, they must be used properly, too. (Studies show that only a small amount of a sprayed medication actually reaches the airways - even less in people who don't use their puffer properly.)
People with persistent asthma require some type of symptom-controlling medication, usually anti-inflammatories or longer-acting bronchodilators. The most common anti-inflammatory medications used in asthma are inhaled corticosteroids, while longer-acting bronchodilators include older medications such as theophylline, new longer-acting beta-agonists, and leukotriene antagonists.
Many new medications have come to the market that combine a long-acting beta-agonist with a corticosteroid. These products may offer help to those who want the ability to control their asthma symptoms and adjust their dosing without the need to add or change inhalers. So if you're taking a combination of medications, you may want to ask your doctor about these new products.
A word of caution for people with asthma, though, especially if you are on any maintenance regime: you should have an "asthma plan," an idea about what to do, and when, if your symptoms get worse. You don't really want to figure out what you should be doing when you can't catch your breath and it's getting worse.
