As we start to work our way through the alphabet of health, it is easy to start with Air and Asthma. In medicine, we have an acronym that all doctors and nurses use and are familiar with, when it comes to treating a patient in an emergency situation. The acronym is ABC, which stands for Airway, Breathing and Circulation.
Starting with "A" makes sense, because if your airway (and also your air itself) is not good, your breathing or circulation will not be good either! The term airway really refers to the upper respiratory tree (also known as the trachea or windpipe). This starts in the back of your mouth, and goes down your neck to the upper part of the bronchial tree within the lungs.
When a doctor, tells you that your airway is "good," he or she means that it is not too narrow and that the structure of the back of your mouth allows for the easy passage of air (and a breathing tube, if necessary).
There are several things that can compromise your airway, and these range from temporary things like swelling after surgery or during an infection, to external obesity (which also makes the structures in your airway collapse more easily during sleep, causing sleep apnea or difficulty breathing). Other than your internal upper airway, the other aspect of good air exchange involves your lower pulmonary system (also known as your lungs and lower bronchial tree).
Things that can affect this part of good respiration include everything from asthma, to smoking and infections, such as influenza or pneumonia. Asthma is a condition that affects close to 20 million Americans, according to the American Lung Association. By the year 2020, asthma will affect 1 in 14 Americans and 1 in 5 families!
Most people know that asthma can be life-threatening, but for many people, especially children, it can also affect their day-to-day lives. Recent news reports triggered some concern for people who take two particular types of asthma medication when the Federal Drug Administration heard testimony from experts who recommended that Serevent and Foradill be taken off the market. Studies showed that patients, who were not adequately educated about the proper ways to take these medicines, had a higher risk of complications from severe asthma attacks, because they relied too heavily and exclusively on the bronchodilators to treat their asthma.
Other mainstays of asthma treatment, such as drugs like Advair and Symbicort, contain both the airway-opener (bronchodilators) and a steroid to reduce inflammation, and continue to be very important asthma medications. Steroid medications work in a preventative manner to treat asthma and reduce attacks.
For patients who are on any of these medicines, there are several critical take-home points. Firstly, NEVER abruptly discontinue ANY medication based on a news story without discussing it with your personal physician! Secondly, many patients with asthma require multiple medications, which work differently, to control their symptoms. If you are only using an inhaler, and find yourself needing to use it more frequently, or more than several times a week, check in with your doctor. You may need an adjustment in your medication regimen. Lastly, be vigilant about your air environment as much as possible. Make sure dust, mold, pet dander and smoke are minimized in your home.
Tips for good air in your home: 1. Try to circulate fresh air in your home at least once a day, even in the winter. Cracking open a window for 5 or 10 minutes can make a big difference! 2. Minimize heavy drapes or curtains in your bedroom which can harbor dust. 3. Vacuum under area rugs since a lot of dirt, dust and particulate matter falls through and escapes the suction from the vacuum.
Finally, people with asthma should never smoke or be around those who do smoke. (We will cover smoking in a future blog!) People with asthma should also consider receiving the Influenza vaccine (which is NOT a live virus vaccine) since they are at higher risk for pulmonary complications if they get the flu. It is not too late to get a flu shot this year!
Wishing you good health,
Dr. Jennifer Ashton, M.D., F.A.C.O.G.
