May 6 is World Asthma Day and we at The People’s Pharmacy strongly believe that this global initiative merits your attention. We will be devoting this entire month to important stories about asthma.
This condition is far more common (over 25 million Americans have it) and also more dangerous than most people believe. Sir William Osler, MD, is considered the “Father of Modern Medicine.” That’s because he revolutionized medical education during the mid 1800s. Osler defined asthma as an inflammatory lung condition, but it took almost 100 years for researchers to appreciate the significance of his understanding. In 1892 Dr. Osler wrote in his medical textbook, The Principles and Practice of Medicine: “Death during the attack [of asthma] is unkown.”
Sadly, that is no longer the case. According to the CDC, thousands die every year from asthma. Millions more are impacted because asthma can diminish the quality of their lives. And sometimes treatment itself can be dangerous, if not lethal.
There is still much that is not understood about asthma. Dr. Osler noted that various triggers set off an acute attack. Although that is clearly recognized today, most treatment is centered around calming the inflammation and irritation with corticosteroids.
Inhaled steroids like fluticasone and budesonide are the foundations upon which therapy is based. Such drugs are way safer than oral prednisone, although that is sometimes essential during a bad attack. But steroids carry their own risks. Long-term use takes a toll on the body. Eliminating or controlling the factors that trigger an asthma attack can be equally, if not more, important.
You can read about Joe Graedon’s personal experience with asthma at this link. It reveals a possible trigger that has been pretty much overlooked by the medical profession, ie infection. Here is a link to a fascinating interview with David Hahn, MD, MS, about the role of infection in hard-to-treat asthma.
Dr. Hahn responded to Joe’s story with this observation:
“Joe’s story – of several years of episodic cough and wheeze that escalated to become chronic and disabling – is in my experience fairly typical for many adults who end up with a diagnosis of chronic asthma. In the late 1980s and early 1990s I performed retrospective medical chart reviews on 450 patients with (i) acute respiratory illnesses, (ii) new-onset or (iii) established asthma, that became the basis for some of my first publications in this area.
“Looking back years into the medical records showed that many of those with new-onset asthma or established asthma had previously been seen over years or decades with what their doctors called “acute asthmatic bronchitis (AAB)” which is a description for discrete episodes of asthma-like symptoms that do not persist. That sounds something like what Joe Graedon describes.
“Do all people who experience one or more episodes of AAB go on to develop chronic asthma? Not at all. Many episodes of uncomplicated AAB resolve on their own but may benefit from albuterol (a bronchodilator) to control the wheezing. One must simply wait and see.
“From my perspective, though, the take home message for someone who has had an episode of AAB is: Be vigilant for the development of chronic persistent symptoms and seek medical attention if that happens (preferably with a copy of my book in hand to share with your prescriber).
“Would antibiotic treatment of all episodes of AAB decrease the risk of getting asthma later? Could be. No one knows. That is another reason I wrote that book: To encourage the people who fund asthma research to ask and answer that and related questions.” David Hahn, MD, MS
Over the course of next few weeks, we will offer more information about asthma, its causes, its treatments and a possible cure. We also offer Dr. Hahn’s provocative book, A Cure for Asthma? What Your Doctor Isn’t Telling You–And Why.”
Share your own asthma experience below.