Asthma is caused by widespread, reversible, inflammation of your lung's airways making them narrow. To grasp this asthma information we need to take a microscopic look at your lungs.
Your lungs are like an upside down tree. In fact, you can feel the trunk in the front of your neck as the Adam's apple in males. The trunk divides over and over again like branches and twigs behind your breast bone. The leaves at the branch ends are where air swirls and gases exchanges with your blood.
Your lungs are like an upside down tree. In fact, you can feel the trunk in the front of your neck as the Adam's apple in males. The trunk divides over and over again like branches and twigs behind your breast bone. The leaves at the branch ends are where air swirls and gases exchanges with your blood.
One important difference however, is that this 'tree' is hollow. When you breathe you suck air through the trunk, past the divisions, and ultimately to the 'leaves', or alveoli, where your blood takes up the oxygen it needs and gets rid of carbon dioxide created from burning your food for fuel.
An asthma attack is when the branches and twigs of the lungs get inflammed and narrow. That narrowing is like the difference between blowing through a pipe (1) or a straw (2). Not only is blowing through the straw noisy i.e. wheezing, but it's also more difficult i.e. you feel short of breath.
Symptoms of an Asthma Attack:
- Wheezing. The most obvious sign of asthma is a wheezing musical sound made by narrowed air passages.
- Chest Tightness like a large rubber band around the chest making breathing difficult.
- Coughing with or without sputum.
- Fast Breathing. As less air reaches the lungs you breathe faster to make up the deficit.
- Accessory Muscle Use. As an asthma attack gets worse the airways pushing air through the narrow pipes gets difficult. Muscles of your torso pitch in to help. This is seen as tugging motion at the pit of the throat (2), and sucking in of the belly just under the breast bone (5) and between the ribs (4) with each breath.
- Heart palpitation. As part of your body's reaction to less air and increased work to move air, your heart starts to beat faster (3).
- Posture Change. Note the shoulders in our female asthmatic above. As asthma gets serious asthmatics try to sit up and support their shoulders on outstretched arms with each breath as a brace to force air into their lungs. This is a sign of a serious degree of asthma and is called a 'tripod' stance.
- Gasping Conversation. Another serious sign is when an asthmatic can no longer keep up a conversation with you as they gasp to finish sentences.
- Skin Color Change. When an asthma attack becomes severe enough that too little oxygen reaches the body, the asthmatic can faint and around their lips and fingernails looks blue - blood with too little oxygen turns from red to blue. At this point breathing may slow or stop all together and no wheeze may be heard. This is an emergency.
Types of Asthma:
Though the end result of asthma is the same - irritated airways narrowing - the causes of this irritation that trigger off an ASTHMA ATTACK vary from person to person i.e. one person might start wheezing when in a dusty room while another only wheezes when s/he has a cold. The following are the most common types of asthma:
- Childhood Asthma. As its name suggests, this form of asthma happens as a child, and most kids 'outgrow it'. The reason why is like acne which doesn't bother you as a child but starts in your teen years - your body goes through a number of changes at this transition period making you not only look different but function differently too. Predicting if this will happen to your asthma is reasonably done by asking if your parents suffered from asthma too. If they did, and outgrew it, chances are you will too. The treatment of childhood asthma is no different to adult asthma as the causes are the same. What varies is the doses of medicines which are adjusted to body weight.
- Nocturnal Asthma. Nocturnal just means 'at night'. Some people wheeze mostly at night. The reason is that blood levels of epinephrine and cortisol drop at night to allow you to sleep. But these chemicals also keep your airways open. This type of asthma typically happens in the wee hours of the morning. A useful treatment for this is taking a steroid inhaler before going to bed or a long acting bronchodilator inhaler. This reduces the tendency of the airways to narrow as you sleep.. Another measure is to wash your bed sheets and pillow regularly and cover your bed with a zipped allergen guard as dust mites live on dead skin and produce an irritating stool that irritates your lungs as you sleep.
- Allergy Asthma. An allergy is where your body overreacts to some substance around you. This type of asthma is associated with a runny nose, itchy eyes, sneezing, and dry or productive cough. Steroid inhalers are useful in this condition by 'calming' your air passages. Antihistamine type drugs also play a role. But the best method of control is to get allergy tested and then avoiding the offending substances. If you can't, allergy desensitization treatment may be beneficial. This works by exposing your body to minute amounts of the substance and working back up to normal amounts without a reaction.
- Sports Asthma / Exercise Induced Asthma. After exercise some people wheeze. This is believed to be a reaction to changes in temperature of air in the lung. It can be avoided by using a bronchodilator inhaler just prior to basketball, football e.t.c. and breathing through your nose until your body feels warmed up.
- Cardiac Asthma. This type of asthma is unlike the other types of asthma discussed so far. It is caused by a heart that is failing to push blood around the body at a satisfactory rate. This leads to congestion of small blood vessels and they leak. In the lung this fluid irritates the airways causing them to narrow and makes a bubbling noise called 'crackles' or 'creps'. There's a tendency to cough up pink frothy sputum. While standard inhalers will help to bring the wheeze under control you'll also need diuretics like Lasix and careful blood pressure control.
- Cold and Flu Asthma. Some persons wheeze when they have a sore throat/ flu. This is because the offensive flu virus irritates your lung's airways which then narrow. This will respond to your inhalers and typically the virus lasts only about a week. Bacterial bronchitis infections can also lead to wheezing and in this case addition of an antibiotic is beneficial - antibiotics kill bacteria but not viruses so do not help in a viral infection.
- Occupational Asthma. This is a form of allergy asthma to something at your work place like smoke, dust, mold, or fumes. Sometimes it can be controlled by steroid inhalers and bronchodilators. If not, ventilating the area by opening windows or wearing a dust mask helps. If severe, you may be left with no option but to seek transfer to another area or job.
- COPD / Emphysema Asthma. Common in smokers, this type of asthma is caused by permanent loss of 'elastic-ness' of airways causing the floppy airways to narrow. It responds to asthma medications but symptoms tend to be daily and residual shortness of breath is common.
Asthma Treatment:
Home
- Asthma Prevention. This means avoiding things which make you wheeze, and using your preventative steroid inhaler everyday. If you haven't wheezed in six months then a trial off of inhalers can be made.
- Asthma Allergy Testing. Learning what your asthma triggers are helps you avoid them. If you come into contact with them or expect to, you can take both your preventative and bronchodilator inhaler before the wheeze has a chance to start. This can completely abort or reduce the severity of an upcoming asthma attack. Common triggers are things like dust, smoke, colds, etc. For example, if you know that cat dander makes you wheeze and you were planning to visit Aunt Mary with fifty cats,before going over you should take two puffs of both your preventative and bronchodilator inhalers.
- Remove Asthma Triggers at home. This means keeping pets outside if allergic to furs, removing dusty carpets and drapes or regular vacuuming if allergic to dust, asking smokers to smoke outside, keeping an eye out for mold in your bathroom and around sinks.
Hospital
Most hospitals have a section specialized for asthma treatment. When you get there you typically are first assessed by an attendant listening to your chest, taking your vitals and by asking you to blow into a peak flow meter (PFM).