ASTHMALiving with

If you are reading this leafl et, then you or somebody you know is probably living

with asthma. And you would like to do something about this. This leafl et can help

you to understand what asthma is, what you can expect and what you can do your-

self to limit any problems that you may have.

Asthma

There are many stories about asthma. It is defi nitely an illness that requires the serious attention of both doctor and patient. How-ever, to reassure you: there are currently approximately half a

million people in the Netherlands with asthma. Most of these will re-spond to the question ‘Can you live a normal life with asthma?’ with a resounding ‘Yes’.

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In plain English: the smallest air-ways are easily irritated without good reason. This irritation causes swelling and mucous formation, which reduces the pathway through the small airways. You will notice this in the form of shortness of breath. Compare it to breathing through a straw: that makes breathing a lot more diffi -cult.

Other triggers, such as exertion, can cause the same reaction in sensitive lungs. The text box pro-vides an overview of the most common types.

Medically speaking, asthma is ‘a shortness of breath with mucous formation

and coughing caused by chronic bronchial hyper-reactivity’.

What is asthma?

Allergic triggers

House dust mite.

This almost invisible creature (0.3 mm) lives

primarily in dusty surroundings such as

carpets.

Skin fl akes from animals.

Most well known are cat, dog, horse, guinea

pig and birds.

Pollen from grass, trees and plant species.

Pollen is released when plants fl ower; this is

why people with asthma suff er more

symptoms in the spring and summer than in

winter.

Spores from fungi/mushrooms.

Spores occur primarily in forests in the autumn.

Basements are a popular place for fungi and

mushrooms.

Food products, such as cow’s milk, eggs,

nuts/peanuts and wheat.

Children can outgrow certain allergies.

Medicines, e.g antibiotics and Ibuprofen.

If you have ever had an allergic reaction to

a medicine, it would be wise to have this

included in your medical records.

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Non-allergic triggers

Trigger substances.

For example, tobacco smoke, exhaust fumes, fuel vapours, smog,

cooking smells, cleaning products, solvents, paint fumes, perfumes,

air fresheners and even printer ink.

The weather.

Fog, rain, humidity (in the home too), cold air, large temperature

fl uctuations.

Exertion.

Sudden exertion in particular can result in shortness of breath,

particularly with outdoor sports, when you breathe in cold air via the

mouth. As a result, the air is not heated and humidifi ed by the mucous

membranes in the nose.

Stress.

Emotions and tension (both positive and negative) can cause shortness

of breath or make it worse. This is a double problem, as the stress that

you experience as a result of an attack can then make the shortness of

breath worse.

Infections.

The airways of asthma patients are extra susceptible to infections and

react more severely to infections.

‘We are going to a grill restaurant with the whole family, but this makes me so short of breath.’

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‘Everyone reacts diff erently to triggers. What does apply to everyone is that it is best to avoid your personal triggers.’

Prevention is achieved partly through lifestyle rules: a lot can be achieved by having a stronger body and avoiding certain trig-gers. But medicines can also help to prevent shortness of breath. For example by making the air-ways respond less fi ercely to trig-gers. But also consider the fl u shot in this matter: the lungs of asthma patients are more susceptible to infections and once a person has an infection this can trigger an asthma attack.

Sharing helps: tell those around you that you have asthma. You will experience a greater under-standing, even if you want to can-cel a barbecue or other outdoor activity during the pollen season. Another tip is not trying to re-in-vent all the wheels yourself: visit www.longfonds.nl to view fora in

which you can share knowledge, tips and experiences with many other asthma patients, or visit www.luchtpunt.nl.

Even if you stick to lifestyle rules and treatment plans, something can still go wrong. Therefore, you should ensure that you have an emergency plan ready to counter an attack when you feel it coming on. Draft this plan together with your treating doctor, know it by heart and ensure that you have the required products to hand. Also discuss it with those close to you, so that nobody will panic un-necessarily and everyone knows how to help.

There are two main aims in treating asthma: fi rstly, preventing an

asthma attack from occurring. And if an attack does occur, then the

other aim is to neutralise that attack. The latter is also called

‘cutting short’ an attack. As you can imagine, prevention is better

than cutting short in the case of asthma.

Asthma treatment

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Lifestyle rules

Know your weak spotsFirst point of attention is getting rid of/avoiding triggers that you are susceptible to. For example, house dust mite lives in uphol-stered sofas, not on smooth ones.

Laminate fl oors are better than carpets. Make sure you do this both at home and at work.

And consciously plan your life around triggers, for example you can avoid allergens in the open air by scheduling activities in the morning or after a rain shower when there is less pollen in the air.

Check whether a destination is asthma-friendly before booking a holiday. Dusty or humid houses, thatched roofs, pets or smoking permitted: these are all very un-pleasant, but also so easily avoid-ed.

And you should preferably have yourself tested for an allergy be-fore deciding to buy a pet.

Make yourself stronger Exercise for at least half an hour and do not smoke. These two life-style rules are very valuable for asthma too. The fi tter you are, the less you will be troubled by asth-ma. Being fi t means, for example, that you will be less susceptible to respiratory tract infections and these develop into pneumonia more quickly in asthma patients. Does this mean you need to start lifting weights in the gym? No, not really. Half an hour of cycling or walking per day is a good start. Swimming is also fi ne.

A gym or physiotherapist may be useful if you want a bit of advice or structure. Most will have clear programmes for improving physi-cal fi tness. Physiotherapists can also teach you relaxation and breathing exercises that help you through an attack of shortness of breath. And if you suff er from exercise-induced asthma, then a medicine just before exercise that briefl y dilates the airways may be very useful.

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And of course... Quitting smoking. In the Nether-lands, there are many resources, organisations and medicines available to help you quit smok-ing. The GP or pulmonologist can assist you in this matter and can help you to determine the short-est route to clean lungs.

‘I have a pollen warning app on my phone. It’s almost like cancelling your asthma attack.’

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Medicines

Step 1: Lifestyle rules We start without medicines: more exercise, quitting smoking and checking whether you can avoid triggers that you are sensitive to at home and at work.

Step 2: Medicines only for shortness of breath If symptoms persist, then you can cut these off with short-acting bronchodilatros (inhalers). You will take these only if you have symptoms.

Step 3: Medicines that make the lungs less sensitive If you need these inhalers more often than twice a week, then it is better to make your lungs less sensitive to triggers. There are an-ti-infl ammatories that you inhale on a daily basis to achieve this.

These products help to keep you free of symptoms. So do not stop taking them when the symptoms reduce!

Step 4: Daily medicines that prevent shortness of breath In addition to anti-infl ammato-ries, it may be necessary to provi-de more assistance to keep the small airways open. This can be achieved using long-acting bron-chodilators. The short-acting bronchodilators are then used for any remaining episodes of short-ness of breath.

If these steps do not lead to the desired result, then the GP will want to refer you to a lung specia-list. This specialist has other op-tions at his/her disposal. It is also possible that you gain such good

Most people with asthma use medicines that you can inhale: inhalation medicines.

These are roughly divided into three types: short-acting bronchodilators, long-

acting bronchodilators and anti-infl ammatories. These medicines can be prescribed

separately or in combination, depending on your symptoms. The aim is to achieve

optimum treatment that leaves you without any symptoms.

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control of your asthma that your GP will suggest that you try to take a step back in the treatment schedule.

Inhalation techniqueThe pleasant part of inhalation treatment is that the medicine im-mediately reaches the site where it is required: in the lungs. This means that you can achieve the desired eff ect even at a low dose, which reduces the risk of side ef-fects. A good inhalation techni-que is important. The medication will only reach the area where it is needed if you use the correct technique.

Inhale calmly, take your time. There is only a few seconds’ dif-ference between hasty and prop-er inhalation, but there’s a world of diff erence in eff ectiveness. Therefore, go every year to have someone check whether you are still doing it right. You can go to the GP’s surgery, the pharmacy or the hospital for this. Of course you can also learn how to inhale correctly via the internet: visit www.inhalatorgebruik.nl.

‘Those inhalers are like a monitor for my other medicines: as long as I don’t need my inhaler too often, then I am doing well with my medicines.’

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Practical tips

Triggers.

Avoid the triggers that you are susceptible to at home, at work and

on holiday.

Surroundings.

Let your surroundings know that you have asthma.

Health.

Keep yourself healthy and strong.

Medicines.

Inhale your medicines correctly and at the required times.

Test.

Visit www.longfonds.nl to test whether you have your asthma

under control.

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Notes

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AN INITIATIVE BY

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