Every year, around 40,000 Australians are hospitalized, and between 400 and 500 die because of asthma, a condition that affects around one in nine individuals – 11.2% of the Australian population. If you are in a room with more than ten people, it is fairly likely that at least one of them will have an asthma inhaler with them.
Doctors have known about asthma for a very long time. There are mentions of it in ancient Egyptian texts, and it was given its name by the “Father of Medicine,” Hippocrates, in 450 BC. Its name is derived from the ancient Greek word for “panting.”
But what is asthma, really? And what does it do? Is there a cure, and how can someone with asthma be helped?
What is asthma?
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In simple terms, asthma is a chronic inflammatory condition of the lungs and airways. It reduces airflow and makes breathing difficult in certain conditions. Shortness of breath and wheezing are two symptoms.
There is no way to catch asthma from someone else; it cannot be transmitted. Genetics is known to play a role in asthma, especially in young people. Other risk factors include long-term exposure to airborne pollutants like cigarette smoke, dust, pollen, and industrial chemicals.
At present, there is no cure for asthma, but it can frequently be controlled and limited in terms of its impact on someone’s life. This is typically achieved through medication and by controlling the factors that may trigger an asthma attack.
Asthma attacks are known to have a number of triggers, including:
- Vigorous exercise
- Smoke, including cigarette smoke
- Changes in the weather
- Workplace chemicals
- Some medications
- Inhaled pollen, dust, and other allergens
- Respiratory illnesses like colds and flu
What does asthma feel like?
Having asthma reduces the diameter of the airways, reducing the amount of air that can get into the lungs. This makes breathing more difficult for the person, as they must work harder to inhale the air they need.
Think of the airways of someone with asthma as being like a straw. To suck air up through the straw is easy enough, but if you put the straw into a milkshake and suck it up, there’s a sensation of having to suck harder and of resistance in the other direction while you drink.
This increased resistance is similar to the increased difficulty in breathing experienced by someone with asthma while they’re having a flare-up – their airways narrow, so the work needed to draw air through them increases. Depending on the severity of the flare-up, this can be frightening for the person affected as they have to work much harder than usual to breathe. This is exacerbated if the lung muscles begin to tire – the sufferer cannot exactly take a temporary break from breathing so those muscles can rest.
What are some symptoms of asthma?
Many asthma patients exhibit no visible signs of the condition under normal circumstances. Some mild sufferers may go weeks without exhibiting any signs of asthma, or they might have persistent coughing or wheezing as if they have a cold.
When the airways are triggered to constrict, causing an asthma flare-up, a few common symptoms are likely to appear:
- Tightness in the chest
- Shortness of breath
- Persistent coughing
- The sound of phlegm when they breathe or cough
The timing of an asthma flare-up can be unpredictable. They can be building up for several days before beginning in earnest, or they can begin suddenly.
Although asthma often appears for the first time in children, it’s not unheard of for a sufferer to show their first symptoms in adulthood. It’s a good idea to talk to a doctor if you notice any of the symptoms above in yourself. Asthma can be complicated to diagnose, but the sooner it is identified, the sooner a doctor can help you get it under control.
What is an asthma attack?
An asthma attack (also called an exacerbation) occurs when a person’s asthma symptoms progressively worsen, making it dangerously difficult to breathe. Someone suffering from an asthma attack may show all the signs of a flare-up listed above as well as some of the following symptoms:
- Blue lips
- Increased heart rate
- Agitation or confusion
It may be difficult for them to breathe and to speak in full sentences without stopping to catch their breath. They may even lose consciousness because of oxygen deprivation.
Just like in asthma flare-ups, an attack can come on suddenly or build up over a few days.
Asthma attacks can be fatal. Four hundred and sixty-one thousand people all over the world died as a result of asthma in 2019, 436 of them in Australia. If someone is having an asthma flare-up and you see any indication that it’s progressing into an attack, call emergency services immediately.
Asthma first aid
Most people who have asthma know that they have it and are prepared to treat themselves with asthma medications. However, there are some people who develop asthma late in life and have neither access to the medication they need nor the knowledge of what to do with it. Sometimes a person may have asthma symptoms for the first time quite suddenly, as is often the case with thunderstorm asthma. And once an asthma attack is underway, the person may be unable to help themselves.
If you see someone experiencing asthma symptoms, it’s a good idea to ask if anyone nearby has first aid training – treatment of asthma is included in the course. If you know someone with asthma who has a history of attacks, you might consider doing first aid training yourself. It’s better to be prepared ahead of time than to be frantically searching “asthma first aid” on the internet while someone you love is gasping for air.
Usually, the first step in first aid treatment for a person showing asthma symptoms is the use of a puffer or an inhaler. To be more specific, what you need to look for is a bronchodilator or asthma reliever. Inside these devices are rapidly-acting medications like salbutamol that work quickly to open the airways and make breathing easier. Not only do these work immediately, but it’s difficult to overdose on them, so you can keep using them as much as necessary. As much as ten puffs per 15 minutes are usually okay.
One thing you should know is that asthma devices can be colour-coded. One that’s blue-grey is usually an asthma reliever, while an orange or red one is more likely to be an asthma preventer, containing medications that gradually improve asthma but don’t help much in the midst of a flare-up. Just remember, when an asthma flare-up is happening, reach for the blue-gray inhaler!
If you administer the reliever and the symptoms don’t diminish, it’s likely that the situation has progressed into a full-blown asthma attack. Call the emergency services in your area (for example, 911 in the USA or 000 in Australia) immediately for an ambulance.
While you wait for paramedics to arrive, have the person sit upright and breathe slowly and steadily. Try to help them stay calm and keep using the asthma puffer to provide some relief in the meantime.
What does an inhaler do for someone without asthma?
Asthma inhalers containing medications like salbutamol are largely harmless. If someone who doesn’t have asthma uses them, the worst side effects they are likely to suffer are shaking hands and an increased heart rate. With that in mind, there isn’t likely to be any harm in giving an inhaler to someone with symptoms resembling those of asthma.
What is thunderstorm asthma?
Thunderstorm asthma is a situation where pollen particles swell up and burst because of stormy weather. This can cause mass asthma attacks even in many people with no previous history of asthma. This is uncommon but can be deadly – the most severe case ever recorded (in Melbourne, Australia, in 2016) killed ten people and left 14,000 hospitalized.
Although such events are outliers, they serve as a reminder that asthma can affect just about anyone.