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Saturday, February 28, 2009

8 factors may increase risk of fatal asthma

I've been reading this great book called Fatal Asthma lately, in which the authors have pinpointed some factors that might contribute to increasing your chance of having a fatal asthma attack.

Factors that increase your risk of a fatal attack are:

  1. Low socioeconomic status: It causes barriers to good care including lack of health insurance and financial ability to pay for meds needed to manage asthma. Plus, poor economic status makes it difficult to get away from poor quality housing such as those infested with common allergens like dust mites, cockroaches and even rodents. Another barrier to good health created here is lack of funds to afford regular doctor visits and the medications required to prevent and treat asthma.
  2. Poor social support: It's important to have people around you who understand asthma and can encourage you to take care of yourself, and help you spot early warning signs. If you are a severe asthmatic, it's good to have someone encouraging you to eat right, exercises and take your meds. The same can be true of kids. Also, failure of parents to remove a child from harmful environments (such as second hand smoke, allergens, , dust mites, etc) may be a problem that contributes to uncontrolled and chronic asthma.
  3. Smoking: This increases airflow obstruction and usually results in severe asthma.
  4. Cardiac disease: Drugs used to treat arrhythmia's may worsen asthma.
  5. Substance abuse: This can delay treatment for asthma and require its own separate treatment.
  6. Previous near fatal attack: Bronchial sensitivities may persist as steroids and other meds are being weaned, predisposing the asthmatic to an even more severe episode. Plus the fact that one was just released from the hospital may lead one to not wanting to go back, thus delaying treatment upon return of symptoms. Denial that symptoms have returned can also lead to further asthma complications which increase the risk of fatal asthma.
  7. Denial: If you don't admit you have a problem you will not get the care you need to manage your disease.
  8. Poor perception: Some people may overlook early warnings signs and under treat, and this may result in the asthmatic waiting too long to get the care he or she needs.
  9. Location: All of the following may lead to an inability to get proper and quick care: Lack of easy access to medical help, or if the closest hospital is far from where the asthmatic is, or if the asthmatic is alone
  10. Allergies: 60-80% of asthmatic children have at least one allergy.

2 comments:

Anne said...

I am not clear as to the connection/causation between asthma and COPD, but when asthma ("reversible") becomes something else, which is not reversible, is asthma then sometimes blamed when the second condition causes the death?

Rick Frea said...

Great question. It is possible that might be the case, but it's difficult to know for sure.

There was one study I read about where in 80% of the near fatal asthma cases reviewed, the asthmatic also smoked. That means the patient probably had asthma paired with COPD, and thus enhanced airway obstruction.

Whereas if the patient had asthma alone he may have been able to manage his asthma, the COPD component compounded the already compromised lungs making these cases near death experiences.

While asthma gets blamed for the death, the real culprit was COPD.