Wheezing Asthma

Wheezing & Asthma

RESPIRATORY DISORDERS – Wheezing & Asthma

In general, no one will hear their own breathing sounds or heart beats unless otherwise they get physically more strained. If any one happens to hear their own breathing sounds and heart beats even under resting condition, then that sound should be treated as Nature’s alarm to take care of the lungs or body. Here one should act fast to take care of the situation to avoid medical emergencies.

Normally, whenever pressurized air passes through a narrow space, it produces continuous whistling or humming sounds. One such whistling / husky sound heard abnormally from lungs (due to partially constricted / obstructed airways) is medically termed as wheezing. Sometimes in extreme cases, it is readily audible to near ones and sometimes it may need palpation or stethoscope to realize the wheeze.

Wheezing – is an abnormal high pitched continuous / prolonged whistling sound heard all over the lungs especially during expiratory phase of respiration. It is otherwise called as Rhochi. Wheezing usually refers ailing lungs. Even though both inspiration and expiration seems to be difficult for wheezing patients, the abnormal sound occurs more prominent during exhalation since during inspiration, lung happens to get expand with dilatation of narrowed airway. Wheezing is commonly heard in Asthma, Croup, Pneumonia, Bronchitis, Emphysema, Allergic respiratory illnesses, etc.

Wheezing usually occurs due to partial obstruction of the lumen of lungs which is caused because of swelling of the mucous membranes / spasm or constriction of smooth muscles / loading of viscid or mucous secretions, etc. It can also arise due to allergic reactions, untreated or maltreated cold and exposure to irritants. It will go off immediately on clearing lung complaints or infection or obstruction.

Other than whistling wheezing sound, many other abnormal short interrupted sounds can also arise from chest with diseases. They are

• Croup – Rattling chest with barking cough (common in children)
• Stridor – an abnormal sound most commonly occurring with viral or bacterial infections of throat – here inflamed epiglottis / vocal cord / laryngx gets swollen and block / narrow the airway to cause this sound. The characteristic sound of stridor will be very short crowing sound. Stridor can also be heard when foreign objects or food enters the throat or airways causing obstruction. This sort of sounds will be heard more commonly during inspiration since process of inspiration occurs as forcible and expiration occur only as a passive natural recoil of lungs.
• Rales – are named for fine, coarse and short interrupted sounds – Crepitations / Clicking sounds / Cracking sounds / Bubbling sounds / Rattling sounds, etc. They occur commonly due to alveolar diseases and with fluid collections.

Auscultation of lungs with expertise knowledge of abnormal sounds and disease can help one to differentiate the abnormal sounds from one another and can provide clue for the diagnosis of the disease. Lacking the differentiating ability, common people use to call all the abnormal sounds as wheezing. Likewise, they use the term Wheezing and Asthma for one another. Actually wheezing is a symptom whereas Asthma is a disease. Every asthmatic patient can have wheezing but all the wheezing patients need not be asthmatic, i.e., wheezing can occur due to various other reasons too – for example pulmunory odema, heart failure, etc.

Asthma – is a chronic inflammatory lung disease characterised with difficulty in breathing and whistle breathing (wheezing) especially during exhalation. It may be transient or persistent (seasonal or perennial). Asthma has a tendency to wheeze due to sensitive tracheo bronchial tree. So, it is also called as Reactive lung disorder. Commonly, children who suffer constantly with allergy, dermatitis and eczema use to develop asthma in due course, unless otherwise properly cared. They all seem to be closely associated and genetically related. In these cases, the antibodies IgE are found to be elevated in the serum. Medical advancement still cannot configure the complete picture of asthma, since it has different types and it also seems to have interactions with genes, foods and environmental factors.

Asthma can restrict lung functions and can also restrict one’s life style. In asthma / wheezing, oxygen supply to the body (which is very essential for survival of the parts / life) will get affected. Normally, breathing happens around 14 times / minute. In case of asthma / wheezing, it can vary from 20 – 40 times / minute to compensate the oxygen need of the body through narrowed airways. Here, breathing will be very shallow and frequent.

incidences – The incidences of asthma / wheezing seems to be increasing throughout the world even in developed countries. It can affect any one irrespective of age, sex and race. Even though it is not contagious, it is often found to descend through genes. In olden days, the incidences are more common with elderly people, but now-a-days, children suffer more commonly and frequently than elderly people. The cause is unknown. Any how, pollution and weakened immune mechanisms can be blamed as the causes. Their incidences also seems to be high in cases of maltreated or untreated recurrent cold. Roughly around 6-8% of the total population suffers with asthma / wheezing / allergies.

To create awareness about Asthma, W orld Asthma Day is coming up on May 6 th 2008 with the theme of “You Can Control Your Asthma”. The goal of having Asthma day is to help asthmatic people to stay away from asthmatic spells as much as possible and to combat restricted life (if any) caused by asthma. As an action plan to control and fight against asthma, Pulmunologists / Chest specialists / Health professionals / Educators from all over the world, have come forward by organizing awareness camps / free screening camps to make people aware of proper management and treatment of Asthma. We, also wish to join this campaign by publishing articles related with asthma to create good awareness among people and sufferers to have easy breathe and comfort life in spite of having Asthma.

With proper care, Homeopathy exhibits good healing potential for asthma. Even though no one thinks of Homeopathy in acute spell of asthma attack, homeopathy can provide very good relief. It doesn’t provide relief just with dilatation of bronchi and bronchioles but also it acts with our immune system and aims to expel the tendency of recurrent suffering permanently in smooth manner. As ultra low doses of drugs are used as Homeopathic medicines, side effects are usually nil. Its work out on childhood asthma and elderly asthma will be amazing. Most of the childhood asthma can be rooted out completely with the help of homeopathy medicines and in case of adulthood asthma it can help one to manage bouts of wheeze spells easily and can help to maintain good health to stay away from repeated asthmatic attacks.

Causes & TRIGGERS OF ASTHMA

Every disease comes with a cause, but no one can fix a single cause

for asthma, as it often remains as multifaceted. Even though lung remains as an inner part of the body, it is always exposed to the chemicals and pollutants as equal to the outer surface of the body, since no one can avoid breathing atmospheric air. Sensitivity to allergen or suffering with allergy usually varies widely from person to person. One can see many persons working in polluted environment without any complaints, but at the same time, allergic or asthmatic people often suffer violently even for a single moment exposure. Likewise some use to have hectic cold & cough for weeks without any wheeze, but for asthmatic, from day one, it may trigger the wheeze.

Even though research professionals can point out several factors as triggers of asthma, avoidance, treatment or rooting out of the sufferings will be very tough in case of asthmatic patients since it often varies from person to person (and sometimes even in same person at different times),. Generally asthmatic complaints manifest with exciting causes (allergens / dust exposure, excessive stress and strain, exposure to change of temperature, infection, etc). Commonly, triggers can be classified in the following way.

Triggers –

• External factors
• Internal factors
• Psychological factors

External factors –

• Low or inadequate supply of oxygen – for example in high altitudes, poor ventilated rooms, in congested crowds, etc.
• Inhaling pollutants – dust, smoke (industrial or cigarette or of automobiles), pollens, perfumes, room sprays, furs of animals / birds, preservatives in foods, chemical irritants / acids, etc
• Exposure to extreme of temperatures
• Violent exercises or strain (especially in cold temperature)
• Infections – bacterial / viral / fungal – causing cold and cough
• Bites of Insects / mites to cause allergic reactions
• Drugs induced (due to sensitivity or allergy) – antibiotics, anti inflammatory medicines, hypertensive or cardiac drugs, etc
• Aspiration of small foreign bodies (parts of toys, foods during deglutition, pins, etc) entering into upper or lower respiratory tract to cause obstruction or cramps or irritations of lungs

Internal factors –

• Genetic factor – trait of asthma / allergy / eczema
• Allergic tendency or hypersensitivity or immune response of body to cause oedema of lungs with any of the triggers / pollutants – for example lactose intolerance
• Nose – suffering more with allergic rhinitis, sinusitis, post nasal drip, nose block (nasal polyps), etc can also lead one to asthmatic spells
• Throat – Laryngitis, Pharyngitis, etc. can also trigger asthma
• Lung – Acute / Chronic bronchitis, Pneumonia, Bronchiectasis, Pleurisy, Pulmonary oedema / hypertension, etc. can any time turn to reflect as or get settle as asthma with or without proper treatment.
• Stomach – Acidity or GERD, indigestion, vomiting, hiatus hernia can also flare up or induce an asthmatic attack. Here wheezing complaints will be more after food intake, lying down, etc.

Psychological factors – Stress, tension, fear, anger, anxiety and excessive laugh can cause or intensify one’s asthma. Moral support and relaxation can bring back the sufferer to unruffled easy breathes.

Symptoms – Medical advancement still cannot configure the complete picture of asthma, since often it reflect as of different types and also seems to have interactions with multiple factors like season, environment, food, stress, sleep, etc. It may be for transient period or in persistent manner (and may also be seasonally or perennially). Reactions of lungs cannot be understood easily. It usually depends on sensitivity of the lungs which varies from person to person.

The intensity, frequency and period of the sufferings will also vary from person to person and sometimes even in same person at different times, i.e., some can able to do all their routine work in spite of suffering and some may not even speak or walk or lie down.
The common symptoms of Asthma are

• Changes in breath in depth and frequency
• Shortness in breath in due course (shallow and frequent breathing / fast and irregular breathing)
• Smothering feeling with want of more air or fanning
• In severe cases sufferer often feels like choked
• Restlessness (constantly changing / adjusting positions) to get ease and comfort breathe
• Cough / croup with deep breathe
• Bouts of cough which use to get worse by night and with vigorous exercise or play
• Inability to speak or work
• Heaviness or tightness in chest
• Nasal flaring
• Stooping of shoulders to ease the breathe

Also, most commonly asthma patients would have associated symptoms like sneezing / running nose / nose block / exertional dyspnoea / nocturnal dyspnoea / aggravation by lying down, etc in addition to the above said symptoms.

Diagnosis and Management of Asthma

Early diagnosis and early treatment will always provide excellent results. Asthma is no way exception. If any person happens to diagnose asthma in early stage and treat it at the early stage itself, then the person need not fear for recurrent sufferings or medical emergency condition like status asthmaticus. Any how, due to multifaceted symptoms of asthma, it is often misdiagnosed and maltreated in early stages.

Commonly, symptom presentations alone will not help to fix the

diagnosis, but in case of asthma most often, one needs to depend on them only. Even though, there are lots of investigations to detect abnormalities in lungs, they all help to rule out other diseases. Also assessing functional ability of lungs helps to assess the improvement, but not the diagnosis by itself. So, every asthmatic sufferer needs to narrate all their symptoms / sufferings / feelings to the doctor to help him to fix the diagnosis.

Tell your health professional regarding asthma

• How it occurs?
• When it occurs?
• How often it occurs?
• What are all the alerts / warning signs?
• How long it usually lasts?
• Whether rest brings normalcy or not?
• What are the triggers? cold, allergens, exposure to cold wind, etc
• What are all the aggravating factors? exercise, strain, laugh, etc
• Related with day or night when it often goes worse?
• Is there any identified irritants / allergens?
• Whether it restricts any activities?
• How you get relief – with positions and management?
• Is there any family history of asthma / allergy / eczema?
• How about your stamina and immunity with infections?
• What are all your associated complaints?
• How about the betterment or response with tried out medications?

Differential diagnosis for asthma is usually wide, i.e. from simple bronchitis to carcinoma of lung. Heart failure, Pneumonia, Pulmonary embolism, etc are few others. With the advice of doctor, one needs to undergo series of tests to rule out complications, according to the symptom presentations.

Investigations

• Auscultation of lungs to assess the whistling sound with respect to character and its origin
• Percussion of lungs to analyse its resonance
• Pulmonary function test – (with spirometry / peak flow meter) to analyse the functional ability of the lungs especially for forced vital capacity and forced expiratory volume
• Radiological evaluation of chest & sinus
  • X-ray – Para nasal sinuses – to rule out sinusitis
  • X-ray – Chest – to rule out lung infections
• CT or MRI scan to rule out structural abnormalities of lungs / sinuses / adenoids
• Sputum for AFB with culture and sensitivity tests
• Nasal smear / Throat swab depending upon necessity
• Routine blood Tests and for serum IgE & Absolute eosinophils count
• Allergy Skin testing

SELF MANAGEMENT

• Don’t be panic – be relaxed
• Move to warm and ventilated area
• Take some rest and opt for comfort position
• Have some luke-warm water sip by sip
• Breathe slowly and in relaxed manner

PREVENTION – Controlling Asthma and preventing episode most often become a simple procedure, since most of times it can be

well controlled with control over food and environment itself.

Avoid

• Allergens / allergic foods which can cause an episode, as much as possible
• Working in areas of noxious fumes or polluted air.
• Cold things & cold winds
• Pets & pollens
• Drugs which can cause allergy
• Smokes and Smoking
• Congestive places where oxygen quotient is very less
• Strain or strenuous exercise while having lung infection or shortness of breath

Do’s

• Take complete course of medicines as instructed by physician
• Taper the dosage of medicines with the advice of physician
• Keep your living area clean
• Care for good ventilation
• Improve lung functions with regular breathing / aerobic exercises
• Have nutritious foods to lead healthy life
• While cleaning house wear mask for protection

Clean

• Air filters (of air conditioners / windows) often
• Damp places to reduce molds & dust mites
• Bedspreads, pillows, blankets, mattress, rugs, every week
• Houses with vacuum cleaner rather than sweeping or dusting
• Carpets frequently with vacuum cleaner

With proper understanding, management, hygienic measure and proper medicines every one can root out or keep their asthma under control.

living with Asthma – Cure & Control

Now-a-days, Asthma seems to be very common and affecting millions & millions of people all over the world irrespective of age, sex and race. Also, it is one of the most common complaints which make the children to get hospitalized next to diarrhoea and fever. Annoying asthma needs to be cared and treated properly or otherwise flare up can occur by any of the time. Since asthma is one among the chronic debilitating illness, it needs to be treated properly (for prolonged period) and also early treatment is the best treatment. Treatment must be started properly with diagnosing the cause and its elimination (if possible). Improper or lack of treatment not only provides foundation for recurrent tendency to suffer again and again but can also cause persistent of complaints always with variable intensities.

With proper understanding, care, hygienic measure and proper medicines every one can root out or keep their asthma under control. Children can outgrow asthma with growth (after getting widening of airways) as natural cure. But, s ometimes disease may also grow with age i.e. asthma become persistent and most annoying in adolescence. For some other, it may resolve in childhood and get flare up in adolescence . Here, proper care with exercises and medicines (for clearing lung complaints – if any) can support one to root out the complaint once for all in its early stage itself.

GENERAL TREATMENT – Commonly Allopathy claims no cure with asthma but challenge asthma in every way for complete comfort life. Shortness of breath usually makes the sufferer panic and compels to go for hospitalization. Whatever may be the cause or symptom (cough / wheeze / suffocation) they can control asthma completely with bronchodilators and antihistamines itself. Recent medical advancement with bronchodilators (tablets / inhaler puffs) treats asthma very easily even in most emergency condition with simple painless procedures, sometimeseven as an outpatient case. This way of acute management is revitalizing

thousands and thousands of status asthmatic (most severe) cases daily. Every one needs to thank medical advancement and allopathy system for this great achievement. But only thing is it may be needed for prolonged period or needed then and there to combat flare-ups through out life. And also inhalers and nebulizers become part and parcel of their life. Several thousand people use to carry inhaler to comfort breathe and life then and there. They all learn to live comfortably with asthma than to cure it.

Previously oral tablets and intra venous injections (bronchodilators – salbutamol, theophylline, Prednisone, etc) were used to control asthma. They all usually have lot of side effects, but in recent trend, medicines are administered as vapours / mist in minute or metered dose through inhalers, spacers or nebulisers to hit lungs directly. Sufferer will be adviced often to use inhalers regularly for quick relief and to bring asthma under control. After getting betterment, they will be adviced to taper the dose and keep maintaining dose of puffs for a prolonged period as a long term control therapy. This new mode of medicine administration through inhalers outweighs most of the complications and side effects since inhaled minute dose of medicines acts only on the lungs to keep them dilated to have good amount of air. Any how, i n case of over dosage or continuous use of steroids / bronchodilators, the side effects are very common. Asthmatic patients need to be aware about this, so that they can reduce the dosage of medicines or get alternate medications without treating side effects as a new symptom. The common side effects are

• Recurrent cold and cough due to weakened immune system or constantly suffer with cold
• Restlessness and tremors
• Sleeplessness or sleepiness
• Dizziness / poor concentration
  
• Sinusitis / headache
• Sore throat / hoarseness / vocal cord problems
• Discomfort in chest and stomach

Further the constant use of steroidal drugs (oral and intravenous medicines) can cause

• Variation in Blood pressure
• Early diabetes
• Renal failure
• Stunt growth

In addition, for allergy, cold and cough, Antibiotics / Anti inflammatory drugs / Anti viral drugs / Anti histamines / Mucolytic agents / Immune therapy are prescribed according to the condition and necessity of the sufferer. Asthma patients need to be cautious while taking aspirin or other pain killers since sometimes, it may also give flare-ups.

HOMOEOPATHIC APPROACH – Commonly there is a myth that Asthma cannot be cured and can only be maintained. Actually it is not so, with appropriate management and treatment, it can be cured completely (especially in case of childhood asthma – more than 60% of the cases can be cured – any how it also depends on the living conditions and complications), however asthma of elderly people cannot be claimed for complete cure. Childhood asthma usually responds extremely well to homeopathic treatment and recurrent bouts of attack can be cured completely if treatment is started in early stage itself. Even with the family history of asthma, childhood asthma can be treated well. Any how, one may need regular and long term treatments to root out the complaint. Patients and doctors need patience in treating asthma. Here, real secret of efficacy of the treatment lies in proper care and proper treatment.

Homeopathy treats patients (symptoms of the patients – for example, wheeze is a symptom) and not the disease as such. Homeopathy gives importance to the individual symptoms / patient’s feelings with respect to the disease than for the disease symptoms itself. Symptom presentation often varies from person to person. Remissions and flare-ups also differ from person to person. For example, some may be comfortable in open air and some other may be comfortable in closed room, for some sitting posture will be more comfortable and lying posture may be worst position and for some others it may be exactly opposite. Some people may be allergic to certain foods and particular seasons whereas for others it is not at all a factor. Homeopathy stands here with individualization to treat the disease / tendency at its root level by strengthening one’s vital force.

Homoeopathy is the finger post on the cross roads of healing which directs the way of safest and permanent cure. Homoeopathy works towards nature and has no side effects. Homeopathy can make one breathe well, not with just dilating the bronchi but by making lung functions in better way. By strengthening body’s defense mechanisms / raising immunity, it can prevent recurrent relapses. With constitutional approach and minute diluted doses of medicines, Homeopathy can provide antigenic desensitization too to lower the allergic response for allergens. Thus it helps patient to live better in their circumstances. With proper care and treatment, Homeopathy can switch off the forceful rough breathe smoothly and effectively at the earliest. Even though, its process may not be incidental, it provides recovery in slow phase in a permanent manner.

When smothering mounts over life, Homeopathy can surely open windows widely for better breathe without any resistance. One can discover a new relaxed comfort life with Homeopathy to control or cure of asthma. Homeopathic medicines commonly used in cases of asthma are Aconite, Ambra grisea, Ammon Carb, Anti tart, Aralia Racemosa, Ars Alb, Baryta carb, Belladonna, Blatta, Bromium, Bryonia, Caladium, Causticum, Calc carb, Grindelia, Hepar sulph, Ignatia, Ipecac, Kali bich, Kali carb, Lachesis, Lobelia inflata, Lycopodium, Naja, Nat mur, Nat Sulp, Nux vom, Opium, Phosphorus, Pothos, Psorinum, Pulsatilla, Rhus tox, Rumex, Sambucus Nig, Senega, Silicea, Sticta P, Sulphur, Thuja, Tuberculinum, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com  / www.drcheena.in

(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)