Don’t Let Asthma Take Your Breath Away

People may sometimes mistake asthma for a viral infection, bronchitis or even a summer cold. But it takes more than throat lozenges and chicken noodle soup to ease the coughing, wheezing and shortness of breath associated with asthma, a chronic lung disease that affects the airways and makes breathing difficult. It requires lifelong, expert care – the kind delivered by pulmonary medicine specialists at Bridgeport Hospital.

Asthma affects an estimated 8 percent of the population in the United States, including children and adults, but its cause is unknown and its onset, unpredictable. “It is kind of perceived as a childhood disease, but it can happen at any time and it can happen to anyone,” said Nasheena Jiwa, MD, a Northeast Medical Group pulmonary and critical care physician at Bridgeport Hospital.

“Asthma is an obstructive lung disease,” Dr. Jiwa explained. “Although you can get air in, you really can’t get air out effectively. And when you try to breathe out, that’s when you hear wheezing. When you feel like you can’t breathe, there is an impending feeling of panic and it kind of worsens the cascade."

See your doctor

How do you know if you’re experiencing asthma symptoms, or something else?

“Typically, you won’t have infectious symptoms with asthma, but at the same time, infections can also produce an asthma attack, so it is a little confusing,” Dr. Jiwa said. “I think after any sort of infectious episode, if persistent symptoms continue, it would be good to get checked out to see if your airways are healthy.”

Similarly, a dry, nonproductive cough that lingers for weeks at a time could indicate a cough-variant asthma. “If you have a cough that is persistent beyond three weeks, for example, it would be good to check it out to make sure it’s not asthma-related,” she said.

When in doubt, see your doctor. Pulmonary function tests are often done to evaluate lung function and to confirm or rule out asthma.

Know your triggers

“Asthma can present in different ways, but the most obvious signs would be if someone gets short of breath and hears themselves wheezing,” Dr. Jiwa said. Oftentimes, it is associated with certain triggers that can range from environmental allergies to the air you breathe.

Conditions like postnasal drip or acid reflux can also trigger asthma symptoms. By avoiding your asthma triggers, you may be able to prevent an asthma attack.

Be compliant with your inhaler regimen

To reduce inflammation and open up the airways, patients with asthma typically use two broad categories of inhalers: bronchodilators and anti-inflammatories. “People who have the symptoms of an asthma attack generally reach for the bronchodilator, called albuterol, because it’s short-acting and it helps them get in air right away,” Dr. Jiwa explained.

“But as our guidelines are changing, we are now urging people to go for a combination inhaler,” Dr. Jiwa said. “We are urging them to reach for the inhaled steroids plus the bronchodilator because we’ve found that they are more effective in terms of asthma attack recurrence. The bronchodilator plus the anti-inflammatory takes a little bit longer, but in the long run, it does help with the inflammation,” she said.

While asthma cannot be cured, it can be controlled, and additional therapies are now providing some patients with greater relief. A pill called Singulair®, or montelukast, is available as an add-on therapy for allergy-associated asthma, Dr. Jiwa said. Biologic therapy is also available to qualifying patients as an injection.

“The patients who qualify for biologics are often steroid-dependent, or they have many exacerbations in a year,” she explained. “With biologics, their exacerbations may decrease, their steroid dependence may decrease and their lung function may also improve.

"As more options for therapies are available for the management of asthma, patients can start to breathe easy," Dr. Jiwa said.

Learn more about pulmonary medicine services at Bridgeport Hospital.

Got asthma? Five tips to live by

1. See your doctor
   Asthma symptoms can be confusing, so see your doctor for a proper diagnosis and go for checkups as needed.
2. Know your lung function
   Get baseline pulmonary function tests and have them updated if your condition changes.
3. Know your triggers
   Asthma triggers are everywhere – from changes in the weather to environmental allergies such as smoke, pets, dust and perfume. Find out what triggers your symptoms.
4. Optimize conditions that can impact asthma
   Conditions like postnasal drip or acid reflux can also trigger asthma symptoms. Find out what you can do to keep those conditions in check.
5. Be compliant with your inhaler regimen
   Have an inhaler regimen, learn how to use your inhaler properly and carry it with you at all times.