Asthma

As asthma is a respiratory condition, it affects the airways and the ability to breathe easily. The condition is widespread in Australia, where 1 in 9 members of the population have asthma. This is equivalent to 2.5 million people.

Asthma is similar to other chronic diseases of the airways, including chronic obstructive pulmonary disease (COPD). COPD includes chronic bronchitis, emphysema, and chronic obstructive airways. The same treatments can be used for COPD as for asthma, although the symptoms tend to be more severe.

Your doctor will be able to tell you which condition is causing your breathing problems.

Asthma usually develops during childhood, but it can happen at any time. Some people who are diagnosed during childhood will find that the symptoms ease as they get older.

• Males aged 0-14 years of age are most likely to have asthma, whereas for females it is those aged 15 or over that are most likely to suffer from the condition.
• Indigenous Australians are almost twice as likely to have asthma as non-Indigenous Australians. Among older adults this rate increases still further.
• In Australia, asthma is more commonly reported in people that live in socioeconomically disadvantaged areas.
• The asthma rate is also higher among people who live in inner regional areas rather than large cities or outer regional and remote areas.
• Everyone who has asthma should have a written asthma plan, but only 20% of people aged 15 or over have one. Among children, this percentage increases to 41%.
• Asthma is a significant issue in Australia and cost the health service $655 million in 2008-9.
• The condition can require hospitalization if it is poorly managed, and patients report a poor quality of life in some cases.
• Some 34% of people say that asthma impacts their daily life, and 21.8% of 15-25-year-olds took time off work or school due to asthma.
• Asthma killed 421 people in Australia in 2015.

There are various symptoms of asthma that occur due to the reaction of the airways to certain asthma triggers. These triggers are certain substances or situations that cause the sensitive airways to tighten, become inflamed, and produce more mucus.

This leads to breathlessness, wheezing, coughing, light-headedness and a tight chest. These symptoms can be relieved using one of a number of medications that are administered using inhalers or other methods.

No one really understands what causes asthma to develop, however, there are a number of possible explanations.

The following are possible causes of asthma:

• Family history of allergies, asthma or eczema
• Past problems with lung infections such as bronchiolitis, especially during childhood
• Premature birth or below average birth weight
• Use of an inhaler at an early age
• If a expectant mother smoked during pregnancy
• Exposure to secondhand smoke during childhood
• Ongoing exposure to secondhand smoke
• Exposure to harmful chemicals or smoke in the workplace
• Hormone imbalance in women

There are also asthma triggers, which are different to causes. While a cause is an underlying factor that leads to the development of asthma, a trigger is something that causes your asthma to worsen.

Everyone has different things that trigger their asthma. The following are some of the most common examples of asthma triggers:

• Cold or flu viruses
• Pollution
• Smoking/secondhand smoke
• Depression or anxiety
• Stress
• Hay fever
• Animals and pets
• Weather
• Dust mites
• Chemicals
• Certain food and drink
• Mould and fungi
• Drugs
• Hormones
• Sex
• Exercise

If you experience any symptoms associated with asthma, book an appointment straight away. A diagnosis can take some time because symptoms and triggers differ from person-to-person.

Before you go to the doctor, collect some information that will help them to evaluate your condition:

• Write down the symptoms that you experience and note what days and times they are most noticeable.
• Think about whether there are any asthma triggers that you can think of.

By providing this information you can assist your doctor in correctly diagnosing your condition. This will help to prevent any confusion.

During your appointment you will be asked about your personal and family medical history, as well as your symptoms, working environment and lifestyle choices. Your doctor may then carry out a number of tests:

• A peak flow reading is used to measure your lung function and involves exhaling into a tube.
• Spirometry requires you to breathe in through a mouthpiece and then breathe out to measure the inflammation of your airways.
• An airways responsiveness test examines your response to an irritant such as histamine.
• Allergy tests may be used to see if there is a certain trigger for your asthma.
• FeNO testing measures the level of nitric oxide expelled as you breathe out.

Once your doctor is confident that they have made the correct diagnosis, you will be offered treatment. This usually takes the form of an inhaler.

Asthma treatment is usually administered using an inhaler. There are two main types: reliever and preventer.

Preventer inhalers are used on a regular basis, usually on a daily basis, to administer continual treatment. Reliever inhalers are only used when needed, such as before playing a sport or if you experience asthma symptoms.

Some of the most common types of inhaler include:

• Turbohalers
• Easyhalers
• Accuhalers
• Autohalers
• EasiBreathe
• Metered Dose

Each type of inhaler is operated in a different way. Your doctor will provide specific instructions when you are prescribed an inhaler.

The main differentiation is that some inhalers deliver medication as an aerosol, and others as a dry powder. It is important to practice using your inhaler correctly otherwise the medication will not be able to do its job. This will lead to poor management of your asthma and increase the risk of suffering an asthma attack.

There are ways that you can make using your inhaler easier. You may be given a device known as a spacer, which is a good way of making sure the medication is inhaled properly.

Always store your inhaler as instructed and use it according to your prescription.

Many asthmatics will go through life without experiencing an asthma attack. The chances of an asthma attack occurring are higher if your condition is poorly managed, so it is important to stay on top of your condition.

Effective treatment should mean that you don't experience symptoms of asthma. However you can spot an asthma attack coming and work to stop symptoms from getting worse.

The following signs may point to an imminent asthma attack:

• Your symptoms have been present for some time
• Symptoms do not improve
• Your usual inhaler isn't having any effect
• You can't control how fast you are breathing
• You can't speak, sleep or eat normally

If you do experience an asthma attack, the following steps will help you to manage it:

• Sit up straight
• Tell someone nearby if your symptoms feel out of control
• Take a puff on your reliever inhaler
• If there is no improvement, take more puffs every 30-60 seconds up to a maximum of 10 puffs
• Concentrate on regulating your breathing

If your inhaler has no effect after 10 puffs, call the emergency services.

If you have been diagnosed with asthma there are a variety of things that you can do to improve the management of your condition. In addition to using your medication as prescribed by your doctor, you should try to implement the following lifestyle changes:

• Quit smoking
• Take a different route to work to avoid polluted areas
• Wear a face mask on your way to work
• Act quickly if you feel symptoms
• Download apps to reduce stress and anxiety
• Take a note of when triggers occur and monitor your triggers

Your doctor will provide you with a written asthma plan. Make sure that you follow the instructions on this plan.

You should also be aware that asthma can change over time. It is important that you maintain good communication with your doctor to report any changes and attend regular asthma check-ups.

Leading a healthy lifestyle will also help you to manage your asthma. If you are overweight, try to lose some excess fat by eating a balanced diet and getting regular exercise. In fact, one of the best treatments for exercise-induced asthma is to exercise.

Give your body the best chance to neutralize the effects of asthma and you will find that your life is uninhibited by the condition. The aim for every asthmatic is to be able to live day to day without noticing any effects from asthma.