Asthma Kills!

For so long, I have heard people say things to make excuses for not adhering to their health care regimen. "I grew out of my asthma" (that's #1 on the list), "I really don't need all those medications", "I only have an attack once in a while, when I have a cold", "I couldn't find my inhaler", "My inhaler ran out", the list goes on and on.

This is the very reason, we need to be better educated about the effects and dangers of this Inflammatory Process which strong effects our Airways (breathing). I spoke with a woman after her recovery from what is called Status Asthmaticus, and she said, "all I could think about, was getting in one good breath". She arrived by ambulance to the hospital, ended up in our ICU (intensive care unit), breathing with the assistance of a ventilator. She was someone who we caught in time. There was a woman, who figured she could finish up her workday before going to the hospital, knowing she needed to treat the "attack" she felt coming on. She persisted, until someone at work insisted she go. Apparently, she felt she could drive herself, her thoughtful co-worker called an ambulance. Without sharing all the details, after we worked on her for well over an hour, she didn't make it.

I implore everyone who has been diagnosed or shows symptoms of Asthma, to see your doctor and be specific in describing your symptoms. You should be referred to a Pulmonologist to receive specific testing. We will talk about these tests later on in this blog. I want to share with you, the four classifications of Asthma:

• 1.) Mild Intermittent. This classification addresses people who rarely experience an exacerbation (attack) without the presence of an irritant. This person has symptoms less than twice weekly, and nighttime symptoms less than twice monthly. Their FEV (Forced Expiratory Volume, a Pulmonary Function test) greater than 80%.
  
  
• 2.)Mild Persistent. This classification addresses people who experience an exacerbation more than twice a week, but less than daily. So, perhaps this person feels "tightness of the chest" or wheezing from time to time in the course of a week. The nighttime symptoms also occur more than twice monthly. Their FEV is around 80% with a variance of 20 - 30% at onset.
  
  
• 3.)Moderate Persistent. This person has daily symptoms with nighttime symptoms occurring at least once weekly, and absolutely MUST use their "rescue" inhaler daily. This medication is classified as a Beta2 Agonist (i.e., Albuterol), and works immediately on the smooth muscle tissue of the airway to quickly allow for improved airflow. The FEV for this person is definitely ranges between 60% - 80%. 80% is being very optimistic.
  
  
• 4.)Severe Persistent. This person has very little daily activity. Symptoms occur early and a strong medication regimen is required. There are very frequent nighttime symptoms and the FEV of this person is definitely going to remain below 60%.

Let's talk a little bit about these classifications. If you should find yourself between two different classifications, then you should defer to the strongest of the two. For example, during the day, you rarely ever have any symptoms, yet you have problems sleeping at night due to symptoms more than twice a month, you should consider your symptoms as Mild Persistent instead of Mild Intermittent. Once you visit a Pulmonary Specialist, and receive your Asthma Action Plan, you should definitely stick to that plan, as if your life depends on it. After all, it's true. Your life really does depend on your diligence and commitment to this plan. I won't fill this blog with a lot of technical jargon and spirometric values, that will only cause confusion. I will however, strongly urge you to talk openly and specifically to your physician about onset and frequency of symptoms.

Keep in mind, AGE IS NOT A FACTOR for new diagnosis of Asthma. As a matter of fact, there was a time, when we did not diagnose a child with Asthma until that child reached 2 years old. Thank God things have changed and advances in health care have provided for much stronger diagnostic tools and skill sets. On the flip-side of the age chart, don't feel that if you're well over 35 years old, you cannot be diagnosed with new onset Asthma. It's quite possible.

Here are a few statistics for you:

• Prevalence: 20.5 Million Americans are diagnosed with Asthma. 6.2 Million of these 20.5 Million, are children.
• Morbitity (effect of illness): Patients experience a combined 100 Million days of limited activity. There are 485 Thousand hospitalizations annually, with 1.9 Million Emergency Room visits per year.
• Mortality: 4,200 deaths are reported annually.

Please understand, this data is available because of recorded reports. The number of people who are not addressing the seriousness of this Airway Disease, remain unknown. I guess we'll continue to count on the mortality rates.

Hold on to your hats, there's much more to come!!!