By Dr. Dorian James, RCP
Milwaukee is affected by asthma more than most cities in the U.S. and currently is in the midst of an asthma crisis.
As recently as 2009, Milwaukee’s asthma population ranked second in the nation and has been in the top five worst cities for almost a decade. Statistics for asthma in America are so high that the CDC (Centers for Disease Control) has labeled it an epidemic. More alarming are the high rates of asthma in racial minorities and low income individuals. Blacks and Hispanics are five times more likely to be hospitalized or to die from asthma complications than nonminorities.
What is asthma?
Asthma is a chronic condition that cannot be cured but it can be controlled. Asthma is a disease of inflammation in which the inner lining of the bronchial tubes become swollen and inflamed.
This swelling causes narrowing of the bronchial tubes and produces wheezing and shortness of breath. Also, part of this process is excessive mucous production and tightening of the muscles around the bronchial tubes, which further narrows the airways and causes coughing and chest discomfort.
This chest discomfort has been described as a tightening in the chest or a “heavy pressure” inside the chest cavity.
The large amounts of phlegm can cause a rattling noise in the chest. The main symptoms of asthma are cough, wheezing, shortness of breath, and chest tightness.
These symptoms are different from person to person and can be different within the same person from day to day depending on triggers like weather, time of day, activity levels and allergy symptoms.
What causes asthma?
Asthma is primarily genetic and very hereditary passed on from one generation to the next. Having one or both parents with asthma, bronchitis, or allergies increases the risk for their children to develop one of these conditions.
Generally, asthma in families exists in large groups where multiple family members are afflicted.
Asthma can exist anywhere in the family tree line, but if those individuals were never properly identified with it, you may never know who in your family actually has it.
We see many individuals in our community using an inhaler because they have trouble breathing or coughing all of the time but they may have never been evaluated or treated for asthma.
We even see many individuals getting short of breath with very little or sometimes no activity at all.
We hear people breathing or say they’re “breathing funny” which is a sign that something is wrong because breathing is something nobody should know that you’re doing. Other than the fact that you’re alive, there should be no other signs to indicate that an individual is breathing.
Other factors contributing to the development of asthma is exposure to cockroaches and mice at an early age. Mice and cockroaches leave behind allergens that children inhale and can become allergic to.
Homes in high-asthma communities also had high levels of the cockroach allergen as well as allergens associated with mice and cats.
Other factors that contribute to developing asthma are low birth weight, smoking during pregnancy, and drug or alcohol use during pregnancy.
Especially harmful to the child’s lung development is exposure to tobacco smoke during the formative years of life.
Exposing infants and children to secondhand smoke is one of the most dangerous activities a parent can engage in and will be the most harmful to their respiratory health.
How is asthma managed?
An important medication for asthma is the rescue inhaler known as Albuterol which quickly loosens up muscle bands that squeeze and tighten around the bronchial tubes. Albuterol — also known by the names ProAir, Ventolin, or Proventil — is a fast acting, quick relief asthma medication and should be on hand at all times.
All other asthma medications are for prevention and control of symptoms and must be used on a daily basis and are known as controllers.
However, if you’re only using Albuterol to control your symptoms, you may be doing more harm than good. Albuterol used alone as a controller can cause serious lung damage and possibly death.
Inhaled steroids are the primary controller for asthma.
They are very safe and the most effective treatment for controlling asthma symptoms.
Controlling allergy symptoms are another important factor in the management of asthma as both of these conditions are connected together.
In conclusion, if you have asthma or a related condition such as bronchitis or emphysema, you should have a minimum of two inhalers for your condition.