Dr. W. Edward Davis, section head for allergy and immunology at Ochsner Clinic Foundation, discusses asthma and allergies with Kandace Power Graves. The medical center soon will open The Asthma Center at Ochsner to meet asthma management needs of the region and now offers asthma education on its Web site: www.ochsner.org.
Q: Exactly what is
asthma and what happens during an asthma attack?
A: Asthma is an inflammation of the bronchial airway that is experienced by most
people by shortness of breath, coughs or chest tightness and may be heard
as a wheeze.
Q:
How dangerous is it?
A: If treated properly, asthma is a disease that can be well controlled, with
people leading a normal lifestyle. However, there are approximately 5,000
deaths in the United States each year attributed to asthma alone.
Q: Why is that?
A: There are several reasons. One is a delay in recognizing the severity of symptoms.
Sometimes it's a matter of the patient not having the appropriate understanding
of the disease and not seeking the appropriate medical care.
Q: What causes asthma?
And what triggers attacks?
A: There are two types of asthma: allergic and non-allergic. Most commonly, asthma
is an allergic process in the lung, much like hay fever. Triggers may be
allergens such as animals, dust mites, pollen or molds, or may be non-specific
triggers such as viral infections, cold weather and exercise. Exercise-induced
asthma has to do with the way air enters and exits the lung during exercise.
Q: I understand that more
than 25 million Americans -- and an estimated 245,000 Louisianans -- have
been diagnosed with asthma.
Does this correspond to numbers worldwide?
A: Asthma and allergies tend to be diseases seen more prevalently in developing
countries. Some of the reason, ironically, may be the good health care that
our children receive. It may also have to do with the way we live, specifically
with indoor carpeting as a harbinger of dust mites and allergens.
Q: Is there a cure for
asthma?
A: There's no cure, but there is much better understanding
and patient education about ways of empowering the patient to have control over
their situation. The goal is to have as few days missed at school and work as
possible and as little interference with things that are enjoyed in life as possible.
Q: What are the preferred
treatments?
A: There are several different
types of medications. For people with infrequent asthma, medications (inhalers)
that open the airway
immediately after taking them relieve the spasm of the bronchial muscle.
If people are using their inhalers more than several times a week, then the
preferred treatment is the use of inhaled steroids, which have been shown
to be safe and efficacious even in children and pregnant women. There are
other treatments ... that are available in pill form. The side effects with
these medications are minimal, and most (of the costs of the medicines) are
covered by most health insurance. Patients should check with their doctors
for diagnosis and treatment of asthma.
Q: Does asthma lead to other respiratory or medical problems?
A: Uncontrolled asthma can certainly complicate other chronic diseases such as heart disease ... and it could eventually lead to death from the asthma itself.
Q: Is there data that suggests the incidence of asthma is higher in some areas than others because of environmental or social factors? Is stress a factor in asthma episodes?
A: Yes, both environmental and social factors can contribute. Stress can make it worse, but it does not cause asthma. In New Orleans in particular, dust mites are the No.1 cause of allergic asthma. A long time ago, there was no good way to control the humidity, and people with asthma were told to move to the desert. And they did; they built a city called Phoenix. It was dry and they irrigated it, and because they wanted it to look like home, they lined the boulevards with olive trees, the most allergenic trees. They had children, and since asthma is genetic, their children had asthma. Now Phoenix has one of the highest rates of asthma in the country. What we've learned is that perhaps the real answer is not to change your environment, but to deal with the environment you have.
