Facts and Myths about Asthma

1/ Asthma is completely incurable

Asthma is indeed an incurable, chronic disease however the reality of the condition isn’t as bleak as it sounds. The primary reason behind the lack of a cure is the inability of medical experts to identify its origins, although there is strong indication that they are related to genetics. Other factors that may contribute to the development of this condition include exposure to respiratory or viral infections as well as certain airborne allergens during infancy or childhood.

Asthma patients can enjoy a normal life by managing the symptoms associated with this condition i.e. coughing, wheezing, laboured breathing. Doctors normally prescribe a medicine called Ventolin for this condition. It relaxes the inflamed passageways of the lungs that are the root cause of asthmatic symptoms. This in turn alleviates the asthma attack, and if taken prior to an asthma inducing activity e.g. exercise, will prevent the attack altogether.

The most common way of consuming this medicine is by inhalation, for which either an Evohaler (a device that dispenses the dose in the form of a fine mist), or an Accuhaler (a device that dispenses the dose in the form of inhalable powder) is prescribed.

Therefore, the statement that asthma is incurable is true but slightly misleading; with adequate medication, its symptoms are completely manageable and in most cases, preventable, so the patient can still lead a fulfilling life. In fact, the majority of fatalities that occur due to asthma are a result of negligence in using proper medication either by the patient or by the medical professional.

2/ Your menstrual cycle can affect your condition      

This is a fact. While asthmatic females experience fewer episodes during childhood compared to males, this trend reverses with the onset of puberty: by age 20, women have a greater likelihood of being diagnosed with this condition than men. In fact, there is a 30% greater chance of women having asthma and a 40% greater chance of women suffering a fatality due to the condition.

For the average adult female who experiences a 28-day menstrual cycle, there is a decline in oestrogen and progesterone levels during the last week of the cycle (starting from the 22nd day). The hormones levels are at their lowest on day 28, right before the period starts. Experts believe that the decline in the levels of these hormones could be responsible for restricting the airways, or for an adverse impact on the immune system, resulting in an acute asthma episode.

Additionally, research has shown that blood vessels form and disappear in a woman’s lungs as her hormone levels vary, which can affect a patient’s ability to inhale oxygen. This may also contribute to alleviated asthma symptoms.

A small study of female subjects between the ages to 8-17 years found that girls who experienced early menstruation developed more severe asthma, which indicates a potential link with earlier hormonal fluctuations.

Other hormone related milestones that can trigger asthma attacks in women are pregnancy and menopause. For the former, it is a matter of statistics: one in three women experience a deterioration of their asthma symptoms; one in three women experience an improvement; for the last third, it stays the same. This has likely to do with the unpredictable hormonal fluctuations experienced during pregnancy.

In the case of the latter, a series of peaks and valleys in oestrogen levels are experienced, with the valleys being more frequent in many cases. These can trigger asthma episodes unless actively managed, possibly through temporary hormone replacement therapy (HRT).

In order to minimise the effect of your menstrual cycle on your asthma, you should keep a daily diary of the symptoms you experience and discuss its contents with your allergist punctually so they can recommend a suitable treatment. Avoiding common triggers such as cold air, dust, dander and smoke will also bring down the chances of a premenstrual asthma (PMA) episode.

3/ It’s possible to die from asthma

Asthma, if left untreated or unchecked, can cause a patient’s death depending on the severity of its symptoms. In fact, asthma mortality is on the rise around the globe. That being said, fatal asthma attacks are, in most cases (65 to 85% according to research), fully preventable.

The most common causes associated with a fatal asthma episode are underdiagnoses and/or insufficient treatment. In some cases, the doctor fails to mark the severity of the patient’s condition, while in others, the patient themselves don’t take the condition seriously. Ultimately, the patient fails to get the right dosage of Ventolin, which exposes them to the risk of a life threatening attack.

To prevent the onset of fatal asthma, you must remain constantly vigilant about your symptoms and regularly discuss your condition with your health specialist. As an example, some individuals may not be able to ingest the full dosage by means of an Evohaler, thus risking a dangerous attack. They will need to use their inhaler more frequently; this trend should be noted and the doctor informed of it, so they can decide on an alternative approach such as an Accuhaler or a syrup to ensure that the patient gets their prescribed dosage.

4/ Ventolin is overprescribed

While in the past, asthma patients experienced under diagnosis resulting in fatalities that could have been prevented, today the situation seems to have reversed. With the great deal of asthma awareness that has occurred over the past few decades, some doctors have started diagnosing the apparent symptoms associated with asthma without ascertaining the underlying condition itself. In certain cases, such patients have been prescribed Ventolin when it is unnecessary. This can be due to the condition requiring preventer treatment, not relievers, or the condition itself being misdiagnosed (i.e COPD or another respiratory condition).

A research by two leading Australian respiratory doctors revealed that among 100 child patients prematurely diagnosed with asthma based on their symptoms, only 5% were confirmed to be asthmatics after extensive testing. In other words, just because someone is suffering from asthma-like symptoms doesn’t necessitate that they are asthmatic; there are a number of other respiratory conditions that could be causing those symptoms.

This trend is bothersome given the considerable cost of Accuhalers, Evohalers and other Ventolin dispensing treatments. Furthermore, more aggressive asthma medications such as inhaled corticosteroids can have serious side effects that include growth suppression, adrenal failure, and respiratory infections.

It is a sound idea to ask for multiple opinions should you feel even slightly doubtful about your asthma diagnosis, especially if the prescribed medication seems to be ineffective.

5/ Pollution causes asthma

About two thirds of asthmatic individuals claim that breathing in poor quality air worsens their condition.

One of the most frequent pollution based triggers is ozone, characterised by the haze or ‘smog’ that can be observed across the horizons of urban metropolis, especially in summer when there is bright sunlight and still air. Ozone irritates the airways of your lungs, which can lead to an asthma attack if the exposure is prolonged. It compromises lung function and hampers breathing, and has been known to trigger severe asthma attacks that ended up in hospitalisations.

Other fine particles such as those found in dust, smoke or haze can pass by way of your mouth or nose to your lungs and cause problems as well. They contribute to both short and long-term health issues for asthma patients e.g. more frequent attacks, reduced lung functionality etc.

Indoor air pollution i.e. caused by cigarette smoke, wood fires and chemical detergents has the same effect on asthmatics. Besides actively inflaming the airways of your lungs, air pollutants can also make you more sensitive to your regular triggers e.g. fungi, pet dander, pollen and so on. Consequently, you’ll experience wheezing, coughing, troubled breath, a scratchy throat and nose.

While those asthmatics who have their condition under control and experience minimal symptoms may not be affected a great deal by air pollution, it can be problematic for children and young adults suffering from this condition. The reasons behind this vulnerability are their developing lungs and faster breathing rates that make their bronchial airways irritate faster. Air pollution can also be a major trigger for asthma patients who also suffer from COPD or some other long term ailment e.g. heart disease.

In order to determine whether air pollution is affecting your asthma or not, you’ll need to look for the following signs:

  • Increased sensitivity to usual triggers
  • Harder to manage / more aggravated symptoms
  • A lower than usual peak flow score
  • More frequent usage of your Accuhaler / Evohaler inhaler

Recent studies have also revealed that long-term exposure to high levels of air pollution may actually cause asthma in both adults and children. Pregnant mothers who are exposed to excessive pollution levels – even if they’re not asthma patients themselves – may introduce the condition to their babies.

It is hard to avoid a trigger such as outdoor air pollution, since it is present in almost all urban environments. This makes it all the more necessary that asthma patients who come in frequent contact with high levels of air pollution be strictly observant of their prescription.

Indoor air pollution can be managed through countermeasures such as HEPA air filters that can clean up the air around you. Be mindful that you do not use standard air cleaners which emit ozone.

6/ Only severe asthmatics get asthma attacks

Triggers cause asthma attacks and the reaction of the asthmatic to each trigger varies. For instance, a mild asthmatic may not suffer from an attack when exposed to air pollution, but the same individual may experience an acute asthma episode when they come into contact with an allergen such as pollen or pet dander.

This is especially true for children with mild asthma. Once they have developed the condition, they become vulnerable to allergies and upper-respiratory viruses; both of these can trigger their symptoms rapidly. Extreme levels of stress can have the same effect on individuals who had previously only shown signs of mild asthma.

In short, there is no definite rule that asthma attacks are exclusive to severe asthmatics: this condition’s symptoms can be triggered by such a diverse and extensive list of substances that a sweeping statement such as the one mentioned before is inapplicable.

7/ Ventolin becomes ineffective over time

The effectiveness of Ventolin will not reduce over time if you use it in a controlled, well-managed way. You may even start requiring lesser than what was originally prescribed if you take it punctually as instructed by your doctor.

That being said, overusing your Evohaler or Accuhaler can have a paradoxical effect on its ability to alleviate your symptoms. Ventolin is a beta-2-agonist that relaxes the muscles of your bronchial airways to give you rapid relief from asthma symptoms, however, excessive consumption will result in your lungs developing an affinity for the medication that will reduce their responsiveness to it.

If you are not careful, this could compel you to take it in even greater dosages as time progresses, to the point that regular inhalers would have only a marginal effect on your condition. When you start using Ventolin the moment you experience breathing difficulties, it’s a warning sign that the medication has become a ‘feel-good’ substance for you and its consumption needs to be controlled.

Remember that Ventolin is only a short-term relief medication. In order to treat asthma long-term, you’ll need to discuss options such as steroids or allergy shot therapy to deal with the underlying inflammation. However, the ineffectiveness part holds true for longer acting inhalers as well. Overusing them could make your lungs hypersensitive and actually increase the likelihood of an asthma attack due to common triggers such as allergens, infections or cold.

It is vital that you immediately seek the advice of your GP should you feel your asthma medication is not providing the relief it is supposed to.