Essential Guide to Asthma

Chapter 1: Struggling for Breath Four-year-old Sophie had a cold and tenacious cough, as she often did these days. Her father wiped her stuffy nose, tucked her into bed, and read her a story until she nodded off to sleep. Thinking all was well, he finished his chores and went to bed. Around 3 o'clock in the morning, he and his wife awoke to sounds of a loud barking cough. They raced into Sophie's room to find her pale faced and wheezing between the fitful barking sounds. As they rushed her to the hospital emergency department, Sophie's father wondered how a cold could make his little girl so sick. He never imagined the cause was asthma.Fourteen-year-old David was helping his family by shoveling a thick blanket of snow from the driveway and sidewalks. The previous night's blizzard had resulted in subzero temperatures today, but David was warmly dressed. David attacked the snow vigorously. After about 20 minutes, though, David felt winded. He stood still, coughing and gasping, trying to catch his breath. A sickening feeling washed over him, and it continued for 30 minutes after he came in and sat down. David felt embarrassed by the incident and was relieved when his parents decided to take him to the doctor. Neither David nor his parents ever suspected his problem could be asthma.Fifty-year-old Janet was getting ready for bed. She had spent a long day cleaning in her basement, which had become mildewed after a flood. Something caught in her throat, making it hard for her to breathe. She coughed and choked, then went for a drink of water. When that didn't work, she blew her nose, thinking mucus from a persistent nasal drip prompted the surprise attack. Nothing eased the choking sensation. Her chest and back felt tight and heavy, so she vowed to be more diligent about her back exercises. For now, however, Janet tried desperately to clear her throat as perspiration beaded on her face. The catch in her throat disappeared in a few minutes, but her inability to take in a full breath lingered. Finally, she drifted into a tight sleep, only to awaken exhausted in the morning. Janet did not realize then that her symptoms added up to asthma.Few people are aware of the many forms asthma can take. At one time, physicians thought people with asthma produced a characteristic wheezing sound. Even the name asthma comes from the Greek word panos, meaning to pant or breathe heavily. Doctors followed the logic that asthma caused breathing difficulties because blocked airways prevented air from entering the lungs.Through the centuries, prevailing wisdom dictated a variety of theories for the blockage -- some accurate, some not. Physicians connected asthma to a seizure disorder of the lungs prompted by such outside irritants as feathers, smoke, strong perfumes, or animal dander or by psychiatric causes. Treatment focused on reducing a person's symptoms once airways became obstructed. Little was documented about how asthma changed the body's internal systems or the possibility of multiple causes of asthma.Today, though researchers know more than before, much remains unknown about asthma. An exact cause or cure evades discovery. A few researchers suggest that the different patterns of asthma will one day translate into separate lung conditions. A predisposition to asthma seems to be inherited in some people. Yet, doctors cannot say with certainty why some people get asthma and others do not. The closest thing to an explanation is that certain children and adults have supersensitive airways.Still, people like Sophie, David, and Janet have reasons to be hopeful. More is known about asthma now than ever before in medical history, and new medications are being developed and made available for hard-to-control symptoms. Although severe asthma can be fatal, the airway narrowing it causes is reversible with proper management. Modern treatment also focuses on prevention, so children and adultsAMA Staff is the author of 'Essential Guide to Asthma' with ISBN 9780743403573 and ISBN 0743403576.