Asthma Control: Know Your Score (cont.)

MEMBER QUESTION:
Does weight and asthma together affect the heart?

EDELMAN:
Well, weight certainly affects the heart. One of the major complications of being significantly overweight is a stress on the heart. Asthma by itself does not affect the heart unless it's prolonged and severe over many, many years. However for people who already have heart disease from another cause, asthma may cause a risk of having an adverse event.

MODERATOR:
Where can people find the Asthma Control Test online?

BETTIS:
You can go to www.asthmacontrol.com or call 800-990-4100.

MODERATOR:
Dr. Edelman, what are the basic steps everyone with asthma should take to get their disease under control?

EDELMAN:
We should start at the beginning. The first thing people must do is learn whether they have asthma or not. Studies have shown that as many as one-third of children with asthma don't know it. That is, their parents don't know it. So we have to have what we call a high index of suspicion. Suspect asthma if you have a child who is coughing unexplainably every night, a child who gets short of breath playing games before the other kids get short of breath, or sometimes, for young children, irritability. It may be the only sign that a child is having difficulty breathing. The first thing is to do is understand if you're not breathing right, if you're waking up coughing without explanation night after night, get yourself tested, have your doctor make sure that you don't have asthma.

The second thing is to understand that control of asthma involves many, many elements. What people need is an asthma action plan. They ought to do this with their physician or other health care provider. The action plan includes many things. The corner stone, of course, is the right medication. But also important is the understanding of what your asthma triggers are, perhaps allergies or cigarette smoke or sometimes even exercise, and learning how to deal with or avoid the triggers. An important part of your action plan is knowing what to do in an emergency: what to do when you have an attack. Patients ought to know exactly how to adjust their medication and when to ask for help. For children at school, part of an asthma action plan is communicating with teachers, especially physical education teachers. Children with asthma should not be made to sit on the bench. Teachers should know exactly how to tailor their program to those children.

I guess the last thing is, remember that the American Lung Association wants everybody with asthma to know that just living with it, just accepting symptoms, is not necessary. Most people can feel better and function better.

"In general, the kinds of exercise that do trigger asthma attacks are bursts of intense activity."

MEMBER QUESTION:
I have asthma related to exercise only. I'm a baseball player and when I run in certain weather conditions I suffer attacks, but this is rare. I hate the idea of taking medicine all of the time when I know I will only have an attack under certain conditions. Can I just take medication before practicing or playing in adverse conditions?

EDELMAN:
The answer is yes. Consult your doctor and work out the right regiment for yourself. Many people get asthma just when they exercise. Frequently exercise in cold weather makes it worse. I know Jerome is one of the people who has a harder time exercising in humid weather. But it is possible to take medication prior to exercise which will help prevent an asthma attack during exercise.

MEMBER QUESTION:
I am on all the right meds, but still cannot attain enough control to exercise. Is exercise a particular challenge for asthmatics?

EDELMAN:
The answer is yes. For many people with asthma, exercise itself is a trigger for the asthma. We're not sure we understand the mechanism, but it may be that when you exercise and breathe rapidly the air in your lungs is not fully humidified, and dry air is an asthma trigger.

One of the best things you can do is find the best exercise for you. It's been found, for example, that swimming is a great exercise for most people with asthma (not all -- occasionally they are sensitive to the chlorine in the pools.) For many people swimming is a superb exercise that does not trigger an asthma attack.

In general, the kinds of exercise that do trigger asthma attacks are bursts of intense activity. You might try and tailor your exercise to something different.

Again, consult with your physician and make sure the medications are optimized. Keep trying. Don't give up.

MODERATOR:
Bursts of intense activity -- that sounds like Jerome!

EDELMAN:
It sounds like football, and Jerome is a great success story because he can do it all. Just by keeping his inflammation under control, he can do anything.

MODERATOR:
Jerome, do you have a plan to deal with the possibility of another attack on the field?



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