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Asthmatics Can Breathe Easy

IT is rather ironic that I should get an asthma attack while I was interviewing a doctor on, you guessed it... asthma! It only took Professor Dr Jesse de Bruyne a few minutes to detect the breathlessness in my voice.

"Are you wheezing?" she asked. After I admitted I was, I was surprised at the extent of questioning that followed.

"But I don't have asthma," I protested. "It is just a bad cough." I didn't mention the runny nose, tearing eyes and that tight, gasping wheeze. After all, I was there to interview HER.

But she didn't buy it. De Bruyne, who is an associate professor at the Department of Paediatrics, Faculty of Medicine at University Malaya, has been treating children with asthma for many years and she knows the signs.

"People with asthma have sensitive airways," she said. "Asthma, an inflammatory disease of the respiratory system, shows itself in persistent wheezing and coughing."

She explained that often an irritant, for example, pollen or animal hair, causes the bronchial tubes to become tight and they often become inflamed, or swollen.

The breathing passage gets narrow, which does not allow much air into the lungs. At the same time, mucous starts to fill up the bronchial tubes. Breathing becomes difficult and the person may cough, wheeze or gasp to try to get enough air.

Only after the asthma attack passes can the person breathe comfortably again.

Science is still struggling to understand what causes the illness but opinion is now falling on the side of environmental "triggers" especially air pollution, dust, perfume, exercise, animal hair, strong chemical smells and tobacco smoke.

In addition, viral infections and influenza often bring on asthma attacks.

It is more common when there is a family history of asthma and allergy. A careful medical history, a physical examination and tests of lung function provide the information needed to diagnose asthma.

Measurement of lung function is useful both for diagnosis of asthma and to monitor the course of the disease.

Such tests include spirometry, which provides an assessment of airflow limitation, and peak flow, which measures the maximum speed at which air can flow out of the lungs.

I failed my peak flow test... twice. Even after being put on the nebuliser. Maybe I do have asthma.

"Asthma is not to be taken lightly," she scolded. "If untreated, it can be fatal."

But before I could panic, she quickly said that although there is no cure, asthma can be effectively controlled through awareness and medication.

Two types of medications are used in asthma care: controller medications (especially anti-inflammatory agents such as inhaled glucocorticosteroids) that are taken over the long term and keep symptoms and attacks starting, and reliever medications (rapid-acting bronchodilators) that work fast to treat attacks or relieve symptoms.

De Bruyne is also honorary secretary of Kelab Asma Kanak-Kanak.

According to her, the prevalence of childhood asthma in Malaysia is high. She cited a study in 1995 which revealed that 10.9 per cent of children aged 13 to 14 years and 10.4 per cent of children aged six to seven years were diagnosed with asthma.

The most recent study of the Klang Valley, done by the International Study of Asthma and Allergies in Childhood, suggests an increase in the prevalence of childhood asthma in the 13 to 14 years age group at 16.4 per cent.

Among chronic medical conditions, asthma is the most common cause of school absences and even hospitalisation for children.

For parents, one of the keys to coping with a child who has asthma is to become as informed as possible about the condition and how to control it.

"There is no reason why children who are getting treatment should avoid sports and normal play. Most parents become over-protective, not allowing their child with asthma to participate in normal activities such as sports and even school dances because they are afraid of provoking an attack," she said.

"If you make the child feel sickly, he will act that way. These children will learn to use asthma as an excuse for getting out of activities and chores." 7 Most children can lead full, active, wheeze-free lives if they are taught to manage their asthma properly. Exercise actually improves airway function by strengthening breathing muscles.

"Children can anticipate. Begin by teaching your children to understand their bodies and to recognise symptoms of asthma -- a slight cough, a tightness in the chest, noisy irregular breathing."

She encouraged parents who have children with asthma to create a special plan in the event the child has an asthma attack while they are at school or in the care of others.

Keep attacks away

MANY times, it is not possible to keep an asthma attack from happening. But Prof Jessie de Bruyne, associate professor at the Department of Paediatrics, Faculty of Medicine at University Malaya, said there are many things a parent can do to keep attacks away:

* Keep your home free of dust and pet hair. If you have pets, vacuum once a day. Dust often, and if you can, use a cloth, not a feather duster, and very little chemical sprays.

* Find out what foods may trigger an asthma attack in your child. Remove those food from his diet.

* Do not allow anyone to smoke in your house or around your child. If anyone in your family smokes, encourage them to quit, not only for the health of your child, but for their own.

* Be careful about using hair spray, powder, perfume or make-up around your child.

* Encourage your child to do some moderate exercise every day. The more he stays in shape, the less likely exercise will trigger an attack.

* Keep your child indoors when pollution levels are high. Don't let him play near streets or parking lots where many cars are coming and going.

* Keep your child calm during crisis situations. Let her know that she will handle any situation best if she is cool, calm, and collected. This could prevent future asthma attacks if you are not around to assist her.


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