WITH asthma being one of the major noncommunicable diseases, the Jamaica Observer reached out to consultant physician and pulmonologist Dr Althea Aquart-Stewart to debunk some of the myths and misconceptions about the lung condition ahead of this week’s recognition of World Asthma Day.

Asthma — estimated to affect more than 300 million people of all ages worldwide — is one of the most common long-term diseases in children.

“In asthma, the small airways in the lungs shrink, the air passages swell, and there is excess mucus production,” said Dr Aquart-Stewart, who added that some of the symptoms associated with asthma are shortness of breath, chest tightness, coughing, and wheezing.

She said symptoms might occur several times in a day or week and, for some people, can worsen during physical activity or at night.

Triggers

According to the World Health Organization (WHO) the cause of the disease are likely a combination of genetics and external triggers.

Highlighting some of the common triggers, Dr Aquart-Stewart said they include smoke from the burning of bush and garbage, dust, some fragrances, and cats.

“Food also plays a major part in asthma triggers. Foods like shellfish, nuts, preservatives, and even Chinese food – as they will use MSG seasoning,” she added.

Management

The WHO said, too, that asthma is incurable but manageable.

According to Dr Aquart-Stewart, proper education, medication, and a peak flow meter are integral to asthmatics managing their condition.

“[In order] to control asthma and the attacks, the patient needs to have asthma education, that is, understanding the signs, triggers, medications, and monitor their airways. It does not make sense to have the pump [asthma inhaler] and not use it properly,” she stressed.

The pulmonologist explained that the peak flow meter to the asthmatics is like the glucose monitor to the diabetic or the blood pressure machine for someone with hypertension.

If asthma is not controlled, the patient can have decreased lung function, recurrent coughing and wheezing, and persistent shortness of breath. The patient can also experience airway inflammation. Additionally, the airway can become fixed and lose its ability to open in response to inhaler use.

Dr Aquart-Stewart pointed out, too, that asthmatics, particularly black asthmatics, are notorious for having a poor perception of the severity of their asthma attacks.

“So they will be going along and the chest is tight, but they become so accustomed to a certain level of chest tightness that they seek medical attention too late. They are accustomed; they have not yet grasped the understanding that this can be better.

“They are so accustomed to this level of chest tightness because they are not being properly managed or they are not being compliant that what happens is that they seek medical attention too late. They seek medical attention when they are going into a severe asthma exacerbation and they may die,” she added, driving home the point that there are many problems that can arise from not having asthma properly managed.

Three myths

1. Asthma can be outgrown.

“Usually…they tell you that, ‘Oh, I used to have asthma but I grow it out.’ This is not really true.

“What happens is that [with] somebody who is asthmatic their airway is just hyperactive, [so] the least little thing that they are exposed to — once they inhale it — it will excite the constriction in the airway and the inflammation. So when they tell you that they grow out asthma, usually what’s happening is that they have been removed from whatever used to trigger their asthma but if they are re-exposed to the trigger in the right concentration, they will have an asthma attack,” Dr Aquart-Stewart said.

2. People with asthma should not exercise

“An asthmatic can lead a normal life. What happens is that you will use two puffs of your Ventolin [inhaler], which is your reliever, before you start the exercise, or before you play football, or before you swim… An asthmatic can lead a normal life with proper management,” she said.

3. If you aren’t wheezing, then it isn’t asthma.

“No. You can get the constant coughing and the chest feels a little tight but not tight enough for the wheezing, but the constant coughing – that can be asthma,” the pulmonologist said.