Asthma: Education and Proper Treatment Is Vital by MaryLou Bernardo

If you suffer from asthma, you know about triggering symptoms: chronic cough, shortness of breath, wheezing and a feeling of tightness in your chest.

Asthma is medically defined as 'chronic inflammatory disease of the airways.' It occurs when 'triggers' cause inflammation in the airways which can cause muscles around your lung's airway to tighten and close. Additionally, in response to the inflammation, your airways produce mucus, that can 'clog up' or shrink the inside of the tubes even more.

Symptoms vary from person to person. Coughing tends to be a common symptom of asthma, especially in children.  Other symptoms include wheezing, chest tightness, and shortness of breath.  Some people react to only a few irritants while others deal with several 'triggers' including: cold and chest (viral infections); smoking or breathing second-hand smoke; pollen, flowers, grass, plants, trees, dust, cold air, house-dust mites, pets, exercise or sports.  

Asthma is a chronic condition, meaning it needs to be monitored and controlled over a lifetime. Asthma can be diagnosed at any age however it often starts during childhood. Risk factors include: a family history of asthma; history of eczema or allergies, frequent cold like symptoms/pneumonia and exposure to tobacco smoke or chemical irritants.

Globally between 100 and 150 million people suffer from asthma and this number is rising. It's estimated that over 3 million Canadians have asthma. In Ontario, about 8 per cent of adults and 12 per cent of children have been diagnosed and it is also the leading cause of hospital admissions for children.  It's a very serious condition and if neglected, it can be fatal. Sadly, there are 500 asthma-related fatalities in Canada every year and it's estimated that more than 80 per cent of asthma deaths could be prevented with proper education.

Before asthma can be diagnosed, your primary care provider first has to rule out other conditions including: pneumonia, cystic fibrosis, heart disease, chronic obstructive pulmonary disease and gastroesphageal reflux disease (GERD).

If you've been diagnosed, the Group Health Centre's (GHC) Algoma Asthma Education Centre (AAEC) provides essential educational services for residents of Sault Ste. Marie and the Algoma District. Although AAEC is based at the Sault Area Hospital (SAH), Plummer site, it has been part of GHC's umbrella of services since 2005.

Janice Belanger, certified asthma educator and registered respiratory therapist, is the AAEC coordinator. She explains, "By providing education for asthma sufferers, less visits to the emergency department and less hospitalizations with asthma are documented and most importantly, those individuals are experiencing a better quality of life."

Patients are taught the proper use of their puffer medications because according to Belanger, "There are all types of devices available on the market, making it confusing for many."

There are two kinds of medications prescribed to people with asthma: 'controllers or preventers' that reduce inflammation in the airways and should be taken every day. 'Relievers' are a short-term solution to help to alleviate symptoms immediately however they do not help any underlying problems of inflammation.

AAEC staff teach patients how to keep their asthma controlled by educating about the early warning symptoms of asthma, allergic and non-allergic triggers; the importance of not smoking and living in a smoke-free environment as well as total environment control. Belanger explains, "That can include the removal of indoor carpets, pets, dust, mould etc. These items are just as important and have to be dealt with as well."

Certified asthma educators also conduct(s) a breathing test known as 'spirometry to determine if a person is reaching their predicted lung values and to assess if the asthma is under control. "By teaching self-management (and action) skills and the use of an action plan , patients can learn how to monitor their breathing while at home. This is done by monitoring daily symptoms and learning 'peak flow monitoring.'

A peak flow meter is a small, hand-held device that monitors airflow through your  bronchi and the degree of obstruction being experienced in the airways. (The bronchi is the airway in the respiratory tract that conducts air into the lungs). Peak flow readings are higher when you're well, and lower when the airways are constricted. By documenting changes in 'recorded values', you and your health care providers can determine lung functionality, severity of asthma symptoms and treatment options.

According to the asthma consensus guidelines, asthma is not controlled if:
~ inhaled medication is becoming less effective and is required more frequently; rescuer/reliever such as Ventolin/Salbutamol or Bricanyl should be used less than four times per week;
~ waking up at night with a cough, wheeze, or shortness of breath;
~ experiencing wheeze, cough, or tight chest despite your ongoing treatment more than 4 days/week;
~ usual daily activities are limited or interfered with and
- frequent asthma attacks/flareups

AAEC referrals are made through the SAH emergency department, physicians, nurse practitioners, family health workers, and pharmacists or by self-referral. For more information, please call (SAH) 759-3434, ext. 5268, weekdays.

Dr. Anne Lee, family physician with the Algoma District Medical Group is AAEC's medical advisor.

For more information, please visit: The Asthma Society of Canada: www.asthma.ca  and  The Lung Association: www.lung.ca

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MaryLou Bernardo is the Communications Coordinator with the GHC's Patient Relations and Communications department. Email: bernardo_m@ghc.on.ca