All I need is the air that I breathe

The first World Asthma Day, in 1998, was celebrated in more than 35 countries.
In 2019, World Asthma Day will be celebrated on May 7.

Breathing is the process of moving air into and out of the lungs to facilitate gas exchange with the internal environment, mostly by bringing in oxygen and flushing out carbon dioxide.

Aerobic creatures need oxygen for cellular respiration, which uses the oxygen to break down foods for energy and produces carbon dioxide as a waste product.

Breathing brings air into the lungs where gas exchange takes place. The body’s circulatory system transports these gases to and from the cells, where “cellular respiration” takes place.

The number of respiratory cycles per minute is the breathing or respiratory rate and is one of the four primary vital signs of life.

Under normal conditions, the breathing depth and rate is automatically, and unconsciously, controlled by several homeostatic mechanisms which keep the partial pressures of carbon dioxide and oxygen in the arterial blood constant.

A person who has difficulty breathing feels short of breath. It is hard or uncomfortable to take in the oxygen the body needs, it may feel like not getting enough air.

Many breathing problems are chronic or long-term and can be caused by many different conditions, which can be mild or severe as breathing difficulty can also develop as a result of stress and anxiety.

It is important to note that frequent episodes of shortness of breath or sudden, intense breathing difficulty may be signs of a serious health issue that needs medical attention.

Asthma and COPD
Bronchial asthma and COPD (chronic obstructive pulmonary disease) are the most common respiratory diseases and the most common causes of feeling short of breath. Heart problems, infections in the airways and allergies can also be responsible for breathing difficulties. The risk for breathing problems also increases with obesity.

Asthma and COPD are obstructive pulmonary diseases that affect millions of people all over the world. Asthma is a serious global health problem with an estimated 300 million affected individuals. COPD is one of the major causes of chronic morbidity and mortality and one of the major public health problems worldwide. COPD is the fourth leading cause of death in the world and further increases in its prevalence and mortality can be predicted.

Although asthma and COPD have many similarities, they also have many differences. They are two different diseases with differences in etiology, symptoms, type of airway inflammation, inflammatory cells, mediators, consequences of inflammation, response to therapy, course. However, some similarities in airway inflammation in severe asthma and COPD are obvious.

Asthma and COPD are not fully curable, not identified enough and not treated enough.

Asthma is most often associated with onset during childhood and is common in those with a family history of atopy (allergies) or asthma. Symptoms typically increase with exposure to allergens and triggers, such as pollen, dust mites and animal dander. In some cases, asthma symptoms disappear after childhood.

In contrast, COPD is almost unknown in children, rare in adults under the age of 40 and almost always associated with a long history of smoking, while asthma occurs in non-smokers as well as smokers. The classic presentation is an older current or ex-smoker with progressively worsening shortness of breath, possible cough and mucus production accompanied by decreasing physical activity, often assumed to be a sign of ageing … It should also be remembered that COPD and asthma can occur together as those with asthma who smoke are likely to develop COPD.

Daily symptoms are present in only 27% of people with asthma, whereas in COPD symptoms are more likely to be constant.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

For some people, asthma signs and symptoms flare up in certain situations:

■ Exercise-induced asthma, which may be worse when the air is cold and dry;
■ Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust;
■ Allergy-induced asthma, triggered by airborne substances, such as pollen, mould spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander).

Asthma is sometimes caused by gene changes that are passed down through families. If one of the parents has the disease, it is more likely for their children to have it. Asthma cannot be cured, but its symptoms can be controlled.

Asthma and spring
It is finally spring! The days are getting longer, flowers are starting to bloom, the weather is warming up and … oh, unfortunately asthma and allergy triggers are making their seasonal appearance.

If you have asthma, allergies or both, as about 50% of people with asthma do, the pollen that comes with the season is a strong problem.

Pollen is perhaps the most obvious springtime asthma and allergy offender. As flowers, weeds, trees, grass and other plants begin to bloom, they release pollen into the air. If you are allergic to pollen, you know what happens next!

Allergic reactions can cause symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach or on the skin. Allergies can also trigger symptoms of asthma, making it more difficult to breathe. But pollen is not the only spring allergy and asthma trigger, air pollution and temperature changes can also make asthma symptoms worse.

When someone has asthma, their airways go into spasm which causes tightness of the chest; the linings of the airways become inflamed and produce phlegm leading to extreme difficulty in breathing.

Not nice! The good side of all this is that the present state of the art Medicine has many ways to help prevent and treat these events.

There is an old proverb that states “Life is in the breath. He who half breathes half lives”.

Daily control is vital to living an active, productive life.

Best healthy wishes,
Dr. Maria Alice

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Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service / Medilagos. Medical Director – Grupo Hospital Particular do Algarve