Asthma & winter respiratory care

On 5 Nov, 2022, Seniors Today weekly Health Live webinar hosted Dr Aditya Agrawal a leading Consultant Pulmonologist attached to several large hospitals in Mumbai, who spoke on and answered questions about Asthma Care & Winter Respiratory Care. 

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 means that the individual has increased resistance, or sudden bronchospasm which means that your bronchi suddenly shrinks when exposed to certain stimuli in the environment or their surroundings. Change in weather is also a trigger/ stimuli 

In the case of a bronchospasm, the airways get constricted, the air is trapped inside the lungs and the amount of air that is released or is blown out is very low. These patients often present with the complaint of chest pain or wheezing (which is a whistling sound in the chest) or difficulty in sleeping, incessant coughing. 

The first triggers to happen are the ones at home. 

Once you realise that you have a chronic lung condition such as asthma or bronchitis. It is important to see your doctor when you’re still in a relatively healthy state. It is a precautionary measure, like how we do it with our cars by taking them to the service centre before the monsoons hit. 

It is also important to understand the level/ severity of your disease. 

Sometimes because of your chronic illness, which may or may not be uncontrolled, you can sometimes land up in an exacerbation of the illness which can land you up in the hospital/ ICU. 

The most important health matrix in a known patient of bronchial asthma is the number of asthma/ bronchitis attacks in the past 12 months. A patient who has had frequent attacks in the past 1 year will also have high chances of future exacerbations and future attacks. 

It is important to speak to such patients about their condition, inform them that they have uncontrolled asthma and that they should try to control their asthma. 

The outside temperature is not in our hands but it is also a trigger for patients with asthma.

Here are a few things known asthmatic patients can do during the winter season to avoid an asthmatic attack: 

• Avoid extremes of temperature- for example stay in a very warm room and then suddenly go out in the cold. 
• Keep your air conditioning to a temperature which is close to the environment temperature. 
• Make sure you’re using air purifiers inside the home. 
• In case you use heaters ensure that you have carbon monoxide detectors and alarms set in place 
• The poor quality of air can also trigger your asthma. 
• Not just take of yourself but also those around you, avoid bursting crackers, lighting bonfires in closed spaces/ areas 
• In the bedroom, when using blankets/ quilts and heavy linens it is imperative that you reduce the amount of bed mites and for that ensure that you change your linens frequently and if you cannot change your linen frequently, ensure that you are using a hot iron to iron your linens before going to bed. 
• Avoid using wooden blankets, if you cannot avoid using them, make sure that you use a cover over them 

If you are an asthmatic, here are a few things you need to keep in mind/ ensure: 

• If you use inhalers, it is important that you carry them with you
• Make sure and take steps to keep your asthma under control and not just by your symptoms or how you perceive them, but by the health matrix or by the criteria as advised by a chest physician/ specialist. 
• Ensure that your surroundings are clean 
• While cooking, make sure that your kitchen is an well ventilated space/ area 

Infection is the most common trigger/ factor for bronchitis. Which is why it is important that asthmatic patients take their flu shots. And also prevent yourself from streptococcal pneumonia infection which can be done by taking two simple vaccines- prevnar-13 and the pneumovax-23