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No
one seems to know why Asthma has become
astoundingly common in Britain. The
obvious ‘culprit’ is the awful air pollution that exists today.
But in fact, asthma has also increased in parts of the UK where
there is practically NO pollution! This
is very odd indeed, and at the moment scientists can’t explain it. But
some researchers think that the increase in asthma – in both older
people and in children – may be due to one of the following factors: v
Increased use of air
conditioning – which of course doesn’t allow fresh air to circulate; v
Increased use of fitted
carpets – which cut down on currents of fresh air and also encourage
dust mites in the home; v
Possibly pet ownership,
since some folk are allergic to cats and dogs without realising it; v
The increased use of food
additives; v
The increased
popularity of gardening, since some older people are allergic to certain
common garden plants (including grass!); Also, very latest research has come up with the somewhat surprising finding that people who were brought up in very clean environments are more likely to suffer from asthma as they get older. If this turns out to be true, it seems to suggest that a certain amount of exposure to germs when you are young is not a bad thing! What is asthma?Basically, it’s a closing down of your air tubes. The passages that carry air down into your lungs are little pipes. And unfortunately, it’s all too easy for those pipes to suddenly ‘clamp down’ and get narrower. When that happens, it becomes very difficult for the air to get in. Result:
you can’t breath properly. That’s
an asthma attack and very frightening it can be, too. One 64 year old recently had an attack for the first time
ever told me “It was the most scary thing that’s ever happened in my
life’. But
why do these attacks occur? Why
do the air tubes suddenly get narrower?
There are several main factors involved: v
ALLERGY
– unfortunately many people have bodies, which are ‘programmed’
so that if the air tubes come into contact with an allergy-provoking
agent, they respond by suddenly getting narrower for a while. v
INFECTION
– if an asthmatic person suddenly develops a chest infection, that
can tip them over into an asthma attack and regrettably, chest infections
are really common particularly in the over-55s. v
PSYCHOLOGICAL
FACTORS – in the past doctors are always ‘going on’
about how emotional factors – such as stress- could bring on asthma
attacks. Frankly, it
sometimes seemed to me as if this was an unfair way of blaming the patient
for his/her asthma! Nevertheless,
it is true that getting upset can sometimes make a person drift into an
asthmatic attack. So keeping
calm is a good idea! v
PHYSICAL
FACTORS – external physical factors like suddenly having
to breathe cold air can sometimes trigger an attack.
So can certain drugs. And
exercise can sometimes bring on an attack, though sensible amounts of
exercise are generally good for people who have asthma.
Finally smoke (like tobacco smoke!) will usually make things worse. Click
here to go back to the top of the page. SymptomsSo
what are the symptoms of asthma? From
what we’ve just said, you’ll appreciate that a primary symptom is
difficulty in getting your breath. Other
common features include: v
Wheeze v
Cough v
If
things are getting really bad, going blue. Happily
most asthmatic people don’t have these symptoms all the time.
For much of their lives, they are perfectly fine.
They may go weeks or months without an attack and in some folk, the
asthma eventually decides to go away altogether – which is always very
good! Click here to go back to the top of the page.TreatmentWhat
about treatment? Treating
asthma is never easy and the best therapy must be worked out by the
partnership of you and your doctor. In
most cases, your doctor means your GP, though some asthmatic people will
see specialist chest physicians. However
there are now so many asthmatic people that they can’t all be managed by
specialists at hospitals. You
might like to note that lots of general practitioners have set up special
‘asthma clinics’ at their own surgeries, usually run by nurses
who have had extra training in this subject. But
what does the treatment consist of? It
falls into various categories: 1.
Avoiding the cause of the problem – if you know what brings
on your attacks (the allergen), you need to avoid it like the plague.
So if it’s clear that a particular type of pollen starts of your
asthma, or if dog hairs bring it on, then commonsense dictates that you
must steer clear of these things. You
should also steer clear of asthma-provoking drugs, such as aspirin and
beta-blockers. Also if you
are cigarette, cigar or pipe smoker, it is lunacy to continue. 2.
Avoiding chest infections – avoiding infections certainly
isn’t easy in Britain – especially in the autumn or winter. But
if you have asthma, it makes sense to keep away from crowded places, such
as packed buses and train carriages.
The worse possible place to be is a doctor’s waiting room with
people coughing germs all over you! Also,
if one of your grandchildren has just developed a cold or cough, it’s
better to keep your distance from them until they are better. 3.
Medications – sadly I find that in the UK many people do
not really understand the nature of the anti-asthma medications which they
use. Some folk tend to talk
rather vaguely about ‘the brown one’ and ‘the blue one’ without
being clear about what they are on. So
here is a brief guide to the main categories of drugs: v
Bronchodilators
– this word means ‘drugs which open up the air tubes’ that includes
agents like salbutamol and terbutaline given in inhalers. v
Inhaled
anti-inflammatory agents – these are drugs, which are meant
to damp down inflammation in the air tubes.
They include sodium cromoglycate and also inhaled steroids like
beclomethasone. v
Oral
steroids – these are cortisone like tablets, given by mouth
and usually only to cover a short period (since side effects can be
serious). They include
prednisolone pills. Click
here to go back to the top of the page. Other measuresIn
some countries, doctors try to ‘desensitise’ people to asthma
allergens. This is rarely
done now in Britain because it is felt to be risky and ineffective. Hypnosis,
homeopathy, herbal remedies and yoga seem to help some people.
But in general, you won’t be able to get them through the NHS and
will have to make your own arrangements. What
you can get through the health services is a device called a ‘peak
flow meter’. This
clever little invention is very useful for showing what sort of state your
air tubes are in. You blow
into it and it gives you an instant reading of how fast the air is moving.
All asthmatics should get one of these excellent ‘PF meters’.
Use the device regularly, keep a record of your results and show it
to your doctor when you go and see her.
The record can be of much help in seeing how you are doing and in
forecasting whether you are heading into any trouble. There
are some commonly asked questions about asthma in the Q & A section
which follows. Good
luck and may you breathe easily! Click
here to go back to the top of the page.
Q
I have had asthma all my
life. My daughter has just had a lovely baby girl.
It is inevitable that she will get it too? A
No it isn’t although
admittedly asthma does tend to run in families.
The risks of your grandchild developing asthma will probably be
reduced if she is breast-fed and not bottle-fed.
This is because many infants are allergic to cow’s milk. Q
I didn’t develop asthma till
two years ago when I was 57. I
am just a light smoker around about 10 a day.
Do I really have to give up as my doctor insists? A
Well, 10 a day isn’t ‘light
smoking’, sir. Cigarette
smoke inflames your air passages and so makes you more liable to asthma
attacks. If you want to live long, I should give up.
Now. Q
I developed asthma when I was about 50.
So far, it hasn’t been much trouble.
But the other day, I was horrified to read in the paper that asthma
can kill! Does this happen very often? A
There is no point in me denying
that asthma kills around two thousand people in Britain every year. But if you take sensible precautions against it and always
take your medication, then the chances of such a tragedy are very low. Q
Is asthma catching in any way? A No, not at all. You can’t give it to other people Click here to go
back to the top of the page.
Q
Do bones take longer to heal in
the over 70s? My mother has
broken a rib in an accident. Any
tips for a speedy recovery? A
Sorry to hear about your
mother’s accident. First
thing to say is that breaks are much more common in anybody over 55.
This is mainly because thinning of the bones (osteoporosis) is so
common. Fractures (that is,
breaks) are also rather slower to heal in older folk.
But given luck, your Mum’s ribs should be mended in about seven
weeks. Try to keep her as
active and mobile as possible, but obviously she shouldn’t do any
activity which causes her pain in the ribs. Q
I am 67, and recently I have
noticed that my bowels don’t seem to be working in the same way as they
used to! Sometimes I go more
often than formerly and sometimes I go less often.
Is this all right, doctor? A
Could be that you are perfectly
OK. But I can’t stress
strongly enough that in anyone over 60, a change in ‘bowel habit’
needs to be checked by their doctor.
This is because of the fairly high incidence of bowel cancer in the
over 60s. So please see your GP this week. Q
How often should one’s blood
pressure be taken? Mine has
always been all right, but my wife says I should have it checked
regularly. A
Anyone over about 50 should
have the ‘BP’ checked at least once a year.
Your surgery nurse will gladly do this for you. Q
I would like to have my
prostrate checked but really do not relish the prospect of having my GP
put his finger up my bottom! Isn’t
there some other way he can examine it? A
No I am afraid there isn’t
sir. The male human body is
so constructed that the only way of feeling the prostrate gland is through
the rectum. There is a blood
test for prostrate problems, but it really isn’t very good yet.
It’s nowhere near as efficient as having a prostrate examination
by your doctor. Sorry! Click here to go back to the top of the page.
© 2000, 2001, 2002 Dr David Delvin/Retirement Matters Ltd. All rights reserved.
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