Asthma is dangerous without proper care
We have all heard of asthma. Most of us probably have a friend or family member who has been diagnosed with the disease. After all, it affects almost one in 10 Malaysians. However, it is surprising how often asthma is misunderstood, if it is indeed understood at all.
Asthma is a chronic, inflammatory condition that affects the airways to the lungs.
In English, that means it is a long-term condition where tiny muscles around the breathing airways tighten and the walls swell up, leading to smaller-sized tubes to channel air into the lungs. This leads to a drop in the amount of oxygen that goes into the body.
Asthma has a number of symptoms, such as the classic wheezing. Patients can show other signs, too, including breathlessness, chest tightness, increased phlegm production or coughing.
The symptoms vary between individuals, but they tend to be worse at night or in the early hours of the morning, and can be set off by tobacco smoke, dust, cats, exercise, a change in temperature or the seemingly unabating haze.
Researchers are still unclear as to why only certain individuals suffer from this condition, but it is likely to be due to a combination of genetic susceptibility and environmental stimuli.
What is clear though, is the fact that although there is no cure, asthma can (and should) be controlled.
I have come across many patients who “just live with it” or are resigned to the fact that the symptoms of asthma will never go away.
I even had one patient who visited the Accident and Emergency Department on a monthly basis to receive nebulised medication and steroid tablets — and she thought this was normal!
Others have the mistaken notion that using inhalers are addictive and can weaken the lungs, or they can be stopped at whim. In fact, research has revealed that only six per cent of Malaysian patients have appropriate control over their asthma.
In most cases, patients are given two types of inhalers — a “reliever”, which is a short-acting inhaler (usually blue) that gives immediate relief and a “preventer”.
The latter contains steroids, which is the primary medicine for asthma that decreases the number of attacks and saves lives. Preventer inhalers must be used regularly and should only be stopped on the advice of medical professionals.
Stopping the use of inhalers inappropriately can be dangerous, if not lethal. The United Kingdom, through the National Review of Asthma Deaths, had looked at more than one thousand deaths that occurred between 2012 and 2013.
The report’s conclusion makes sombre reading — at least half the deaths could be prevented, especially if patients were on the correct treatment.
The number of asthma-related deaths in Malaysia is unknown, but it would be unwise to assume that a high level of treatment vigilance is not necessary.
Compliance with medication is particularly important for those who have recurrent attacks or have been hospitalised in the past, especially children and the elderly.
In fact, the consequences of sub-optimal asthma control are affecting more than just the individual patient. The burden of increasing hospital cost and sick days taken will impact productivity and society’s wellbeing.
It is for this reason that the Global Initiative for Asthma, a global movement to improve the standards of care, has declared May 3 as World Asthma Day.
This provides an opportunity for medical professionals to highlight the deficiencies in asthma management and also to shine the light on the disease in hope that the public would be more aware of its dangers and complications.
As mentioned earlier, asthma has no cure and even when it is quiescent, there is a risk of a flare-up.
However, patients can take precautions to minimise attacks. Such measures include avoiding triggers like tobacco smoke and other allergens, and to always comply with the use of medication.
Dr Helmy Haja Mydin is a founding associate of the Institute for Democracy and Economic Affairs (IDEAS) and a consultant respiratory physician at Pantai Hospital Kuala Lumpur
PictureSource : AFP Pic