Controlling Asthma

Managing asthma and controlling it well is the only way for the afflicted to live normally. Despite knowing this and recognizing estimates of alarmingly rising asthma rates in children and adults, most governments have neglected asthma control and not done enough.

Rajendra Prasad, Director of the Vallabhbhai Patel Chest Institute in Delhi, told Citizen News Service that asthma is a chronic and lifelong disease. It is important whom we consult and also to be regular with medicines as well as to be regular in consultations with the treating doctor.

Symptoms, he said, occur early in the disease's progression, forcing patients to seek early medical advice. Patients can lead a normal life even though asthma is a chronic disease provided they remain on regular follow-ups by the treating doctor and adhere to treatment and care as advised. As an indication of hope, 84 Olympic Gold Medalists are living with asthma, Prasad said.

If the affliction is well managed, people living with it can live life normally, meaning patients must not let asthma take control of them, but that rather people must keep asthma under control. This is possible, otherwise people with asthma would not have been able to live life normally and pursue their dreams and fulfill them!

The iconic Bollywood film star Amitabh Bachchan lives with asthma, keeps it under control and has indeed created a history. His interviews are testimony to how gruelling his daily routine is. He continues to work hard and inspire even at the age of 70 years. Many other people who are world famous and have lived with asthma include: Theodore Roosevelt and John F Kennedy, former Presidents of the United States; Ludwig Von Beethoven, composer and pianist; Alice Cooper, rock singer, songwriter and musician; Elizabeth Taylor, two time Academy Award winning Hollywood actress; Charles Dickens, novelist; among others.

Every person with asthma can be a heroine or hero if the disease is kept under control. With at least 84 Olympic Gold medalists having asthma, it is clear that people with asthma can surely exercise provided asthma is kept under control.

"Exercising is not a trigger for asthma for everybody," Karen Bissell, Deputy Coordinator of the Asthma Drug Facility, International Union Against Tuberculosis and Lung Disease and a co-author of a 2011 study on pricing, affordability and availability of asthma medicines, said in an interview. "I think it does not trigger asthma with all people with asthma and generally we recommend children to do exercise because you can have other health issues if you do not do any exercise. It can bring out poor health in other ways. It is important that people must do some exercise. What is important is that when people with asthma exercise they should have releaser and inhaler with them.

"While exercising if you have symptoms you can take a pause, rest, and wait for 5 minutes and then go again. So, if people's asthma is properly controlled then they can exercise just like the way normal people do. So, you should be able to do your daily activities including exercise. Of course in countries where people do not have medicines this is a bit harder because they do not have a releaser to use when symptoms arise. There they may feel more vulnerable. So, let us pass our concern of giving access to people to essential asthma medicines in low income countries where they can carry out their daily activities including exercise as exercise is very good. It is very good for lungs to do exercise. But if they do not have medicines then they may feel more vulnerable while exercising."

Christophe Perrin, Pharmacist at The Union and Coordinator, Asthma Drug Facility, agrees. "Exercise can be one of the triggering factors for a mix of reasons. Exercising in cold air might trigger asthma as it is irritating for the lungs of asthma patient which are already inflamed and in a bad state. It is advised that people must not exercise in polluted air. We need more awareness to protect oneself from these known triggers. For example in Paris there are radio announcements when weather conditions can put people with asthma at risk."

So if we manage asthma well, have backup inhalers and other medicines, stay away from potential asthma-related triggers or aggravating factors, then perhaps one can exercise normally and rest in between or seek medical help if so indicated. Taking care of asthma also means protecting oneself from asthma-related triggers and aggravating factors.

"There is widespread belief that allergies are the major reason for developing asthma," Perin said. "At least half of asthma cases in children and adults involve allergic mechanisms. There is quite a wide range of allergens that one can consider in relation to asthma. Apart from pollen there are wide range of allergens people with asthma may be sensitive to such as animal fur, or other allergens at work place. Allergic mechanisms are not well understood. Factors that aggravate asthma include second-hand tobacco smoke, fumes from vehicles' exhaust, among others."

It is very important in countries to have national guidelines for standard management of asthma. It needs to have standard case management so that a standardized approach is set. Proper medicine procurement system needs to be functional. Proper prescription of medicines is important so that people know what to use. More doctors, nurses, healthcare workers must be trained to identify and diagnose the patient and to care for them because many times it is realized that they do not have access to medicines or they do not prescribe the right medicines.

Education must be provided to people as on how to use the inhalers and on checking the symptoms. They should have the knowledge and they should know when they have their warning sign. If something is out of control they must know what to do. They should know when they have to go to the healthcare facilities for help. Having chronic patient with asthma, knowing how to manage their own asthma, is very important to keep people out of the hospital wards.

It will be important to ensure that asthma medicines are also included in national list of essential medicines so that adequate resources and programming can be invested in it. Keeping asthma under control as that is the only way to live life normally. Governments must do all what it takes to ensure uninterrupted adequate supplies of affordable and quality assured essential medicines for asthma, robust patient education programmes so that people with asthma can take control of their lives and asthma care.

(Bobby Ramakant is the editor of Citizen News Service)

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