Asthma: get the facts

Asthma is a long-term condition that can cause coughing, wheezing and/or breathlessness. With asthma, the airways become over-sensitive and react to things that would normally not cause a problem, such as cold air, exercise, animal fur, pollen or dust. Muscles around the wall of the airway tighten up. The lining of the airways swells and sticky mucus is produced.

Approximately 470,000 people have asthma in Ireland. Ireland has the fourth highest prevalence of asthma in the world after Australia, New Zealand and the UK. Asthma in children is more common in boys than in girls. Children who develop asthma at a very young age are more likely to 'grow out’ of the condition as they get older.

There is no cure for asthma. Treatment is based on relief of symptoms and preventing future symptoms and attacks. Successful prevention is through a combination of prescription only medication, lifestyle changes and identification and avoiding asthma triggers.

Short-acting beta 2-agonists inhalers work quickly to relieve asthma (eg) Ventolin^® inhaler. If an asthmatic needs to use their beta agonist inhaler too regularly (three or more times per week), they should have their therapy reviewed. Excessive use of short-acting relievers has been associated with asthma deaths. This is not the fault of the reliever medication, but is down to the fact that the patient failed to obtain treatment for their worsening asthma symptoms.

Preventer inhalers reduce inflammation in the airways and prevent asthma attacks. The preventer inhaler must be used daily for some time before full benefit is achieved. Preventer inhalers contain an inhaled corticosteroid. (eg) Becotide^® inhaler

If short acting beta 2-agonist inhalers and preventer inhalers are not providing sufficient symptom relief, a long-acting reliever (long acting beta 2-agonist) may be tried. Inhalers combining an inhaled steroid and a long-acting bronchodilator (combination inhaler) are more commonly prescribed than long acting beta 2-agonists on their own. (eg) Seretide^®, Symbicort^® inhalers.

If treatment of asthma is still not successful through use of inhalers alone, options include oral leukotriene receptor antagonists (eg. Singulair®) and oral theophylline (eg. Uniphyllin®, Phyllocontin®). If asthma is still not under control, regular oral corticosteroids may be prescribed.

Asthmatics who are pregnant should manage their asthma in the same way as before pregnancy. Most medicines used for asthma have been proven to be safe to take during pregnancy and when breastfeeding. The exception is leukotriene receptor antagonists (eg. Singulair®).

This article is shortened. More detailed information and leaflets on Asthma is available in Whelehans or at www.whelehans.ie. Tel 04493 34591

Disclaimer: Information given is a very general overview of asthma; ensure you consult with your healthcare professional for specific advice

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

Asthma : Why is it getting more common?

Many studies show that asthma is getting more common in Ireland. I often get asked why this is the case? As an asthma sufferer myself, I decided to look into it more.

The 'hygiene hypothesis'

The 'hygiene hypothesis' is a theory that lack of exposure in early childhood to infectious agents means that the child’s immune system has not been activated sufficiently during childhood. This lack of exposure is down to our super clean modern living conditions including anti-bacterial washes, antibiotics and general sterility where children are not exposed to germs in a similar manner to previous generations. The theory is that immune system is “not activated” during childhood; this leads to the immune system becoming over sensitive to common substances such as pollen, dust-mite, animal fur; leading to the higher incidence of auto-immune conditions like asthma, hayfever and eczema in recent years.

One of the first scientific explanations of this theory was by David P Strachan from the London School of Hygiene and Tropical Medicine, who published a paper on the theory in the British Medical Journal in 1989. He noticed that children from larger families were less likely to suffer from autoimmune conditions like asthma. Families have got smaller in the Western world over the last forty years, meaning lower exposure to germs and infections. It is over the same period that health authorities have seen an explosion in autoimmune conditions such as asthma. Further studies show that asthma is less common in developing countries, however when immigrants from developing countries come to live in developed countries where living environments are more sterile, these immigrants suffer from increased levels of autoimmune conditions like asthma and the rates increases the longer immigrants live in developed countries. It is a difficult to advise parents accurately on what is the best way to bring up their children in relation to this theory. All parents want the best for their children and common sense tells us all that cleanliness is important. No health care professional will be able to give you exact advice. In my opinion, a balanced view is to ensure children are administered important vaccines but “allow kids be kids”, let children play outside with friends and try not to worry about them coming in contact with dirt and germs, but always be cautious with children with life threatening food allergies. Only use antibiotic when really needed.

This article is shortened. More detailed information and leaflets on Asthma is available in Whelehans or at www.whelehans.ie. Tel 04493 34591

Disclaimer: Information given is a very general overview of asthma; ensure you consult with your healthcare professional for specific advice

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. Tel 0449334591. If you have any health questions e-mail them to info@whelehans.ie

 

Some helpful study and exam preparation tips

An old saying goes, “You cannot plough a field by turning it over in your mind”; the same is true for exams; worrying will not help but study will.

With exams looming, stress levels are rising. Essentially it is time to clear the “desk” of guilt and regret for what appear to be many lost hours not devoted to study. It may very well be the situation; however it is essential to realise that there is still a considerable amount of time left to prepare for the looming exams. It is important not to lose hope or minimise expectations. There is still adequate time to brush off the study cobwebs and get stuck in to a study plan, so you have to stop procrastinating and get organised. Avoid getting overwhelmed; it is amazing how much you can learn in a short space of time

As Gandhi said, “You may never know what results come of action, but if you do nothing there will be no result”

Planning

The secret to doing well in exams lies in planning so if your notes are not in order, this is the first thing to attend to; file your subjects and gather all your written homework essays assignments. Pay particular attention to the suggestions/comments your teachers have made. Organise physical space to study and establish a routine of going there. Do not study on the bed, always use a study desk; bed might induce sleep and it can also impact on your sleep pattern during the night. 

Have study and a revision plan; if you have not done one, do one now. Following the plan and developing study patterns will enable you to study more productively. Avoid interruptions and start off with ten minutes revision of the subject in hand. Especially avoid having your mobile phone at hand or any such distractions as it will break your concentration. Everyone revises differently. Use headings, highlighting and revision cards, get revision guides. Make notes of the important points when revising. Use past exam papers and do model answers. Make sure to check past exam papers and familiarise yourself with the structure and format of each exam subject.  It is a good discipline to practice answering exam questions within the specified time limits. Check your answers against your notes to make sure you’ve got them right. Know the exam timetable and try to study in the same order. The night before the exam, leave cramming to one side and stick to what you already know. When studying the night before an exam, you run the risk of making yourself nervous if you try to learn new information. Review your notes or test yourself on key points.

Exam Day

On the day of the exam avoid talking to fellow students about the exam as it could confuse you or make you lose confidence in yourself. Similarly avoid talking to others about the exam after it’s done as you might start to doubt yourself, which may lead to stress and reduce your confidence in your next exam paper. During the exam remember to use your time strategy for reading the exam paper and the amount of time you need to allocate to each question. Read the instructions very carefully then scan the whole exam paper. Start with the questions you’re most confident with, break the questions down to make sure you really understand what you’re being asked.

Parental Support

As a parent guardian you can support your exam student through exam preparations and the actual exams by making home life as calm and pleasant as is possible. Some short term allowances may need to be made to alleviate the pressures and stress that come naturally with exams.

There will be some free time from school in the run-up to exams, if possible try to be at home so that you can share a break and a chat together. It is important to make sure there are plenty of healthy snacks in the fridge to provide good, nutritious food at regular intervals. Eating a balanced diet of “brain food” that includes fresh foods (especially fruits and vegetables) and regularly eating at meal times (especially breakfast) can help to maximise brain function and manage stress levels more effectively.  Ensure that there is a protein source in the diet (eg. Fish, chicken which are necessary for energy), include Vitamin C and B-complex Vitamin sources (eg. broccoli, tomatoes, citrus fruits, potatoes) Make sure that he or she eats a good breakfast on the morning of the exam. Encourage your son or daughter to join in on family meals (even if it's a busy revision day) as it is important to have a change of scene and get away from “the books” for a while. Encourage and support regular exercise, such as a brisk walk as it can help clear the mind before the next revision session. Tensions can get high during these few weeks, so be mindful of this and avoid “nagging” or make any demands on your son or daughter during exam time.

Benjamin Franklin once said, “By failing to prepare, you are preparing to fail“. Good luck with the exams!

 

Thanks to Finola Colgan Development Officer of “Mental Health Ireland (Midlands)” for her help with this article.

 

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591. You can also e-mail queries to info@whelehans.ie.