Managing asthma, common chronic lung disease

Harriet James @harriet86jim 

When Vivienne Adala’s eldest son was just two years, she noted a persistent cough every night and sometimes he would be short of breathe and even vomit.

Upon taking him to the hospital, and the doctors tracing the family history, her now nine year old son was diagnosed with asthma. 

“I wasn’t in shock since it’s genetic in our family and had witnessed some of my cousins using inhalers and taking care of themselves.

This prepared me on how to handle my sons once they were diagnosed with it,” she narrates.

Her eldest one, now 10 years old, was diagnosed with the same ailment too at just four years.

According to the World Health Organisation, asthma is a condition that causes sporadic breathing difficulties.

While it is the commonest chronic lung disease globally, it remains under-diagnosed in Kenya. 

There is little prevalence data on respiratory diseases currently in the country, but according to the Kenya Association for the Prevention of Tuberculosis and Lung Diseases findings, children are the most affected by the ailment.

The International Study of Asthma and Allergies in Childhood revealed that between 1995 and 2001, there was a prevalence of current asthma symptoms in 13-14 year old children from 10.4 per cent to 13.8 per cent in Eldoret and 17.1 per cent to 18.0 per cent in Nairobi. 

Last year during the Asthma Day celebrations, the Kenyatta National Hospital CEO Evanson Kamuri revealed there are approximately four million Kenyans living with respiratory disease in the country.

He added that the burden of the disease is higher in urban areas than in rural areas, and the cases are growing and that in the end, nearly 10 per cent of the population will be affected by this lung disease.

Avoiding triggers

Some symptoms of this chronic respiratory disease of the lower airways that affects both children and adults include coughing, wheezing and difficulty in breathing. It can also present as night time cough. 

“The airways become narrowed in response to triggers. Children can get wheezing during viral infections, but this does not necessarily mean they are asthmatic.

Asthma is chronic with repeated episodes of the symptoms of coughing, wheezing, breathlessness. 

Whereas viral infections are acute and short lasting,” says Dr Priya Bowry, an allergist.

The treatment of asthma comes in two types of inhalers that use a special device called a spacer to ensure the drugs reach the airways well.

One inhaler is a low dose steroid, which helps reduce inflammation in the airways; the second is a reliever, which is used to alleviating tightening of the airways during an asthma attack.

It is important to know the correct way to use the medication otherwise the treatment may not be effective.

Besides medication, Vivienne also understands the significance of avoiding asthma triggers­—anything that irritates and inflames the airways.

Such triggers can aggravate symptoms such as wheezing and coughing, which make the patient have a rough time catching their breath.

The first thing she did was to track her children’s symptoms and detail every environmental factors that might triggers their asthma.

She began with her sons’ room where she removed anything that would collect dust in the room such as a carpet, shoes, book shelf.

Every night, she ensures that the room is heated one hour before her boys go to bed. 

She also ensured the beddings were changed and opted for feathers for pillow instead of a fluffy material. 

Correct treatment

“The bedroom can be an asthma nightmare, harbouring allergens that cause attacks and reactions.

We also use bar soaps instead of powder so that it doesn’t leave dust on the beddings when cleaning.

However with proper planning as well as some strategic changes in the room, I restored peaceful sleep to my boys,” she notes 

The mother of three has also ensured there are no pets in the house and regularly gets pest control.

She also avoids using scented products and has learnt to crotchet scarfs for her children to keep them warm.

Being that they are currently at home, Vivienne ensures they are all in one room where they do their online studies and watch TV for social distance and also to minimise the number of people who come into contact with them as they  are at a higher risk of contracting  Covid-19. 

“I also ensure that I boil hot water in a flask and take the honey and lemon concoction after every two hours.

I also have plenty of fruits this season for them to take and ensure that they have at least a tablet of Vitamin C to boost their immunity,” she explains 

One product that Vivienne uses on her sons is axe oil, which she applies on the pillow, bed and sometimes scarves to clear the air passage.

For centuries,  essential oils have been employed as alternative treatment for a variety of medical conditions particularly asthma.

However, Dr Priya cautions people to be careful while using home remedies and instead use proper treatment. 

“They have to take medication as prescribed regularly and in the correct way. This is a serious condition, which must be treated in the correct way.

Herbal and other naturopathic remedies do not have any role to play in treatment of asthma,” she cautions.

Dr Priya says it is vital for parents and guardians of asthmatic patients to know allergic triggers such as environmental and food allergens, which may lead patients to be poorly responsive to their medication. 

Family history of asthma or other allergic conditions may be present because asthma typically runs in families.

“Asthma symptoms can be made worse during infections and cold seasons so patients should seek medical advice if symptoms flare up and get worse.

It helps if patients have an asthma action plan given to them by the specialist for how to respond during an asthma attack and how to recognise when they need to go to hospital,” says Dr Priya.