What is Asthma?

Asthma is a chronic disease that affects your airways. The airways are the tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways are inflamed swollen). The inflammation makes the airways very sensitive, and they tend to react strongly to things that you are allergic to or find irritating. When the airways react, they get narrower, and less air flows through to your lung tissue. This causes symptoms like wheezing (a whistling sound when you breathe), coughing, chest tightness, and trouble breathing.

Asthma attacks are not all the same. Each person has one or many different "triggers". And we'll get into those later, but suffice to say they are different for everyone. No one knows what causes asthma. No one. We have many different "maybes", but that's it. It's not curable, but it doesn't have to be debilitating either. I have asthma, not only do I have it, I also smoke.

I was diagnosed with asthma at 16. My father has severe asthma, which basically means his asthma gives him a lot more trouble than mine ever gave me. I had quit smoking at 16 and with the diagnosis of asthma was told it'd be best not to start again. I had a few minor attacks. I wasn't consistent with my medication (a standard inhaler of whatever my doctor said to take) because it made me sick. I began smoking again, my attacks lessened. I didn't put it together until I was 20. Smoking lessened my problems. At 20 I begin treating every wheeze with smoking. I haven't had an attack in 11 years. I've seen several doctors about this. I mean, smoking is a trigger right? So I must not have asthma. Three doctors have told me that I do have asthma. One even told me that smoking only gave me the illusion of being able to breathe. As I told him, if I can breathe, it's no illusion. He said that smoking opens up those airways that constrict, relaxing them. Over time, I've found that most smokers I know also treat their symptoms with smoking. Don't tell us smoking makes it worse, for some of us, it makes it much MUCH better. Now, I'm not saying go out and start smoking. In fact, if you've never smoked before, I'd really suggest you not do it. You are not prepared for it. The shock of that on your air passages might trigger something nasty. But so can fires, barbecue pits, hell, any smoke. But don't tell US it doesn't help either. If you're an asthmatic looking for the medicine that does this for you, do you want someone to take it away because THEY think it shouldn't help?

Here are some of the things that many people without asthma would like to know about asthmatics and how, if you want, you can help lessen their discomfort. I say "if you want" because the asthma is OUR problem, not yours. You don't stop eating ice cream because there are diabetics in the world, but if you have a visiting diabetic then you might try to serve food friendly to them. This is just a list to help you find the asthmatic's "friendly food".

Triggers

As I said, asthmatics have many different triggers. MANY different triggers. If you're allergic to it, it's probably going to set you off. However, don't confuse irritants and allergens. Smoke (of any form) is not an allergen, it can't be. There's nothing in there that you can be "allergic" to. (Note: Allergens are proteins. Tobacco smoke does not contain proteins. People who believe that they are allergic to tobacco smoke are suffering from the very debilitating >A HREF="welcome.html#Witch">nocebo effect.) It's merely an irritant. I don't say "merely" to invalidate the importance of irritants on asthma, but anyone with an allergy should know that there is a world of difference between an allergy and an irritant. As someone allergic to *everything*, an irritant is nowhere near the level of problems an allergy is on the whole. Some examples of allergens are pet dander, dust mites, pollen and mold. It's been my experience that allergens are more likely to send you into a severe attack all by themselves, with no assistance from irritants or other outside forces. My asthma seems to be mostly triggered by my allergies. Summer I tend to smoke more, as everyone is mowing and I'm very allergic to grass. I stay inside a lot.

That isn't to say the second set of triggers doesn't play it's own part. However, I've noticed that all attacks I've been witness to (and one of my own) need multiple irritants to set off an attack. Irritants are air pollution, smoke of any kind, changes in the weather, perfume ( a powerful irritant), strong emotions (including crying hard and laughing), and stress. I'd like to say more about two of these irritants; cigarette smoke and perfume.

If you aren't sensitive to any other kind of smoke, but you are to cigarette smoke you are brainwashed. Cigarette smoke contains most of the same chemicals and toxins as any other kind of smoke. I have actually yet to meet anyone who's been triggered by smoke at all. I'm willing to admit the possibility, but not if the ONLY irritant is cigarette smoke but not candles, fireplaces, etc. That's illogical and, well, stupid. I've met a woman who SAID she was so sensitive to cigarette smoke that the smell of it on someone's clothes was enough to trigger an attack. However, I'd like to point out that there were several smokers in the group, including one sitting right next to her (me) and she didn't begin wheezing until several of us stood up and said we were going out to have a cigarette. I find that suspicious and proof of absolutely nothing but her own idiocy.

Perfume is the other irritant I feel the need to mention. I find, from many, that perfume actually causes more problems as an irritant (not just to asthmatics) than most things in a normal life (if you live in a normal town without a ton of industrial plants, air pollution, etc). Ladies, learn to apply it correctly. Don't BATHE in it. If your scent is overpowering, YOU are a problem, not just to asthmatics but anyone. You don't smell good, you STINK. That is too much. Perfume should be LIGHTLY applied. A dab to the pulse points of your body, i.e, on your neck just below your ear lobes, behind your knees, at your ankles, between your breasts, and at your wrists. That's a DAB, as in a little dot. Have you people never heard of Miss Manners? (Yes, I've read it and I'm only 31!). I know those bottles have the little sprayer and how nice is that, but get over it. Proper application is a must. I can't even PASS some of you without an instant headache, let alone the problems with my asthma. What good is it to smell "nice" if you drive off everyone who could stand near you? When you walk by you should leave behind a hint of your perfume, not a an overwhelming rush.

I'm an asthmatic and I can wear perfume. My perfume is light and properly applied. I get many compliments on how the scent smells on me and it gently wafts through the room if I'm the sole woman present. If I'm not, there's no competition between my scent and someone else's properly applied. It also helps to make sure your perfume smells good ON you, not TO you. Body chemicals mix with perfume to let off a different smell on you than the smell in the bottle. Take a friend, a real one, who will tell you the truth. This applies to men, too. My favorite cologne is Stetson. It makes me melt with desire, until some wannabe cowboy goes strutting by after bathing in it. I asked my husband to please apply it like a woman...we're back to melting and not meltdown. Ok, ok, I'll get away from this and move on.

Words of Wisdom for Asthmatics

There is another list of outside things that can trigger an attack. Dried fruit or wine can due to the sulfites in it. Medicines like aspirin or beta-blockers. Acid reflux can cause issues, as well as infections. It's up to you to find all your triggers and learn to avoid them, if possible. In most cases it's not possible. Air pollution, weather changes, pollen are all things you can do very little to avoid. We just have to learn to deal with them. But there are other things you can avoid. Don't go where there's smoke, dodge the laundry aisle in the grocery store (I send one of my family down to get my Tide), and don't sit next to whoever is bathing in perfume. Remember, asthma is OUR disease, not everyone else's. Unless you're willing to share the limits of having diabetes, don't insist others share your limits because you have asthma.

Treatment

As I said earlier, I've been treating MY asthma with smoking. It's worked well for me for about 11 years. However, it does not work for everyone. Many of my friends and I use a sole treatment of smoking tobacco. It works for us. My father has asthma so bad that even tobacco cannot always help and he must have much stronger medicine. I've noticed my friends who've used smoking to treat their asthma, those with a lighter case can use a sole treatment of smoking. Those with very bad asthma must at least have backup medicines. I have non-smoking asthmatic friends who use medicines. Since I am not up on the medicines, I went and bugged them. Again, I do not say you should take up smoking. In fact, if you don't smoke DO NOT DO THIS. I remember my first puff of a cigarette and I wouldn't suggest someone with a trigger happy disease test this out. If it's too late and you've already taken up smoking, I AM saying it's worth checking out depending on your personal situation.

First of all, avoiding problematic situations is a big thing. That does not mean go around telling folks that they shouldn't do something because you have asthma. For one you are not the center of the world, but for two, no one likes a whiner who won't help themselves. It's up to YOU to avoid situations. So, the more problems you can avoid, the less medicine you have to take and the fewer problems you will have.

Then medicine. You have two types of medicines, quick-relief and long term control. Quick-relief medicines work within minutes, for treating at the first sign of problems. They relax the muscles around your airways so the airways can open up and allow air through. Sometimes your doctor will ask you to use it at other times, like right before you exercise. Usually, not always, when you see someone using an asthma medicine it's one of these. These are paired with long term control, as quick-relief medicines are for "rescues" and do little for asthma in the long term.

The most effective medicine is a long term control medicine, inhaled corticosteroids. These are anti-inflammatory drugs that reduce inflammation in your airways and prevent blood vessels from leaking fluid into your airway tissues. They help reduce asthma attack frequency and the need for other medications. You still need rescue medicines, just not as often. There is a pill form of medication, theophyline. However, no one I know takes it, so I can't attest to it's effectiveness.

If you suffer from mainly allergy asthma, there's immunotherapy. They do an allergy test to see what all you are allergic to and then give you shots to desensitize you to what you’re allergic to. They start out once a week for a few months, then once a month. I started this treatment, but I can do the same thing at home by exposure and I'm willing to risk it. Except grass...I'm highly allergic to cats, I've had cats ALL my life (like 4 or more at a time) and I don't have allergy symptoms unless I pet the cat with an open wound (and then we had to cut off my wedding ring from the swelling). Immunotherapy is great if you have allergy asthma, where your only triggers are your allergies. There IS a risk though, of it precipitating an allergic reaction. But hey, risk is everywhere.

Mostly treatment is based on the severity of your asthma. So if you're asthma gets worse, you should go back to the doctor to work up a new treatment plan.

If the Need Arises...

If you see someone having an asthma attack, the best thing you can do is not crowd that person. They are already feeling constricted; let’s not add psychological constriction to that. ONE person is quite enough help up close. Ask if they have an inhaler and ask if they have an instruction card. Some asthmatics carry an instruction card, and if you can get to it, it will tell you everything you can do. If you can only get the inhaler, help the person sit up and take their medicine. Most of us know what to do, but we may have trouble if we keep our inhaler in an odd pocket or if it’s somewhere in our purse. If, for some reason, we don’t have an inhaler, it’s safe to use anyone else’s usually. So ask around the crowd. After getting the inhaler, give 2-4 puffs of the inhaler waiting a few seconds between puffs, then wait about 5 minutes before doing it again. Position the mouthpiece of the inhaler into the person’s mouth and let them know you are fixing to give a puff so they know to breathe in as you puff. Something short and sweet: “ready?” “now”. It’s very important that all the medicine makes it into the lungs. If after 10 minutes there’s no improvement, call an ambulance. Keep giving the inhaler treatment even if it doesn’t seem to be working, it will help keep the attack from getting worse. Above all, stay calm.

No matter how many times we have an attack we still cannot breathe and it still freaks us out. If you panic, we will panic, and that could make the attack worse. If you can, ask if they know what the trigger was, then remove them to an area that is safer for them. If cats set them off, try taking them to another room where the cats don’t go. If we don’t answer, move on. If we’re having trouble breathing we’re having trouble talking. If there is no inhaler, call the ambulance and just stay calm. Help the person sit up, as it’s easier to breathe sitting up and just wait. I know that seems like a sucky thing to say, just wait, but there’s nothing you can do really other than be calm and talk calmly. But that’s a big thing if you can keep us calm enough to keep it from getting worse. If you see someone helping already, ask the helper if you can do anything. You can help that person continue to keep the asthmatic calm by playing errand boy/girl. Then the helper doesn’t have to leave the asthmatic alone.

You have to understand, we cannot breathe and THIS one might be the one that kills us. Not all asthmatics think that way...we might not usually think that way, but it does cross our minds sometimes during an attack. The experience is horrifying to us, no matter how many times we go through it. That something can sneak up on us like this; make our own body betray us. All because we passed hay or a cat. In the throes of an attack, we are suffocating, and that is horrifying.

Smoke and Asthma

Ok, from the above you can tell I have a problem with calling out smokers for their "hateful" disregard of those poor asthmatics and asthmatic children. Since I am both, I think I have some insight on this.

1. I can't say this enough. Asthma is not a world disease; it's an individual's disease. I'm really sorry someone has asthma, cancer, diabetes, etc. But I ONLY have asthma, and that's my cross to bear and no one else’s. On an equal note, I don't have diabetes so I feel free to eat as much chocolate and candy as I like. In fact, there are any number of diseases out there I don't have and I refuse to live like I do have them to show I feel bad for those that have them. I really am sorry you have a disease, if I could cure it I would. If you are invited into my home, I will make it comfortable for you. If you can find a charity group that puts 80% of the donations to research into the disease I will donate, but I'm still living my life free of that disease and I intend to take advantage of that. If however, everyone must live with the asthmatic at heart, I must insist on a few things that would make our lives easier. I have a list. However, every asthmatic's list is different and the whole world will shut down if we abide by it.
2. Asthma sufferers rise in numbers even while supposedly cigarette smokers have quit by the thousands. Most places have no second hand smoke, and yet asthma is still rising. How is smoking causing asthma again? All you have to do to see this is check out the number of asthmatics in the last 50 years, and then look at the claims from anti-tobacco on how much less smoking and SHS there is. A great many smokers have now started going to smoke outside their own homes because of their children. Yet asthma rates continue to rise.
3. We don't know, at all, what causes asthma. Quite a few asthma specialists say that it seems that we are living too cleanly, that our children's immune system receives no decent workout anymore. Others say it's air pollution. I'm sure I can find a few more "we think it's caused by...." but I don't want "we think". Until I see "we know" then we don't know. You can explore all the options, and that's great. That gives us clues and more things to eliminate but, as of yet, we don't know the cause(s).
4. Remember, asthma is OUR disease, not everyone else's. Unless you're willing to share the limits of having diabetes, don't insist others share your limits because you have asthma. Also you should know, before you blame someone for an asthma attack, there are literally THOUSANDS of allergens and irritants. Don't be so quick to blame one unless you have done your own extensive testing.
5. One last thing, don’t use me as an excuse for your own prejudices. If you aren’t asthmatic, I don’t care what you have to say anyhow. You don’t get it and you probably never will. I reject you speaking for me. Especially since you do it so badly. You can’t go after cigarette smoke “for the asthmatics” and not go after other things that actually are worse. If you really want to help us poor asthmatics, ask us for a list of our triggers and go after ALL of them we can affect. Don’t trot us out like children because you want to make others feel guilty and support your cause. We are not your poster children.

Thanks!

Jalestra