In the not-so-distant past, researchers believed that asthma was a condition that always developed during childhood, and one that merely worsened in later adulthood. That theory has since been proven wrong, as asthma has begun to affect problem-free individuals in their thirties and later adult years. Doctors have discovered that environmental allergens, skin conditions like eczema, and even outdoor exercising can all trigger asthma, even in adulthood. Having a history of asthma issues is no longer the defining cause of adult asthma. Adult asthma is also a problem that appears to be affecting women more often than men.
Factors that Affect Adult Asthma
The typical analysis of adult asthma focuses on two areas: childhood history and efficiency of the lungs. However, new causes are becoming more prevalent among adults. Abnormal weight gain, fluctuating hormones, and exposure to pollution are some of the newly recognized triggers of adult onset asthma.
• Weight Gain and Asthma - Abnormal increase in body mass puts an increased burden on the respiratory system. The new adipose (fatty) tissue also secretes substances that provoke inflammation of the lungs and even can cause lung cancer.
• Hormone Fluctuation - Studies point out that women around menopausal age often have wide fluctuations in estrogen (female sex hormone) levels. These women are more prone to respiratory conditions, particularly asthma.
• Workplace Pollutants - Incidence of asthma and lung cancer in industrial workers and those with prolonged exposure to pollutants is increased.
Childhood asthma has high chances of becoming dormant once the child in question attains sexual maturity. But adult asthma is often much more difficult to overcome and more likely to become a chronic condition. Some of the risk factors for near fatal Asthma include:
• Prior severe attacks
• No adherence to therapy
• Poor asthma self-management skills
• High baseline peak flow variability
• Frequent beta-agonist (bronchodilator) use
• Inadequate use of inhaled corticosteroids
• Age group below forty years
• Cigarette smoking
• Prior barotraumas (decompression sickness)
• Hospitalization despite chronic oral corticosteroid (anti-inflammatory drug) use
• Psychiatric illness
• Recreational drug and alcohol abuse
• Diminished ability to sense and respond to airway obstruction
• Females are more prone
• Poor socio economic status
There are four stages of blood gas progression in status asthmaticus (severe asthma attacks). The first stage is characterized by hyperventilation with normal pO2 (partial pressure of oxygen, i.e. the amount of oxygen dissolved in the blood) and low pCO2 (partial pressure of carbon dioxide, i.e. the amount of carbon dioxide in the blood). The second stage accompanies hyperventilation but hypoxemia (inadequate level of oxygen in the blood) so that both pO2 and pCO2 are low. The third stage gives a false-normal pCO2 as the ventilation has decreased. This is extremely serious and indicates respiratory muscle fatigue with the need to be admitted in the intensive care unit and probably intubation with mechanical ventilation is demanded. The fourth stage has a low pO2 and a high pCO2 as respiratory muscles weakens. This situation is even more serious and requires intubation and ventilator support.
Making Sense of Adult Asthma Treatment
During an asthma attack, the muscles surrounding the bronchioles constrict and reduce the airways in a person's lungs. Mucus secretions often make matters worse and increase breathing difficulties. The result of these factors is an asthma attack accompanied by labored breathing, pain in the chest, and wheezing and rattling sensations as air forces its way in and out of the lungs. Painkillers and anti-inflammatory medications are necessary to quell these symptoms.
Children have stronger lungs, and therefore respond well to inhalers that deliver vaporized medication to the lungs. Adults, on the other hand, often find inhalers a tricky option and struggle to coordinate inhalation with vapor release. Nebulizers seem to work better for adults and seniors, as the vapors they produce are easily inhaled while breathing slowly. The dosage and frequency of inhalation in a nebulizer can be adjusted depending on how severe the condition becomes.
Chronic asthma in Adults
Most patients who present with an acute asthma exacerbation have chronic uncontrolled asthma. Careful examination of following factors is mandatory:
a) Previous history of near fatal asthma.
b) Patient taking three or more medications.
c) Heavy use of SABA (Short Acting Beta Agonist) and frequent ER visits.
Patient should be assessed to determine the severity of acute attacks. Peak Expiratory Flow (PEF) and pulse oximetry measurements are complementary to history taking and physical examination
Lifestyle Changes for Adult Asthmatics
It is necessary for all asthma patients to accept the fact that it is not fully curable, but can be improved by living a healthy lifestyle. Here are some changes to make that may improve asthma:
• Clean your home thoroughly to remove allergens and possible irritants. Get rid of cluttered areas, dispose of unwanted items, and change sheets regularly. Don’t allow your home to become filled with dust and germs.
• Do your research and seek proper treatment. The three indispensable practitioners for asthmatics are a pulmonologist, an allergist, and an immunologist. These doctors can all examine your condition and suggest corrective medications.
• If you are exposed to hazardous pollutants in your workplace, you may need to change jobs.
• Food can contain many allergenic triggers. Sticking to a simple diet, choosing organic foods, and staying away from processed and canned foods can all help avoid asthma attacks.
As asthma cannot be cured completely, appropriate management can control the disorder and help people to enjoy a good quality of life. Keeping a hygienic living environment helps achieving it. This includes:
• Clean the house at least once a week. Don’t forget to wear a mask while cleaning.
• Avoid pets with fur or feathers.
• Wash the bedding (sheets, pillow covers, mattress pads) weekly in hot water
• Encase the mattress, pillows, and sheets in dust-proof covers
• Replace bedding made of down, foam or rubber
• Consider replacing carpeting with hard floors
• Use the air conditioner if possible
• Maintain the humidity level in the house low.