Asthmatics should avoid factors that trigger symptoms
Consultant physician and pulmonologist at the Lagos University Teaching Hospital (LUTH) Idi-Araba, Lagos State, Dr. Michele Dania, in this interview with PAUL ADUNWOKE, spoke on how to manage asthma.
What should the public know about asthma diseases?
Asthma is a chronic lung disease usually, characterised by difficulty in breathing. In addition to this, there are other symptoms such as noisy breathing, chest pains and persistent coughing. Usually, these symptoms are not there permanently, but occur at night, or in the mornings. Asthma is treatable, but for now, there is no cure for it, even though people living with it can live well if it is properly managed.
How frequently can these signs and symptoms come around?
This will always occur differently in patients. While some patients cannot breath well, in other words, experience shortage of breath, or even noisy breathing, which would be episodic, others would feel as if they are not breathing enough air, as well as, experience cough that is productive.
Most times, you can identify some of the things that trigger symptoms. They include, exposure to strong fumes, perfumes and dust. Some females have it triggered after a cooking session in the kitchen, while some children begin to pant after an exercise session or running. Actually, asthma was derived from the word panting, so, most times asthma patients pant whenever they feel the symptoms.
For patients, what should be the next logical step e after noticing these symptoms?
The patient needs to visit a hospital right away. The reason self medication is not allowed is because the patient needs to have a test to confirm that it is asthma. This is so because there are other sicknesses that present with similar symptoms. It is after a proper diagnosis, through tests that drug administration would commence. However, we have different categories of medications for this ailment. This includes reliever medication, which is the medication that can relief the symptoms at a particular point in time. There is also controller medication. This is used to prevent frequent attacks. Usually, because asthma is a disease that affects airways, these drugs are given through inhalers, rather than tablets. Though tablets are available and cheap, but they have more side effects, but the side effects of inhalers are less, even as inhalers are more effective.
What age is at risk of coming down with asthma?
One can develop asthma at any age in life. We have allergic and non-allergic asthmas. Allergic asthma is most common in children, and they begin to have the symptoms at the age of two. We have adult-onset asthma, which occurs in old people. So, people develop asthma at early age, middle age and at old age. There is also occupational asthma, which occurs when people are exposed to some allergies at work. For instance, exposure to flours, detergents and dusts. This set of people are disposed to developing asthma later on in life.
What are the preventive measures to take?
Asthma is a disease that has different components; part of it is genetic, while the other part of it is environmental. Genetic asthma cannot be prevented as these are people who have a family history of asthma. However, environmental factors can be prevented. For instance, cigarette smoking has been associated with asthma. Not those who are smoking, but those who are exposed to second-hand smoking, So, we advise people to stop smoking not just for their sake, but for the sake of their children. Pregnant women that smoke, expose their unborn children to the risk of developing asthma. Now, there is an upsurge in the epidemic of obesity, and obese people are predisposed to asthma. So, there is need for us to control smoking, obesity and indoor air pollutions. People are advised to keep their houses clean to avoid cockroaches, houseflies and those living with asthma should avoid things that trigger symptoms.
Asthma patients should avoid strong smells and certain drugs that can trigger symptoms. It is also very important to notify a doctor or pharmacist so that such persons can be spared certain drugs. Since exercise can sometimes trigger asthma, persons prone to suffering this, need to use one or two of their inhalers before they exercise.
Quality of air in factories should be controlled, and workers wearing masks at workplace should be sensitive about environmental exposure.
Those who are exposed to second-hand smoking are those who are not smoking, but live or work in environments where they inhale involuntarily, smoke from tobacco being smoked by someone else. Persistence exposure to second-hand smoking can also cause asthma because cigarette has dangerous particles. After inhaling this smoke for a long period of time, a non-smoker can also develop similar diseases and symptoms like a smoker.
Does stigmatisation have any effect on those living with asthma?
Yes, truly there is stigmatisation among those living with asthma. For instance, colleagues always see children who have asthma as being lazy. When it is time for sports, such children cannot participate actively in the exercises and sometimes miss school altogether. When this happens, they are not seen as being serious. The same applies to adults who have asthma, and cannot work as much as their colleagues who do not have, just like women who are down with asthma cannot carry out domestic chores as they should, especially when it is time to sweep or cook.
Stigmatisation against asthma patients leads them to hide their diagnoses, and makes some patients not to go out with their inhalers. This might expose them to severe attacks that might lead to death. So, people should stop stigmatisation of asthmatic patients who use their inhalers in public.
Again, some people believe that asthma is a spiritual problem. This is a major challenge that we face in counseling and treating asthma. Unfortunately, this might lead some patients not to adhere to doctors’ advise, by refusing to take their drugs. This development can also lead to more attacks, complications and eventually death before help gets to them.
Are there foods that can help prevent asthma?
Generally, what we advise is healthy eating. Of all the foods we have, none of them has been improved to the point of saying that once you eat this type of food asthma is cured. So, we advise people to eat a lot of fruits and vegetables because research has shown that people low in Vitamin ‘D’ can be exposed to asthma because this is an environment where we have a lot of sunlight. I do not think that is a major challenge though. Sometimes, we advise people to stay away from certain food because there are some people who live with asthma and have concomitant food allergy. These people may notice that when they take milk, particularly cow milk, peanuts and shellfish and others, they begin to have attacks. Based on this and other factors, we say that generally, people should eat healthy.
We also encourage exclusive breastfeeding because breastfeeding reduces the chances of children having diseases generally.
What is your general advise to asthmatic patients?
They should know that they could also live healthy. They need to be faithful in taking their drugs and visit their doctors when necessary. They should not see asthma as something that would stop them from achieving their dreams.