Treatment for Asthma

a. Treatment at Home

• Inhale steam. This will dilate the airways and help in loosening the mucous and its coming out.
• Drink warm water or any other warm liquid such as soup or lime juice.
• put hot water bag on chest and abdomen.
• Do rigorous massage on the upper and middle back.
• Lie on your stomach on the bed with chest and head coming out of the bed and stooping towards the floor with the help of hands resting on floor. Have someone thumbing or hacking your back with his hands for a few minutes. This helps to loosen the mucous and allowing it to come out with the help of gravity. It is important to cough out as much mucous as possible. The above technique of removal of cough is known as chest percussion and postural drainage.
• Sit in a comfortable position on a chair or stool leaning on a table with your head on a pillow. Now breath in forcibly through one nostril which is more open and force air out through the mouth. Hold breath for a few seconds, then repeat. Make sure that your breathing is abdominal i.e. during inhaling your stomach should come out and during exhalation, it should go in.

b. Medical Treatment

• Administering oxygen through nose in case the attack has been very severe and has resulted into a deficiency of oxygen in the blood.
• Expanding the airways and inhibiting the production of secretions by bronchodilator drugs like Deriphylline, Salbuta - mol ( Asthaline), Theophylline, Aminophylline. Side - effects of these drugs are mainly adverse effect on heart in the form of palpitation. Bronchodilators are given either in the form of tablets or injections or spray in a pressurized aerosol for inhalation.
• Giving intravenous glucose - saline, if the patient seems dehydrated. If Asthma attack is not adequately controlled by bronchodilators, corticosteriod drugs may have to be given. If there is lung infection, suitable antibiotic drugs also need one to be given.

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Do and Don ' ts

1. Rise early in morning, sunrise is a sensitive period for asthmatics and they should be active at sunrise and not lying down.
2. When you get out of bed in the morning, immediately put on a warm covering
3. Bath in warm water in winter. Don 't go out right after a bath
4. Avoid direct cold breeze on the face, as this causes a spasm and production of mucus in the sinuses
5. Don't walk barefoot. Keep your feet warm
6. Take morning walk in fresh air
7. At night go to sleep early and at regular hour
8. Have the dinner light and at least two hours before sleeping
9. Keep your house specially the bedroom clean and dust - free. Have no rugs or carpets in your bedroom.
10. Have adequate sleep
11. Don 't overeat
12. Keep yourself away from smoke , pollution and dust.

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Causes of Asthma

1. Allergy

Asthma is prominently an allergic disorder. Allergy is an abnormal reaction of the body to a normally harmless substance. Substances like pollens of flowers, spores of fungi, house dust, eggs, fish, wheat, nickel, chromium or milk are harmless to most people, except those who are allergic to them. These are called allergens. The body opposes such an allergen or antigen by producing antibodies.

When the offending allergen and antibodies react, substances like histamine and serotonin are released into the blood stream. These released substances give rise to various manifestations of allergy like spasm (involuntary contraction) of the muscles of lung airways in case of asthma and other types of symptoms in other cases.

2. Heredity

The hereditary factor in Asthma is well recongnized for the disease frequently appears to be passed on from one generation to another within a family. Even where no positive family history of asthma is detected, there is often a family tendency to some other allergic disorder. Infact what is inherited is allergy and not a particular manifestation of allergy. Aparent may have asthma and amongst his sons, one may have eczema and the other sneezing. Similarly a person may have eczema in childhood, develop sneezing when he grows up and then may contract asthma. Asthma, seasonal or perennial sneezing, urticaria (swelling and redness of skin) and eczema are many and different manifestations of one condition called allergy. About 50% of asthma patients give a family history of either asthma or some other from of allergy.

3. Psychological Causes

Psychological factors are well recognized in the onset of Asthma. At the psychological levels, suppression of negative emotions such as jealousy, anger, resentment and hatred is often a precipitating cause, as are loneliness, longing for affection, emotional hypersensitivity, fear of rejection and hesitation in life.

Generally the asthmatic is one who has undergone some from of painful rejection or loss early in life which he has been unable to accept subconsciously, even if his conscious mind has come to terms with it.The sufferer feels he is all alone without anyone to depend on, fighting for his very existence as symbolized by his elusive breath.

4. Infection

Infection makes an allergy prone individual getting symptoms of allergy. A preexisting sensitivity to specific allergen may become manifest in the presence of infection.

5.Climate

Asthma can also arise during changing climatic condition and incidence of attacks is higher in the winter and rainy season in the tropics. The reason is that when cold air strikes yours lungs. it constricts the tiny blood vessels which must extract oxygen from the air you breath. The result is reduced oxygen . This is taxing on your bronchial respiratory tubes and your heart, too

Similarly in humid atmosphere, the amount of water vapour in the air is greatly increased. It lowers the pressure of oxygen in the air which reduces the diffusion of oxygen in the blood for more respiratory effort to bring in the same oxygen in the body.

6. High Altitude

Going to higher altitudes also becomes the problem for Asthmatic patients. At high altitudes, the atomospheric pressure decreases and concentration of oxygen in the air also reduces resulting in reduced diffusion of oxygen in the body and calling for more respiratory efforts.

7. Diet and Life Style

Unhealthy diet and lifestyle also play a role in the genesis of asthma. A low residue, mucus producing diet consisting of excessive refined carbohydrate products like bread and cakes, ghee and oily preparations, milk and milk products is the common culprit. Besides producing mucous, this diet is excessively taxing on the asthmatic ' s preweakened digestive processes.

Asthma problem can aggravate in those types of occupation and places which are full of pollution, dirt and those allergens which a person is allergic to.

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Asthma

Asthma is characterized by narrowing of lung airways (bronchi) and excessive production of mucus secretions in the airways. It makes respiration difficult and a feeling of breathlessness and suffocation in chest is felt by the sufferer.

Types of Asthma

There are two types of Asthma;

1. Bronchial Asthma - So called because the trouble occurs in the bronchi

2. Cardiac Asthma - Here the basic problem lies in the heart and breathlessness is due to heart failure.

The asthma that is normally talked about is bronchial asthma and we shall deal only with this in the present chapter.

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Control of Hyptension

1. Weight Reduction ; Your B.P. will fall by about 1.5 mm of Hg for every kg of weight loss.

2. Reduction of salt intake:(not more than 5-6 gm of salt per day).B.P.patients can use potassium salt salt.To reduce salt intake,limit eating processed,canned foods, pickles, chutneys, papads, salted peanuts, wafers, potato chips etc. as they contain lot of salt.

3. Aerobic Exercises:Walking, running, swimming, cycling,sports etc. can reduce your resting blood pressure by 5-10 mm of Hg. This happens because of two reasons. First by aerobic exercises, arteries are dilated, so heart has to apply less pressure to send the same amount of blood. secondary, aerobic exercises increase HDL cholesterol (good cholesterol) and reduce harmful (LDL) cholesterol in blood which leads to reduction in blood pressure applied by the heart.

4. yogasanas and stretching Exercises: They relax muscles and promote free flow of blood leading to lowering to lowering of B.P.However, those exercises in which body is held upside down or the head remains below the level of heart for some time and those exercises which require holding of breath for some time, should be avoided.

5. Reduce Alcohol intake

6.Stop smoking

7.Reduce intake of sugar , coffee, tea, cola drinks

8.Avoid Saturated Fats ; Limit food having saturated fats ( egg, meat, ghee, butter, whole milk, cream, biscuits, cake, ice - creams, pastries, chocolates etc.) as these increase blood cholesterol. For list of foods having saturated and unsaturated foods and cholesterol content of various saturated foods, please refer to tables 1.4 to 1.7

9.Calcium, Potassium and Magnesium ; They have been found to reduce B.P. Hence foods rich in these minerals should be taken. For example, lemon, banana, potato, peas, broccoli, tomato, cauliflower, sprouts and organ are good sources of potassium.

10.High Intake of Fibres (Soluble Fibres) ;Apple, banana, orange, potato, carrot,tomato, cabbage, beans, are good sources of such fibres. soluble fibre binds to dietary cholesterol and gets it excreted out of body and so indirectly helps in reducing B.P.

11. vitamins: vitamins c,vitamin B3(Niacin) and vitamin E are considered good for lowering High B.P.

12. Relaxation Techniques: Any technique which reduces mental stress and promotes physical and mental relaxation (e.g.massage, music, meditation, humour \laughter, savasana, lying or walking in fresh air in a garden etc.) helps in reduction of High B.P.

13. special food items :some special food items like garlic, amla , honey,lemon juice, onion are considered very effective in lowering High B.P.

14.Intake of Water ; Drink lot of water and more so in the morning in empty stomach . This helps to keep the blood thinner and reduces blood clotting tendency.

15. General Change in Outlook towards Life ; If one makes his outlook towards life a positive one,then he won' t be stressed by life ' s incidents so easily and therefore his B.P. will not rise because of mental stress.

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Symptoms of Hypertension

1. Lack of sleep

2. Headaches, especially throbbing pain, which is associated with anger and working under stress

3. dizziness

4. Flushed face on exertion

5. Excessive craving for salt

6. Obesity

7. Increased irritability and tendency to become angry or violent

8. Hurry and impatience and always racing against time.

A rapid or sudden increase in B.P. to very high levels(usually 240/140 Hg or more) frequently leads leads to severe headaches, blurring of vision, drowsiness, vomitting and breathlessness. The requires emergency treatment.

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Risk of Hypertension

1. Angina Pectoris & Heart Attack
It is characterized by severe pain in the chest region because coronary arteries supplying blood to the chest region because coronary arteries supplying blood to the heart become narrow and don't expand during during physical activity (because of atherosclerosis leading to narrowing and hardening of arteries), while the heart. at the same time, requires more blood. If the process of atherosclerosis goes unabated, a coronary artery may become too narrow and may get totally blocked. This results in heart attack. The blood vessels of a healthy person are highly elastic and expand and contract accordingly as per the need of the blood requirement for an organ but in the case of High B.P. patient, they become narrow as well as hardened. It is to be noted that atherosclerosis not only causes High B.P. but it is other way round also i.e High B.P ( Caused due to any other reason ) will also aggravate process of atherosclerosis. The proof to this claim is the fact that pulmonary arteries where the B.P. is as low as 35 /15, never develop atherosclerosis.

2. Stroke ( Brain Haemorrhage )

Atherosclerosis also renders the blood vessels brittle brain artery ruptures due to High pressure in the artery, it is termed as ' Stoke ' (bleeding in the brain ). It may also lead to paralysis of some portion of the body.

3. Heart Failure
When B.P. is high, the heart has to work harder. To perform the increased work , the heart muscle thickens and increases in size. The enlargement of the heart is visible in X -rays. For a period of time, despite the increased work load, the heart does well. But there comes a time when it tires and is not able to meet the strain. The result is congestive heart failure. In this situation, the heart doesn 't stop beating but its contractions are weak. With each contraction less volume of the blood is supplied so less blood reaches the tissues of the body and the whole body starts suffering. For example reduced blood supply to legs may lead to early pain and fatigue in legs on walking.

4. Effect on Kidneys
If the B.P. rises, kidneys can't perform their work of blood filtration effectively. Consequently salts and toxins accumulate in the body. Each gm of salt accumulated in the body has a capacity to hold back 70 gm of water from being excreted. Such water retention aggravates heart failure. High B.P. also gradually destroys the cells nutrients through the urine.

5. Eyes are also one of the target organs under attack in H.B.P.

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