I have been suffering from ASTHMA for over 20 years. I come across loads of people, who have no idea of the condition or are scared of this. So, when I got this opportunity to interact with Dr. Bala Raju Tadikonda (M.D. Pulmonary Medicine), I was excited to ask all the questions I have had in my mind forever. I was specially interested in knowing how it can affect children.
ShishuWorld: How serious is lung ailment? What are the different type of lung ailments.
Dr. Bala Raju:Looking at the current scenario the lung ailments have become major concern. Pollution, lack of exercise, smoking, our lifestyle, etc. all contribute to the poor lung health. Asthma, Bronchitis, Chronic Cough, Chronic Obstructive Pulmonary Disease (COPD), Sleep Apnea, Tuberculosis, etc. are some of the lung ailments that effect people depending on age, sex, family history, occupation and as mentioned earlier, lifestyle followed.
According to a report by the World Health Organisation (WHO), the deaths due to lung diseases in India are on the rise accounting for 11 per cent of the total deaths. As many as 142.09 in every one lakh, died of one form of lung disease or the other giving India the dubious distinction of ranking first in lung disease deaths in the world.
SW: Throw light on the deteriorating lung health in the region?
Dr. : Public health in the region has been greatly affected due to pollution and choices made for modern lifestyle. We have seen increase in the number of patients. The increase in the patient may not be alarming but is definitely a worrisome state.
SW: Are asthma and Bronchitis same?
Dr. : Asthma and bronchitis are both obstructive lung diseases. In both the disease patients find it difficult to breath. The air has a hard time getting out of your lungs. However, they are different diseases with different treatment. Asthma is a long-term, chronic condition, whereas bronchitis is an isolated incident occurring in response to acute infection and will most likely resolve on its own.
SW: How serious can asthma be in children?
Dr. : Asthma in children is a serious concern. The symptoms of pediatric asthma can range from a nagging cough that lingers for days or weeks to sudden and scary breathing emergencies. Most children with asthma have symptoms before they turn 5. In Kids, if asthma is not properly managed, it often leads to anxiety, social isolation, and constant fear of flare-ups. Rather than risk another episode, children restrain themselves from all activity, exercises, and social events requiring exertion, which further adds to the physical and emotional stress. Support of family, and peers, coupled with counselling by professionals can help children handle the psychological distress. Additionally, eliminating the risk factors triggering asthma attacks and providing prompt medical attention goes a long way in ensuring the physical and psychological health of children suffering from asthma.
- Rising levels of pollution are one of the major causes for fatal lungs disorders and severe respiratory problems
- Asthma is not only caused due to environmental factors such as infection, microbial exposure which may act as risk factors depending on the point at which the exposure occurred in childhood or infancy but also because of the hieratic predisposition is the main reason to increase the asthma rates
- Maternal smoking, diet, stress, antibiotics and mode of delivery which is a prenatal risk factor contributing to the development of asthma in the child
- Indoor pollution such as exposure to allergens, dust, animal danger, pollens poses a severe threat to trigger asthma in your child
- Odors, fragrances, volatile organic compounds in sprays and cleaning products are other components that lead to frequent asthma attacks in children
- The daily lifestyle may also have an adverse effect on asthma differently at a different point in life and relevant triggers may change according to the period.
SW: Can Asthma be treated completely?
Dr. : It is very important to note here that asthma can be controlled through inhalation therapy. Asthma is a long-term disease that has no cure. The goal of asthma treatment is to control the disease. Inhaled medicines are not just meant for severe asthmatics. Asthma is a condition of inflammation (swelling) of the lungs.
The best treatment for inflammation of the lungs is steroids, and the most effective way of taking it is through inhalation therapy. When you take inhalation therapy, the steroid medicine goes directly through the lungs and has minimum side effects. Inhalers are not only meant for those with severe asthma. It is recommended even for those with moderate asthma. The steroid in your Controller will usually contain a corticosteroid, which is safe.
SW: How can a person with Asthma live normal life?
Dr. : You can lead an active and healthy life despite your asthma. If you have asthma, you can rest assured that you will be able to lead a normal and active life. If you/your child follow your physician’s advice, educate yourselves about asthma, use your inhaled medication correctly as prescribed by the doctor, and avoid your triggers, there is no reason why asthma should get in the way of your dreams, your life. There are many successful men and women – film stars, politicians, business people, doctors, cricketers, even Olympic gold medalists who have asthma and still continue leading normal, active lives.
SW: What precautions should one take when one is suffering from asthma?
Dr. : Asthma patients needs to manage their asthma by following correct medication, don’t opt for home remedies – consult the doctor, opt for inhalation therapy and identify what triggers asthma attack. Eating a balanced diet and maintaining a healthy weight will make it easier to manage the condition.
SW: What is inhalation therapy and why is it so important?
Dr. : Inhalation therapy with corticosteroids has emerged as the mainstay of asthma management. Moreover, as compared to oral medications, inhaled corticosteroids are required to be given in small amounts to the patient as they reach the lungs directly. Inhaled corticosteroids work by reducing mucus production and swelling in the airways, which make the airways less sensitive and thus decrease the chances of an asthma attack. Corticosteroids can be termed as lifesavers because they help in preventing or reversing inflammation in the airways while making them less sensitive to the triggers. These drugs, that can be referred to as “long term control” medicines, help in keeping both inflammation and asthma flare-ups under control.
SW: Majority of people are taking oral tablet for asthma. Do think it is a correct way to treat asthma?
Dr. : Oral medication is not better than inhalation therapy and there is enough research to prove it. In most countries, inhalation therapy has succeeded in replacing oral therapy. Oral therapy, i.e. tablets and syrups which have to be swallowed, takes time to act as they have to pass from the stomach to the bloodstream and finally to the lungs. Whereas, inhalation therapy is quicker because the drug is delivered directly to the place where it is required, i.e., the lungs. In oral therapy, you need a larger dose (almost 40 times more than in inhalation therapy) which means greater side effects. In inhalation therapy, the drug is in micrograms and since very little medicine is allowed to reach any other part of the body, you have lesser side effects.
SW: Steroids are not good for health, inhalers too have steroids. What make them good when taken as inhalers?
Dr. : Asthma is a condition of inflammation (swelling) of the lungs. The best treatment for inflammation of the lungs is steroids, and the most effective way of taking it is through inhalation therapy. When you take inhalation therapy, the steroid medicine goes directly to the lungs and has minimum side effects. Inhalers are not only meant for those with severe asthma. It is recommended even for those with moderate asthma. The steroid in your Controller which contain a corticosteroid, which is safe.
SW: Can steroids when taken for long term in inhalers cause any health hazard?
Dr. : Corticosteroids are a copy of the steroids that are produced naturally in our bodies. Thus it is a very safe and effective treatment for asthma. It is important that these are not the same steroids that are misused by some athletes and body builders. However, not all inhalers contain steroid, some contain a quick relief drug.
SW: What are your thoughts about the recent awareness campaign running in Hyderabad #BerokZindagi?
Dr. : The campaign has positioned the inhaler as not a sign of weakness, but echoes the patients’ undeniable resolve and spirit. Impact of asthma on quality of life is far greater than as perceived by the patients and the perception of the disease management is far more controlled in the minds of patients. Public awareness is the need of an hour. Increased awareness about inhalation treatment (including non-sufferers) to overcome social stigma; the assurance that inhalation is safe and reliable and to know that asthma can be controlled and thus is not a hindrance in living a full life are major concern areas.
I hope the campaign break the stigma associated with asthma and use of inhalers.
Dr. Bala Raju Tadikonda, MD (Pulmonary Medicine), IDCCM (Critical Care), FCCP (USA).
Consultant Chest Physician (Pulmonologist) Interventaional Bronchoscopist, Intensivist in Visakhapatnam.
I hope these answers will clarify plenty of doubts and stigma that people have around the condition of asthma and other pulmonary diseases. I have been able to lead a very normal life with the use of inhalers as well as with exercise and basic precautions. If you have any questions, do leave them in comments.