For some people, asthma is a minor nuisance but for many, it’s a problem that greatly impacts their daily activities. If asthma is left untreated, it can be a life-threatening attack. WHO is taking several measures to increase diagnosis and treatment of asthma. Asthma is part of the WHO Global Action Plan for Prevention and Control of NCDs. It is also part of the United Nations 2030 Agenda for Sustainable Development. Medicircle is conducting an exclusive series for awareness of asthma in which you can gain direct and more reliable information from Asthma Specialists, Pulmonologists and Respiratory Therapists.

Dr. Manish Sachdev is an Asthma Specialist, Clinical Diabetologist, and Smoking Cessation Expert. He is associated with Diabetes and Asthma Clinic, Mumbai. He is a marathon runner and an ardent follower of Art of Living and Vipassana.

Covid-19 can aggravate problems of asthmatics who have not been on optimal treatment before

Dr. Sachdev mentions, “Asthma attack is lung attack. To understand the underlying reasons for it, we would have to ponder upon the issues surrounding it. Generally, what we see is that when there is a cough and cold, one goes to the family doctor and lots of antibiotics get prescribed. After a course of time, the problem subsides. 90% of people in this category suffer from mild allergic bronchitis during season change, exposure to dust, or during small allergic situations with cough and cold, sore throat, light sputum, etc. In these conditions, antibiotics are not required. Only when the sputum starts getting yellow, antibiotics should be given, otherwise, such conditions are symptomatic allergic rhinitis bronchitis which can be cured by anti-allergic medicines. Lung attack gets indicated by cough, wheezing, chest pain, shortness of breath, etc. Severe lung attack is not very common in these modern times and there are very unfortunate ones who suffer from a very severe form of it due to delay in treatment or non-optimal treatment.”

He further points out, “Covid-19 attacks lung and if asthma patients get affected by covid, particularly when they have not done enough in the past to control it, then it’s major comorbidity. People who were not taking optimal treatment of asthma before are the worst sufferers during these Covid times.” 

Significant points of asthma diagnosis

Dr. Sachdev explains, “We do clinical diagnosis first by asking basic questions like are you exposed to dust, strong paint, or pet’s hair – hair of dogs and cats as these can cause asthma. We also ask whether one has been working in any paint factory or is there any family history of it or if the person is prone to having cough and cold during season change. If the answer to even a few of these questions is yes, then it indicates asthma. Also during check-ups, if we come across wheezing tendencies in the chest then it's asthma. These are the clinical investigations. Other than that, we do objective investigations. The most common one is the Lung Function Test which helps in the diagnosis of obstructive airways, reversible asthma, etc. LFT might not be available all the time so we keep the peak flow meter for on-the-spot diagnosis and we can measure how much air a person breathes out, and how quickly.”

He points out, “It has been observed that COPD (Chronic Obstructive Pulmonary Disease) is more harmful in comparison to asthma and this affects women staying in rural areas and who are exposed to biomass smoke from childhood. It harms airways, similar to that of excessive smokers and the condition is irreversible obstructive airway whereas asthma is a reversible obstructive airway condition. Thus, comparatively, asthma is better than COPD.”

Cure is through prevention

Dr. Sachdev emphasizes, “Many people are allergic to incense sticks, dust, etc. So, we advise them to stay away from such allergens. We also treat asthma with counseling that an inhaler is the best treatment. People do not want to use the inhaler as there is a sort of stigma attached to it in society. We counsel patients to use that as well as the nasal spray which is direct treatment. Many doctors miss the nose and concentrate on the chest only. Both should be focused on. There are two types of inhalers; reliever and preventer inhaler. Preventer inhaler is inhalator steroids and it’s the best anti-inflammatory drug and the only medicine nowadays. Doctors are so busy these days that they prescribe inhalers but do not guide how to use them. Proper counseling about the inhaler's effectiveness and technique of using it is required so that patients follow the required treatment.”

Live in the Moment

Dr. Sachdev mentions, "Let’s not forget the role of pranayam and breathing exercises which is an effective addition to the treatment by inhalers. Abdominal, chest, and shoulder breathing exercises; which are three sectional breathings are means for aerating prominent areas of the body. So these are important. As far as Vipassana is concerned, it helps to remove psychosomatic factors which come from stress and bereavement leading to an asthma attack. Similarly, running helps expand your lungs. However, there is a caveat to this. There is something called exercise-induced asthma for which too; inhaler and medications are required. The basic idea behind meditation and exercises is to live in the moment which helps in getting relief from psychosomatic ailments and keeps the general well-being high.”

Covid and Asthma

Dr. Sachdev says, “Many people have been approaching me with Covid related anxiety and shortness of breath thinking that its asthma but it's Covid phobia which I deal with mild anxiolytic and counseling. They get total relief from it. Just as we are taking the Covid vaccine, the asthma vaccine is also advisable. There are two vaccines, one is the influenza vaccine and the other is the pneumococcal vaccine which keeps the severity of asthma in control. You should talk to your doctor and take these vaccines. Avoid taking antibiotics unnecessarily,” advises Dr. Sachdev.

(Edited by Amrita Priya)