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DateLine Sunday, 6 May 2007

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Body & Soul  - Compiled by Shanika Sriyananda
shanika@sundayobserver.lk

Asthma, wheeze that could kill

Asthma, even in this modern world with all the medical miracles, still exist in its disastrous form killing thousands of people around the world. But it is not an illness to ignore or something that would be put down to mythological beliefs.

The shocking revelation comes from Sri Lankan health experts who recommend extra care against asthma, which kills over one thousand Sri Lankans annually.

It is the illness that forces over 180,000 people to get admitted to hospitals every year. Out of a total number of children admitted to hospitals with asthmatic complaints between 20 to 30 percent children receive get in-house treatment.

According to statisticians, the state expenditure on asthma treatment is much higher than the money spent on TB and HIV/AIDS prevention.

This article is an attempt to refresh your knowledge on preventive measures and to highlight the steps that you should take to ease your breathing difficulties when you get asthmatic symptoms/attack.

Follow these steps:

Take your reliever inhaler (usually blue), immediately.

1. Sit down and ensure that any tight clothing is loosened. Do not lie down.

2. If no immediate improvement during an attack, continue to take one puff of your reliever inhaler every minute for five minutes or until symptoms improve.

3. If your symptoms do not improve in five minutes see your doctor.

4. Continue to take one puff of your reliever inhaler every minute until help arrives.

You are having an asthma attack if any of the following happen:

* Your reliever does not help symptoms.

* Your symptoms are getting worse (cough, breathlessness, wheeze or tight chest).

* You are too breathless to speak, eat or sleep.

Do not be afraid of causing a fuss, even at night. If you are admitted to hospital or an accident and emergency department because of your asthma, take details of your medicines with you.

After an emergency asthma attack:

* Make an appointment with your doctor or asthma nurse for an asthma review, within 48 hours of your attack.

* You will also need another review within one or two weeks after your asthma attack to make sure your symptoms are better controlled.

Do not ignore worsening symptoms.

Most people find that asthma attacks are the result of gradual worsening of symptoms over a few days.

If your asthma symptoms are getting worse do not ignore them! Follow your personal asthma action plan. If symptoms continue to get worse make an urgent appointment to see your doctor or asthma nurse.

Quite often, using your reliever is all that is needed to relieve your asthma symptoms when you start to have an asthma attack. At other times, symptoms are more severe and more urgent action is needed.

Healthy lifestyles for asthma

Improving your lifestyle doesn't have to mean spending hours in the gym. It's easy to incorporate changes that will gradually help you become fitter, healthier and less stressed. When you've decided to make some lifestyle changes, take them slowly! If you imagine your path to fitness involves running a mile a day without fail, it's unlikely to happen.

Think about the reasons why you want to get fit. Look at how best you can manage your goals without disrupting your normal routine. If you try and over stretch yourself too soon, it's likely that you'll be back to your old ways before you know it.

When you have your plan of action, set a start date. Prepare yourself, perhaps by throwing out the cigarettes or filling the fruit bowl, and if you still feel ready, go for it!

****

Stress

It is easier said than done, but everyone needs time to recharge their batteries, and creating 'me time' is a simple way to reduce your stress levels. If you need an excuse, tell yourself that stress is a common asthma trigger, and you really are doing this for your health.

Learning to manage your time and fit everything in that you need to do, as well as the things you would like to do. Write the dreaded 'to do' list and whittle it down to the bare necessities. Decide when you must complete each task and tick it off when it's been dealt with.

You will be encouraged by how much you manage to achieve. Don't waste time over non-essentials, leave them until you are less busy. If there are things that you really don't want to do schedule time to do them. Make sure you treat yourself afterwards.

A long bath, or a walk in the park are great ways to de-stress. Watch your favourite video, or look through old photo albums and switch off from the work, home and life factors that have left you wanting to scream.

****

Smoking

Smoking is bad news for anyone concerned about health, but especially for people with asthma.

If you smoke and have asthma you:

* Are increasing your risk of an asthma attack

* Could be permanently damaging your airways

* Could be blocking the benefit of your asthma medicines

Also, if you smoke as a teenager you are increasing the risk of your asthma persisting. And if you smoke around children or while you are pregnant you are putting them at risk of developing asthma.

Most people know about many of the dangers of smoking but nicotine is a highly addictive drug and stopping smoking can be difficult. However, it is not impossible and many people stop smoking every day in the UK.

It is also important to know that most people will attempt to stop smoking several times before they stop for good. This is normal in breaking the cycle of addiction and the most important thing is that you don't stop trying.

If you do start smoking again, do not be too disappointed and do not see it as a failure. Use it as an opportunity to see what went wrong with your quit attempt and to make the next one more successful.

Some helpful tips to stop smoking:

* Be prepared, the better prepared you are the more likely you are to succeed.

* Understand your habit. Before you stop try keeping a diary of when, where and why you smoke. Knowing the situations or triggers that may make you want to light up will help you to plan a different response or to avoid these triggers altogether.

* Know your reasons for stopping. Make a list of all the reasons why you want to stop smoking. Keep this list with you to remind you if you are tempted to smoke.

* Set a date: Set a date and stick to it. Stub out your last cigarette; throw away lighters, ashtrays and all cigarettes. Start thinking of yourself as a non-smoker and stay determined.

* Remember there are people to help. Your doctor, nurse or those who are close to you can support and advise you about stopping.

****

Exercise

Regular exercise is essential for good health, but it is particularly beneficial for people with asthma. Read on for information about exercise options, plus what you should do to ensure you exercise safely.

Children and exercise

Evidence shows that exercise is good for everyone, including children with asthma. In many cases it can help to prevent symptoms and enable children to cut down on the amount of medicines they have to take.

Despite this, around one-third of children with asthma miss out on sports about once a week because of their condition.

Why is exercise good for people with asthma?

Exercising regularly keeps the heart, bones and digestive system healthy and helps to keep unwanted weight off. It makes us feel good and better able to cope with the stresses of everyday life. Exercise also helps to strengthen the lungs and can therefore lessen your asthma.

Keeping fit and active becomes even more important as we grow older. We need to keep using our bodies in order to get the best out of them. Staying physically active keeps our joints working; it helps the speed of our reflexes and helps keep us strong.

Evidence from a number of studies shows that those who continue to exercise through their middle years show less physical deterioration as they get older, compared with their less active counterparts.

There are all sorts of ways to exercise that can be both enjoyable and beneficial for everyone that does not have to include hours in the gym.

As fitness guru Rosemary Conley, who has had asthma all her life, says: 'Go gently at first, but even a five minute walk three times a day will make a real difference. Walk to the shops, use the stairs more, mow the lawn, anything!'

Don't let asthma prevent you from exercising

While it is true that exercise can sometimes bring on asthma symptoms, there are lots of steps you can take to prevent this happening.

The first thing to do is to check with your doctor or practicing nurse that your asthma is as controlled as it could be. Your ultimate aim is to do 30 minutes of exercise three to five times a week at a level of exertion that makes you only mildly breathless. We are not talking of exhaustion here. And remember, as you get older, even a small amount of gentle exercise will make all the difference.

Below are some tips for exercise if you have asthma.

* Make sure the people you are exercising with know you have asthma.

* Increase your fitness levels gradually.

* Always have your reliever inhaler with you when you exercise.

* If exercise triggers your asthma use your reliever inhaler immediately before you warm up.

* Ensure that you always warm up and down thoroughly.

* Try not to come into contact with things that trigger your asthma.

* If you have symptoms when you exercise, stop, take your reliever inhaler and wait until you feel better before starting again.

* If you use preventer medicine, take it as prescribed by your doctor or asthma nurse.

Exercise options

Aerobic exercise

Either specific fitness classes or activities such as cycling and dancing will increase heart-lung capacity and improve circulation, as well as improving muscle tone and stamina.

If you have painful and stiff joints avoid weight-bearing high-impact exercise such as aerobics and running. But don't let stiffness be an excuse for not exercising. There are plenty of things you can do, for example, swimming and some forms of yoga, that put very little stress on weight-bearing joints such as knees and ankles. There are even exercises that you can do while sitting in a chair.

Yoga

Yoga is the hottest trend around with its constant stream of celebrity endorsement. It can provide a workout for both body and mind. Yoga focuses on bringing the body back into balance with itself, and gentle postures are performed in harmony with breathing techniques to leave you feeling lighter, calmer and energised.

Some people find that breathing techniques are beneficial for their asthma. However, it is important that you do not stop taking your normal asthma medicines unless your doctor advises you otherwise.

Swimming

Swimming is a particularly good exercise for people with asthma, because the warm, humid environment in the pool is unlikely to trigger asthma symptoms (although for some people the chemicals used in swimming pool may be a trigger).

Swimming is also an excellent activity for people of all ages and fitness levels, burns off 300 or more calories an hour, and is unlikely to pull or strain muscles because the water acts as a support for your body.

Everyday activity

If time is an issue, build exercise into your routine slowly. A brisk 20 minute walk in your lunch hour, or small changes such as getting off the bus stop earlier and taking the stairs rather than the lift will all count. Every little bit of activity really does help.

At the end of the day, you are much more likely to make exercise a regular part of your life if you find something you really enjoy doing. If you can achieve that goal, the resultant boost to health and well-being will soon become obvious even to the most dedicated couch potato!

So get out and get active: the old adage is true, use it, or lose it!

***

Diet and food

Eating a healthy balanced diet is important for everyone.

Most people with asthma do not have to follow a special diet. In some cases, certain foods including cow's milk, eggs, fish, shellfish, yeast products, nuts, and some food colourings and preservatives, can make symptoms worse.

People with asthma are also recommended to avoid Royal Jelly products as they may trigger symptoms. If you think you have a food allergy, contact your doctor or nurse for further advice.

Remember, just avoiding your triggers alone is unlikely to control your asthma. You need to take regular asthma medicines as well.

Losing weight can help in managing asthma, and combined with a more active lifestyle, can also help to improve lung function.

Base your healthy eating plan around a variety of foods, including fresh fruit and vegetables, grains and cereals. It is recommended that you eat five portions of fruit or vegetables everyday and drink plenty of water.

Foods that may protect against asthma

Some foods have also been found to help protect against asthma and improve lung function.

Dutch research has shown that people who ate the most fruits and vegetables had the healthiest lung function. Vitamin C and E are also believed to help reduce the severity of the inflammatory response in the lungs of people with asthma.

A diet that includes a high level of nutrients can also boost the immune system and help ward off colds and flu both common asthma triggers.

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