FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

READER'S "ADULT ONSET" ASTHMA INCREASINGLY COMMON

Question: I'm 35 years old and just started having problems with coughing and wheezing. My doctor has diagnosed my condition as asthma, which I thought was a children's disease. Is asthma common in adults, or am I just entering my second childhood as my wife suspects?

Answer: Asthma is becoming an increasingly common disorder. Today it affects from 3 to 6 percent of the United States population, and it's estimated there are now 3 million more asthmatics than just a decade ago. This may be due, in part, to the poor ventilation in newer, better-insulated homes. Most of these new sufferers, as you suggest, are children. However, it is not unusual for the first attack of asthma to strike at age 35 or older, as in your case. The "later-in-life" onset is more common in those who smoke or have other chronic lung problems, but people without these risk factors develop asthma, too.

The term "asthma" creates confusion for many individuals. Most picture a wheezing child when they think about this disease. And indeed, wheezing is often present in those suffering an asthma attack. But, not all asthma attacks produce wheezing, some non-asthma conditions can cause wheezing, and asthma as you now know is not limited to children.

We doctors think of asthma as a reversible obstruction of the air passages. Those with asthma have alternate periods when they breathe relatively normally and when their breathing is labored. These periods of distress are often marked by wheezing and coughing. In fact, coughing is often the dominant complaint among those who develop asthma during adulthood.

Question: Is my asthma going to interfere with my physical activities? So far, my breathing gets worse when I mow grass or do other activities that require physical exertion.

Answer: There are many things that trigger asthma attacks. Allergies and physical exertion, particularly in cold weather, bring them on in almost all asthmatics. You could live as a couch potato inside a sterile plastic bubble to avoid asthma attacks, but that isn't practical or much fun. Fortunately, there are medications that are quite effective at preventing exercise-induced asthma. That means that you will still be able to cut the grass darn! and do other activities that require physical exertion.

Allergies bring on attacks in 85 percent of those with asthma. House dust mites, animal dander and bugs particularly cockroach leavings are notorious offenders. You should attempt to rid your home of them. It's especially important to keep your bedroom "operating room" clean. Many asthmatics fail to get complete relief from their allergies by regular and scrupulous house cleaning, including moving the pets out of the house. These individuals often benefit from allergy shots to reduce their allergic reactions and resulting asthma attacks.

In addition to exercise and allergies, asthma attacks can be triggered by a variety of things, such as:

the common cold or other respiratory infections,

emotional stress,

aspirin and other medications, and

inhaled irritants such as smoke, dust or fumes.

Medications are used to reduce the frequency of attacks while others are used to treat acute asthma when it occurs. Usually, both types of treatment are prescribed for those with asthma. And fortunately, this treatment is quite effective. That is not to imply that asthma is a trivial illness, because it isn't. People die as a consequence of their asthma every year. Fortunately, this is uncommon. A far more common sequela is days missed from school or work because of asthma. The best way to stay in the "common" group of those who only experience inconvenience from their disease is to follow you doctor's advice, take your medications as prescribed, and make efforts to avoid things that trigger your attacks.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.