How to understand if you have Asthma
Asthma is a treatable disease that behaves like an allergic reaction: some environmental factors trigger the inflammation of the airways, as a result of respiratory problems that subsist only when the inflammation is cured and reduced. This disorder is very common and affects about 334 million people worldwide, including 25 million in the United States alone. If you are afraid of suffering from asthma, you may notice some signs and symptoms, analyze the risk factors and undergo diagnostic tests to know for sure.
Know the Risk Factors
1) Consider the combination of gender and age.
In the United States, for example, there are 54% more cases of asthma among boys under 18 than girls. But from 20 years on, girls suffer more than boys. After 35 years this gap increases further and 10.1% of women suffer from asthma, compared to 5.6% of men. After menopause, this percentage is reduced in women and the gap decreases, even if it does not completely disappear. Experts have some theories about why sex and age seem to affect the risks of suffering from asthma:
An increase in atopic syndrome (a predisposition to allergic sensitivity) in adolescent males.
A reduced airway volume in male adolescents compared to girls.
Hormonal fluctuations during the premenstrual phase, during menstruation and in the years of menopause in women.
Studies have found that menopausal women who have undergone hormone replacement therapy have increased the number of new cases of asthma.
2) Check the family history.
Scholars have found that there are more than 100 genes associated with asthma and allergies. From research done on families, especially on twins, it has been found that asthma is caused by hereditary factors. In a 2009 study, in particular, it was inferred that a past history of asthma in the family is the major risk factor in the development of this disorder. If families with a normal, moderate and high genetic risk are compared to each other, it is clear that those at moderate risk are 2.4 times more likely to develop the disorder, while those at high risk are 4.8 times more likely.
Ask parents or other relatives if there is a genetic predisposition to asthma in your family.
If you have been adopted, your biological parents may have provided your clinical history to the adoptive family.
3) Pay attention to every sign of allergy.
Some studies have associated immunoglobulin called “IgE” to the development of asthma. If you have high levels of IgE in your body, you’re more likely to suffer from an allergy to inherited causes. If you have this immunoglobulin in your blood, the body triggers an allergic inflammatory reaction that causes constriction of the airways, skin rashes, itching, watery eyes, dyspnoea, and so on.
Check to see if you have an allergic reaction to certain triggers, such as food, cockroaches, animals, mould, pollen and dust mites.
If you have allergies, you run greater risks of developing asthma.
If you suffer from various allergic reactions, but you can not identify the triggering factor, ask your doctor for allergy testing. You will be placed on the skin of small pads containing different allergens to control the reaction and changes in the skin. 14 MARCH 2018
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4) Do not inhale cigarette smoke.
When particles are inhaled into the lungs, the body reacts with a cough. These smoke particles could also be responsible for an inflammatory response of the organism and asthma symptoms. The more you remain exposed to tobacco smoke and the more you risk developing asthma. If you are an avid smoker and can not get rid of this habit, talk to your doctor to find programs and drugs to stop smoking. Among the most common methods are chewing gum and nicotine patches, the gradual reduction in the number of cigarettes or even the use of drugs such as Chantix or Wellbutrin. In any case, even if you have difficulty quitting, avoid smoking near other people, because passive smoking can cause asthma also in other individuals.
Women who smoke during pregnancy may cause dyspnoea in the child, increasing the risk of food allergies and the release of inflammatory proteins in the blood. The effect is even greater if the child continues to be exposed to passive smoking even after birth. Talk to your gynaecologist before taking any oral medication to try and quit smoking.
5) Reduce stress levels.
Many studies have found that high levels of stress hormones can provoke an asthma crisis, increase sensitivity to allergens and a feeling of chest tightness. Try to identify the factors that most put you under pressure and commit to getting rid of it.
Try relaxation techniques such as deep breathing, meditation or yoga.
Exercise regularly to release endorphins, relieving pain and reducing stress levels.
Improve your sleep habits: go to bed when you’re tired, do not sleep with the TV on, do not eat before bedtime, avoid taking caffeinated drinks in the evening and keep a regular sleep schedule every day.
6) Do not export to environmental pollutants in the air.
A significant proportion of asthma cases in children are caused by polluted air from factories, construction sites, vehicles and industrial facilities. Just as tobacco smoke irritates the lungs, the polluted air triggers inflammatory reactions that cause damage to the lungs and a sense of chest tightness. Even if you can not eliminate pollutants, you can try to reduce exposure.
If you can avoid staying for too long in high traffic areas and close to motorways.
If children play outdoors to keep them away from highways or construction sites.
If you have the opportunity to move and change locations, get information at the ARPA of your region or the one you want to go to know the air quality data of the various locations.
7) Take your medications into consideration.
If you are taking certain medicines, check to see if the asthmatic symptoms have worsened since the start of therapy. If so, consult your doctor before thinking about stopping the treatment, reducing the dosage or changing the type of medication.
Research has shown that aspirin and ibuprofen can cause lung constriction in asthmatic patients sensitive to these drugs.
ACE inhibitors prescribed to control arterial hypertension do not cause asthma but cause a dry cough that can be mistaken for this disorder. However, an excessive cough due to these drugs can irritate the lungs and trigger an asthma crisis. The most common ACE inhibitors are ramipril and perindopril.
Beta blockers are taken to treat heart problems, high blood pressure and migraine; these too can cause a constriction of the pulmonary pathways. Some doctors can prescribe these drugs even in the presence of asthma; the important thing is to monitor any changes or symptoms. The most common beta blockers are metoprolol and propranolol.
8) Keep a weight on the norm.
Research has confirmed a correlation between weight gain and a greater risk of asthma. Excess weight makes breathing more difficult and increases the effort of the heart to pump blood into the body. This causes an increase in inflammatory proteins (cytokines) in the body, facilitating the development of the inflammation of the airways and of the thoracic constriction.
Recognizing the mild and moderate symptoms
9) Contact your doctor, even if the symptoms are mild.
The first symptoms are usually not particularly serious to interfere with normal activities or everyday life. However, when the disorder begins to progress, you notice a greater difficulty in performing ordinary daily activities. In most cases, the symptoms do not change but only become more intense and disabling.
If they are not diagnosed or treated, these first light symptoms of asthma, with the passage of time, are getting worse and worse. This is especially true if you can not recognize the triggers and avoid them.
10) Pay attention to an excessive cough.
With asthma, the airways are blocked due to constriction or inflammation; the body then reacts trying to free the respiratory passages with a cough. In the case of a bacterial infection, coughs are fat with a lot of mucus, while in the presence of asthma they tend to be dry, with very little phlegm.
If a cough starts or gets worse during the night, it may actually be asthma; in fact, the nocturnal cough or that of the morning when you wake up is a typical symptom of this disorder.
When asthma progresses and gets worse, the cough also extends throughout the day.
11) Listen to the noise you emit when you exhale.
Asthmatics often hear a whistling sound or an acute whistle during the exhalation phase, which is caused by the reduction of the diameter of the air passages. Be careful when you hear this sound; if it occurs in the last phase of exhalation, it is an early sign of asthma. When the problem gets worse from light to moderate, the hissing is heard throughout the exhalation.
12) Take note of an unusual shortness of breath.
Exercise-induced bronchoconstriction, or exercise asthma, is a type of asthma that manifests itself in those who have just done some particularly challenging activities, such as training. The constriction of the airways causes a feeling of tiredness and leaves you breathless before normal; as a result, you may be forced to give up the action sooner than you wish. Try to compare how long you can train normally and how often you feel tired and out of breath.
13) Pay attention to accelerated breathing.
To try to assimilate more oxygen through narrow respiratory channels, the body instinctively breathes faster. Put a palm of your hand on your chest and count how many times the chest lifts in a minute. Use a stopwatch or a clock that shows the seconds, so that you can count accurately. In normal breathing, you should generally have between 12 and 20 breaths in 60 seconds.
In the case of moderate asthma, respirations in one minute are about 20-30.
14) Do not neglect the symptoms of cold or flu.
Although an asthma cough is different from that caused by cold or flu, bacteria or viruses can also trigger asthma. Pay attention to the symptoms of infections that can cause this disorder: sneezing, rhinorrhea, sore throat and congestion. If you expose a dark, green or white mucus, the infection can be bacterial; if it is transparent or white, it can be viral.
If these symptoms are associated with noise during exhalation or when breathing, it means that the infection has probably triggered asthma.
Get to the doctor for an accurate diagnosis.
Recognize the Severe Symptoms
15) Contact your doctor if you cannot breathe even without physical activity.
In general, in asthmatics, the short or laboured breathing caused by exercise improves with rest. However, when symptoms are severe or an asthma attack is ongoing, you may suffer from dyspnoea even at rest due to the inflammatory process that caused the seizure. When the inflammation is quite severe, you suddenly feel breathless or gasping for air hunger.
You may also experience the feeling of not being able to fully exhale. When the body needs oxygen and inhales the air, it tends to reduce the phase of exhalation so as to absorb oxygen more quickly.
You may also find that you can not utter a complete sentence, but that you can only use words and short sentences between a rattle and the other.
16) Check the respiration rate.
During mild or moderate asthma attacks, breathing may be accelerated, but in a severe crisis, this rhythm may be faster. The forced areas of the streets prevent a sufficient supply of fresh air to the lungs, causing a lack of oxygen. Accelerated breathing is the body’s natural reaction to take as much oxygen as possible and remedy the situation before suffering from more serious problems.
Put the palm of your hand on your chest and count how many times the chest rises and falls in a minute. Use a stopwatch or a clock that also appreciates seconds, so you can record data more accurately.
In the event of a severe attack, the frequency exceeds 30 breaths per minute.
17) Measure the heartbeat.
The blood absorbs the oxygen the organs and tissues need from the air in the lungs, distributing it throughout the body. During a severe attack, when the blood can not guarantee an adequate supply of oxygen to the body, the heart must pump faster in order to make up for this deficiency. So, during a serious attack, you may feel that the heartbeat accelerates without a real motivation.
Extend your hand with the palm facing up.
Put the index and middle fingers of the other hand on the outside of the wrist, under the thumb.
You should feel a rapid beating pulsing from the radial artery.
Calculate your heart rate by counting the beats in a minute. In a normal situation they should be less than 100 per minute, but in the presence of severe asthmatic symptoms can also be over 120.
There are some smartphone apps that can measure heartbeat. If you are interested, you can download some of them.
18) Check if the skin appears bluish.
Blood is bright red only when it carries oxygen, otherwise, it is much darker. We can only see it when it is on the outside of the body, where it comes into contact with oxygen again and is bright again; this is why we are not used to thinking of other colours. During a severe asthma attack, however, you could become “cyanotic” because of the dark, “hungry” blood that flows through the arteries. The skin appears bluish or greyish, especially on the lips, fingers, nails, gums or in the eye area where it is thin.
19) Check to see if you are contracting the muscles of your neck and chest.
When you have difficulty breathing or being in respiratory failure, put on accessory muscles (those that are not usually essential for the breath). These are the muscles on the sides of the neck: the sternocleidomastoid and the scalene. Check to see if your neck muscles are swollen when you realize you have shortness of breath. Also pay attention to the intercostal muscles, because in times of air hunger they are contracted inwards. These are the muscles that help lift the rib cage while inhaling and you may notice that they detract from the ribs when the situation is severe.
Look in the mirror to check the muscles on both sides of the neck if they are very outlined and if the intercostal ones are retracted.
20) Pay attention to the pain and tension of the chest.
When you have a lot of difficulty breathing, the muscles of the chest that work to ensure breathing must work under stress. As a result, they get tired and cause pain and tension. The pain may seem dull, acute or excruciating and may occur around the central area of the chest (area of the breastbone) or slightly outside (parasternal area). If you experience this pain, you must immediately go to the emergency room to rule out any heart problems.
21) Check if the noise during breathing gets worse.
When symptoms are mild or moderate, whistling and dyspnea are only perceptible during exhalation. However, in case of more severe asthma, you can also feel them during inhalation. The whistle during inspiration is called “stridor” and is caused by the constriction of the throat muscles in the upper respiratory tract. Dyspnea instead occurs more often during expiration and is caused by constriction of the muscles in the lower respiratory tract.
The noise you hear during inspiration can be caused by both asthma and serious allergic reactions. It is important to be able to distinguish between them in order to find the appropriate treatment type.
Check for signs of hives or red rashes on the chest, as they indicate an allergic reaction and not an asthma attack. Also, the oedema of the lips or tongue is indicative of allergies.
22) Treat asthma symptoms as soon as possible.
If you have a severe asthma attack that makes it difficult for you to breathe, you must call 118 and go to the nearest emergency room right away. If you have never been diagnosed with this disorder so far, you probably will not have a life-saving inhaler. Otherwise, however, use it.
Salbutamol inhalers should only be used 4 times a day, but during an attack, you can use them as often as necessary every 20 minutes for 2 hours.
Take slow deep breaths, mentally counting up to 3 both in the inhalation phase and during exhalation. By doing this you can reduce stress and respiration rate.
Avoid exporting triggers if you can identify them.
Asthma can be reduced if you take steroids that your doctor prescribes. These drugs can be inhaled through a pump or taken orally. Spray the medicine or take it as a compress with water. It will take a few hours before it starts to take effect, but it is able to keep the symptoms under control.
23) Look for immediate medical attention in the case of severe symptoms.
In this case, it means that you are experiencing a dangerous asthma attack and your body is struggling to assimilate sufficient air. You must immediately turn to the emergency services because the problem can become very serious if not treated promptly until it is deadly.
Get a Diagnosis
24) Give your doctor all your medical history.
Try to be as accurate and accurate as possible so that the doctor can get a general idea about the problems you are suffering from. You should prepare the topics in advance, so you do not have to think too much about these questions when you go to your office:
Any sign or symptom of asthma (coughing, shortness of breath, noise during breathing, etc.);
Previous medical history (previous allergies, etc.);
Family history (pulmonary problems or allergies of parents, siblings, etc.);
Your life habits (use of tobacco, nutrition and physical activity, surrounding environment, etc.);
Any medication (such as aspirin) and any supplements or vitamins you take.
25) Submit to a medical examination.
During the examination, the doctor could check some or all of these parts of the body: ears, eyes, nose, throat, skin, thorax and lungs. He could also use the stethoscope on the front and back of the chest to listen for respiratory noises or even to see the absence of sounds in the lungs.
Because asthma is related to allergies, the doctor could also control the presence of rhinorrhoea, conjunctival hyperemia, tearing and rash.
Finally, it will also examine the throat to see if it is swollen and determine your ability to breathe; it will also note abnormal sounds, which may indicate a constriction of the airways.
26) Let the doctor confirm the diagnosis by performing a spirometry exam.
During the test, you need to breathe in a tube connected to a spirometer that measures your airflow and how much air you can inhale and exhale. Take a deep breath and exhale vigorously for as long as possible while the device calculates the power. Although in the case of a positive outcome, the presence of asthma is certain, a negative result does not automatically exclude it.
27) Take the expiratory flow peak test to understand if you have Asthma
This exam is similar to spirometry and measures how much air you can exhale. Your doctor or pulmonologist may recommend this for a certain diagnosis. To undergo the test, you have to place your lips on the opening of a device that is calibrated to zero. Stand up and take a deep breath, then blow harder and faster than you can in a single exhalation. The procedure must be repeated a few times, in order to obtain consistent results. To obtain valid results for the test, the greatest value detected, which is the peak of the respiratory flow, must be considered. When you feel asthma symptoms are rising, repeat the test and compare this airflow with the previously observed peak flow.
If the value is more than 80% of the best-detected flux peak, you are in a safe range.
If the value you find is between 50 and 80% of the best peak flow seen under normal conditions, you are not following appropriate treatments for asthma and the doctor will have to find other more suitable drugs. If you fall within this range of values, you have a moderate risk of suffering from an asthma attack.
If the resulting value is less than 50% of the best peak flow, it means that you suffer from a serious pathology of the respiratory functions that must be treated with drugs.
28) Ask the doctor to perform the bronchial provocation test with methacholine
. If you do not have any obvious symptoms when you visit your doctor, it may be difficult to diagnose your asthma. In this case, it is advisable to perform this test, in which the doctor will provide you with an inhaler containing methacholine. This substance causes airway constriction, if you suffer from asthma, and triggers symptoms that can be measured with airflow peak tests and spirometry.
29) Check the body’s response to asthma medications.
Your doctor does not always decide to undergo these tests and may simply provide you with medications to improve your condition. If the symptoms subside, it is likely that you suffer from asthma. The severity of symptoms, a previous history of asthmatic episodes and the results of physical tests are the main factors that a doctor takes into account when choosing the drug.
A widespread device is the albuterol/salbutamol based inhaler that is used by resting the lips on the opening and spraying the drug, which is then inhaled into the lungs.
The bronchodilator drugs help to open the forced airways thanks precisely to their dilatory action.