Diplomate, Board Certification of Emergency Medicine
My readers asked me to discuss asthma. I have discussed this
before, but I will repeat it.
Asthma is a disease where the lung passages fill with mucus
and they spasm, as well. It usually occurs in kids and the
elderly, but all ages can be affected. People who have
allergic histories are the most susceptible, and they often
have other allergies as well, or skin disorders such as
eczema.
Asthma can be brought on by colds, viruses, pregnancy,
exercise, and cold air. Acute treatment involves the use of
inhalations with medications that stop the spasm. This is
where our sponsor's Ventolin is one of the most-often-used
medications. It can be given by inhalation therapy, but a
hand-held inhaler with a spacer device is just as good. This,
however, will only take care of the spasm.
If there is a lot of mucus plugging up the passages, then
steroids must be used to calm this down, and this takes time.
Basically, if the first ventilation therapy does not work,
then steroids are given. Patients with severe spasm and
plugging can need to be put on a respirator, and may do
poorly. Yes, people still die of asthma.
So you are correct my dear reader, that prevention is best.
Steroid inhalers such as beconase can keep asthma at bay and
Serevent is a long-acting anti-spasm drug that may help in
prevention -- before exercise for example. It is not for an
acute attack. Glaxo has combined these medications into
something it calls Serentide.
SIDS is the next question. This is the horrible case of
children being found dead, Rachmono litzlan, in their
cribs. We do know that putting babies in their cribs on their
stomachs, and mothers who sleep with their children, are risk
factors. It isn't related to snoring in adults, but often
there are close calls. Babies like that need to be on
monitors that will ring if they stop breathing.
Wheat allergy is often a disease called sprue and a special
blood test should be taken to prove it, since there is often
more of a risk of colon cancer. Milk allergy is well known in
kids, and they often grow out of it. We no longer believe
that milk should not be given to people with diarrhea. Indeed
nursing is the best thing for diarrhea and to put off cow's
milk allergies.
Other points: Pure air is definitely better for breathing. Go
up to the Golan one day and feel the difference. Smog can
worsen all types of breathing problems. Peak flow meters
measure breathing passage obstruction, but they need a really
cooperative patient. I do not believe asthma is related to
stress. If you are an asthmatic who smokes, then you are
really asking for trouble. Write me in care of the
Yated.
GlaxoSmithKline sponsors this column.
