Borgman, D. (2000). Asthma. S. Hamilton, MA: Center for Youth Studies.

OVERVIEW

No one knows why, but asthma is increasing around the world. Many people die from asthma every day. It is most prevalent among the urban poor.

The American Medical Association’s Family Medical Guide describes asthma as a chronic condition marked by periodic attacks of wheezing and difficulty in breathing (p. 355). This article continues with the following information:

Cause. Partial obstruction of the bronchi and bronchioles due to the contraction of muscles in the bronchial walls. Difference between bronchitis and asthma. With bronchitis, you have constant wheeziness until you recover from the disease. With asthma attacks come and go and there are wide variations in the degree of obstruction at different times. Cure. Asthma cannot be cured, but attacks can be relieved. Without treatment, asthma attacks usually end naturally. On the other hand, asthma attacks can be fatal. What triggers attacks? Most asthma is triggered by an allergy to such things as pollen, skin particles (dander), or hairs of cats or dogs, or minuscule mites in house dust. Some attacks start for no apparent reason. Attacks can also be caused by infections (especially in the respiratory track), certain drugs, inhaled irritants, vigorous exercise, and psychological stress. Symptoms. The main symptoms of asthma are difficulty in breathing, a painless tightness in the chest, and varying amounts of wheezing. Degrees of severity.

• Wheezing only detectable with a doctor’s stethoscope.
• Audible wheezing and discomfort in breathing.
• Loud wheezing, breathing so difficult to cause sweating, increased pulse rate and extreme anxiety.
• Very severe attacks may turn face and lips blue because of diminished supply of oxygen. Prolonged loss of oxygen may cause death.

Prevalence. Asthma is highest among the urban poor and especially the homeless. The risks. Thousands of people die from asthma each year. Most of these are elderly persons with other illnesses as well. If treated well, there is little risk of death. Treatment of asthma is broken down into self-help and professional help. Self-help. Self-help begins with understanding as much as possible about when, why and how it strikes you. For this reason it is good to keep a record of attacks. The triggering irritant should be identified if possible—doctors may give you a skin test with suspected allergens. Look for dust, dirt, pet hairs, etc. in your room or the place where attacks occur. Examine your diet and see if shellfish, eggs or chocolate may be the offending substance. Reducing dust is a key. Professional help. Doctors who have already been helping you may prescribe a prophylactic or bronchodilator drug for relief. Prophylactics are taken regularly; broncholdilators are taken only after an attack occurs. These drugs are best taken as aerosol inhalents which takes the drug directly to the site of obstruction. They can also be taken as pills or liquids. Self-help during a regular asthma attack. Some have found it helpful to straddle a chair backwards, sit up straight resting elbows on back of chair. This allows you to relax and the chest muscles to move air efficiently. Help in an acute attack. If regular medication is not helping, or if one does not have medication, and there is extreme trouble in breathing, make the person as comfortable as possible and notify a doctor. It is important for all to stay as calm as possible since stress contributes to the intensity of the attack. If a doctor is coming, lay out the drugs and breathing apparatus and record of dosages and when the attack began. If no doctor is available, calmly take the patient to a hospital emergency room.

QUESTIONS FOR REFLECTION AND DISCUSSION

1. Did you ever have an asthma attack? How severe were your attacks?
2. Have you been with someone else during an asthma attack? What was your response? How effective was it?
3. Did you ever hear that no one ever dies from an asthma attack?
4. Do you think this article is a helpful introduction to this disease? What would you add or suggest?

IMPLICATIONS

1. The fact that this disease is growing and that it particularly afflicts the poor ought to make us concerned.
2. As a young urban youth worker, I took care of a young man who had severe asthma attacks. I was told by many that asthma is never fatal. When they pass out, they start to breathe again. Several times, while this young man was staying with us, I took him to the emergency room. But that misinformation could have cost him his life.
3. Asthma, even when it is not fatal, can be very frightening. It is important for everyone to know something about this disease and how to respond to its attacks.
4. It is important to distinguish what we can do for ourselves and where professional service is needed.