Fresh air does not smell of fragrance

Frisk luft lukter ikke av parfyme.


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The early signs of asthma

In general, most asthma attack symptoms are not severe enough to stop you from going about your daily activities. But if you learn how to recognizing these signs, you can stop an asthma attack or prevent one from getting worse.

Early warning signs of an asthma attack include:

  • Frequent cough, day or night, but some got it more at night.
  • Reduced peak flow meter readings (PEF)
  • Losing your breath easily or shortness of breath
  • Wheezing and/or coughing
  • Feeling tired or weak
  • Feeling very tired or weak when exercising
  • Wheezing or coughing after exercise or exercise-induced asthma
  • Feeling tired, easily upset, grouchy, or moody (can be signs of not feeling well because of the strain coming)
  • Decreases or changes in lung function and/or as measured on a peak flow meter
  • Signs of a cold and/or allergies (sneezing, runny nose, cough, nasal congestion, sore throat, and headache)
  • Trouble sleeping with nighttime asthma
  • Take care, eat and sleep well, if you are tired you get more easily sick, that is my experience not so often told elsewhere.

The severity of an asthma attack can escalate rather rapidly, so it’s important to treat these symptoms immediately once you recognize them.

Source besides my own experience: WebMD


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NAAF on occupational asthma

Norway Asthma and Allergy Association (NAAF) got a new much better website. I must really congratulate them on their effort to give more and better information. And they have added a special section about occupational asthma, and that I think is really formidable!

Site in Norwegian but you can always use Google translate. :)

http://www.naaf.no/no/astma/arbeidsrelatert-astma/

http://www.naaf.no/

I am so proud of NAAF now. :)


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Educational image on asthma

When you read or hear about asthma you are told asthma is in the airways. Many believes it is therefore in the throat since that is what most people know as the airways. They therefore deny it is in the lungs. But asthma is located in the lungs. You have upper airways (mouth, nasal cavity, pharynx and larynx) and lower airways (trachea, bronchi, bronchiole, alveoli) that is in the lung, then lung tissue, blood veins, muscles a.s.o. In the lungs that looks almost like a sponge with small pipes air and oxygen is transported. Those pipes are air-ways called Bronchi and out from them springs the even smaller ones called Bronchiole and in the end of those the Alveoli is located. The Alveoli is connected to the blood stream of the body, oxygen is going in to the blood, and the blood transports the oxygen to the rest of the body including the brain, liver, kidneys, muscles and so on.

Asthmatics need oxygen too. Air is breathed in through the mouth and nose and goes through the wind-pipe to the lungs. When the air/oxygen arrive to the lungs it is first transported to the bronchi and over into the bronchiole which then transport the air/oxygen further to the alveoli that is the last stop in the lungs before the oxygen is transported to the rest of the organs in the body including your brain.

An asthma attack can be started by several things, either something a person is allergic to airborne og eaten, or things that simply irritate the lungs airways.

The bronchiole in an asthmatic person narrows (see image) when subjected to perfume, smoke, dust, exhaust or other things the person having asthma get sick from. When the bronchiole’s narrows it hinder air to get through to the alveoli, the lung tissue gets to little air and oxygen, and the person get hard to breathe or what we call an asthma attack. When breathing fresh air with no pollution, irritants or allergens in the air breathed in, the asthmatic person usually can breathe rather normally. Note that food allergies can also be airborne. When a person having an asthma attack get all tight lungs then it is the bronchiole that get inflamed and cramp, and the asthmatic person can not breathe. Therefore oxygen can not be transported to the rest of the body and organs. If not helped and the person having asthma do not get to breathe normally again the person can in worst case suffocate and die. The help needed is to get away from irritants and allergens that make the person sick, and also to give medicine at once. If the person do not get better, or are fading away, the person should be brought to the Emergency Room to get stronger medicine.

The lungs also transport oxygen to the rest of the body including your brain. If you are careless with your lungs it can end up bad for you. Your lungs are designed for fresh air, not smoke, perfume or any other pollution.

Photo of lung map at the lung clinic at the hospital.

 

What is it like and how do you know?

Just a little knowledge shared from me to you.

Hva er astma? What is Asthma?
Asthma – What is?
Educational image on asthma
Asthma treatment – PEF, Peak flow, Optichamber, asthma medicine
AeronebGo
Optichamber mask + AeronebGo nebulizer
Optichamber Inhalation chamber and how to make best use of your medicine

Have a nice day.

/ Annelie


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Mannitol test done

Today 17 of June 2011 at 1330 was the time for my Mannitol asthma test. Because I got my asthma from working in a bus wash in the period of 2005-2007 I am to be granted long term damage payment from the socail security department NAV in Norway, and therefore they have ordered and demanded that I will have to do this test. Before I worked in the bus wash I was as healthy as can be.

Plan was to be able to film the whole thing. I asked them to allow me to do that but the nurse did not approve. But I took some photos instead just to show the machine and so on.

During the last three days I have not been allowed to take any medicine at all. So I was totally unprotected to any of the stuff I get sick from. It has been a hazzle to not be able to take any medicine, and I have gotten ill several times since Tuesday. I have solved this problem to not get sick by trying to avoid people I know smoke and use perfume, and I have used a protective mask to prevent to breathe in fumes I get ill from.

When I came to the hospital I was a bit unsure of where to go. It was a long time since I was at the lung clinic and needed advise where to go, so I knocked at the reception desk window in the main entrance to get help. The lady opened the window smiling. That was nice. But in the same second she opened the window perfume flew out the window in my direction, and I got ill and had an asthma attack all the way from there to the lung clinic and even through waiting to get in and also when I got in. I had managed to stay away from perfume for three days, and when I get to the hospital I get sick from it! : (
I complainted at the lung clinic and got informed that they are not allowed to use perfume there. But they did anyway and I got sick. : (   And I could not take any medicine because if I did I could not take the test, and also then 3 days of struggle without medicines would have been pointless and useless. I could not take any medicine because the medicines would make that the result come out wrong. To take the test I had to be unmedicated.

Well, luckily I came in almost at time after only have been waiting a little while.

I talked to the nurse about the last test I did 3-4 years ago and we came to the conclusion that it was a Metacholin asthma test I took back then. The Metacholin was rather straight forward, even though rather painful and hard. At the Metacholin test I first made a PEF measure to check the before test values of my breathing capability. And after the PEF test I breathed in Metacholin, and after that I took a new PEF breathing measure to get the after value of my breathing capability. During the Metacholin test I got all closed up lungs and could no breathe.

This photo shows the healthy lung on the left side, and on the right side the resault to the lungs with different illnesses. On the upper right side you see some of what asthma do to the lungs, even though the imige do not show the total progress.

Today it was time to do the Mannitol asthma test of my lungs to state the long term damage. The Mannitol test is more complicated and more measurements are done.

Test equipment

First step of the Mannitol test is that I did a PEF measurement to get the before result of my breathing capability. After that I had to breathe in a gas from a hugh gas tank. I felt a small irritation in my lungs from that and started to cough. And after the gas I did another PEF measure.

Then it was time to do a surrogate test. I was to breathe in a surrogate to see the result of that. I even reacted a bit to the surrogate. And then another PEF measure.

After all that it was time for the real Mannitol test.

Here I am breating in the test machine. This is a staged photo because I had not possibilities to photograph while taking the acutal test since it was to painful to focus on photographing all together. But this is what it looks like.

The nurse put some Mannitol capsuls in a piece that I put in my mouth and then sucked down my lungs. The test in all is in 9 such Mannitol intakes and the dozes is increased each time. For each increased doze of Mannitol the asthma attack get more severe.

I felt a small reaction on the first try with only one capsule. Then took a PEF measure for the after result. Then she gave me a higher dose on the second try, and then a new PEF measure to see the difference to the first. On the third go she gave me two capsules with an even higher dose and I got all tight in my lungs, and after that a new PEF measure to see the effect on my lungs and breathing ability. Fourth go with the Mannitol and even another increased dose in two capsules and another PEF measure after to see the difference. When I came to the fifth and increased dose of  breathing in Mannitol it got really bad. It was really bad, I felt my lungs take a long pause and hold, and I could not breathe. After the fifth PEF measure the values was so bad that she said the rules obliged her to stop the test.

So what does that mean that I could not take all the nine Mannitol doses? It actually mean that my asthma is so bad that I could not take all the doses in the test. If my asthma would have ben less aggressive I would have been able to take all the nine doses of Mannitol. But with my asthma I could only take five doses.

The dark blue lines shows my lung function before the test. The green lines shows what measure would have been expected during the test  if I were a person without asthma. And the red lines shows my lung function after the fifth breathing in of Mannitol.

After I got the fifth dose of Mannitol it was very hard to breath,and breathing even stopped. Serious stuff.

In the photo above the dark blue lines shows my lung function before the test. The green lines shows what measure would have been expected during the test if I were a person without asthma. And the red lines shows my lung function after the fifth breathing in of Mannitol. It is a big difference. It was so bad she actually stopped the test. If she would have gone further it could be dangerous for me.

And now I will tell the naked plain truth about asthma. This happens every time I or another person with asthma is subjected to any of what we get sick from either it is perfume, tobacco smoke, dust, hairspray, exhaust, or whatever it might be. It happens exactly as it does in the test, only in the test another substance is used to start the attack.

When she finished the test I got medicine. Ventoline in an Optichamber. And that was lovely! First medicine in three (almost 4 days) and being able to breathe again after the test was a blessing in itself.

And then it was time for the talk with the doctor. It was an interview about what my experiences is with what I react to and get sick from, and such things. Then I was done.

The doctor will write his notes and inform the social health security department the results.

Now I am going to take som medicine and enjoy it. :)

ps. If you are about to have an Mannitol or Metacholin test done on you I have two things to say. Yes, it can be a bit stressful, dramatic and maybe even scary. But you get medicine after so you will get better. The hours and the day after you can be a bit sore in your air-ways and you might also be a bit more sensitive then else to irritants and allergens. So try to stay away from that and take your medicines. Just relax and follow the nurse’s/doctor’s instructions and you will be fine.


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Avoid asthma

I live and I do almost whatever I want even though I got asthma.

I have a much better day with this:

This I must avoid – EVEN ON YOU

… and this too

Secondhand smoke can trigger asthma episodes and increase the severity of attacks. Secondhand smoke is also a risk factor for new cases of asthma. Scientists believe that secondhand smoke irritates the chronically inflamed bronchial passages in the lungs of people with asthma. Secondhand smoke is linked to chronic respiratory illnesses.

What YOU can do to prevent asthma attacks:

  • Do not use perfume or perfumed products.
  • Choose not to smoke in your home or car and don’t allow others to do so
  • Choose not to smoke in the presence of people with asthma.
  • Choose not to smoke in the presence of children.
  • Choose not to be cruel. Emotional stress triggers asthma.

If you use perfume, smoke, or are cruel I


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Scent

Often when people want to describe what it is that make allergice, asthmatic, mcs people sick the word scent is used.

I think really the word fragrance is an unfortunate word to use on what we become sick from us who have asthma, allergies, mcs, or what we have. The word scent is often perceived as the smell of diversity in general. Therefore, you often hear that:

“-Do you want to ban perfume, smoke, and anything that smells?” …asuming one is a little bitt stupid or troublemaker.

Anything smells but not everything we get sick from. As I usually say (and as I said on my blog before) If you fart, it smells, but I will not get sick from it. Tobacco and perfume smells too, but I do  get sick from it. So the word fragrance I think should be changed to something else. It is actually not the scent that make us ill, it is what is in the scent, the chemicals that make us ill. And as a person I know so fine stated it:

“-It is rather the scent that make us aware of the danger coming.”

It really do only work as a warning signal.

It is so true. It is really the chemicals held by the scent that makes us ill. So do anybody have any suggestions for a better word?


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Asthma facts

Asthma is a chronic illness of the lungs, where the airways tighten and causes problems breathing. It is caused by allergies and irritants inhaled. When this happens the musculature around the airways cramps and mucus i produced in in the lungs in an increased grade. This together make it hard for the person having asthma to breathe. It feels like the lungs shrinks, and one get trouble breathing.

In Norway about 20% of children got asthma, about 5 % of the adults got asthma. If both the mother and the father got asthma then the child are in 50 % higher risk of developing asthma. More and more of the population get asthma. Smoking during pregnancy and the first years of life increases the risk for children to get asthma. The environment is very important for if the children and also if adults develop asthma.

Colds, cold temperatures, wet weather, mist, and wet damages, and allergies and irritants are some of what causes asthma. Irritants can be just anything, it depends on what the person having asthma is sensitive against. Asthma can be inherited, but do not have to be inherited. Even people with parents without allergies and asthma can develop asthma. During evening, night and in the mornings asthma can be worse.

Exercise is good for a person having asthma, but can also be what give an asthma attack and breathing problems. An asthmatic person need to exercise in its own pace.

An asthma that is not right treated with medicine and staying away from irritants can develop into COPD (KOL/KOLS).

People that smoke and got asthma often do not have the same benefit from the asthma medicines provided as those who do not smoke. Active smoking and passive smoking worsen asthma.

Hormone changes and pregnancy can worsen asthma.

Psychological stress can worsen asthma.

It is very important to be in control of your asthma. Control you gain by taking your medicines daily as prescribed, stay away from what make your asthma break out, and see to that you get fresh air.

It is important to use medicines even more when having a cold, because a cold can worsen your asthma.

No medicines can cure asthma. Medicines available reduces the symptoms and effect of the illness. But even when taking the medicines a person can get sick if not being careful, and if not staying away from what make the asthma break out.

Asthma is an invisible handicap, and it can cause trouble for a person working in surtant environments. Those work environments can be kitchen, welding halls, factory, cleaning, car repair garages, or any environment where the person is subjected to pollution of the air.


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Purple lips – asthma/astma

You know when you were a child and you were swimming in cold water to long you got purple lips by the cold? (And if you have not experienced that, that is what happens.) Same happens to me when I get low lung capasity. During the last weeks I have woken up in the morning with purple lips. Meaning the body get to little oxygen. When my asthma is less they are more red, and when the asthma is worse they are more purple. That alongside the coughing means I have to take more medicine. So I better do that now.

Facts about purple lips:
“Purple lips, also known as cyanosis in medical terminology, is caused by the discoloration of the skin and membranes. The area that is affected by cyanosis appears to be bluish in color. Though purple lips can be caused due to cold weather, it can also be a cause for concern, as it may be a symptom of underlying diseases related to the heart and respiratory system causes of purple lips are chronic bronchitis, asthma, hypoventilation etc.” Buzzle.com

If you do not receive adequate treatment for an asthma attack, you will eventually be unable to speak and will develop a bluish coloring around your lips. This color change, known as “cyanosis,” means you have less and less oxygen in your blood. Without immediate aggressive treatment in an intensive care unit, you will lose consciousness and eventually die. An asthma attack is a sudden worsening of asthma symptoms caused by the tightening of muscles around your airways (bronchospasm). During the asthma attack, the lining of the airways also becomes swollen or inflamed and thicker mucus — more than normal — is produced. All of these factors — bronchospasm, inflammation, and mucus production — cause symptoms of an asthma attack such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack include: Severe wheezing when breathing both in and out, Coughing with asthma that won’t stop, Very rapid breathing, Chest pain or pressure, Tightened neck and chest muscles, called retractions, Difficulty talking, Feelings of anxiety or panic, Pale, sweaty face, Blue lips or fingernails, Or worsening symptoms despite use of your medications.” WebMD.com


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Educational videos on Asthma

View those two educational videos on asthma and COPD (KOLS/KOL).

Inside the body:


http://www.youtube.com/watch?v=jmuWKSRqvKI&NR=1

Asthma attack:
This video shows a very sever asthma attack. There are many degrees on an asthma attack, not all asthma attacks are like this. This video shows the worst outcome. Un untreated sever asthma attack may cause the end of the asthmatic person. To avoid sever asthma attacks one must avoid what make the asthmatic person ill.


http://www.youtube.com/watch?v=jAiKHfeIcek&feature=related

 


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Asthma – What is?

Asthma is a chronic (long-term) lung illness that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing.

Asthma affects people of all ages. As an example in the United States, more than 22 million people have asthma. Nearly 6 million of these people are children. Ginasthma and WHO has estimated that in 2011 about 300 million people got asthma world wide. In  Norway approximately 1,5 millioner people got asthma and allergies. Facts from WHO: Chronic respiratory diseases worldwide caused over 4 million deaths in 2005, including over 3 million deaths from COPD and 255,000 deaths from asthma.

Overview

The airways in the lungs are tubes that carry air into and out of your lungs. Those airways in the lungs are called the bronchioles. People who have asthma have inflamed airways. This makes the airways swollen and very sensitive. This is not an inflammation as we normally know it like a sore throat, this one is chronic and will not go away. Only treatment is using asthma medicine that keep the asthma down. They who have asthma tend to react strongly to certain substances that are breathed in.

When the airways react, the muscles around them tighten. This causes the airways to narrow, and less air flows into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can further narrow your airways.

This chain reaction can result in asthma symptoms. Symptoms are likely to happen each time the airways are irritated.

Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms. (Click image for bigger picture.)

Sometimes symptoms are mild and go away on their own or after minimal treatment with an asthma medicine. At other times symptoms continue to get worse. When symptoms get more intense and/or additional symptoms appear, this is an asthma attack. Asthma attacks also are called flare-up or exacerbation.

What happens in the airways?

There are three factors in particular which individually trigger attacks;

  • Spasm of the musculature surrounding the airways. Airways tighten and you get a problem breathing.
  • Inflammation of the mucosa in the airways – not due to infection. The inflammation leads to swelling of the mucosa and hence the bronchi become narrower and tighter. The work of breathing is increased and the sufferer feels short of breath.
  • Collection of mucous in the airways.

It’s important to treat symptoms when you first notice them. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can cause death.

Outlook

Asthma can’t be cured. Even when you feel fine, you still have the illness and it can flare up at any time.

But with today’s knowledge, medicines and treatments, most people who have asthma are able to manage the disease. They may have few, if any, symptoms, or have more but can treat it themselves. Treatment with asthma medicines increase the chance to live normal active lives, and sleep through the night without interruption from asthma.

For successful, comprehensive, and ongoing treatment, take an active role in managing the illness.

What Causes Asthma?

The exact cause of asthma isn’t known. Researchers think a combination of factors (family genes and/or certain environmental exposures) can interact to cause asthma to develop, most often early in life. No more than one factor is needed, but more than one factor together can be the cause. These factors include:

  • An inherited tendency to develop allergies, called atopy (AT-o-pe)
  • Parents who have asthma
  • Certain respiratory infections
  • Contact with some airborne allergens or exposure to some viral infections.
  • Non-inhereted asthma is developed by for example tobacco smoke, chemicals, dust, compounds in home decor products, sprays, damage caused by damp in houses, mould, cold and more.
  • Some people develop asthma because of exposure to certain chemical irritants, fumes or industrial dusts in the workplace. This is called occupational asthma.

If you got asthma exposure to airborne allergens (for example, house dust mites, cockroaches, and possibly cat or dog dander, chemicals) and irritants (for example, tobacco smoke, parfume a.s) make your airways more reactive to substances in the air you breathe.

Different factors may be more likely to cause asthma in some people than in others. Researchers continue to explore what causes asthma.

Most, but not all, people who have asthma have allergies.

What Are the Signs and Symptoms of Asthma?

Common asthma symptoms include:

  • Coughing. (Coughing from asthma is often worse at night or early in the morning, making it hard to sleep. But it also occur in daytime or when you are exposed to things you are sensitive to.)
  • Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe.
  • Chest tightness. This may feel like something is squeezing or sitting on your chest.
  • Shortness of breath. Some people who have asthma say they can’t catch their breath or they feel out of breath. You may feel like you can’t get air out of or in your lungs.

A lung function test, done along with a medical history (including type and frequency of your symptoms) and physical exam, is the best way to diagnose asthma for certain. Your doctor will use a test called spirometry (PEF) to check how your lungs are working.

Peak Flow Messurement

This is an instrument used for messuring the airflow. You hold the handle and blow in the front. You get the results at the left side. Here I blow 350 as you see to the left, and the right side shows the normal value for a healthy person.

This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. When your asthma get worse the result from the test gives a lower rate, and the more sick you are in asthma at the time of the test the lower result you get. Your doctor also may give you medicines and then test you again to see whether the results have improved. If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma.

If your suspect your asthma is work related it is smart to make separate tests at home and at work at the same time over time to see if there is any difference in your lung capasity between the places. This helps determine if your lungs works best at home or at work. Other tests that may be taken by your doctor is allergy testing.

One measure the lung capacity and also forces an attack to break out the check if there really are asthma. A test to measure how sensitive your airways are. This is called a bronchoprovocation test. Using spirometry, this test repeatedly measures your lung function during physical activity, after you receive increasing doses of cold air or a special chemical to breathe in. (This one is a real nightmare. I got so tight airways that I could not breathe. Like putting a sock down your throat. Had to inhale a lot of medicine after to be ok again. I never want to do that again if I can help it. It took all afternoon the get my strength back. Annelie’s comment)

The types of asthma symptoms you have, how often they occur, and how severe they are may vary over time. Sometimes your symptoms may just annoy you. Other times they may be troublesome enough to limit your daily routine.

Severe symptoms can threaten your life. It’s vital to treat symptoms when you first notice them so they don’t become severe.

With proper treatment, most people but not all who have asthma can expect to have few, if any, symptoms either during the day or at night. But it is important to avoid what makes your asthma break out if possible. Subjecting yourself to what makes your asthma break out will make the illness worsen over time.  It is also very important that the people round you is considerate and caring to help you avoid that when necessary.

(September 2008 I have had my asthma for one year. In November 2008 I have had an astma attack that made me have to go the hospital and get connected to a machine that gave me asthma medicine to inhale for 15 min. I coughed very hard and had a tight chest. I got very weak and had trouble breathing and got sick leave. Annelie’s comment)

What Causes Asthma Symptoms To Occur?

A number of things can bring about or worsen asthma symptoms. Your doctor will help you find out which things (sometimes called triggers) may cause your asthma to flare up if you come in contact with them. Triggers may include:

  • Allergens found in dust, animal fur, cockroaches, mold, and pollens from trees, grasses, flowers a.s
  • Irritants such as cigarette smoke, smoke, fumes, air pollution, chemicals or dust at home, public places, transportation or in the workplace, compounds in home decor products, and sprays.
  • Certain medicines such as aspirin or other non-steroidal anti-inflammatory drugs and non-selective beta-blockers
  • Sulfites in foods and drinks
  • Viral upper respiratory infections such as colds and airway infections
  • Exercise (physical activity)
  • People with food allergies (f.eks nuts) can in addition to normal allergy reactions get an asthma attack.
  • Psychological and emotional stress, including stress, grief, depression a.s
  • Laughter, big positive emotions a.s.
  • Fright, being afraid is a kind of stress and can trigger asthma.
  • Excitement do a reaction to the body, that can trigger asthma.
  • Sex, involves all of the emotional levels mentioned and can trigger asthma.

Other health conditions—such as runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea—can make asthma more difficult to manage. These conditions need treatment as part of an overall asthma care plan.

In dayly contact with an asthmatic person you should always consider these facts. Employ it in your dayly rutines to help the asthma sick person to remain well.

Causing unnecessary psychological stress on an asthma sick person can cause serious effects on that person’s health. Asthma is located in the same groups of illness as psoriasis and eczema that worsens from stress, grief and psychological stress. Try to solve problems to help the asthma sick person remain well. Great stress are damaging for the health of an asthmatic.

Asthma is different for each person. Some of the factors listed above may not affect you, other factors that do affect you may not be on the list. It is very personal what triggers asthma and how much you react to them.

Source: nhlbi.nih.gov, Norges Astma- og Allergiforbund NAAF, and own experiences.

On Wikipedia you can read even more: http://en.wikipedia.org/wiki/Asthma

Annelie

First posted 30. november 2008 19:39

Read:
Hva er astma? What is Asthma?
Asthma – What is?
Educational image on asthma
Asthma treatment – PEF, Peak flow, Optichamber, asthma medicine
AeronebGo
Optichamber mask + AeronebGo nebulizer
Optichamber Inhalation chamber and how to make best use of your medicine