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Asthma Attacks Are Unpredictable, But Here’s What You Can Do
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  • Editor’s Note: This article is intended for information purposes only. It does not substitute a doctor. It is vital to always consult a medically trained professional for advice that suits your needs best.

    For an asthmatic person, having an attack, also called asthma exacerbation, can be terribly terrifying because he or she may have to be taken to the emergency room. But many hospitals at this time of rising COVID-19 cases have already reached full capacity, so he or she may not get the needed medical attention.

    What is asthma?

    Asthma is a major noncommunicable disease that affects both children and adults globally, according to the World Health Organization (WHO). In the Philippines alone, 11 million Filipinos have been reported to be suffering from asthma, according to data from the Global Asthma Report.

    But as pointed out by experts from the United States National Heart, Lung, and Blood Institute (NHLBI), the exact cause or maybe causes of asthma remain unknown. They add that a lot has to be studied about the respiratory disease that they describe as a chronic (meaning, long-term) condition that affects the airways in the lungs.

    Dr. Paul Rilhelm M. Evangelista, a specialist in pulmonology medicine and interventional pulmonology, uses in his online talk, Usapang Asthma, the definition of asthma as a "heterogenous, chronic airway inflammatory condition which affects the size and shape of the airways causing breathing difficulties."

    Asthma symptoms and causes

    Dr. Evangelista mentions studies showing that chronic inflammation causes the occurence of asthma symptoms, such as:

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    • Wheezing
    • Cough
    • Breathlessness
    • Chest tightness

    The doctor explains that this happens when your bronchial tubes or airways become hyper irritable or very sensitive and they then get inflammed to the point of constriction. He adds that when your airways come in contact with triggers, they become easily swollen and inflamed.

    This inflammation causes narrowed airways and trapped air. It can be reversed when given treatment. The common triggers include:

    • Animal dander
    • House dust mites
    • Inhaled allergens
    • Air pollutants
    • Respiratory tract infection
    • Weather changes
    • Stress and extreme emotion
    • Certain food
    • Exercise

    Dr. Evangelista says that one way to test if you have asthma is through the spirometry, upon your doctor's recommendation. This will measure your peak expiratory flow (EPF). Your doctor will also assess your condition and help identify the triggers to your attacks, or asthma exacerbation.

    What you should know about asthma exacerbation

    During an asthma attack or exacerbation, experts from Mayo Clinic say that the airways become swollen and inflamed. They add that the muscles around the airways contract and the airways produce extra mucus, causing the breathing (bronchial) tubes to narrow.

    Asthma exacerbations can be classified as mild, moderate, severe, or life threatening, according to experts from the American Academy of Family Physicians (AAFP). They add that criteria for exacerbation severity are based on symptoms and physical examination parameters, as well as lung function and oxygen saturation.

    Dr. Evangelista points out, "Asthma attacks are unpredictable. An asthma attack or episode is a combination of sudden or slowly developing episodes or worsening symptoms," such as asthma cough, wheezing, chest tightness, and breathlessness. He adds that there's also a decrease in air flow shown by changes in lung function or worsening of daily PEF measurements.

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    Although the occurence of an attack is difficult to predict, Dr. Evangelista says it may happen five days after catching a cold. But with other triggers, such as inhaled allergens from fumes and chemicals, the onset of an asthma exacerbation can be quite hard to predict.

    In a study published by the U.S. National Library of Medicine-National Institutes of Health (NLM-NIH), it shows that "the most common triggers for an exacerbation are viral respiratory infections with human rhinovirus (RV)," in particular and most frequent, the subtypes A and C.

    What you can do to avoid asthma exacerbation

    Dr. Evangelista suggests you work closely with your doctor in controlling your asthma and avoiding asthma attacks. You have to religiously take your medications, which can be inhaled, injected, or taken orally. There are also two types: relievers at controllers.

    The doctor also suggests to continuously monitor your asthma. You can do this with the help of your doctor in making and following an action plan. You can also track  your progress by keeping a journal, where you can jot down your observations. He points out that if your condition is controlled, you may lessen or even avoid your asthma exacerbation, such as asthma induced by exercise and allergic asthma.

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