Pascal: “Hi Doc. I came with my son Kilian today. He’s breathing poorly because of his asthma. I think his treatment is no longer working.”

Me:      “Hi Pascal. Hi Kilian, how you’ve grown! How old are you now?”

Kilian:  “15 years old, Doc.”

Me:      “Oh my God… So what seems to be the problem?”

Kilian:  “Well, sometimes I suddenly have trouble breathing and start coughing during the day. It sometimes wakes me up during the night, too. Ventolin works, but I feel tired all the time. Also, I sometimes feel out of breath when I play soccer and stop to take my Ventolin.”

Me:      “Ok, I see. And tell me, Kilian, since when do you smoke?”

Kilian:   “How does he know that, dad?”

Pascal:  “He is a doctor…”

Me:       “Don’t worry; I don’t monitor your networks. It just makes sense from what you’re saying… and I smell it a bit, too (LOL)! Either way, we need to assess your asthma control and make a point.”

What is Asthma?

Asthma is a common respiratory disease, especially in children and young adults, but it can develop regardless of age.

Respiration is a primary biological function. It allows us to live by ensuring the correct gas exchanges:  we exchange the carbon dioxide produced by our body against the oxygen in the air.
The units responsible for this operation are called the pulmonary alveoli. These are bronchial branches of tiny sizes (0.2 mm). Numbering around 300 million, the total surface area of these cells is approximately 100 m²!!!

For optimal functionality, the oxygen-rich air must reach the alveoli. That’s where asthma manifests.

Asthma is a chronic respiratory disease caused by permanent bronchi inflammation, which no longer transports oxygen optimally. The production of bronchial mucus increases, reducing the bronchi caliber.

Asthma attacks are characterized by episodes of shortness of breath, wheezing, dry cough, or tightness in the chest. Asthma attacks have a variable duration, and breathing returns to normal between two episodes.

A clear genetic link shows an increased risk of developing asthma for children whose parents have it. The infographic below summarizes some of its features.

Why is asthma so bad?

Three dimensions characterize the severity of asthmatic disease:

• Physical:
  • Oxygen is fundamental to life. Asthma is a chronic pathology with background symptoms.
  • An asthma attack is the sudden onset of severe respiratory symptoms, most often because of triggers, as we will see later.
  • This respiratory impairment directly affects the patient’s health, with sometimes dire consequences in a violent crisis. Therefore, it’s essential to know that you have asthma and control it correctly.
  • Asthma can sometimes require hospitalization, and in some critical cases, it can lead to death.

• Moral:
  • Like all chronic pathologies, asthma has a direct impact on the patient’s quality of life. Studies show a definite correlation between improved asthma control and good quality of life.
  • In addition, asthma is linked to psychological suffering, particularly among adolescents who require support.
  • Finally, due to its direct consequences on sleep quality, asthma leads to significant fatigue, difficulty concentrating, and a direct impact on productivity.
• Socio–economical:
  • Unmanaged asthma results in a higher rate of absenteeism in school children, which negatively influences schooling.
  • Working people are also negatively impacted, registering a higher absence rate than the healthy population. Studies notice a drop in productivity, work quality, and a consequent cost in terms of public health.

But there is good news…

Treatments exist, and follow-up is strongly recommended for asthma. But as we mentioned above, asthma has various triggers with different impacts on people. Understanding these factors well allows you to adopt a strategy based on the specific characteristics of your asthma. That’s how you can avoid the triggers.

In any case, it is the first step toward optimal control.

TEN POINTS TO CONTROL YOUR ASTHMA

1. Avoid tobacco
Smoking is a classic trigger for asthma. Both primary smoke (inhaled directly from the cigarette) and passive smoking (inhalation of smoke produced by another) impact asthma control, increasing the risk of an attack. You must:

• Get help to quit smoking.
• Make your home or car a “no-smoking” area.
• Encourage those around you not to smoke in your presence or, better yet, to quit.

2. Fight against mites and dust

Mites and dust are “naturally” present in homes and are common asthma triggers. Here’s what you can do:

• Air your house, preferably in the morning, especially in the bedroom.
• Ensure a good hygrometry (humidity level) in your home.
• Maintain a temperature around 19°C.
• Vacuum the house and avoid sweeping that causes dust suspension.
• Wash the sheets weekly at 60°C (this temperature ensures the destruction of dust mites).
• Remember to wash the children’s stuffed animals (especially the cuddly ones).
• Avoid carpets, which are genuine nests of dust mites.

3. Prevent pollen exposure

Pollens are known asthma triggers. The seasonal allergy period depends on the region, the allergens in question, and your sensitivity. Check out the available pollen calendars and government peak alerts in your area.

However, what you can do is:

• Close the windows during the day.
• Stay indoors as much as possible in case of allergy alert, even if it’s complicated.
• Rinse your face and hair to get rid of allergens after walking outside.
• You can also wash the clothes you wore during this outing.

4. Avoid pollution peaks

Air pollution is a significant public health issue because it impacts your life quality. Air pollution sits high on the wretched podium of the most deadly risk factors for asthma. This pollution directly influences the occurrence of asthma attacks.

What you can do is:

• Avoid going out during pollution peaks.
• Consult weather forecasts and bulletins from specialized agencies. You can find these online.

5. Limit mold

Mold is a crucial risk factor, mainly linked to the hygrometry rate. The optimal value ranges from 40% to 60%. Mold triggers an asthma attack quite easily, but simple measures are enough.

What you can do is:

• Ventilate the kitchen and bathroom regularly.
• If you do not have windows in the bathroom, use a humidity absorber.
• Dry the surfaces after washing them.
• Repair water leaks.
• Change the potting soil of your houseplants regularly to prevent mold.

6. Prevent respiratory infections

Any upper (a cold) or lower (bronchitis) respiratory tract infection can trigger an asthma attack.

To avoid these infections, follow these basic rules:

• Strengthen your immune defenses.
• Have a physical activity adapted to your abilities.
• Follow a healthy diet.
• Get vaccinated against the seasonal flu.

7. Know your drug sensitivity

Particular medicine may trigger allergies and asthma attacks. You must understand what you’re taking.

• The most common molecules are anti-inflammatories and aspirin.
• Consulting your doctor is the safest option.

8. Pamper your pets “reasonably”

Our animal friends’ furs are soft, silky, comforting, and possibly allergenic for some. If you want to continue enjoying purrs and other joys, you must:

• Wash your pet’s fur regularly.
• Avoid letting them lounge on your bed.
• Ventilate your house thoroughly.

9. Prepare for physical exertion

Physical effort can trigger an asthma attack. To avoid this, you can take a few simple steps:

• Warm-up gradually before working out.
• Avoid playing outdoor sports during pollution peaks or allergy alerts.
• Stop any exercise if you’re having an asthma attack. Take your treatment and wait a few days before resuming activity.

10. Control pests (especially cockroaches)

Pests are recognized as common triggers of asthma. To limit the impact, it is necessary to:

• Wash the dishes at the end of the meal.
• Clean kitchen counters.
• Do not leave food accessible.
• Keep trash in an airtight container.
• If necessary, use cockroach traps or call a professional.

Bonus: Asthma Control Test

Try different tests that assess your asthma control to gauge your current situation. You can even do some of these online. One example is the ACT (Asthma Control Test), available at the following address:

Adult Quiz (asthmacontroltest.com)

This quick, one-minute test is scientifically validated and allows a relevant assessment of your respiratory health.

More often than not, when my patients implement these measures, they are amazed at the results. Most feel they have better control of their disease. Blame it on the habits: you get used to breathing moderately, and it becomes the norm!

Other ways of doing things exist, too:

Knowing and leveraging them is already a big step towards health improvement and the well-being that accompanies it!