Breath of Fresh Air?
When a person breathes in hazardous elements, like smoke or toxic gases, the body’s natural reflex is to protect the lungs and expel the agent. Thus, we cough. The airways narrow to block entry, and increase mucus production to wash the agent away. Asthma is this mechanism gone awry. For whatever reason, in people with asthma, the airways become hyperreactive, and react even to agents that are not harmful—allergens, dust particles, pet dander, even hot or cold air.
Dr. Jatinder K. Kansal, of the Asthma & Allergy Clinic in Merrillville, has been working with asthma sufferers for more than 25 years, and there are patterns to the condition. In general, asthma is more common in metropolitan areas. It is more prevalent in lower socioeconomic strata, and among minority populations. A person’s risk increases with family history and exposure to certain viral infections. Asthma can be allergic, an immune system response, or non-allergic, a more or less mechanical one. Like many conditions, asthma can worsen with anxiety, depression, obesity and a sedentary lifestyle.
While advances have been made in the last several years, no one treatment fits all. However, even as the number of sufferers has risen over the last forty years, people are living better with the condition. Determining the trigger is key to management, says Kansal, “listening to the patient to find out the kind of asthma and the cause.” Pollen, mold and animals are common allergens. Candles, air-fresheners and aerosol sprays also irritate the airways.
The type of asthma dictates the treatment. Drugs help control inflammation, congestion and bronchial spasm. Inhaled cortico-steroids are still the standard. Albuterol inhalers work on constricted airways. Some drugs combine steroids with bronchodilators. Leukotriene inhibitors reduce the immune response to allergens.
“The problem is,” Kansal says, “there’s no test to find out which person is going to respond to which medicine, so it’s trial and error.”
There are also allergy shots, which give increasing doses of allergen over time to “switch the immune response.” These are most effective against pollens and dust mites. The very latest is an anti-IgE injection that blocks immune response. It only works for allergic asthma, and can sometimes cause an allergic reaction itself.
No matter the type or cause, the most important step is controlling the environment for causative agents. This can include using air-conditioning when pollen is high. To eliminate dust, try having less carpeting if possible. If you have pets, incorporate pet-free zones (especially bedrooms) in your home. Keeping known irritants at a minimum is also a good idea.
