Articles on asthma

Children Control Asthma Better With Home Monitoring of Pefr

Dr. Lalit Mohan Kaushik, Pediatrician
Asthma's the most prevalent chronic disease in children  and is proclaimed to be the third ranking cause of non-injury-related hospitalization among children less than 15 years of age. Asthma is a chronic inflammation or swelling of the airways and is characterized by reversible airway obstruction ---this simply means that the blockage of the airway tubes can be reversed by using medications like salbutamol which are beta2 agonists.A reversal which is more than 12% is diagnostic but can be done using a spirometer only.   During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control ineffectively. However, only a part of the patients reach the goals of control set out by the Global Initiative for Asthma(GINA).  Management of bronchial asthma is conventionally guided by objective clinical and spirometric assessment. These criteria, though reproducible and time tested, fail to address the quality of life (QoL) of children afflicted with this chronic disease. Besides, children with similar symptoms and pulmonary function tests ( PFT) may experience different levels of distress and dysfunction in their lives.  This makes a case for a multi pronged approach to childhood asthma management that addresses qualitative issues like symptom monitoring by patients and their parents, thereby ensuring active participation in the assessment and improvement of their Quality of life of the asthmatic child.Several studies conducted in the past have explored this idea and come up with convincing results. Self monitoring of symptoms and keeping a record of symptoms like cough,wheezing{the whistling rhythmic sound of breathing in and out} ,sleep time cough or sleep disturbance , inability to play or getting exhausted easily,any visit to emergency room or need for inhaled medication.Along with these measurement of peak flow expiatory rate i.e: the force with which the child expires air .Doing a peak flow monitoring at home and recording it helps to control asthma better.  study published in 2014 in Indian journal of allergy and immunology conducted at 2 centers Agra and Aligarh reflected on the scope of improvement of childhood asthma symptoms when home monitoring of symptoms was done by parents using peak flow meter and symptom diary.Children(n =125) were divided into two age groups (6-10 years and 11-15 years)and were classified into intermittent, mild persistent, and moderate persistent grades of severity. Parental and child reporting of quality of life (QoL) scores were recorded on a pretested questionnaire on the initial visit and at 4 and 8 weeks. At each session, appropriate counseling regarding the disease and its primary management at home was done. The change in scores from first and second follow-up visits was statistically correlated with changes in symptom score recorded on symptom diary, peak expiatory flow rates(PEFR), and spirometry.The study concluded that home monitoring of symptoms using a peak flow meter and asthma questionnaire are important tools to maximize control over asthmatic symptoms..Health education has a positive impact on treatment outcome. Self monitoring of symptoms at home fosters more patient involvement and promotes better management at all levels of care.After seeing the results of this study I have shifted my asthma practice from didactic and instructional to educational and inclusive encourage every parent to maintain a symptom diary and a peak flow rate recording using a peak flow meter -it’s a cheap tool about 370 rupees and very easy to use.it shifts the focus of asthma from a disease of perception to a disease of numbers teach every parent and child and advise them to maintaining a recording as best of 3 readings in morning and evening ;and when done over a period of time it reveals lot of information regarding the child symptoms . since the last 2 years the asthmatic children have been faring better;they stick to therapy better and there are less exacerbation in symptoms and the parents feel better as they are an integral part of the therapy.Including the parent as the monitoring angel hands the control in hands of parents and they feel more confident of the therapy.

5 Common Myths About Asthma.

Mrs. Anju Chandna, Yoga and Naturopathy
Anything that is open to public discussion gets its share of myths and mysteries. A chronic disease like Asthma has long been a subject of debate and discussion and also several myths that people have created around it along the way.Let me enumerate some of these myths for you:1. My child who is suffering from asthma will outgrow it in his older years. This is both true and false. In about 50% of children, the ailment may become inactive in teenage years and symptoms of asthma may subside as they grow older. But symptoms may re-occur anytime during the adult years with or without exposure to any external triggers. The pattern remains largely unexplained. But increased body immunity does help in fighting asthma in both adults and kids alike. Proper treatment taken in the childhood years with decreased dependence on inhalers can go a long way in keeping your child asthma free once he grows up. 2. Asthmatics have a low life expectancy.This could not be anymore far from the truth. Asthmatics have the same life expectancy like any other normal person. What more can an asthmatic as for? All you have to do is to take great care of your health, never let your disease escalate (believe me it is possible) and with a few basic lifestyle changes you can outrun any normal person in the race for life.3. Asthma can be fatal. This is not entire false yet not true. Fatality related to asthma in most cases is caused by severe lack of oxygen in the lungs. Also people who have not been taking proper medication or I would say who have been abusing medicines by over-use are more prone to such near-fatal conditions. At times like these quick medical aid with supply of oxygen can save a precious life. Basically your lungs should get the oxygen when they need it. Keeping your lungs clean with natural treatments can ensure that your lungs get the oxygen they need.4. Asthmatics should not exercise.With proper care and treatment, people with asthma can exercise normally and often vigorously. As long as their asthma is controlled, there is no reason children with asthma can’t be physically active. In fact, doctors encourage children to stay active to prevent obesity, which can trigger asthma and make symptoms worse. 5. Asthmatics should move to dry climates.Not true at all. No matter where you move, your asthma will move with you. New location might help for some time but it will have new asthma triggers and some triggers like dust mites are present everywhere. The solution is to enhance body immunity to fight allergens and not run away from them6. You will surely ‘catch’ Asthma if someone in your family has it. Asthma is not contagious like common cold. You have a only - 6% chance of getting asthma if neither parent has it- 30% chance if one parent has it and - 70% chance of getting asthma if both parents have it. So the fight to keep asthma at bay is not lost even if both your parents suffer from it!The best bet against asthma is to fight it from the root, by enhancing body immunity by cleansing your lungs so that more oxygen can be inhaled into the lungs.By Anju Chandna Co-Founder SRT India – The Salt Room Therapy ChainSalt therapy is a 100% natural drug-free treatment for all kinds of respiratory problems with no side effects.

The Lion Who Had asthma..

Mrs. Anju Chandna, Yoga and Naturopathy
At times the most complex of things are said in the simplest of ways and this simplicity is what stays with us for a lifetime. One such incident happened with me during the course of my interaction with our little patients suffering from asthma who come for taking therapy to our centre.This was in August last year. A little girl Angel (name changed to protect identity) was a frequent visitor to our salt therapy centre. She was suffering from asthma since birth and now at 9 years was on heavy medication when she first came to the clinic. A petite girl with pale complexion but very bright eyes, she immediately caught my attention. I stepped out of my room to chat with her. After the initial hesitation to relent, she quickly started talking while her parents were busy with the doctor discussing the course of treatment for their daughter. Upon inquiring about her hobbies, she told me that she loved to read since her mom had restricted her outside play hours owing to her medical condition. I casually asked her as to what she liked to read. Like any girl her age, her reply was ‘I like reading fairy tales”. I’ll be a writer one day and write such stories”. I turned around and said “And what will you write?” There came the answer I had not expected. “The lion who had asthma” she answered unassumingly. The confidence in her voice said a thousand things. It was as if she had already scripted the book in her young mind. It took me a while to respond. “What will you write in the book” I asked. Pat came her answer “I’ll write how the brave lion suffered because of asthma, he coughed instead of roaring and all the other animals made fun of him. But one day he got a magic potion in the forest, he drank it and his asthma was gone”. I was dumbfounded. I hope one day Angel’s dream to have her asthma gone becomes a reality. Lets all hunt for this magic potion for her. By Anju ChandnaCo-founder SRT India - The Salt Room Therapy Chain

Learning to Live With Your Asthma Is Your Key to Fighting It!

Mrs. Anju Chandna, Yoga and Naturopathy
We all know what Asthma is. Medically speaking, Asthma is a chronic inflammatory disease of the airways. It is a condition in which your airways narrow, get inflamed and produce extra mucus. This clogs your airways making breathing difficult and triggers coughing, wheezing and shortness of breath.That is the medical explanation. The real problem here is not restricted to the confines of medicine alone. For some people, asthma is a minor nuisance. Some medication accompanied with some basic lifestyle changes does the trick. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. So an asthmatic needs not just medicine but understanding, empathy, support and encouragement from family and friends to tackle this tricky problem. It is hard for an asthmatic to learn and accept that like any other allergy, asthma too has no cure. It can be worse when your doctor tells that your small kid who has seen barely four or five summers of his life, are at the mercy of inhalers and steroid, that which would last him or her for a lifetime, and the sufferers are left wondering with just a question in mind “Can we really ever lead a normal life with asthma?”Can you? The answer is YES you can! However, this normal life doesn’t come that easy and the road to normalcy won’t be a cakewalk!The key to the problem lies in early detection of the ailment and learning to cope with symptoms. With a bunch of adjustments, changes and lifestyle modifications, it is possible to make it through life without too much dependence on medicines. But the first step towards fighting this menace comes from the first emotion that needs to be handled: Denial. Most patients spend a lot of time coming to terms with the fact that they have asthma.All chronic diseases test your patience making you frustrated, angry or depressed because they are a limiting factor in your day-to-day activities. You may also feel embarrassed by the symptoms of the disease and by complicated management routines.So the first prerequisite of any successful therapy is that you get out of denial mode and take an active part in your care and follow-up plans. Instead of being a patient, be a participant in your treatment. Resorting to heavy medication is the shortest way to treat all such ailments but remember short cuts always leave dirty trails. So instead of grabbing the inhaler every time you feel a shortness of breath, reach out to nature for treatments. One such powerful natural treatment is Salt Room Therapy. It is a scientifically proven natural, safe and drug free therapy for patients of all ages. It involves the inhalation of dry aerosol particles in an hour long session in the salt room where the natural mucolytic, anti-inflammatory and anti-microbial properties of salt do the healing on reaching the deepest level of lungs. This therapy not only relieves asthmatic patients’ of their suffering but also helps boost up their immunity to withstand future attacks or allergen encounters.

Does Asthma Control You or Have You Controlled Your Asthma?

Dr. Rajesh Swarnakar, Pulmonologist
Asthma is a chronic disease which is affecting all age groups. It’s a hyper responsiveness of the airway to certain stimulus such as allergens, stress etc. It starts early in childhood and has symptoms of cough, breathlessness and chest tightness. Most important investigation being spirometry that guides for diagnosis as well as treatment.There is rise in the incidence of asthma in school going children which is of concern as its symptoms leads to absentees in school. This affects the social and psychological development of the child. Lack of awareness in parents let the symptoms to get worsen. The best available treatment is inhalation therapy which is safe as needed in micrograms and almost devoid of any long term side effects. Because of lack of awareness about availability of a very effective treatment in asthma people continue to suffer blaming their fate. While truth is that by controlling your asthma one can lead a normal active life.But how to find out whether your child’s asthma is under control? Well, take the following Asthma Control Test and find out now:How to take the test?Step 1:  Let the child respond to the first four questions (1 to 4). If your child needs help reading or understanding the question, you may help but let your child select the response. Complete the remaining three questions (5 to 7) on your own and without letting your child’s response influence your answers.Step 2:   Do scoring of the responses.Step 3:  The total score is to be added.Step 4: The score is to be discussed with the concerned doctor.Childhood Asthma Control Test (For children 4 to 11 years old)How is your asthma today?Very Bad - 0Bad - 1Good - 2Very good - 3How much of a problem is your asthma when you run, exercise or play sports?It’s a big problem; I can’t do what I want to do - 0It’s a problem and I don’t like it. - 1It’s a little problem but it’s ok. - 2It’s not a problem.          Do you cough because of your asthma?Yes, all the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3Do you wake up during night because of Asthma?Yes, all of the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3During the last 4 weeks, how many days did your child have any daytime asthma symptoms?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many days did your child wheeze during the day because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many did your child wake up during the night because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0Interpretation of score:19 or less:If your child’s score is 19 or less, it may be a sign that your child’s asthma is not controlled as well as it could be. Make an appointment to discuss the results obtained on this Childhood Asthma Control Test with your child’s doctor and ask if your child’s asthma treatment plan should be changed. Ask your child’s doctor about daily long term medications that can help control airway inflammation and constriction, the two main causes of asthma symptoms. Many children may need to treat both of these on a daily basis for the best asthma control.20 or more:If your child’s score is 20 or more, your child’s asthma may be under control. There are other factors that your child’s doctor may consider when assessing your child’s asthma control. Asthma is unpredictible.Your asthma symptoms may seem mild or nonexistent but they can flare up at any time. Have your child take the Childhood Asthma Control Test periodically no matter how good your child feels. Continue to have your child see the doctor on a regular basis to make sure your child’s asthma is treated as we as it can be.Every child has right to effective asthma treatment that can control their asthma. If not the treatment your child is receiving needs to be changed. You should go and talk to your doctor about this. If not contact an asthma specialist.With the help of above test one can know the status of the child. As of today many recent medications are available to keep asthma under control.  It’s important “to have your asthma under control than to have your asthma control you.”                          

7 Ways to Find Out if Your Child’s Asthma Is Under Control

Dr. Rajesh Swarnakar, Pulmonologist
Asthma is a chronic disease which is affecting all age groups. It’s a hyper responsiveness of the airway to certain stimulus such as allergens, stress etc. It starts early in childhood and has symptoms of cough, breathlessness and chest tightness. Most important investigation being spirometry that guides for diagnosis as well as treatment.There is rise in the incidence of asthma in school going children which is of concern as its symptoms leads to absentees in school. This affects the social and psychological development of the child. Lack of awareness in parents let the symptoms to get worsen. The best available treatment is inhalation therapy which is safe as needed in micrograms and almost devoid of any long term side effects. Because of lack of awareness about availability of a very effective treatment in asthma people continue to suffer blaming their fate. While truth is that by controlling your asthma one can lead a normal active life.But how to find out whether your child’s asthma is under control? Well, take the following Asthma Control Test and find out now:How to take the test?Step 1: Let the child respond to the first four questions (1 to 4). If your child needs help reading or understanding the question, you may help but let your child select the response. Complete the remaining three questions (5 to 7) on your own and without letting your child’s response influence your answers.Step 2: Do scoring of the responses.Step 3: The total score is to be added.Step 4: The score is to be discussed with the concerned doctor.Childhood Asthma Control Test (For children 4 to 11 years old)How is your asthma today?How much of a problem is your asthma when you run, exercise or play sports?Very Bad 0Bad 1Good 2Very good 3It’s a big problem; I can’t do what I want to do. 0It’s a problem and I don’t like it. 1It’s a little problem but it’s ok. 2It’s not a problem. 3Do you cough because of your asthma?Yes, all the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3Do you wake up during night because of Asthma?Yes, all of the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3During the last 4 weeks, how many days did your child have any daytime asthma symptoms?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many days did your child wheeze during the day because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many times did your child wake up during the night because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0Interpretation of score:19 or less:If your child’s score is 19 or less, it may be a sign that your child’s asthma is not controlled as well as it could be. Make an appointment to discuss the results obtained on this Childhood Asthma Control. Test with your child’s doctor and ask if your child’s asthma treatment plan should be changed. Ask your child’s doctor about daily long term medications that can help control airway inflammation and constriction, the two main causes of asthma symptoms. Many children may need to treat both of these on a daily basis for the best asthma control.20 or more:If your child’s score is 20 or more, your child’s asthma may be under control. There are other factors that your child’s doctor may consider when assessing your child’s asthma control. Asthma is unpredictable. Your child’s asthma symptoms may seem mild or nonexistent but they can flare up at any time. Have your child take the Childhood Asthma Control Test periodically no matter how good your child feels. Continue to have your child see the doctor on a regular basis to make sure your child’s asthma is treated as we as soon as it can be. Every child has right to effective asthma treatment that can control their asthma. If not, the treatment your child is receiving needs to be changed. You should go and talk to your doctor about this and discuss result of this questionnaire. If the score doesn’t improve contact an asthma specialist who specialise in lung diseases called Pulmonologist.With the help of above test one can know the status of the child. As of today many recent medications are available to keep asthma under control. It’s important “to have your asthma under control than to have your asthma control you.”

A Guide to Manage Asthma

Dr. Yogesh Kumar, Ayurveda
Asthma is a medical disorder in which a person feels difficulty in breathing. Asthma is usually caused by allergens which cause allergy in the body. In asthma the breathing tubes of lungs get swelled up and inflamed resulting in narrowing of breathing tubes (bronchioles). The signs of asthma include difficulty in breathing, cough, sputum production (Phlegm), chest congestion. This is a guide to manage Asthma; in case of medical urgency seek professional healthcare provider’s help.Sign and symptoms of asthma:Cough is a frequent sign in asthma it can be productive (with sputum) or without sputum.Breathing difficulty commonly associated with wheezing or whistling sounds from the lungs.Chest congestion, felling of heaviness in the chest.Breathlessness after slight work or walking.Causes of asthma:Asthma is an autoimmune disorder. Following are some factors that can trigger an asthma attack.Substances which causes allergy are called allergens like dust, pollens, and certain foods like fish or egg, animal dust.Cigarette or tobacco smoke, air pollution from vehicles, dust from home, perfumes or other fumes.Fast food or cold drinks.Heavy physical exertion.Mental stress.Things to do:Deep breathing exercises e.g. Pranayama 25 times a day.Stop smoking completely, if you are a smoker.Avoid all allergens.Avoid dust. A housewife having asthma may be greatly helped by vacuum cleaner to clean dust. Use a mask while dusting.Avoid carpets on the floor, which harbor dust.Avoid pets if you are asthmatic.Avoid industrial fumes in factory workers.Ask your doctor or healthcare provider how to use your emergency inhaler correctly. If a particular food triggers an attack of asthma, avoid it e.g. cold drinks, particular fruits, fish, chocolates.If any emotional or family problem, try to sort out, or use tranquillizer or consult psychiatrist.For repeated attacks, advise change of weather i.e. a holiday in dry climate, will help more than medicines.Avoid mosquito coils and mats.Use mosquito net instead or topical mosquito repelling cream.Avoid passive smoking.Asthma is one of psychosomatic illness. So mind tranquility is very important part of treatment. If a patient of asthma gets a dramatic relief in dry climate and attack otherwise, he or she should change the residence, if possible to a dry climate place.Take a glass of warm water early in the morning; take warm drinks like tea, coffee, soups often.Things to avoid:Junk food or deep fried food like pizzas, hamburgers, chips.Cold foods items like ice creams, cold drinks. Sour foods like non fresh curds, raw onion. Avoid sour fruits like citrus fruits (orange, lemon), sour grapes.By trial and error method and keen observation, note if any particular food is causing an attack of asthma, such food must be totally avoided. Avoid heavy meals – eat in small quantity of meals and take dinner early. Avoid sleep at least for 2 hours after meals.Stress: Learn to manage stress as it can directly prompt the asthma attack. Try Yoga and meditation as it helps to relieve stress.

Why Do We Need a World Asthma Day?

Mrs. Anju Chandna, Yoga and Naturopathy
History is a witness to the fact that the human race comes together as one in unity whenever a problem of magnitudinal proportion like a war, an epidemic or a natural calamity befalls it. It is not surprising then that people of the world have come together on many platforms to fight the menace of various diseases together, diseases that overwhelm us with their intensity and their universality. One such disease is Asthma. World Asthma Day is one such big event observed for an ailment that has vast demographic proportions in the world. According to the American Academy of Allergy Asthma and Immunology (AAAAI), more than 300 million people the world over suffer from asthma with 250,000 annual deaths because of asthma. Estimate that another 100 million people will get added to this number by 2025 points toward a grim future. In India, the burden of asthma is more than TB and HIV put together.The first Tuesday of May every year is observed as World Asthma Day by the foundation called Global Initiative for Asthma or GINA as they call it. Cynics often claim that all such ‘days’ are just a marketing gimmick to enhance sales of relevant drugs or promote brands. I’m sorry I beg to differ. And I can validate my stand.Why does an earthquake in Nepal send the entire world into a ‘helping frenzy’. Aids start flowing in, volunteers from the Red Cross and innumerable other organisations bend backwards to be of help. Somewhere in our hearts we all think that this could happen to any of us any day and at that moment we don’t want the world around us to be a mere spectator.So it is with asthma. The increasing numbers, the worsening pollution levels in the world, increased dependence on medication are factors that are cause for concern and immediate action.We have to contain the phenomenal increase in the number of asthma sufferers by understanding the underlying causes of the disease, involving medical professionals, health professionals, medical researchers, community health groups and health workers. Such increased awareness among public about precautions and preventions can go a long way in treating asthma patients without too much dependence on medication. The need of the hour is to look for holistic methods of treatment that address not just the symptom-part of the disease but the cause-part too. Such holistic methods can help to boost body immunity to fight the disease in its nascent stage without resorting to too much medication especially for kids and young adults.Asthma is treatable, this World Asthma Day lets strive to spread the awareness about Asthma to everyone who needs it! 

Bronchial Asthma & How to Boost Your Child's Immunity

Dr. Loknath Kumar, General Physician
Bronchial Asthma is a chronic inflammatory disorder of the airways characterized by an obstruction of air flow.The inflammation of the airways makes them very sensitive resulting in spasm of the airways that tend to narrow, particularly when the lungs are exposed to allergens, cold air, viral infections, smoke and exercise. The reduced airways result in a reduction in the amount of air going into the lungs making it hard for the child to breathe.How Asthma affects children:The tendency to develop Asthma is often inherited. It has also been suggested that there is an association between day care environment and wheezing. Those who started day care early were twice as likely to develop wheezing in their first year of life as those who did not attend day care. Many children with Asthma can breathe normally for a few weeks or months between flares. When flares do occur, they often seem to happen without warning.Bronchial Asthma was found more often in children born during August to October, possibly due to more viral infections during their first six months of life.Children younger than 18 years of age account for a large portion of emergency department visits and hospitalizations due to asthma exacerbation. Asthma causes children and adolescents to miss school and causes parents to miss days at work.Signs and Symptoms:1) Wheezing: A musical high pitched whistling sound produced by airflow turbulence is one of the most common symptoms of Asthma.2) Cough3) Nocturnal/ Exercise induced cough: Children usually tend to cough after midnight, during early hours of morning or after exercise.4) Shortness of BreathDiagnosis:1) Pulmonary function test2) Allergy Test3) RadiographyManagement of Asthma and is it possible to boost the child’s Immunity:Although Inhalers and medications do provide relief, but considering their side effects and the repeated intervention that is needed,parents prefer Natural therapies like Salt Room Therapy that provide a very potent alternative to heavy medications. Kids have a natural aversion to medicines. A few Salt room therapy sessions under the playful environment provided within the Salt room helps the child build up immunity and steer clear of repeated Asthma and Wheezing attacks.Dr.Vanikala VenugopalRespiCare Whitefield