"Did You Know?” 31 Days of Asthma

May is Asthma & Allergy Awareness Month. These 31 days are devoted to reflecting upon what it is to have asthma and how to make others aware about what it is like to live with this condition. Asthma is a condition fraught with various misconceptions. So here are 31 asthma facts, which I am hopeful, will help in spreading awareness about this condition.

31 asthma facts

1. Asthma origins: “The word “asthma” originates from the Greek meaning short of breath. The term was refined in the latter part of the 19th Century with the publication of a treatise by Henry Hyde Salter entitled “On Asthma and its Treatment”, in which he defined it as “Paroxysmal dyspnoea of a peculiar character with intervals of healthy respiration between attacks“, a description that captures his concept; a condition in which airways narrow due to contraction of their smooth muscle.1

2. May 2nd is World Asthma Day: an annual event organized by the Global Initiative for Asthma (GINA) to improve asthma awareness and care around the world.5

3.Asthma triggers are things that cause your asthma to worsen.6 Asthma triggers differ from person to person.

4. Asthma is diagnosed using a combination of family and medical histories, physical exam and diagnostic test such as lung function tests.5

5. Treating asthma is often approached from a “stepwise” approach such as the GINA guidelines. These incorporate stepping up or down treatment based on symptom assessments, and reviewing response.6

6. Allergic asthma: About 75% of the 334 million asthmatics worldwide have allergic asthma. (Read here: https://asthma.net/living/what-is-allergic-asthma/)

7. Did you know that spacers (Aerochmabers) should be well cleaned at least once a week? “Powder collects in the chamber and around the Flow Indicator Valve. It is also recommended that the chamber and mouth piece are cleaned once a week. 8

8."In 1999, 675,000 people participated in clinical research; they were chosen from 6.5 million individuals who were originally contacted."28 While participating in research and clinical trials will not guarantee an improvement in my health, I feel like I am a more empowered patient and part of the solution.9-15

9. “Increased number of eosinophils in peripheral blood and in airway secretions are characteristic features of asthma”27

10. Are you looking for support on your asthma journey?  A study identified that  health professionals often are limited in  what they can provide to patients. The study emphasizes the need for web-based education, group discussions, inclusion of information, and practical skills for teaching children.2

11. What are asthma phenotypes? “Phenotypes are said to be defined as the outward manifestation of an individuals underlying genetics." Asthma phenotypes guide selection of diagnostics, long term prognosis and responsiveness to specific medications.16

12. The most common asthma symptoms are coughing, difficulty breathing, Chest tightness, shortness of breath and wheezing.17

13. “Not all Asthmatics wheeze and not all wheezing is asthma.”18 Other causes of wheezing are vocal cord dysfunction, congestive heart failure, upper airway obstruction and sinusitis to name a few.

14. The main categories of asthma medication are controllers and rescue medications. Example of controllers are inhaled corticosteroids (ICS), Combination inhalers that ICS and LABA (Long Acting bronchodilators) and rescue medications SABA (Short Acting Bronchodilators . Other common medications are Leutotriene receptor antagnosist (LTRA), Tiotropium and OCS (oral corticosteroids).

15. Asthma action plans are strongly recommended for all asthmatics. The written plan is developed with your doctor to help you manage your asthma. It indicates when you need to make changes to your medications in response to symptoms, call your doctor or seek emergency treatment.19

16. A common alternate diagnosis to asthma is Vocal Cord Dysfunction. VCD has many of the same symptoms as asthma and asthma is much more prevalent, patients with VCD often are misdiagnosed with asthma.3

17. Spring is in the air and so are thunderstorms. Did you know there is something called “Thunderstorm Asthma”? The mechanisms are not fully known, however it is linked to epidemics of asthma, especially during the grass flowering season.

18. Respiratory Therapists (RTs) are integral members of asthma disease-management teams . They care for asthma patients by performing lung function test, providing treatment and care.20 Personally, I am super grateful that I have them in my care team.

19. Don’t forget that medications expire. If you are like me, you may have some meds that you use for those “in case of emergency needs” that are often forgotten about. Check with your doctor or pharmacist about expiry dates and safe disposal.

20. Have you been curious about trends in your symptoms and tracking your medication use? Why not try an experiment them, there are all sort of ways to do that old school notes, apps and web based solutions. Tracking symptoms and medication use can help predict changes in your health.

21. I just booked my Bone Density Mineral Test! Did you know glucocorticoids that are commonly prescribed for treating asthma could decrease calcium absorption and increase bone loss?21

22. Being an active participant in your own care can make the world of difference. This can include good nutrition, physical activity, staying on top of medication use and the use of an asthma action plan. Patients who used the guidance of a written action plan as part of their self management tools, showed a reduction in admission to hospital.

23. Being a driving force in your own care can have great positive outcomes. I have personally seen the benefits of maintaining a active lifestyle make the world of difference in my quality of life. The self management of asthma can prevent exacerbations and improve care.22

24. Many asthmatics have had the dreaded trip to the Emergency Room. A patient introduction note “can save you from having to recite your entire medical history over and over again to people who don’t know you (this is especially helpful, when you can’t breath).”23

25. Participating in regular physical activity is good for you in many ways. There are theories that exercise can decrease airway reactivity and medication use. You should have good general control of your asthma and consult your doctor for any concerns you may have about participating in physical activity.

26. Severe Asthma affects approx. 10% of the asthma population. These patients have a higher morbidity and a disproportionate need for health care support.24

27. A great way to keep track of all you the information that you receive from doctors is to keep a journal of notes from appointments. It is often difficult to remember what the doctor said or in what context. By being the most informed patient you can be, you will be setting yourself up for success.

28. Biomarker discovery in asthma is a growing field. “The challenge is made difficult by the huge number of proteins involved in severe asthma pathogenesis.” The good news is that progress has been made in identifying the following biomarkers neutrophils, eosinophils, fractional exhaled nitric acid, exhaled breath conssendate, periostin, galectins and more are coming into the light as research progresses.25

29. LPR is laryngopharyngeal reflux disease is a potential comorbidity of asthma. Adults with LPR often complain that the back of their throat has a bitter taste, a sensation of burning, or something stuck. Some patients have hoarseness, difficulty swallowing, throat clearing, and difficulty with the sensation of drainage from the back of the nose (post-nasal drip). Some may have difficulty breathing if the voice box is affected. Many patients with LPR do not experience heartburn.26

30. Did you know that there are many different types of asthma? The names of different types of asthma can describe the triggers that cause an asthma exacerbation. Asthma types include allergic asthma, exercise induced asthma, cough variant asthma, nocturnal asthma. As asthma research continues there is work being done to link types of asthma with phenotypes and endotypes.

31. The menu of medications that are available to patients is growing and with more biologics on the market. These therapies are targeting specific phenotypes of asthma. They are considered a step in personalized medicine.

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