World Asthma Day

On April 30, 2022, Seniors Today hosted their Weekly Health Live webinar with Dr. Aditya Agrawal  who spoke on Asthma Care in the Elderly in view of World Asthma Day which is celebrated globally on May 3rd. 

A little about Dr Aditya, Dr Aditya Agrawal is a leading Consultant Pulmonologist attached to several large hospitals in Mumbai. He is extensively trained in respiratory diseases both in India and the US. His special interests are in difficult-to-treat cough, asthma, bronchitis and lung fibrosis, and runs a specialised clinic for patients with chronic cough. He is a dedicated researcher and a peer influencer in the management of respiratory diseases. 

– Asthma is a very misunderstood disease in the Indian population because asthma in Hindi is called “dama” and that loosely translates to breathlessness. And so it is considered that  anyone who has breathlessness is suffering from asthma. 

– Asthma is a taboo in our society, and it is often misconstrued that if you have asthma you will have a life filled with suffering and unfulfilled commitments and dreams which is absolutely wrong. 

– Asthma is a chronic disease which means that it starts very early in life and you may or may not have symptoms of the disease throughout your life. 

– Asthma is a reaction of your airways, your breathing tubes to something which is noxious, harmful to your body which when enters the breathing tubes and as it enters your airways, as a result your airways constrict i.e they completely close down and as a result of which the amount of air that passes through these tubes reduces. 

– Because of the reduced surface area, because of the reduced passage of air what happens is you have lesser amount going in but also because of the construction, the amount of air coming out is also reduced significantly as a result of which air is significantly trapped inside your lung which makes your lung feel full and your chest heavy causing you to feel heaviness in your chest and it’s also results in severe anxiety when your have an asthmatic attack. 

• You can also have a wheeze and this is a result of air trying to pass through narrow tubes. 
• The body of an asthmatic patient is far more responsive to environmental triggers than that of a non asthmatic one.  

An asthma attack can be triggered by either a blow of very hot or very cold air, strong perfumes and smells, smell of petroleum and petroleum products, dust and pollens. 

Another very common cause for asthma attack in the elderly population is 

1. Infections- this can be bacterial or viral. This increases the redness or the inflammation inside your airways which results in constriction
2. Aspiration pneumonia 
3. GERD which is Gastro-esophageal Reflux Disease. When the acid come out from your stomach to your throat, a small amount of the acid that comes to your throat falls sometimes invariably into your breathing tubes which will cause construction by virtue of being a foreign substance. 

Asthma can present in a variety of manner but some of the most common symptoms/ manifestation on presentation are: 

• Breathlessness. The breathlessness is not constant and keeps changing from time to time, day to night, evening to noon. The breathlessness is not so severe that it incapacitated you. You may observe that you have breathlessness when you climb a flight of stairs or that you’re climbing the stairs slower than usual or slower than your peer. 
• Cough. It is dry cough or you may have a very scanty, thick blob of sputum. You might have a few bouts of cough before you produce a small amount of phlegm.
• Awaken you from sleep. Sometimes the cough or the breathlessness can awaken you from your sleep as well. 
• Wheezing. It is a whistling sound which is produced in your chest. Asthmatic patients have what is called a polyphonic wheeze. 
• Anxiety. This is due to significant air trapped in your lungs.

Some identification features of asthma are:

• You have a positive family history of asthma 
• You may have a history of allergies. These allergies can be eye or skin, etc allergies. 
• Snoring or breathing through the mouth or a bad mouth odour, this is due to swollen adenoids and he may also have asthma

– While examining a patient for asthma, it is important that the individual undergo lung function test which has 3 components

1. Spirometry
2. Reversibility testing
3. Lung volumes 

• Inhalation steroids are used as a treatment modality because the corticosteroids help reduce the redness and the inflammation in the airways caused by the foreign substance that has triggered the asthmatic attack. 
• Asthma is a variable disease, each patient is different, if you know and understand that you’re allergic to certain food items or substances it’s best to avoid it. 

– Not every individual who has asthma cannot get triggered by cold water, ice creams and other cold substances. If you have had ice cream or cold food items in the past, it is okay for you to take them. It is very subjective.