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Monday, March 12, 2012

Is asthma more than just a disease of the lungs?

The following is from

"What Other Medical Problems Can Occur When Asthma is Untreated?"  (published 5/3/11)

It's said a gallant asthmatics can live a normal, active life.  Yet what happens to the goofus asthmatic who doesn't treat his asthma?

The truth is, many goofus asthmatics are lucky and are able to escape without asthma trouble, yet far too often they end up making frequent visits to their doctor, or to the local emergency room for asthma flares.  Sometimes they simply stay home and tough it out like our Martyr Asthmatic.

While it's rare, untreated asthma can lead to serious medical problems that can make asthma even harder to control.  Consider the following worse case scenario.

Joe Goofus refuses to see his doctor, and he is too dog-gone lazy to take his Advair discus, or maybe he simply forgets to take his medicine.  He also refuses to avoid his asthma triggers. He's simply a bad asthmatic patient.

So after sifting through dusty boxes in his basement, he makes yet another rushed trip to the emergency room.  His asthma is so bad this time that he needs to be admitted to the hospital.  He's put on systemic corticosteroids.

Finally after a couple weeks in prison he's released on good behavior, and he once again quits taking his asthma medicine.  He's short of breath for two weeks before he finally decides to seek help.

He's readmitted to the hospital and put back on inhaled corticosteroids.  The cycle continues.

The following are the risks of untreated asthma:

1.  Severe Asthma:  Asthma that is not diagnosed and treated agressively with asthma controller medicines can increase the risk for lung scarring.  This is permanent damage to your lungs that can make you always feel short of breath.  It also makes it so your asthma might not be reversible when you use your rescue medicine (Ventolin or Xopenex).  This type of asthma is called severe, persistent asthma, Chronic Obstructive Pulmonary Disease (COPD) or what I like to call hard luck asthma.

2.  Steroid side effects:  If Joe needs systemic corticosteroids long term to control his asthma, serious side effects can occur that can make it even harder to manage his asthma, such as:
  • Fluid retention:  Swelling in your legs
  • Increased blood pressure
  • Mood swings:  Can effect how you manage your asthma
  • Weight gain:  Chemicals released from fat can trigger asthma, plus obesity makes it even harder for you to get the exercise you need to manage your asthma, and keep your heart and lungs strong
  • High blood sugar:  You'll now have diabetes that needs to be controlled
  • Infections:  Can you imagine if you also developed pneumonia?
  • Thin skin:  It easily bruises and is slow to heal. 
3.  Anxiety/ stress/ depression:  These can make it even more difficult for Joe to manage his disease, although treatable.

4.  Muscle wasting:  His lungs become so bad he's unable to get the exercise he needs. This can greatly complicate caring for Joe.  It can lead to obesity, which complicates things even more.

5.  Respiratory Failure:  If Joe doesn't seek help, his asthma attack might get so bad he simply poops out.  This is a serious complication that must be treated immediately.  It can lead to death.

While what I describe here is the worse case scenario, I've seen it.  It's basically self-induced hardluck asthma.  It's not pretty.  It can also be avoided.

It's much better to be a gallant asthmatic.  It's much better to be properly diagnosed and stay on a treatment plan.

Asthma experts have long said asthma is easiest to control when it's diagnosed right away and treated aggressively.  Now you know why.

1 comment:

asthmaticsinger said...

eep! Scary stuff but instructive. What sort of timescales are we talking here, for lung scarring? I don't think I'm there yet and hope never to be; had the impression that it takes years for this to happen but I went two years with either no therapy or ineffective therapy (stubborn lungs + some bad diagnostics). Now on slightly more effective medication (Singulair is amazing) but the control is not happening and the trend is not in the direction I'd like it to be in so curious about whether anyone knows about the general timescales here...

And by the way, I've just discovered your blog (fellow Asthma UK forum member linked me to your small airways post) and wanted to say how great it is. I think I've been at least 5 of the asthmatic types over the years (never a Goofus, I hope). Wish we had RTs over here (I don't think anyone in the UK does quite the same combination of things) - and it would also be nice to have someone who knows the evils of lung function tests even when they're inflicting them - your perspective from both sides is great. So thanks. :)