Asthma –Four More Questions You Should Be Asking Your Doctor-Advocacy Sheet

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Continuing with what you could ask your doctor if and when you are diagnosed with Asthma:

1. Will I have to take medications forever? If so, what are some of the medications asthma patients typically take?
Your doctor will decide on this – which medicines and for how long. Any or a combination of the medications mentioned below could be prescribed for you. Your doctor decides on this, depending on your individual case:

• Inhalers: (Check drug literature for details of how to be used, frequency and dosage of the medication to be administered or taken as well as their side-effects and contraindications. If in doubt, consult your doctor before using them.) Remember that each drug/chemical has its own impact and will be prescribed to you depending on your condition, tolerability, medical history, etc.

o Beta-2-Agonists (Short-acting). These have a short (two to four hour) coverage and help reduce the symptoms of asthma. However, they neither treat nor prevent it from recurring. Corticosteroids will relax the smooth muscles on the interior of the bronchi (as well as other organs) which help it to dilate back to normal size and shape. Glucocorticostreroid chemicals Salbutamol, Levosalbutamol, Fenoterol, Procaterol, Metaproterenol, Terbutaline, and Bitolterol Mesylate. Brand names vary in countries for these chemicals..
o Corticosteroids – These enable reduction of swelling and inflammation of the inner walls of the bronchi. Chemical Beclomethasome, Triamcinalone, Flunisolide, Fluticasone, and Budesonide. Brand names vary in countries for these chemicals.
o Leukotreine Antagonists – These drugs inhibit the production of fatty cells called leukotreins in the immune system that cause the inflammation and constrict the airway passage. In general, they are less effective than corticosteroids. Chemicals Montelukast and Zafirlukast. Brand names vary in countries for these chemicals.
o Beta-2-Agonists (Long-acting). Chemicals such as Salmeterol, Formoterol, Bambuterol, and Clenbuterol. Brand names vary in countries for these chemicals. Studies have shown that regular usage of this drug can prove harmful in the long run. And may also cause fatality among patients. (Source: Ramanujan K. Common beta-agonist inhalers more than double death rate in COPD patients, Cornell and Stanford scientists assert. Chronicle Online. June 29, 2006. Available at:http://www.news.cornell.edu/stories/June06/Salpeter.COPD.kr.html. Accessed June 30, 2006.)
o Monoclonal antibodies: These are cloned antibodies that are produced for the use of detecting and purifying the substance to which it binds thereby curing medical conditions. Chemicals such as Mikolizumab and Omalizumab. Brand names vary in countries for these chemicals.
o Ultra-long-acting Beta 2 agonists: Studies on these drugs are still on and they are prescribed in very special cases and under the close supervision of the doctor. Chemical Indacaterol. Brand name may vary in different countries.
o Mast Cell Stabilizers: These drugs help stop or prevent the asthma’s allergy reaction. They are basically Cromone-based chemicals such as cromoglicate and nedocromil. Brands vary in different countries.

• Oral Medications: (Check drug literature for details of how to use, frequency and dosage of the medication to be administered or taken, as well as their side-effects and contraindications. If in doubt, consult your doctor before using them.) Remember that each drug/chemical has its own impact and will be prescribed to you depending on your condition, tolerability, medical history etc.

o Corticosteroids - Prednisone, Methylprednisone. Long-term usage of corticosteroids leads to increase in appetite and weight. It may also bring on the onset of osteoporosis as well as glucose problems in some patients. Patients in the LT usage category usually intake vitamin C and calcium supplements to tide over this crisis.
o Antimuscarinics: These drugs reduce the production of mucous and thus indirectly help asthmatics from the symptom of spasms.Chemicals ipratropium, Tiotropium and Oxitropium are popularly given as complimentary drugs. Brand names vary in different countries.

• Allergy shots or allergy desensitization: It has been noted that immunotherapy in its various forms helps regain the original immune condition of the patient. Allergy shots not only help stave off allergies but also re-tune the immune response of an individual that helps them stay off asthma.

• Intravenous medications of some of the chemicals mentioned are also given to tackle an emergency situation at hospitals.

2. What lifestyle changes will I have to make?
Though asthma is incurable, you, in consultation with your doctor, can make certain lifestyle changes and adopt a few practices to lead a more effective, smooth and full life. Here is a list of what you can do at your end:

• Have an asthma action plan worked out together with your doctor – that which addresses emergency numbers to contact, medical basics (blood group, medical history, how and when to take the asthma medicine, its compatibility with other drugs, results expected, contraindications if any), and what to do during an attack.
• Check your stocks of medication so you are never without them.
• Always keep a broncho-dilator and a nebulizer handy at home.
• Keep a diary of asthma observations (frequency, prodrome symptoms and severity) and events.
• Learn ways to protect yourself or reduce the harm caused by both known external and indoor triggers.
• Prevent dust and mold build-up at home by seeking professional help or dusting with damp cloth, keeping A/C filters clean, etc.
• Have your home pest free by having it sprayed when you are out and return to air it with open windows.
• Wash stuffed toys once every four to six months, and use vacuum cleaners on stuffed furniture.
• Keep your windows closed in pollen season. Turn on the fans or A/Cs instead to keep cool and ventilated.
• Use all low-scent index detergents, shampoos and cosmetics.
• Keep pets restricted from entering bedrooms, etc.
• Avoid use of aerosols, bleaches, etc.
• Have the smoker in the family smoke outside in open air or in the toilet with the fan running.
• Wear a mask while dusting, mopping or cleaning dishes.
• Reduce stress by practicing relaxation, meditation and breathing techniques.
• Exercise moderately with enough breaks built into your workout routine.
. Check contraindications for asthma for any medication you take.

3. Are there any support groups you are aware of that I could join?
Asthma & Allergy Foundation Of America – Find the chapter in your local town or city.

4. Are there any reliable web resources from where I could read up to understand more about my condition?
• National Heart, Lung and Blood Institute
• Journal of Allergy and Clinical Immunology
• Asthma and Allergy Friendly Certification Program
• Asthma and Allergy Foundation of America
• AAAAI article on avoiding asthma symptoms
• Asthma Society of Canada
• U.S. National Asthma Education and Prevention Program (NAEPP)
• http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm
• The Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma (EPR-2) - National Institutes of Health pub no 97–4051. Bethesda, MD, 1997.PDF
• British Guideline on the Management of Asthma – “British Guideline on the Management of Asthma" (PDF). Scottish Intercollegiate Guidelines Network. 2008. Retrieved 2008-08-04.
• International Study of Asthma and Allergies in Childhood (ISAAC)
• Centers for Disease Control and Prevention's National Health Interview Surveys
• National Heart and Lung Institute at Imperial College, London
• "You Can Control Your Asthma" [PDF, 4074KB]
• American Lung Association
• http://www.ehealthmd.com/library/asthma/asthma_relieve.html

ALL INFORMATION GIVEN IN THIS ADVOCACY SHEET IS TO BE CHECKED WITH YOUR DOCTOR BEFORE IMPLEMENTING THEM OR TAKING THEM AS STANDARD OR VERIFIED.

Mamta Singh is a published author of the books Migraines for the Informed Woman (Publisher: Rupa & Co.) and the upcoming Rev Up Your Life! (Publisher: Hay House India). She is also a seasoned business, creative and academic writer. She is a certified fitness instructor, personal trainer & sports nutritionist through IFA, Florida USA. Mamta is an NCFE-certified Holistic Health Therapist SAC Dip U.K. She is the lead writer and holds Expert Author status in many well-received health, fitness and nutrition sites. She runs her own popular blogs on migraines in women and holistic health. Mamta holds a double Master's Degree in Commerce and Business. She is a registered practitioner with the UN recognised Art of Living Foundation. Link: http://www.migrainingjenny.wordpress.com and http://www.footstrike.wordpress.com

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