TOI: Asthmatics are assured of an improved quality of life: May 02, 2008

WORLD ASTHMA DAY MAY 6 BREATHING EASY

Asthmatics Are Assured Of An Improved Quality Of Life Thanks To Newer Devices And Medicines & Mini Oxygen Cylinders …..Madhavi Rajadhyaksha I TNN

Mumbai: At 9.30 every morning, Parel resident Pravin Mallya gets out a newly-acquired gadget, blows into it and dutifully punches away at the questions it fires. The device, an e-diary, records Mallyas breath power and automatically maintains a daily record of his episodes of breathlessness.

Mallya, an asthma patient, swears the gizmo allows him to precisely map his symptoms before he lands up at his doctors doorstep at the month end. Earlier I would manually chart out my asthma attacks and use a peak flow meter to measure my lung power. But on days that I forgot, I would merely tick the check-list to avoid a yelling from my doctor, admits the 48-year-old, adding that an in-built alarm in the e-diary which goes off twice a day, serves as a good reminder.

The e-diary is the latest in a host of patientfriendly devices in asthma care available in the city today. In the run-up to World Asthma Day on May 6, doctors say a diagnosis of asthma no longer means patients cooped up in their houses for fear of impending asthma attacks as newer drug delivery devices, better medicines and pocket-sized oxygen cylinders assure asthmatics an improved quality of life.

There are a lot of changes taking place to enhance patient convenience. Take for instance inhalers (devices that ensure the drug directly enters the airway). Today you have inhalers packed with multiple doses so that patients dont have to refill all the time, says chest physician Dr A B Mahashur of Hinduja Hospital, adding that inhalers have also been providing a combination of drugs for better action.

Pediatrician Indu Khosla, who has a clinic in Andheri, says convincing parents about inhaler therapy is often the biggest hurdle to asthma management in kids. We prefer inhalers to oral medication as it has quicker action and acts directly on the site, thus minimising side-effects. She says patientfriendly tools like spacers or face masks allow easier hand-tomouth coordination for children and better drug deposition.

Thats not all. Allergy specialist Dr Pramod Niphadkar, who runs a clinic in Dadar, points to pocket-sized nebulisers and mini oxygen cylinders to explain the convenience factor. Today, a patient can carry these in his pocket as they come handy in times of emergency. These nebulisers are easier for patients to use even when they are lying down, he says.

Medicines for asthma used in the West now make their way to Indian shores almost simultaneously. Dr Niphadkar says a drug now available ensures targeted therapy for asthmatics, thereby reducing side-effects such as throat infections or congestion. Dr Mahashur points out that anti-IEG injections, which have recently hit the shelves, address the very pathogenesis of the disease. Dr Amita Athavale, who heads KEM Hospitals chest medicine department, says the efficiency of newer drugs and devices is still being researched at the teaching hospital.

At the hospital end too, technology promises better treatment. Take for instance an exhaled nitric oxide analyser that would gauge the level of gas in a patients breath and thereby be able to precisely diagnose his/her level of asthma.

For patients like Mallya, each innovation offers more succour. It makes a world of difference in day-to-day life. Earlier I would have such aggressive spells of breathlessness that I would be forced to bunk work often. Now, with correct medicines and yoga exercises, I can easily say my asthma is under control and even attacks are rare, he says.

Could it be mere anxiety?

Emotional factors alone cant bring on asthma. However, anxiety can cause hyperventilation or over-breathing and thus worsen the symptoms of asthma or aggravate attacks, observes the American Academy of Allergy, Asthma and Immunology. Scientific studies have shown that patients with asthma are likely to be more anxious than others and may also have clinically diagnosed panic disorder.

A paper published in the British Medical Journal by a general practitioner in Oxfordshire Duncan Keeley and senior research fellow Liesl Osman studied the co-existence of asthma and anxiety-related breathing problems. Since there is an overlap of symptoms of asthma and anxiety, doctors should be careful about repeatedly taking medical history and physiological measurements such as peak flow recordings, it observes. The paper suggests that doctors should routinely gauge what causes anxiety in their patients so as to avoid unnecessarily stepping up their asthma doses if it is an episode of anxiety.

Asthma Factsheet

Asthma is a chronic disease characterised by recurrent attacks of breathlessness, tightness in chest and wheezing. During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and reducing the flow of air in and out of the lungs.

Causes

Though the exact cause isnt known, it is triggered by varied factors, the commonest being pollen, dust mites, tobacco smoke and cold breeze. Certain medications such as aspirin and other non-steroid antiinflammatory drugs, and betablockers (which are used to treat high blood pressure, heart conditions and migraine) could trigger asthma.

Statistics

* There are 300 million people suffering from asthma around the world and 2,55,000 people died of it in 2005. * Over 80% of asthma deaths occurs in developing countries. * Asthma is the most common chronic disease among children.

Asthma management

Medicines

Controllers:

They are medicines which prevent asthma attacks from starting. There are two types of controller medicines: antiinflammatory medicines and airway openers.

Relievers:

They are medicines that provide rapid relief from an asthma attack by quickly opening up the narrowed airways (dilating the bronchi) and are also called bronchodilators.
COMBINATION MEDICATIONS contain both relievers and controllers in the same inhaler. So they open up the airways and reduce the underlying inflammation at the same time. Now combination inhalers let you adjust the dose of drugs to the severity of your asthma BREATHING EXERCISES such as pranayam, or blowing a balloon can help build lung power FOODSTUFFS such as imli, cold beverages, icecreams and bananas act as triggers for some patients and are best avoided. Micronutrients such as magnesium, available in papaya or green leafy vegetables, are known to help build immunity among asthmatics.

Keep pets away.

(Source: Global Initiative for Asthma & World Health Organisation)

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