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If you are asthmatic, you are not alone.
Over 5.1 million people in the UK have asthma – that's
around 1 in 13 people, 50% of whom are children with asthma.
The figures for asthma sufferers are in similar proportions
in most other countries.
Whilst there is currently no known cure for asthma, it
is a scientific fact that 85% of people are allergic to
the dust mite excrement and dust mite skeletons found in
every mattress, even if only a few months old. It is also
a scientific fact that if a pregnant woman inhales this
dust mite excrement and the skeletons, which is inevitable,
that this can cross the amniotic fluid in the womb and cause
asthma in the unborn child.
Can the Mattress Doctor cure asthma? Well
that depends upon your definition of cure. In a survey of
900 of our customers over the last 6 months, 87% reported
a considerable, if not complete alleviation of their asthmatic
symptoms. And in several cases there was no need for the
continued used of any form of medication. That may not be
a cure for asthma but it is certainly a great help for asthma
sufferers. Click
here to read what some of these customers said.
As a secondary preventative measure allergy sufferers should
also consider sleeping with an anti
allergy mattress protector as this will provide an
impenetrable barrier between the sleeper and the dust mites
and their allergens.
Here
is some other information on asthma which could be useful
to asthmatics, and there is also considerable further information
available.
Vaccine: real hope for the future
From The
National Asthma Campaign
Recent media reports have suggested that a vaccine for
asthma is just around the corner. Initial results of the
research, which focuses on a vaccine for people with a cat
allergy, are encouraging, but an effective vaccine for asthma
is still a long way off, say experts.
Professor Barry Kay and Dr Mark Larché are carrying
out National Asthma Campaign-funded research at the National
Heart & Lung Institute, Imperial College, London. They
have developed a prototype vaccine for people with an allergy
to cats, which could eventually be applied to a range of
allergens including pollen and dust mites.
The researchers have designed a synthetic vaccine based
on the structure of whole allergens. The approach is different
to desensitising immunotherapy (sometimes referred to as
'allergy shots'), since it targets only the body's T cells,
which direct the allergic response. Therefore instead of
injecting the whole allergen, they use only the small parts
of it that react with the T cells. This new approach reduces
the risk of side effects and allows a much higher dose of
treatment to be given, compared with conventional immunotherapy.
Sixty patients have received the prototype vaccine, with
promising results. However, it is early days, warned Professor
Kay. 'Far more work has to be done, including extensive
clinical trials,' he said. 'People with asthma should not
have their hopes raised at this stage because it is too
early to say with certainty if the vaccine will pass all
the rigorous tests involved in the development of a new
therapy.'
The Campaign's chief medical adviser, Professor Martyn
Partridge, called the vaccine an 'important development'
and said: 'Hopefully this will lead to new treatments for
people with asthma in the next five to six years.'
Worldwide, dust mites are the main causative agent of one
of the worst ailments of the twentieth-century man.
Lilian R. Blanco, Ph. D., MOIF, D.G.
As there has been increasing prevalence of asthma which
are mite-related in both adult and children not only in
Western countries but also in Asian Pacific countries, there
is an urgent need for mite education.
The fundamental thing to know is that mites are diverse
small arthropods.The ones which are particularly linked
to asthma are collectively called house dust mites having
their permanent residency in house dust. That house dust
contain allergens causing asthmatic symptoms was first suggested
in 1921. However, analysis of dust did not come about until
1964 when a group of investigators led by Voohorst suggested
that a mite may be responsible for the dust allergen. Results
of such studies identified one mite species after another
and showed variable distribution from one home to another,
from one room to another of the same home, and from different
home soft furnishings. Their predominance or survival depend
on richness of their diet and suitability of temperature
and relative humidity of their habitats. In general, humid
homes have more mite and therefore more allergen.
Soon it was established that the faecal pellets which mites
egest and accumulate in home fabrics are allergenic. When
these become airborne following our domestic activities
such as vacuuming or dusting, we inevitably inhale these
particles eliciting from some of us, who are atopic, allergic
reactions. Today, global studies aimed ultimately towards
mite management have increased steadily.
What is asthma?
Asthma is a chronic disease in which sufferers have repeated
attacks of difficulty in breathing and coughing. There seems
to be an increase in the amount of asthma all over the world,
especially in children. To understand what happens in asthmatic
attacks it is helpful to visualise the basic structure of
the airway tubes of the lung (bronchi).
The main airway (windpipe, trachea) of the body is about
2-3cm across. It divides into its main branches (bronchi),
which lead to the right and left lung, which divide further,
like the branches of a tree, to supply air to all parts
of the lungs. The smallest tubes (bronchioles) are only
millimetres wide and they are made up of ring-shaped muscles
that are capable of contracting or relaxing. Anything that
makes them contract will narrow the passages, which makes
it more difficult for the air to pass through and also gives
rise to the characteristic wheezy noise. Asthmatics tend
to be sensitive to various types of irritants in the atmosphere
which can trigger this contraction response from the bronchial
muscles.
The bronchi also have an inner lining that becomes inflamed
in asthma, which makes the lining swell and produce an excess
amount of the mucus (phlegm) which it normally makes. All
of these processes contribute to the airway narrowing and
the treatment for asthma is aimed at reversing them as much
as possible.
People of all ages get asthma but 50 per cent of sufferers
are children, mostly boys, under 10. Among adults, women
are more likely to develop asthma than men.
How do you get asthma?
Asthma can be triggered by external agents, such as irritants
in the atmosphere which are breathed in, or by internal
reactions within the body that have been caused by an external
influence. The kinds of provoking factors can be divided
into two groups:
-
non-specific factors: all asthma patients are affected
by a number of things that are referred to as irritants.
They include exertion, cold, smoke, scents and pollution.
-
specific factors: these are irritant or allergens in
the form of pollen, dust, animal fur, mould and some
kinds of food. A virus or bacteria, chemical fumes and
other substances at the workplace and may also cause
asthma.
To acquire asthma, people seem to need to have been born
with a predisposition to the disease. It may not reveal
itself until they have been exposed to some asthma irritants.
Smoking mothers, low birth weight, a lack of exposure to
infection in early life and traffic fumes have all been
associated with the increase in asthma. Less draughty houses
resulting in a higher concentration of house dust mites
and cooking gases may also be part of the problem. Currently,
a great deal of research looking for the genes that allow
asthma to develop is being carried out. But until we can
prevent asthma, we have to suppress the symptoms and try
to avoid the triggers where possible.
What does asthma feel like?
-
It is difficult to breathe and there is shortness
of breath.
-
Wheezing when breathing out.
-
Coughing, especially at night and with a little
mucus.
What are the warning signals of worsening
attacks?
-
Inhaled medicines appears less effective than usual.
-
Symptoms of cough or wheeze on exertion.
-
Night-time wakening with wheeze or cough.
-
Fall in the peak flow meter reading (a peak flow
meter is a simple device that measures the maximum
speed at which a person can breathe out).
When it appears that your asthma is becoming
less well controlled, you should consult your doctor for
advice on what to do.
What are the danger signals of severe attacks
requiring immediate medical attention?
-
Bluish skin colour and gasping breath.
-
Exhaustion so severe that speech is difficult or
impossible.
-
Confusion and restlessness.
What can you do to help yourself?
-
Avoid the substances you are allergic to, if possible.
It can be difficult to know which specific factors
may give you trouble, but general irritants like tobacco
smoke should be avoided.
-
It is important to take your prescribed preventive
medicines, even if you feel well.
-
If you get a serious attack, contact your doctor
or the emergency services.
-
Discuss your treatment with your doctor or practice
nurse. You should know what to do if, for example,
you get a bit worse during a cold. This will usually
involve a temporary increase in the dosage of your
treatment.
-
Be familiar with the use of a peak flow meter, which
can help you judge your asthma during spells when
it is worse.
-
Make sure you use your inhaler device correctly.
If you are unsure your practice nurse, doctor or pharmacist
will be able to help and advise you.
How does the doctor make the diagnosis?
The diagnosis is made on the basis of the
patient's history of symptoms and on simple tests of the
lungs' function but it is not always easy to come to a diagnosis
of asthma if the symptoms are mild and intermittent. For
those people whose asthma is associated with eczema and
hay fever it can be helpful to take blood samples and skin
tests to look for hypersensitivity towards specific substances.
What should I do?
Be active. If you get attacks during intense
activity it may be a good idea to take 'reliever' medicine
before you begin to exercise. These medicines, properly
known as bronchodilators, have a relaxing effect on the
muscle surrounding the bronchioles. Swimming is probably
the best form of exercise for asthma patients but the most
important thing is to stay active.
What are the prospects for asthma
suffers?
-
Although asthma cannot be cured it can usually be
well treated so that the symptoms give little trouble.
-
Half of the children who get asthma 'grow out of
it'.
-
It is vital to stop smoking to avoid developing
long-term lung damage (chronic bronchitis, 'smoker's
lung'), which will reduce the lung function drastically.
-
Join NetDoctor's free 90-day Stop Smoking Programme.
-
Severe attacks of asthma can be fatal but only if
they are treated inadequately or not soon enough.
Medicine
Medicines for asthma are generally thought
of in two main groups.
-
Relievers (bronchodilators): these are quick-acting
medicines that relax the muscles of the airways. This
opens the airways and makes it easier to breathe.
They are used to relieve symptoms.
-
Preventers: these act over a longer time and work
by reducing the inflammation within the airways. They
should be used regularly for maximum benefit. When
the dosage and type of preventive medicine is correct,
there will be little need for reliever medicines.
Relievers
There are three groups of these.
Beta-2 agonists
Beta-2 agonists act on molecule-sized receptors on the muscle
of the bronchioles. The medicine fits the receptor like
a key fits a lock and stimulates the muscle to relax. Examples
of those which act for a short time (three or four hours
following a single dose) are salbutamol and terbutaline.
These medicines are inhaled from a variety of delivery devices,
the most familiar being the pressurised metered-dose-inhaler
(MDI). They are used when required to relieve shortness
of breath.
Longer-acting beta-2 agonists include salmeterol
and formoterol. Their action lasts over 12 hours, making
them suitable for twice daily dosage to keep the airways
open throughout the day.
Anticholinergics
One of the ways in which the size of the airways is naturally
controlled is through nerves that connect to the muscles.
The nerve impulses cause the muscles to contract, thus narrowing
the airway. Anticholinergic medicines block this effect,
allowing the airways to open. The size of this effect is
fairly small, so it is most noticeable if the airways have
already been narrowed by other conditions, such as chronic
bronchitis. Examples of anticholinergics are ipratropium
and oxitropium. They have a maximum effect 30 to 60 minutes
after inhalation, which lasts for three to six hours.
Theophyllines
Theophyllines are given by mouth and are less commonly used
in Britain because they are more likely to produce side
effects than inhaled treatment. They are still in very wide
use throughout the world. All three types of reliever can
be combined if necessary.
Preventers
There are three main groups of these.
Corticosteroids
Corticosteroids (or 'steroids') have made an enormous difference
to the management of asthma. They work to reduce the amount
of inflammation within the airways, reducing their tendency
to contract and have allowed many patients with previously
troublesome asthma to lead almost symptom-free lives. They
are usually given as inhaled treatment, although sometimes
oral steroid tablets may be required for severe attacks.
Although steroids are powerful medicines with many potential
side effects, their safety in asthma has been well established.
It is also important to balance the problems that arise
from poorly treated asthma against the improvement in health
which occurs when the condition is well treated.
Cromones
There are two medicines in the cromone group: sodium cromoglicate
and nedocromil. They also act to reduce inflammation of
the airways. They tend to be best for mild asthma and are
more effective in children than adults. The medicines are
given by inhalation and are usually very well tolerated.
Leukotriene receptor antagonists
Leukotriene receptor antagonists are compounds released
by inflammatory cells within the lungs and which have a
powerful constricting effect upon the airways. By blocking
this effect with these antagonist medicines the constriction
is reversed. There are two such medicines currently available:
montelukast and zafirlukast, both of which are taken as
tablets.
Based on a text by Dr Carl J Brandt and Dr
Finn Rasmussen.
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