MAY is Asthma Awareness Month and is used to inform individuals about the chronic, potentially life-threatening condition and how it can be controlled.

Consultant internist Dr Keisha Harrisingh-Wong told Your Health Your Wealth that asthma itself by definition is an airway constriction or narrowing. In simpler terms, the lining of the inside of the airway swells or becomes inflamed and the airway state significantly narrows.

Dr Harrisingh-Wong said this narrowing or constriction is caused by histamine release as a result of the allergens which triggered the asthma attack.

“The histamine causes the airways to constrict and have inflammation, which causes blockage and no air is coming into the lungs. For children because their airways are naturally smaller, they develop the wheezing, dry cough or chest tightening. In an adult, the same process will occur but because the airway is so much bigger, they may or may not significantly have any symptoms.” she said.

Of note, socio-economic conditions can make individuals more prone to asthma attacks. Research indicates that black people tend to live in poorer conditions with more environmental hazards and poor personal choices that can trigger asthma attacks.

Dr Harrisingh-Wong said such practices include burning of bush, exposure to cigarette smoking, burning cane and burning garbage. She also mentioned that exposure allergens like pollen and pet dander, weather changes, anger or stress, or even an infection can also be triggers as they cause histamine release.

But a challenge in treating asthma, Dr Harrisingh-Wong said, is the fact that when children develop the condition, adults at times don’t accept it.

“A problem I noticed years ago while working at Bustamante is that a lot of parents refused to accept that their child had asthma. They would keep coming and coming, get prescribed the ventolin and refuse to give their child. Whether they believed it was obeah or they chose to use the banana, where you cut the banana tree over the child’s head and the asthma is suppose to go away, I don’t know. They do a lot of these things and the child comes, literally at death’s door and they have the ventolin and refuse to give the child because they don’t believe the child has asthma,“ she said.

Dr Harrisingh-Wong, however, warned that it is a very serious condition and people do die from it.

“That airway is your main source of breathing and if you can’t breathe you’re going to die. So, the air has to get in through the nose, go down the trachea and separate into the bronchi, which goes directly into the lungs. So all of those — the entire airway — is constricted, as well as the fact that mucus is being secreted which is causing congestion and the inflammation is always there. It’s very serious, people can die, but it is something we can treat if they get to the hospital in a timely manner,” Dr Harrisingh-Wong said.

While asthma can’t be cured, the consultant internist said it can be controlled by avoiding triggers and staying on medication.

“When there is an attack we use an anti-histamine like Allegra, Claritin, Histol or DPH to stop the histamine release and to get the airways open. The Ventolin pump or Bronchodilator is also used to open the airway allowing the client to breathe better. For the inflammation where the cells on the inside of both linings of the airway are also swollen, that’s where the steroid comes in. The Prednisone is the steroid, which is an anti-inflammatory agent. When you take that, it takes away all the swelling happening on the cells on the inside that causes both mucus secretion and causes the space to narrow even more,“ she said.

Dr Harrisingh-Wong added: “Most tend to have attacks round Christmas because of the change in weather and cold air. Prevention medication is usually a steroid and a Bronchodilator in an inhaled form. So they still use the puffer, but they use it everyday. This time now when the allergen — whether it’s the dog hair, pollen or the virus, whatever it is that would have caused the attack, they would have prevention medication already on board.”

Below Dr Harrisingh-Wong suggests other ways to prevent the onset of an asthma attack:

Avoid burning bushes or wear a damp mask over your face until you can get out of the environment

Avoid smoking or being around smokers

During the spring time when blossoms are out and everyone’s sinus is draining, abort the sinus draining. Things like Claritin and Allegra you can get over the counter.

Stay on prevention medication in the Christmastime

Don’t get wet in the rain or be outside in the cold night

Avoid cats and dogs as pet dander can trigger it

Change curtains and clean carpets regularly

Some foods, like peanuts, trigger it. If a particular food is a trigger, avoid it