Understanding Asthma

Elise is currently the Practice Manager at Neal Street Medical Clinic. She is also a regional asthma educator with the Asthma Foundation and also trains practice nurses with the National Asthma Council.

Over 2 million Australians have asthma and the onset can occur at any age. It is the most common reason for hospital admissions in children under 12 and is one of the most common reasons for missing work, school and study.

Asthma is a common airway disease. During an attack the airway gets narrowed and that means the flow of air is affected which causes issues with breathing. People with an exacerbation of asthma have inflamed, red and swollen airways, which react to certain triggers. Asthma can be well managed and an active life can be easily led but there is no known cure.

Exercise is a major trigger for those with asthma.It can occur during and after exercise. It is more likely to occur if unwell or asthma is poorly managed.Common triggers include, exercise, a cold, smoke, pollen, cold air, dust, mould, perfumes, stress and certain medications (such as NSAIDs).

Symptoms are breathlessness, wheezing, chest tightness and persistent coughing. In children a persistent nighttime cough may be the only symptom present. In severe cases there can also be fast breathing, difficultly talking in sentences, and behavioural changes (mainly in children). Children can also have tummy aches, vomiting, be fatigued and lose their appetite.

Conditions associated with asthma are allergies to foods, eczema and hay fever. It is common for asthma and allergies to run in families. 60-80% of asthma patients have hay fever and this should always be considered at diagnosis. If hay fever is treated properly, it can minimise an asthma flare up. Hay fever symptoms are often mistaken for a simple cold, so you should be careful not to ignore these symptoms if you are unwell.

Treatment

Asthma is treated best when the patient and doctor work together. Working together to identify triggers and then avoiding them will help. Discussing with your doctor about how effective your medications are will help tailor a better treatment plan that works for you. The correct inhaler technique is very important and this should always be checked with your doctor or asthma nurse.

The following medications can be used alone or in combination to treat Asthma. Your doctor should be able to guide you with this. If used properly asthma can be very well managed.

1. Relievers

   An example is Ventolin. It is very safe and is used in asthma first aid. Its role is to relax the muscles that surround the airways and it works in minutes. It must always be accessible. It can also be used before, during and after exercise. It can also be used anytime, when the patient notes early symptoms. The use of reliever medication on a regular basis indicates poor control and should be discussed with your doctor.

2. Preventers

   Some examples are Singulair or Flixotide. These medications make the airway less inflamed and less sensitive to triggers. It needs to be taken daily for it to have an effect.

3. Symptom controllers

   Some examples would be Serevent or Oxis. They work by relaxing the muscles around the airways for 12 hours. It also needs to be taken daily. It is usually taken together with a preventer as well.

4. Combination

   Some examples would be Symbicort or Seretide. These work as a preventer and symptom controller in the one inhaler. Also needs to be taken daily.

Other useful info

Spacers improve the delivery of an inhaler to the airway rather than just hitting the back of the throat. It is especially useful in children. Chemists stock a variety of these.

Asthma Action Plans are a written document that is developed in consultation with your GP and Asthma Nurse. It developed for each individual and outlines the appropriate management when the patient is well, unwell and when symptoms get worse. Most schools will request this to be done for children.

Asthma First Aid :

The National Asthma Council Australia has very easy to use charts for an Asthma Emergency. Click on the links below and it will display these charts. Print it out and put it on your fridge door!