Psychology 11 – 4241
March 31, 2009
The Need to Breath
She’s walking at a speedy pace eager to arrive to her destination. Something odd starts to occur within her body and she begins to intake short chopped breathes. She starts to sweat profusely. She feels what can only be described as suffocation. She struggles to intake any oxygen and she feels like she is going to blackout or vomit. Both outcomes had no appeal to her. The reaction occurring within this girl is asthma.
Asthma. It seems so simple. When it happens, your lungs constrict. You take a puff of medication and it immediately goes away. When I think of it in this perspective, it appears harmless, but it is not. I have learned the hard way that asthma is much more deadly than it appears. “Breathing is an essential function that provides oxygen to the body. Oxygen provides energy that keeps us all alive” (Arshad and Babu, 2009, p.33). Breathing is a necessary role in the human body. Asthma disturbs and weakens the breathing process. Imagine what would happen if your lungs closed up and you could not inhale oxygen.
Many people understand the basics of asthma. They understand that when someone is experiencing an asthma attack, it means that they can not breathe. This assumption is correct but the exact process of asthma is more complex then what it appears to be. Asthma is a multitude of symptoms happening at once. It involves inflammation, mucus, coughing and narrowing of the lungs. The Fact: Asthma (2009) by Hasan Arshad and Suresh Babu writes:
The airways are inflamed (swollen) in asthma, and this makes them very twitchy and sensitive. A sensitive airway reacts to various different irritants causing narrowing, leading to reduced airflow through the lungs. This manifests as: Wheezing; chest; tightness; cough; breathing difficulties” (p.2).
People with asthma have higher lung sensitivity then people who do not have asthma. When an individual is having an asthma attack they are actually suffocating. It’s the equivalent of breathing through a straw for non-asthmatic individuals.
Asthma is a disease. It is a disease that has yet to have a cure. An individual can either grow out of it or grow back into it. “Asthma is a long-term disease that affects the breathing tubes that carry air in and out of the lungs” (Arshad and Babu, 2009, p.2). Although asthma is a disease, it is usually brought about by allergic reactions and a person can live a normal and long life.
There are three basic symptoms that are experienced during an asthma attack. Wheezing, breathlessness or hyperventilation, and/or chest tightness. Each symptom has its own identifying factor but each manifest itself because of the very active asthma. “Wheezing. This is a high pitched whistling sound produced when air is forced through narrowed airways” (Arshad and Babu, 2009, p.33). The wheezing that occurs during an asthma attack is very loud and can be easily heard with or without a stethoscope. “Breathlessness [hyperventilation]. This is the feeling of not being able to take in enough air. There is a need to breathe out while, at the same time, a compulsion to breath in. If this symptom develops to an extreme level it can be frightening for the sufferer and very distressing for those close to him or her”( Mckeown, 2008, p.10). Breathlessness can make one panic, and when someone is panicking it may lead to worsening the asthma symptoms. Breathlessness forces you to fight against your lungs in hopes of processing the amount of air you need. “Chest tightness. Trapped air in the lungs generates a feeling that the chest is over inflated. This is often described as someone squeezing or sitting on one’s chest” (Mckeown, 2008, p.10). As time progresses the chest tightness that occurs makes your chest ache and tired of trying to inhale.
There are eight different types of asthma: Allergic asthma, non-allergic asthma, exercise-induced asthma, cough-variant asthma, occupational asthma, aspirin-sensitive asthma, and steroid-resistant asthma. Each type of asthma has its own trigger.
Allergic asthma is usually acquired because of personal allergies. “Individuals whose asthma symptoms are brought about by exposure to one or more allergens are said to have allergic asthma” (Arshad and Babu, 2009, p.3). Allergic asthma is the most common form of asthma among people. The allergens may range from trees, pollen, and animals to dust mite, and cockroaches. It’s important that an individual who suffers from asthma stay away from the allergen that affects them. There are very simply skin test that allows a doctor and patient to find out which allergen affects them.
Non-allergic asthma is a type of asthma that is difficult to identify. “This group does not need to worry about avoidance of irritant triggers as individuals with allergic asthma do” (Arshad and Babu, 2009, p.4). It is unknown what exactly triggers asthma in the individuals with non- allergic asthma.
Exercise-induced asthma occurs during physical excretion. “For some people, exercise is the only cause of their asthma symptoms. These subjects do not usually have any symptoms until they exercise, when symptoms of breathing difficulty, a sense of tightness in the chest, and wheezing develop” (Arshad and Babu, 2009, p.4). When a person with exercise – induced asthma is relaxed and at ease, they breathe through their nose, which warms the air to match the air in the lungs. But when that same person begins to exercise, they begin to breathe through their mouths, preventing the air from warming as it enters the lungs, which shocks it and forces the lungs to work harder.
Cough – variant asthma is asthma that is induced through coughing. “The cough is usually dry or nonproductive. These patients usually do not have the typical symptoms of wheezing, chest tightness, or shortness of breath” (Arshad and Babu, 2009, p.6). Coughing can both produce and worsen asthma symptoms, and since there are no obvious symptoms such as wheezing, it is difficult to diagnose.
Nocturnal asthma is asthma that worsens at night. “It is still being debated whether nocturnal asthma is a separate type of asthma or is only a symptom of severe asthma” (Arshad and Babu, 2009, p.6). The asthma symptoms are exaggerated and heightened. People who suffer of nocturnal asthma wake in the middle of the night struggling to breath. They get less sleep which affects their quality of life.
Asthma that Occurs within the work environment is called Occupational asthma. “Occupational asthma generally affects adults of working age as they become exposed to sensitizing chemicals at their work place” (Arshad and Babu, 2009, p.8). People who work in places such as farms, house keeping, and painting are at higher risk of getting asthma from their occupation.
Aspirin- sensitivity asthma is a term that is used to describe people who get asthma because of sensitivity towards aspirin. “Most people with asthma do not have any problem with aspirin. However, some subjects with asthma develop symptoms if they consume aspirin or other related painkillers” (Arshad and Babu, 2009, p.10). There is no test that has the ability to diagnose Aspirin-sensitivity asthma. It is important to be aware of ones body reaction as aspirin is taken.
Asthma is usually controlled with steroids. “A minority of those with severe asthma do not respond adequately even to oral steroids. These patients are regarded as having steroid-resistant asthma” (Arshad and Babu, 2009, p.12). Those with steroid- resistant asthma, steroids have no affect on their asthma and therefore, different procedures must be use to control and ease the inflammation that causes asthma.
There are many factors or triggers that cause asthma. Most of the time, triggers are allergens; However, a trigger is anything that causes or worsens asthma. Asthma-Free Naturally (2008) by Patrick Mckeown defines triggers:
A ‘trigger’ is something that makes asthma worse. The most common trigger includes (in alphabetical order): allergies; cigarette smoking (and cigarette smoke for non-smokers); colds and flu; cold air; dust mites; exercise; molds; noxious fumes; pollen; stress; and weather types such as fog and damp. In some instances an asthma attack may be triggered by a combination of catalysts (p.9).
There is no set trigger. Triggers vary from individuals to individual. Things such as dust, animal hair, and food can trigger an asthma attack.
Cockroaches are a major problem in cities and heavily populated societies. They are well known in the allergen world. “The allergen from cockroaches comes from the insects’ feces, saliva, and bodies. Cockroaches are on of the most resilient organisms and can survive extreme conditions. However, prevention of exposure to these allergens is usually successful if appropriate measures are applied” (Arshad and Babu, 2009, p.67). The same can be said about mice, rats, hamsters and guinea pigs. It’s important to keep ones’ home clean. Never leave any food out in the open, and improve ventilation to get ride of damp area. Make sure to seal cracks and holes in the wall. This and more will help to lesson the chances of a cockroach infestation.
Asthma can not be cured, it can only be controlled. For those whose asthma is out of control, there are medications that allow control over asthma causing symptoms. The most commonly used drugs in asthma medication are steroids. Steroids have been proven to reduce the inflammation of the lungs that causes asthma. “Asthma is a chronic inflammatory disease of the airway and hence treatment of this inflammation is the corner stone of asthma treatment” (Arshad and Babu, 2009, p.78). It is important to ease the inflammation that resides in the lungs. Even if there are no asthma symptoms there still may be swelling of the lungs, and an individual is at greater risk of suffering a deadly asthma attack. Steroids are a very important factor against asthma. For those with steroid-resistant asthma, they may encounter many difficulties with completely controlling asthma symptoms because inflammation of the lungs may continue to reside.
“Inhalers (also called puffers) are small, hand-held portable devices that deliver medication directly to the lungs. They enable children and adults with asthma to inhale medicine, almost any time and anywhere. Inhalers have transformed asthma treatment” (Arshad and Babu, 2009, p.79 – 80). Inhalers are a revolutionary device for treatment in the asthma world. Inhalers are small and fast acting. They release the appropriate amount of medication needed and if used correctly can have excellent results. There are a handful of inhalers that can travel with an asthmatic individual. “A variety of inhalers are available to help relieve or control asthma symptoms. Two common types include metered-dose inhalers and dry-powder inhalers” (Arshad and Babu, 2009, p.80). Inhalers that are metered-dose are filled with fluid medication that must be inhaled in coordination with releasing the medication. The subject must inhale the medication properly if they are to gain the full benefit and affect the medication offers. Dry-powder inhalers are simpler to use than metered-dose inhalers. There is no need to be coordinated to inhale the dry powder. One must simply open the inhaler and inhale the dose it produces whenever they are ready.
If not all, then most medications have side effects. Asthma medication is no exception. Steroids are the most used in asthma treatment. When given in small doses and for a short term of time steroids are affective and safe, with very few side effects. However, long-term treatment can have diverse effects.
Side effects of long-term treatment of steroids increased appetite and weight gain; thinning of bones, which can lead to weak bones that may break easily; slow-down of growth in children; suppression of body’s own production of steroids; easy bruising of the skin and slow healing of cuts; puffiness or roundness of the face; indigestion of stomach ulcers; fluid retention with swelling of the ankles; cataracts in the eyes; difficulty in controlling diabetes; chicken pox can become a serious problem; suppression of the body’s defenses against infection(this may result in unusual infections that can be difficult to treat)” (Arshad and Babu, 2009, p.93).
Today popular medications such as Advair (a dry dose inhaler) carries with it warnings of asthma related death.
Advair does not contain steroids. What Advair does contain is a long-acting beta-adrenergic agonist called Salmeterol. Long-acting beta adrenergic help to open airways and keep them open. They do not reduce the inflammation of the lungs but they do lessen the effects of asthma. Salmeterol has been linked to asthma related deaths, so it should only be prescribed to patients with severe and uncontrolled asthma. “Doctors face difficult choice with children whose asthma remains uncontrolled with low-dose steroid treatment. If they increase the steroid dose, the risk includes stunted growth, acne, greater vulnerability to infections and changes to skin, eyes, and bone. If they add a long-acting beta agonist, the risk of death, although small, increase” (Harris, 2008). It is a frightening fact that doctors must pick between the chance of death, and the chance of infection along with other symptoms. But these are decision that doctors and asthma diagnosed individuals must face daily.
Individuals, whose parents had diabetes or cancer, are of high risk of inheriting the same disease. Asthma is no exception. “Asthma tends to run in the family” (Arshad and Babu, 2009, p. 23). It is important to have caution when asthma has been known to run through the family.
Who exactly is of greater risk of asthma? For years it has been known that asthma is greater in young boys than it has been in girls. But studies have concluded that girls are most likely to attain severe asthma after adolescence which puts them at higher risk of asthma related death. “Before puberty, asthma occurs more often in males, but after adolescence, it appears to be more common in females. In adults with similar cases of actual airway disruption, women are likely to report more severe symptoms than men” (Asthma risk Factor, 2009). Many consider the changes of body chemicals to be the cause of this reaction. However it is still unclear as to why this occurs.
Obesity and asthma has in current research been increasing along side to each other. Individuals who are over weight are at high risk of being diagnosed with severe asthma. “In both adults and children, the incidence of obesity and asthma has been increasing in parallel over recent years. Studies report a strong association between the two conditions. Some experts suggest that excess weight pressing on the lungs may trigger the hyper reactive response in the airways typical of asthma” (Asthma risk Factor, 2009). Some blame asthma for obesity and others believe obesity is what triggers asthma. In the end it is simply a vicious circle of cause and effect. It is important to look at the fact that not all people who are obese have asthma, and not all fit people are safe from asthma.
Poverty and lack of knowledge plays an immense role in asthma. “Twin studies also suggest that people who have lower educational levels (as well as those who exercise less) are at higher risk for adult-onset asthma” (Asthma risk Factor, 2009). It is assumed that those who live in poverty stricken conditions face constant encounters with allergens and tight living conditions that restrict ventilation. Individuals with lower education may fail to truly educate themselves on the triggers and dangers of asthma. Lower educated individuals may even fail to acknowledge that they are having asthma related symptoms.
As mentioned earlier asthma can lead to death. As time has progressed and the amount of individuals with asthma has increased, so has the death rate. “The number of cases of asthma is increasing, so are the number of persons dying from asthma” (Redd, 2002). This is a reality check that asthma must be looked at in a more critical light. So many people have struggled with asthma and many (including myself) have failed to really understand how deadly it can be.
I was first diagnosed with asthma at the age of four. My mother claims that it was the most dreadful experience of her life. She was walking with me by a construction sight when the wind blew a gust of dust towards our direction. She thought it nothing when I began to cough. It wasn’t until I began to wheeze and hyperventilate that she began to panic. She rushed me to the hospital scared to death that something deadly was happening to me. That was the day I was diagnosed with Asthma.
Two of my friends have died from asthma. My nineteen year old cousin has asthma. My six year old second cousin has asthma. I myself have struggled with asthma for most of my life. For some time I had failed to take my asthma seriously. But after recent experiences, I’m sure it will now be a priority to take care of my self and asthma.
“Take a breath now, and think about it carefully. Breathing is the elixir of life” (Mckeown, 2008, p.5). Breathing is an absolute important feature of life. Oxygen brings life into every cell in the body. “We humans can not live without air for more than a few minutes” (Mckeown, 2008, p.5). Asthma has the ability to reduce the quality of life. Asthma appears to be a very simple disease of the lungs where one wheezes and coughs. And with a simple inhalation from an inhaler, the suffering ends. As mentioned before, this concept is far from the truth. Asthma can have deadly results if not understood and treated properly. So inhale and exhale appreciate the movement of your lungs, enjoy how easily air inflates them. Appreciate the fact that your airways are open and clear and asthma is no where near. And hope that asthma will never strike you
Arshad, Hasan, Suresh Babu. (2009).The Facts: Asthma. New York: Oxford University Press.
Author. (9 January 2009). “Asthma Risk Factor.” New York Times on the web. A.D.A.M. Retrieved April 1, 2009 from <health.nytimes.com...
Harris, Gardiner. (December 2008). “F.D.A. Panel Votes to Ban Asthma Drugs.” New York Times on the web 11. A29. Retrieved April 1, 2009 from <www.nytimes.com.D.A.%20Panel%20votes%20to%20ban%20asthma%20drugs&st=cse>
Mckeown, Patrick. (2008). Asthma-free Naturally: Everything you need to know to take control of your asthma. San Francisco: Conari Press.
Redd, Stephen. (Aug, 2002). “Asthma in the United States: Burden and Current Theories.” Environmental Health PP.557-560. Retrieved April 1, 2009 from <www.jstor.org.lib01.bcc.cuny.edu...>