Annelie on asthma, humor, and the world.

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Hoster lenge?

I Metro.se var det i dag en god artikkel om noe jeg har tenkt på lenge og som er meget viktig.

“Lider du av långdragen hosta? Så vet du om det är dags att söka hjälp

Det kan ibland kännas som att hostan aldrig kommer att gå över. Du hostar gång på gång. Och det känns som att hostan aldrig kommer att gå över. Men är det farligt? Så vet du när det är dags att söka hjälp.

Det är ovanligt att det är något farligt underliggande när du har drabbats av en långvarig hosta. Det säger Lennart Hansson, överläkare vid lung- och allergisektionen på Skånes universitetssjukhus.

– Det behöver man oftast inte bekymra sig för. Den allra vanligaste orsaken till att hostan finns kvar beror på rester efter en luftvägsinfektion som man har haft. Det är också vanligt med långdragen hosta efter en besvärlig infektion under vintern.

Sedan beror det på vem det är som har drabbats av hostan.

– Pratar man om personer i 60-årsåldern som röker, hostar och hostar blod eller är det personer i 25-årsåldern som inte röker? Och har personen en pågående förkylning eller inte? Orsaken bakom hostan kan bero mycket på omständigheterna.

Långdragen hosta kan också vara en odiagnostiserad astma.

– Det kan också bero på besvär från näsan och bihålor, sedan kan sura uppstötningar och halsbränna också ge en långdragen hosta. Det är mindre vanligt att man har en underliggande infektion som orsak, men det finns alltid undantag.

Lennart Hansson säger att det är väldigt ovanligt att man skulle kunna hitta lungcancer hos en person med långdragen hosta som har tagit en röntgen på lungorna som ser normal ut.

Han brukar dela upp hosta i tre olika typer.

– Den urakuta hostan är den som uppstår när du till exempel sätter i halsen. Sedan har du den akuta hostan som vanligen är lite slemmig, även om den inte behöver vara det. Den hostan är nästan alltid infektionsrelaterade och varar kring två-tre veckor. Sedan har vi den långdragna hostan som vi pratar om när det har gått mer än åtta veckor.

Han tycker att det ska gå minst två månader innan man söker hjälp hos en läkare om man har en torrhosta som inte går över.

– Sedan kan man också gå till läkaren om hostan ändrar sig, blir mycket värre, om man hostar blod och har återkommande luftvägsinfektioner gång på gång.

Små barn under två år är dock ett undantag.

– Då tänker man lite annorlunda. Barn under två år ska inte gå och hosta under långdragen tid. Gör barnet det kan man börja fundera på om det är någon variant av astma den är drabbad av.

Dessvärre finns det inte så mycket man kan göra åt den irriterande hostan på egen hand.

– Generellt sett finns det inga bra hostdämpande läkemedel överhuvudtaget, det finns väldigt lite vetenskapliga belägg för de som finns ute.

Kan den långdragna hostan smitta andra?

– Absolut inte. Det är mer att omgivningen blir irriterad och påtalar att man har hostat ovanligt länge för att de tvingas lyssna på ljudet” Metro.se

Ja akkurat sånn er det før diagnose, hosting i ukevis fra middels til ille, tungt og vanskelig å puste og forlite oksygen slik at du blir orkesløs. Sånn  hadde jeg det i 2007 før jeg fikk diagnose astma og medisiner. Etter det var det om å gjøre å lære seg håndtere sjukdommen, lære seg medisinene og virkning og hva som forverrer astmaen for å lære seg hva å unngå for å være symptomfri, det ble en reise om 4-5 år før det ble skikk på det. 

Har du langvarig hoste, gå til legen.

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#Astma #medisin kunnskap – #Asthma #medicine knowledge

Translate: (Go to English version)

Kunnskap om respirasjonsorganene og medisin

“Respirasjonsorganer

De viktigste sykdommene i denne gruppen er de vi kaller obstruktive (innsnevrende) lungesykdommer. Astma, kronisk bronkitt og emfysem er de vanligste sykdommene. Astma er en kronisk sykdom med anfall som gir pustevansker fordi luftrørene overreagerer på noe som irriterer dem, musklene trekker seg da sammen og slimhinnene rundt luftrørene svulmer opp. På lang sikt kan astma føre til tap av elastisk vev i lungene. Mange eldre får diagnosen «kronisk obstruktiv lungesykdom» (forkortes KOLS). Dette er en samlebetegnelse for sykdommene kronisk bronkitt og emfysem. KOLS medfører vanskeligheter med luftflyten inn og ut av lungene. Ved kronisk bronkitt er det økt slimdannelse og seigere slim som skaper problemer, mens emfysem er ødeleggelse i lungevevet slik at det blir mindre elastisk, lungeblærene (alveolene) og de minste luftrørene (bronkiolene) faller sammen og det blir vanskelig å puste. Dermed blir også tilføringen av oksygen til blodet redusert. I behandlingen brukes ofte astmamidler og midler som reduserer slimdannelsen.

(R03) Midler ved obstruktiv lungesykdom

Til behandling av lungelidelser brukes i stor grad inhalasjonslegemidler med lokal virkning i lungene. Det finnes legemidler til forebyggende behandling og til behandling av astmaanfall. Midler med innhold av både forebyggende og anfallsmedisin har de siste år blitt meget populære. Disse kombinasjonene ser ut til å være effektive både ved astma og ved KOLS.

(R03 A C) Selektive b2 – agonister

I denne gruppen har vi både midler som er rasktvirkende og langtidsvirkende. De rasktvirkende blir oftest brukt ved astmaanfall (eks. Ventoline® og Bricanyl®). De langtidsvirkende blir først og fremst brukt forebyggende (eks. Serevent® og Oxis®).

Virkning: Midlene virker avslappende på muskulaturen i bronkiene slik at de utvider seg. Dette letter passasjen av luften og letter passasjen av slim ut av lungene.

Bivirkninger: Ved lokal inhalasjonsbehandling er det ikke noe særlig med bivirkninger. Det kan oppleves en lett skjelving i hendene og litt hjertebank, som skyldes at noe av virkestoffet kommer over i blodbanen. Dette er ubehagelig men forbigående.

Interaksjoner: Betablokkere (hjertemedisin) kan senke effekten av disse legemidlene – og motsatt kan da for eksempel Ventoline® senke effekten av betablokkerne.

(R03 A K) Andre adrenergika

I denne gruppen har vi to legemidler som inneholder kombinasjoner av virkestoffene i gruppene Selektive b2-agonister og Glukokortikoider. Dette er meget praktisk, mange (men ikke alle) kan da klare seg med kun en inhalator som de bruker morgen og kveld. (Symbicort® er en kominasjon av Oxis® og Pulmicort®, mens Seretide® er en kombinasjon av Serevent® og  Flutide®).

(R03 B A) Glukokortikoider

Denne gruppen legemidler bruker tid på å virke (timer til dager). Midlene benyttes derfor kun som forebyggende (eks. Pulmicort® og Flutide®).

Virkning: Disse midlene virker antiinflammatorisk, det vil si de hindrer betennelsesreaksjoner i kroppen og hindrer væskeansamlinger i slimhinnene.

Bivirkninger: Ved inhalasjon av disse midlene er alvorlige bivirkninger svært sjeldne. Oppvekst av sopp i munnhulen, tørr hals og heshet er vanlige bivirkninger som forebygges ved å skylle munnen godt etter inhalasjon.

(R03 B B) Antikolinergika

I denne gruppene hadde vi inntil nylig kun ett virkestoff – med relativt kort virketid (Atrovent®). Det må derfor doseres ofte – vanligvis 4–6 ganger daglig, men for de sykeste inntil 8–12 ganger daglig. Vi har nå fått en videreutvikling med navnet Spiriva® som kun er godkjent til bruk ved KOLS. Dette middelet virker så lenge at det skal være nok med 1(–2) dose(r) i døgnet.

Virkning: Legemidlene i denne gruppen får musklene rundt luftrørene til å slappe av (ved å hindre dem i å trekke seg sammen).

Bivirkninger: Ved inhalasjon er vanligste bivirkning munntørrhet. Husk derfor god munnhygiene. Større doser vil også kunne gi forstoppelse, hodepine, hoste og bihulebetennelse.

Andre legemidler ved obstruktive lungesykdommer

Om man ikke når målet med inhalasjonsmidler, finnes alternativer. Beta2-agonistene finnes også som mikstur, injeksjon og tabletter. Andre eksempler er Nuelin Depot® depottabletter og Singulair® tabletter. Slimløsende midler finnes i gruppe R05 C B både som inhalasjon, mikstur og tabletter. Glukokortikoider som ikke er til inhalasjon finnes i gruppe H02 som tabletter og injeksjon (eks. Prednisolon® tabletter).”

Kilde: Legemiddellære for hjelpepleiere, omsorgsarbeidere og helsefagarbeidere Kompendium til bruk ved kurs i legemiddelhåndtering Cand.pharm Agnes Gombos 2008

In English

Knowledge of the respiratory organ and medicine

“Respiratory organ

The main diseases in this group are those we call obstructive (narrowing) respiratory diseases. Asthma, chronic bronchitis and emphysema is the most common diseases. Asthma is a chronic disease seizure
causes breathing difficulties because air pipes overreact to something that irritates them, muscles cramp and mucous membranes around the air passages swell. In the long term asthma lead to loss of elastic tissue in the lungs. Many older persons are diagnosed “chronic obstructive pulmonary disease” (abbreviated COPD). This is a collective term for diseases chronic bronchitis and emphysema. COPD causes difficulties with air flow in and out of the lungs. In chronic bronchitis there is increased mucous and stickier mucus that causes problems, whereas emphysema is destruction of lung tissue so that it becomes less elastic, the air sacs (alveoli) and the smallest air passages (bronchioles) coincide and it becomes difficult to breathe. Consequently, the addition of oxygen to the blood is reduced. In the treatment is often used asthma agents and agents that reduce mucus formation.

(R03) Drugs for obstructive lung disease

For the treatment of lung disorders is widely used Inhaling locally acting medicine in the lung. There are drugs for preventive use and treatment of asthma attacks (acute medicine). Preparations Containing both preventative and reliever medication has in recent years become very popular. These combinations seem to be effective both in asthma and COPD.

(R03 A C) Selective b2 – agonists

In this group, we have the medicines that are fast acting and long-acting. The fast acting is most often used for asthma attacks (for example. Ventoline® and Bricanyl®). The long-acting are primarily used preventive (for example. Serevent® and Oxis®).

Impact: The drugs act by relaxing the muscles in the bronchial tubes so they expand. This facilitates the passage of air and facilitates the passage of mucus out of the lungs.

Side effects: At local inhalation therapy there is no particular side effects. It can be experienced a tremor in the hands and a palpitation, caused by medicine substance comes in to the bloodstream. This is unpleasant but temporary.

Interactions: Beta-blockers (heart medicine) may reduce the effect of these drugs – and conversely when such Ventoline® lowering effect of beta blockers.

(R03 A K) other Adrenergics

In this group we have two medicines that contain combinations of active substances in groups Selective b2-agonists and glucocorticoids. This is very convenient, many (but not all) may then make do with only one inhaler that they use morning and evening. (Symbicort is a combination of Oxis® and Pulmicort® while Seretide® is a combination of Serevent® and Flutide®).

(R03 B A) Glucocorticoids

This group of medicines take time to work (hours to days). The drugs are therefore used only as a preventive (excl. Pulmicort® and Flutide®).

Impact: These agents act anti-inflammatory, ie they prevent inflammation in the body and prevents water retention in the mucosa.

Side effects: By inhalation of these medicines are serious side effects very rare. Growth of fungus in the mouth, dry throat and hoarseness are common side effects that can be prevented by rinsing the mouth after inhalation.

(R03 B B) Anticholinergics

In this group we had until recently only a single agent – with a relatively short duration (Atrovent®). It must therefore be dosed frequently – usually 4-6 times a day, but for the sickest up 8-12 times daily. We now have a development named Spiriva® only approved for use in COPD. This remedy works so long that it should be enough with 1 (-2) dose (s) a day.

Impact: The drugs in this group will have the muscles surrounding air passages to relax (by preventing them from contracting).

Side effects: By inhalation is most common side effect dry mouth. Remember therefore good oral hygiene. Larger doses could also result in constipation, headache, cough and sinusitis.

Other drugs for obstructive airway diseases

If you do not reach your goal with inhalants, there are alternatives. Beta2-agonists are also available as oral, injection and tablets. Other examples are Nuelin Depot® release tablets and Singulair® tablets. Mucus dissolving group R05 C B both inhalation, oral and tablets. Glucocorticoids not inhaled’s group H02 as tablets and injection (excl. Prednisolone tablets). ”

Source: Drug Doctrine for nurses, care workers and health care workers Compendium for use by course in medication Cand.pharm Agnes Gombos 2008


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#Astma er potensielt #dødelig – Asthma is potentially deadly

(Scroll down for English)

Plutselig og tiltagende forverring av astma-symptomene er potensielt livstruende

“4.4 Advarsler og forsiktighetsregler
Dersom pasienten må øke forbruket av β2-agonister med kort virketid for å kontrollere astma-symptomene, tyder dette på en forverrelse av sykdommen.  Plutselig og tiltagende forverring av astma-symptomene er potensielt livstruende, og man bør vurdere å starte eller øke kortikosteroid-terapi. ” Slv.no

Dette burde egentlig stå på alle informasjonssider om astma på nett, for å finne denne infoen måtte jeg søke via en medisin og fant det på Statens Legemiddelverk. Dette er informasjon som jeg mener enhver person som har astma og publikum ellers har krav på å få på en lett tilgjengelig måte, det kan redde liv.

Jeg fant også dette på nett om kvelning:

“Kvelning betyr at hjernen ikke får nok oksygen. Mangel på oksygen i hjernen fører raskt til bevisstløshet og død. Kortere perioder med oksygenmangel  i hjernen kan føre til hjerneskade. En tilstand der kroppens vev har en mangel på oksygen kalles hypoksi.

Kveling kan være forårsaket av fysisk hindring for luften å komme inn i lungene, som kutter i brystet, tett knyttede slips eller astma, å puste luften har et lavt oksygeninnhold  eller inneholder giftstoffer  som hindrer oksygen transport som karbonmonoksid.
Asfyksi (asphyxia neonatorum) kalt oksygenmangel  som oppstår ved fødselen. Dette behandles først og fremst ved at man behandler barnet med CPAP og tilfører oksygen. Dette fører til at lungene blir blåst opp og oksygenering  av blodet lettes.” Wikipedia

Nå visste jeg dette fra før men det er det nok langt fra alle som er klar over at det er slik, det hører man på diskusjoner på nett.

Vis hensyn til astmatikere, hensynsløse har større ringvirkninger enn du tror.

Kilde:
https://www.legemiddelsok.no/_layouts/15/Preparatomtaler/Spc/0000-07488.pdf

sv.m.wikipedia.org/wiki/Kv%C3%A4vning

In English

Sudden and progressive deterioration of asthma symptoms are potentially life threatening

“4.4 Special warnings and precautions
If the patient must increase the consumption of β2-agonists with short duration to control asthma symptoms, it indicates a worsening of the disease. Sudden and progressive deterioration of asthma symptoms is potentially life threatening and consideration should be given to starting or increasing corticosteroid therapy. “Slv.no

This should really be on all information pages about asthma online, to find this info I had to search through a medicine and found it on the Norwegian Medicines Agency. This is information  I think any person who has asthma and the public otherwise are entitled to have in an easily accessible way, it can save lives.

About Asphyxiation (smothering)

“Asphyxiation (smothering) means that the brain does not receive enough oxygen. Lack of oxygen in the brain leads quickly to unconsciousness and death. Shorter periods of oxygen deprivation in the brain can cause brain damage. A condition in which the body tissues have a lack of oxygen is called hypoxia.
Choking can be caused by physical obstruction for the air to get into the lungs, which cuts or damages in the chest, tightly knotted tie or asthma, that the air has a too low oxygen content or contain toxins that prevents oxygen transport such as carbon monoxide.
Asphyxia (asphyxia neonatorum) called oxygen deprivation that occurs at birth. This is treated primarily by treating the child with CPAP and adding of oxygen. This leads to the lungs inflated and oxygenation of the blood is facilitated.” Wikipedia
Now I knew this already but it is far from anyone who is aware that this is so, this is rather obvious when participating in conversations both in real life and online.

sv.m.wikipedia.org/wiki/Kv%C3%A4vning


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#astma og #død – #asthma and #death @astmaallergi #astma #allergi

(Scroll down for English)

Astma og død

Leser man på norske, danske og svenske offentige sider om astma er det meget vanskelig å finne noe kalle fakta om at astma er en sjukdom man kan dø av. Ikke engang på Astma og allergiforbundenes sine sider finner man noe om denne kunnskapen. Folk har krav på sannheten, det er kun med sannheten i eie at man kan lære seg å respektere astma, både de som har astma og alle rundt omkring de som har astma.

Astma: Ordet astma kommer fra gresk og betyr åndenød. I 85% av tilfellene er det på grunn av astma, lungebetennelse , hjerte-ischemi, interstitiell lungesykdom, kongestiv hjertesvikt, kronisk obstruktiv lungesykdom at man får åndenød.

“Astma kan vise seg i flere grader ved besvær, lindrig, til alvorlig akutte astmaanfall. Ved akutte, alvorlige astmaanfall vil du i begynnelsen av anfallet være uttalt tungpustet, ha vanskelig for å snakke, ha smerter eller ubehag i brystet, ha kraftig hoste, gjøre store anstrengelser for å trekke pusten, og ofte høres kraftige pipelyder fra lungene eller halsen. Du kan bli blek, puste svært raskt og ha forhøyet hjertefrekvens. Når anfallet har pågått en tid, vil du kunne bli utslitt og medtatt. Du har ikke lenger krefter til kraftige pustebevegelser og hosting. Dette er et svært alvorlig tegn, og det haster med behandling og hjelp. Medisinere Dersom symptomene ikke bedres raskt, eller de kommer tilbake innen kort tid, eller dersom du blir svært medtatt, skal lege kontaktes. Legen vil vurdere om det er behov for å gi andre medisiner eller sykehusinnleggelse. Ved alvorlige anfall vil det ofte være behov for oksygentilførsel, og det kan være nødvendig å gi væske og medisiner rett i blodet (intravenøst).” NHI.no

Det er hva du finner om astma i Norge. Det viser på alvoret men det forteller ikke at man faktisk kan dø av det. For å få den kunnskapen må man gå ut på nett og søke på engelsk. (Oversettelse under)

“Asthma is a disease of the lungs and the air tubes leading to them. It causes the walls of the bronchioles, the tiny airways in the lungs, to swell and produce mucus so that the sufferer has difficulty in breathing. Most deaths caused by asthma result from a gradual worsening of symptoms. The ultimate cause of death is a shortage of oxygen.” Dr. Professor. Martyn Partridge, Faculty of Medicine, National Heart & Lung Institute, Chief Medical Adviser to the National Asthma Campaign UK

Samme tekst men på norsk:

“Astma er en sykdom i lungene og luftrørene som fører til dem. Det fører til at veggene i bronkiolene, de små luftveiene i lungene, hovner opp og produserer slim slik at den lidende har problemer med å puste. De fleste dødsfall forårsaket av astma skyldes en gradvis forverring av symptomer. Den ultimate dødsårsaken er mangel på oksygen. ” Dr. Professor. Martyn Partridge, Faculty of Medicine, National Heart & Lung Institute, Chief Medical Adviser to the National Asthma Campaign UK

Selv WHO snakker om astma som en av mange organisasjoner og nettsteder:

“Astma er en stor ikke smittsom sykdom preget av tilbakevendende anfall av åndenød og tungpustethet, som varierer i alvorlighetsgrad og frekvens fra person til person. Symptomer kan oppstå flere ganger på en dag eller uke i berørte personer, og for noen mennesker forverres astmaen under fysisk aktivitet eller om natten. Under et astmaanfall hovner slimhinnen i bronkiene opp og forårsaker at luftveiene begrenses og luftveien reduseres og hindrer luftens passasje inn og ut av lungene. Tilbakevendende astmasymptomer fører ofte til søvnløshet, tretthet på dagtid, redusert aktivitetsnivå, fravær fra skole og arbeid. Astma er et folkehelseproblem ikke bare for høyinntektsland, det skjer i alle land uavhengig av utviklingsnivå, dok forekommer de fleste astmarelaterte dødsfall i lav- og lavere mellominntektsland på grunn av mangel på medisin. men det skjer også i høyinntektsland i mangel på skikkelig behandling.
Astma er underdiagnostisert og underbehandlet. Det skaper betydelig byrde for enkeltpersoner og familier, og ofte begrenses enkeltpersoners aktiviteter for en levetid. De sterkeste risikofaktorer for å utvikle astma er inhalerte stoffer og partikler som kan fremkalle allergiske reaksjoner eller irritere luftveiene.
Medisiner kan kontrollere astma. Å unngå det som utløser astma kan også redusere alvorlighetsgraden av astma.” WHO

Det tok meg 7 år å finne ut av dette, og jeg fant det da jeg snublet over artikler da jeg søkte om kunnskap om asthma på engelsk. Da jeg fikk astma i 2007 var det ingen som opplyste meg om dette, det var ikke noe å finne om det på norske, danske og svenske sider på nettet. Det er kun med sannheten i eie at man kan lære seg å respektere astma, både de som har astma og alle rundt omkring de som har astma. Dette er for dårlig. Jeg må kalle en spade for en spade. Hvorfor skjuler dere sannheten for oss alle?

/ Annelie

This is real / Dette er ekte

Skjermbilde-astma-dod

Skjermbilde / Screendump Death of a child in the US – En ung skoleguts død i USA.

 

Read more / Les mer: http://www.kctv5.com/story/26760590/police-8-year-olds-death-after-asthma-attack-now-a-homicide#ixzz4BUeAKYol

Jente døde / Girl died: http://articles.philly.com/2014-09-05/news/53568671_1_laporshia-massey-daniel-burch-wrongful-death-suit

Kvinne døde av astma / Woman died from asthma : http://pzimedia.com/health/Famous-People-That-Died-Of-Asthma–29618.html/

Mann døde i vente på ambulanse / Man died waiting for ambulance: http://therightscoop.com/man-dies-from-asthma-attack-after-cops-stop-him-on-the-way-to-hospital/

Astmaattacker kan gi oksygenbrist som kan gi andre skader. / Asthma can cause oxygen shortage that can lead to other damages.: https://www.youtube.com/watch?v=QmNGAKuwcVI

Det er bare tre av flere hundre tusen som dør av astma hvert år i verdenen. Astma skal behandles med større respekt.

In English

Asthma and Death

If you read on Norwegian, Danish and Swedish public pages about asthma it is very difficult to find anything about the cold hard facts that asthma is a disease one can die of. Not even the Asthma and Allergy Foundations websites has something on this knowledge. People are entitled to the truth, it is only with the truth of owning that one can learn to respect asthma, both those having asthma and everyone around those having asthma.

Asthma: The word asthma comes from Greek and signifies dyspnea. In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, chronic obstructive pulmonary disease.

“Asthma can show in several degrees for the person having asthma, mild, to severe acute asthma attacks. For acute, severe asthma attacks you at the beginning of the attack experience pronounced wheezing, find it difficult to talk, have pain or discomfort in the chest, have a bad cough, make great efforts to draw breath, and often sound sharp beeps from the lungs or throat. you may be pale, breathing very quickly and have elevated heart rate. When the seizure has been ongoing for some time, you will be exhausted and battered. You no longer have the strength for powerful breathing movements and coughing. This is a very serious character, and the urgency of treatment and help is critical. Medicate. If symptoms do not improve quickly, or they will return shortly, or if you become very battered, seek medical attention. Your doctor will consider whether it is necessary to provide other medications or hospitalization. in severe cases it will often be a need for oxygen, and it may be necessary to give fluids and medications directly into the bloodstream (intravenously). ” NHI.no

That’s what you can read about asthma in Norway. It shows the seriousness but it does not tell that one can actually die from it. To get the knowledge you have to go out on the Internet and search in English.

“Asthma is a disease of the lungs and the air tubes leading to them. It causes the walls of the bronchioles, the tiny airways in the lungs, to swell and produce mucus so that the sufferer has difficulty in breathing. Most deaths caused by asthma result from a gradual worsening of symptoms. The ultimate cause of death is a shortage of oxygen.” Dr. Professor. Martyn Partridge, Faculty of Medicine, National Heart & Lung Institute, Chief Medical Adviser to the National Asthma Campaign UK

Even WHO talks about asthma as one of several websites:

“Asthma is a major noncommunicable disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. Symptoms may occur several times in a day or week in affected individuals, and for some people become worse during physical activity or at night. During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and reducing the flow of air into and out of the lungs. Recurrent asthma symptoms frequently cause sleeplessness, daytime fatigue, reduced activity levels and school and work absenteeism. Asthma has a relatively low fatality rate compared to other chronic diseases. Asthma is a public health problem not just for high-income countries; it occurs in all countries regardless of the level of development. Most asthma-related deaths occur in low- and lower-middle income countries due to lack of medicine, but it also happens in high income countries in lack of proper treatment.
Asthma is under-diagnosed and under-treated. It creates substantial burden to individuals and families and often restricts individuals’ activities for a lifetime. The strongest risk factors for developing asthma are inhaled substances and particles that may provoke allergic reactions or irritate the airways.
Medication can control asthma. Avoiding asthma triggers can also reduce the severity of asthma.” WHO

It took me seven years to figure this out after long time searching for knowledge on asthma, stumbling over this and that searching. When I got asthma in 2007, no one informed me about this, there was nothing to find about it on the Norwegian sites on the web, nor at Danish or Swedish sites. Articles above is only a few of those several hundreds of thousands of people who die from asthma every year in the world. This is too bad. I must call a shovel a shovel. Why do you hide the truth from all of us?

/ Annelie


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Folk ser astma som triviell og overser risikoen for død – People see asthma as trivial and overlooking the potential it has to kill

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Folk ser astma som triviell og overser risikoen for død

“De to Lungelegene fra Imperial College og Royal Brompton Hospital i London skriver i tidsskriftet Archives of Disease in Childhood, hvor de to legene bekrefter at astma kan være en dødelig tilstand som en gang ikke ble godt nok diagnostisert. De hevder har pendelen nå svingt for langt den andre veien -. Med så mange diagnoser som blir stilt i dag resulterer i at noen mennesker ser astma som en triviell sak, og overser potensialet den har til å drepe ”

Dette er noe jeg har ment i mange år, folk har en innstiling til astma som om det er noen lett snue eller hoste, de skjønner ikke at det er en alvorlig lungesjukdom som ikke er å kimse av. Man skal ta det seriøst og man skal både respekt for og vise hensyn til dem som har asthma.

http://www.bbc.com/news/health-35967380

In English

People see asthma as trivial and overlooking the potential it has to kill

“Writing in the journal Archives of Disease in Childhood, the two respiratory doctors from Imperial College and the Royal Brompton Hospital in London acknowledge that asthma can be a fatal condition that was once not being diagnosed enough.

They argue the pendulum has now swung too far the other way – with over-diagnosis resulting in some people seeing asthma as a trivial matter and overlooking the potential it has to kill.”

This is something I have meant in many years, people have a setting to asthma as there are some slight cold or cough, they do not realize that asthma is a serious lung disease that is not to underestimate the seriousness of. One should take it seriously and you should show respect and care to those who have asthma.

http://www.bbc.com/news/health-35967380

 


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Hva er astma? What is Asthma?

(Scroll down for English)

Hva er egentlig astma for noe?

En liten kjapp lesning på legevakthåndboken så finner man dette:

“Anfallsvis opptredende obstruksjon av luftstrømmen i små og store luftveier. Symptomene skyldes redusert luftveiskaliber som følge av spasmer i bronkienes glatte muskulatur, slimhinneødem og/eller økt bronkial sekresjon. Etiologien er ufullstendig kjent, men både arv og miljøfaktorer spiller en rolle. Enkelte har allergi (mugg, midd, dyrehår, pollen) og har nytte av allergimedisiner (særlig barn og unge). Uspesifikk bronkial hyperreaktivitet er vanlig (bronkokonstriksjon ved eksposisjon for stimuli som kulde, tobakksrøyk, parfyme, luftforurensning, fysisk anstrengelse, enkelte medikamenter, luftveisinfeksjoner og emosjonell ubalanse). Både pasienter, pårørende og leger undervurderer ofte alvorlighetsgraden av akutte astmaanfall. Slik undervurdering kan forsinke livreddende behandling. Alle henvendelser om akutt astma bør tas på alvor med umiddelbart tilsyn av pasient.” Legevakthåndboken

astma-skjermbilde-hva-er-astma

Skjermbilde Beskrivelse av alvorlighetsgrader ved astma. Kilde: lvh.no

Moderat astmaanfall

  • Personen kan snakke normalt.
  • Respirasjonsfrekvens (pustefrekvens)  < 25/minutt
  • Puls < 110/minutt
  • PEF > 50% av forventet eller optimal verdi

Akutt alvorlig astmaanfall

  • For kortpustet til å si en hel setning.
  • Respirasjonsfrekvens (pustefrekvens)  > 25/minutt
  • Puls > 110/minutt
  • PEF < 50% av forventet eller optimal verdi

Livstruende astmaanfall

  • Avtakende eller sparsomme fremmedlyder
  • Cyanose eller kraftløs respirasjonsanstrengelse.
  • Bradykardi eller hypotensjon
  • Utmattelse, forvirring eller bevisstløshet.
  • PEF < 33% av forventet eller optimal verdi.

Les mer  og kilde:
http://www.lvh.no/symptomer_og_sykdommer/nedre_luftveier_og_lunger/obstruktiv_lungesykdom/astma

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

In English

Really? What is asthma?

A fast read at the Norwegian ER book online one find

“Paroxysmal occurring obstruction of airflow in the large and small airways. The symptoms caused by reduced airway caliber caused by spasms in the bronchial smooth musculature, mucosal edema and / or increased bronchial secretion. The etiology is incomplete known, but both genetic and environmental factors play a role. Some people have allergies (mold, mites, animal hair, pollen) and benefit from allergy medications (particularly young people). Non-specific bronchial hyperresponsiveness is common (bronchoconstriction by exposure to stimuli such as cold, tobacco smoke, fragrance, air pollution, physical exertion, certain drugs, respiratory infections and emotional imbalance). Both patients, families and physicians often underestimate the severity of acute asthma attacks. Such underestimation can delay life-saving treatment. All inquiries about acute asthma should be taken seriously with immediate supervision of the patient.” Norwegian Casualty handbook Legevakthåndboken

Moderate asthma attacks

  • The person can talk normally.
  • Respiratory (breathing rate) 50% predicted or optimal value
  • Pulse < 100/minute
  • PEF > 50% of predicted or optimal value

Acute severe asthma attacks

  • Too short of breath to say a whole sentence.
  • Respiratory (breathing rate)> 25 / minute
  • Pulse > 110 / minute
  • PEF <50% predicted or optimal value

Life-threatening asthma attacks

  • Decreasing or sparse strange noises
  • cyanosis or powerless effort breathing.
  • bradycardia or hypotension
  • Fatigue, confusion or unconsciousness.
  • PEF <33% of predicted or optimal value.

read more and source (Norwegian site):
http://www.lvh.no/symptomer_og_sykdommer/nedre_luftveier_og_lunger/obstruktiv_lungesykdom/astma

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


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Help someone with asthma

What to do?

You can actually make a huge difference for everyone having asthma so they become more healthy and get a better life. Yes You!

What is asthma?

How to recognize asthma?

I know this person

If you know the person, ask what the person can not tolerate, allergies and other stuff they get sick from. When a person have asthma even things they are not allergic to can make their airways kick back and make trouble in form of an asthma attack. When you know what the person get sick from keep this away from the person at all times. If it is something you use yourself. STOP! even if you think in your own mind that it must be a silly thing.

I do not know this person

Around you there are many people who have asthma. One count that about 20-25 % of the population in a country have asthma. Worldwide (numbers from 2011) 300 million people have asthma, in Europe (counting from 2014) approximately 30 million people have asthma, and it is estimated that around 2036 about 400 million people will have asthma worldwide (information from World Health Organization WHO, Ginasthma.com, and EFA). In Norway for example there is in 2015 about 5 million people. 20 % out of 5 million people (counting low) is 1 million people who have asthma (5.000.000 x 0,20 = 1.000.000). How many live in your country? Count how many ( x million people times 0,xx equals?) So you see out of the hundred of people you see around you about 20 of those have asthma. And that is if we count low with 20 %. That is 20 people! So what can you do for all of those?

The nature of asthma is like this:

A person can be allergic to different things that causes asthma attacks, and in addition there are substances that causes irritation to the airways in the lungs causing asthma attacks even if the person is not allergic to them. Asthma comes in 4 different levels from mild to severe. Asthma can be deadly. To live you must be able to breathe, and the nature of asthma is trouble breathing. Think about this when you travel in the room where the public have access, and also in your home if your friends or family have asthma.

Common triggers for asthma:

  • Tobacco smoke
  • Vaping – some but not all react to vaping
  • Fragrance (both male and female scents) – both from the bottle and added to other products.
  • Incense
  • Scented candles and candles
  • Air fragrance, also known as signature scent
  • Airfreshener – what you use to hide bad odor or to fragrance the room
  • Animals – most common is fur and birds. But remember that it is not only the fur and the feathers that is source for the allergy, saliva and skin dandruff too.
  • Food – most commonly known is nuts and peanuts and that is both the whole nut or added to food and oils. Nut allergy can be fatal both taken in and airborne. But even milk, egg, fish and other foods can give such reaction both by eating it and airborne.
  • Exhaust from vehicles, both diesel and gasoline, and maybe others. Gas – actually most people have it bad from gas, but people with asthma have it even worse since they do not tolerate even smaller amounts.
  • Gassing from stuff – it can be gas from filling petrol, diesel, oil, alcohols, solvents, new plastic, cleaning products, ammonia, among many other things.
  • Dust of various kinds, not only house dust.
  • Pollen
  • Flowers
  • Grass
  • Evaporates

So how can you make the world better for a person having asthma to avoid the person get an asthma attack? It is actually rather easy.

  • Do not smoke or vape around other people. Smoke outside away from entrances and ask before you light a cigarette or e-cigarette.
  • Cut out the fragrance and fragranced products, only use fragrance free. The emissions, pollution, from fragrance and fragrance products cause asthma attacks. If you use fragrance and someone tells you to stay clear it is not to be rude it is to stay healthy.  Take the hint and go fragrance free.
  • Do not use incense, it pollutes the air. A sensitive person gets asthma attacks from it (even outdoors). If a person tells you not to use it, it is not to be rude, it is not to be against your religion, it is to stay healthy.
  • Do not use candles and scented candles since they emit a lot of invisible chemicals to the air that triggers an asthma attack. And the smoke from putting them out is just as bad.
  • Airfresheners, products giving away scent and signature scent for marketing is a big no! no! it goes under the same as Fragrance.
  • Turn the engine off as soon as you have stopped the car.
  • Think of fire smoke and other kinds of smoke, gas and off-gassing as pollution and keep such away from others. Ask before you do something that can emit to the air.
  • Avoid if possible to bring animals where there are a lot of people. A rather big percent of the 20 % of the population is allergic. That also goes for your clothes if  you have been around animals. Change your clothes to allergen free clothes and wash yourself.
  • Flowers are lovely, unfortunately many is allergic, so if possible try to keep the flowers packed in during transport home. And if you are going to give someone flowers, ask if they are allergic to it before buying it. Maybe something else is a better gift?
  • Dust and dirty – Keep the place clean from dust, but use as less chemicals as possible to get as clean air as possible. Cleaning and washing agents goes under the same as fragrance products, it causes asthma attacks. Go fragrance free here!
  • Pollen, yes it is a natural thing and not your fault. What you can do is to think of all that is allergic to it, do not brush or dust it off indoors, and if someone tells you to hand your coat outside it is not to be rude it is to stay healthy.
  • Food – Avoid eating where other people travel the society. Of cource you can eat in a restaurant or a cafe’, but avoid eating other places. Rather many get sick from airborne food emits, and when you eat you might get it on handles, seating, doors and so on, and the next one get it on their hands and then in their mouth for example (grown and children).

Remember that things that emits and evaporates to the air can be for sensitive people as pollution regardless of the smell. It is not the smell that hurts it is what is in the smell. We are constructed to breathe air, nothing else. If someone tells you – No!, it is not to be rude, it is to stay healthy. Avoid to have things that evaporate and emits to the air where the public is. Make the air as fresh as possible without additives, additives that is for all of us sensitive nothing more than pollution. Maybe it is a new way of thinking for you, but regardless what you think of it, it is all sensitive persons reality. If you adopt the way of thinking you can make the air cleaner and fresher for us all to breathe. In that way you can help us stay healthy. In polluted air we get sick, in fresh air we are healty. It is that simple. Have a nice day. / Annelie


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Merry Christmas shut out

Happy Holidays?

Fresh-Air-For-All-Guests-Christmas It is this time of year when all families gather together and salubrate the holidays together, first Christmas and then New Years.

Invitations are sent and everyone is expected to come on the invitation like the host want it.

I am visiting in different asthma and allergy, and sensitivity fora online and read page up and page down about relatives inviting their kids, cousins, grandkids, siblings and other relatives to the holidays and everyone want to come, just they can not.

And why?

Family can sometimes be even worse than other friends in life, it seems like they are deaf to life and others needs. They want to be presentable and they want to make a cozy holidays for all and make a happy party – on their terms.

I then wonder why they are not listening to what their family and friends tell them about their asthma and allergies, that they can not be around cats, dogs, birds,, tobacco smoke, vaping, fragrance, air fresheners, incense, scented candles, and can not eat a range of different things. Many allergies are even airborne so if any of the things they are allergic to is there they get sick from breathing.

I read about families who invite to holidays and parties and demand to have the gathering at their home even though they know and have been told many times their friends or family members are sick from their animals, fragrance products, tobacco smoke (second and third hand), vaping and some food, fragrance, aftershave and other things. They are told all year-long and every year at Christmas and New Years that the family member is sick from these things, still it is like the host behave like they are thick in the head. Either they have a hearing problem, or it must be they are either thick in their head and do not grasp for a moment what is the problem, or they just do not care.

But actually it should not have to be explained in detail what happens in the body when a person is exposed to allergens and irritants, it should be enough they are told the person get sick from it, and when told – Could you please come to our place instead? And could you please come fragrance free, smoke free, fur free, and bring no food or what ever the allergy and asthma is against? They should do that without hesitating, all for the cause and best for the person we all love who has allergies and asthma.

Every year it is the same thing, and every year I wonder what is wrong with these people? They say they love their family and friends, but still they seem to not care and go on hurting them.

In the end the person having asthma and allergies end up having a Christmas and New Years being sick, really sick, being on medication and having a bad health. All because some people do not listen.

It should be easy. They could just listen and do as asked of them for the greater good and good health of someone they claim to like and love, and someone they claim they care for.

If you claim these things, that you love and care for a person, please step up and show for real that it is true by showing it with your actions.

Caring about your loved ones should be more important than where and how you salubrate your Christmas and New Years.

Or your loved ones end up sitting alone at the Holidays, or getting really ill just because you do not care.

Read about asthma and allergy by looking through the menu, and links. Also read about testimonials, Go fragrance Free archives, and all the other knowledge. Take your time and be a better family and friend.

Please, let it be a Happy, including and Healthy Merry Christmas and Happy New Year for everyone.

Fresh-Air-For-All-MerryChristmas

/ Annelie


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Extinguishing fire with wood @astmaallergi #asthma #astma #astmaallergi #lunghealth #lunge #helse

(Scroll down for English)

Å slukke ild med ved

Om ICD-10 kode J44a -46 Astma
Astma er en kronisk betennelsestilstand i luftveiene, vanligvis assosiert med hyperreaktiv luftveisrespons og variabel luftmengdeobstruksjon. Kronisk betennelse og det faktum at musklene rundt bronkiene kramper gir obstruksjon (hindrer  normal pust).

I NAAF kampanjer og andre organisasjoners astma og allergikampanjer ser man ofte utsagnet:

“Astma er INGEN hindring…”

Det er i grunn skitprat at astma er INGEN hindring. Jeg har astma og astma er en hindring å gjøre mange ting. Derimot skal man ikke la seg hindre å forsøke så får man se om det går så lenge som det er trygt. Men også med medisin så er det en hindring i mange høve. Det er bra å peppe folk å tørre å forsøke ting, men det gir også signaler til alle de som ikke har peiling på hva astma er, dvs de som ikke har astma, at tro at astma er som en bitte liten forkjølelse. Det gir inntrykket at bare ta en pille du så kan du gjøre hva du vil. At så lenge som den som har astma tar en pille så kan alle andre drive på som de vil. At det kun er astmatikerens ansvar å holde seg frisk. At det bare er å ta seg en pille, det er FEIL mine damer og herrer. Noe nyansering vil være på sin plass.

“Astma svekker skole- og arbeidsprestasjoner og det sosiale liv. Fysisk livskvalitet er svekket av bronkiale symptomer, det sosiale liv er også svekket av rhinitt.” (WHO 2007)

Astma er en potensielt dødelig sjukdom, det er noe som Norges Astma og allergiforbund NAAF  i alle regioner i Norge feiler eller unnlater å fortelle folk. 300 000 000 (300 millioner) mennesker verden over har astma og 250 000 personer dør i astma hvert år (tall fra WHO. Kroniske lungesjukdommer står for ca 7 % av dødsfallene i verden. (WHO) Continue reading


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Why do we need fresh air?

I was talking to a person I know very well today that have not been taken care of their asthma lately and had a violent asthma attack yesterday. Too few understand how dangerous this is, that goes both for them who are sick in asthma and those around who have not.

Why do we need fresh air?

About 20 % of inhabitants in society have asthma, and more are getting it from year to year.

When a person having asthma is exposed to allergens and irritants and stuff that the lungs is ill from MUCUS is formed in the lungs and clogs the airways. In addition to the mucus clogging the bronchies (airways in the lungs) cramp due to muscles around the airway cramping making the already mucus filled airways even tighter. This is what makes it hard to breathe. It is also important to note oneself that even insensitive and uncaring behaviour that cause emotional stress to a person having asthma can cause the same Health issue.

This is what happens if a person having asthma is subjected to airborn allergens and irritants, or eating something they get sick from, and it worsen by the hour they are subjected to it.

If the person do not get treatment this is what happen:

1 The asthma attack is sneaking on the person making it hard to breathe until he /she get too little oxygen and ultimately die from it.

2 Have a acute asthma attack that is very violent, with violent coughing, violent breathing problems, muscle cramps and ace, it is easy to spot and in the long run just as deadly. Often you can not stand up straight because you cough so violently.

3 A combination of the two above.

4 Anaphylactic shock. Death comes quickly.

So before you say “take a pill” and “let me smoke and fragrance in Peace”, give us fresh air. That is what we need!


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Boy died from asthma attack – Ryan Gibbons – lfpress.com

A boy Ryan Gibbons was not allowed to carry his inhalor With him at School and died from a asthma attack.

“Sandra Gibbons knew something needed to change when her son Ryan, 12, died after an asthma attack at his school in Straffordville last year (2012).

Ryan wasn’t allowed to carry his inhaler with him at school, Gibbons said. So she started a petition to require school boards to adopt standardized asthma plans.

Gibbons’ petition garnered more than 1,500 signatures. The bill passed second reading with all-party support at Queen’s Park this week. The government has an obligation to ensure that (when) kids are at school that they have the safest environment possible.

It would also allow asthmatic students to carry a reliever inhaler at all times, with a doctor’s approval.

“There will be, of course, discretion,” Yurek said. “You’re not going to have a four-year-old carrying around their own puffer.”

Asthma is well known to be a Deadly disease if not treated properly with medicine and avoiding what makes the person ill. It is a shame that the School and People in generally do not respect it as such. Here a boy died from other Peoples ignoranse and overruling a persons needs.
And why a four year old can not carry his own puffer to use whenever the kid needs it is for me not understandable. I have asthma myself and I know that sometimes you do not have the possibility to run all over a School yard to get the teacher to get Your medicine, you must have it there and then, not later. Asthma medicine should be taken at once one feel a problem evolving, not wait 10 minitues to half an hour or more. The puffer is a life saviour and should be handled as such and carried With oneself eat all times. It should not even be a matter of questioning it.

I get upset, sad, angry and a lot more and tears are coming. I have a question for all wanting to deny a person having asthma their puffer:

– Would you deny a heart patient to wear his heart medicine?

It should be a human right to have ones medicine at hand at all times.

We have sertant organs that is crusual for living: heart, lungs, kidneys, liver, stomach, brain a.s.o. Without those organs functioning we are no more. Medicine helps the organ function so if you deny the person having or using their medicine they die.

Rest in Peace Ryan
Annelie

Read the Whole story:
http://www.lfpress.com/2013/12/06/jeff-yureks-private-members-bill-would-require-asthma-policy-at-schools


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Asthma 30 million in Europe

Did you know that

30 million people in Europe are affected by asthma, with six million of these people suffering from severe symptoms of the disease.

Asthma and allergy are the most common chronic diseases in adults and children and one of the leading cause of emergency department visits and hospitalisations. For children also one of the leading causes of school absences, (2013)

Source: EFA Efanet.org


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Breathing problem due to Alpha 1 Antitrypsin deficiency – Video

Alpha 1 Antitrypsin deficiency

I found some really good videos on YouTube.com about Alpha 1 Antitrypsin deficiency. This is about Alpha 1, but the first part also describes the sensation having asthma without Alpha 1. So to understand the nature of asthma you really need to see the first part of the video. Note! that asthma and Alpha 1 Antitrypsin deficiency is not the same even though the experience of the symptoms are in many ways much similar.

Part 1
Part 1 show you what it feels like having Alpha 1 Antitrypsin deficiency, but also what it feels like having asthma even though asthma and Alpha 1 Antitrypsin deficiency is not the same.
http://www.youtube.com/watch?v=wYsaosI26oQ

Part two
Part two show you the real severity view of Alpha 1

http://www.youtube.com/watch?v=lCW0gutkGzs

Good Reading on Alpha 1 Antitrypsin deficiency

There are many with Alpha 1 also has some form of asthma, others have bronchiestase, fibrosis, cyatisk fibrosis, chronic bronchitis, etc. Many people experience emphysema early in life because of its Alpha 1. It is often when you have emphysema you get infusion therapy.

Alpha-1 Antitrypsin Deficiency (Alpha-1) is a genetic (inherited) condition – it is passed from parents to their children through their genes. Alpha-1 may result in serious lung disease in adults and/or liver disease at any age.

For each trait a person inherits, there are usually two genes; one gene comes from each parent. People with Alpha-1 have received two abnormal alpha-1 antitrypsin genes. One of these abnormal genes came from their mother and one from their father.

Alpha-1 occurs when there is a lack of a protein in the blood called alpha-1 antitrypsin, or AAT. AAT, the alpha-1 protein, is mainly produced by the liver. The main function of AAT is to protect the lungs from inflammation caused by infection and inhaled irritants such as tobacco smoke.

Source and Read more: http://alpha-1foundation.org/what-is-alpha-1/

Because Alpha-1 is genetic, Alpha-1 lung disease is commonly called “genetic COPD.” People with Alpha-1 lung disease have two abnormal genes (one from each parent). The most common abnormal genes are called Z and S genes.

Early diagnosis of Alpha-1 is very important because quitting smoking (if the Alpha smokes) and early treatment are both essential to help slow the progression of Alpha-1 lung disease.

However, Alpha-1 Antitrypsin Deficiency can’t be diagnosed by symptoms or by a medical examination alone; you need to get a blood test to know for sure.

Alpha-1 is often first diagnosed as asthma or smoking-related Chronic Obstructive Pulmonary Disease (COPD). COPD includes emphysema and chronic bronchitis. Alpha-1 is the most common genetic risk factor for COPD. About 3 percent of all people diagnosed with COPD may have undetected Alpha-1.

The World Health Organization (WHO), American Thoracic Society (ATS), and the European Respiratory Society (ERS) recommend that everyone with COPD, bronchiectasis, or asthma that isn’t controlled with usual medications, be tested for Alpha-1.

Source and Read more: http://alpha-1foundation.org/about/

Treatment

There is no cure for Alpha-1 lung disease, but treatments are available.

Alphas with lung diseases such as asthma, COPD or bronchiectasis can be helped by the same drugs used by non-Alphas for these conditions.

These include drugs to open up the lung passages (bronchodilators) and reduce the chronic inflammation that is common in the lungs of Alphas (corticosteroids).

Since infections in the lung can bring millions of extra white blood cells into the lungs, many doctors who care for Alphas recommend that lung infections be treated early and aggressively with antibiotics. One sign of a lung infection is when the Alpha starts to cough up mucus or phlegm that is yellow or green in color.

Besides the usual treatments for COPD in general, there is a specific therapy available to Alphas with lung disease.

Augmentation therapy consists of intravenous infusions, usually weekly, of alpha-1 antitrypsin protein purified from healthy plasma donors. The goal is to increase the level of alpha-1 protein in the blood and lungs in order to slow or stop the progression of Alpha-1 lung disease.

Augmentation therapy has been shown to increase blood and lung levels of alpha-1 antitrypsin protein, reduce the rate of decline of lung function, and improve survival.

Augmentation therapy cannot restore lost lung function and is not considered a cure. However, this therapy is currently the standard of care for Alphas with COPD.

Source and Read more: http://alpha-1foundation.org/augmentation-therapy/

Transplant

Neither medicine or transfusion Cure Alpha 1 Antitrypsin deficiency. In the end all having Alpha 1 Antitrypsin deficiency die. To survice they need to have a lung transplant.

But the medicine and the transfusion help those having Alpha 1 Antitrypsin deficiency live longer.

Article is written With help of a friend having Alpha 1 Antitrypsin deficiency and my own knowledge in normal asthma. Please contact www.alpha-1foundation.org for more Information on Alpha 1 Antitrypsin deficiency.

Fact Source: my friend having Alpha 1 and  www.alpha-1foundation.org


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Asthma Cardiale and Asthma Bronchiale

Two types of asthma

  • Asthma Cardiale
  • Asthma Bronchiale

Asthma cardiale

Asthma Cardial, airway obstruction due to declining heart function. Originally a term for nighttime breathlessness in patients with heart failure. The term was later used in heart failure patients where an acoustics can hear the beeps of bronchial asthma.

Source: MD A Hegge Hansen and sml.snl.no/asthma_cardiale

 

Asthma bronchiale

Asthma Bronchiale is the best known sort of asthma among most people.

This type of asthma got several kinds  of severness from mild ot severe and leathal. It is very well described on this website at page Asthma – What is?


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Asthma and death

Is it possible to die from asthma?

Yes. The possibility to die from asthma is real.

According to figures by WHO and GinAsthma 2011 about 300 million person have asthma world wide, and about 250000 die from asthma every year.

Nearly all cases of asthma-related deaths result from a lack of oxygen and not from cardiac arrest. This is significant because rapid oxygen administration can prevent asthma-related deaths.

Most fatal asthma attacks do not occur in the hospital. Most patients who reach the hospital with an intact central nervous system survive.

Most people who die from a severe asthma attack delayed going to the hospital which is something people not taking asthma seriously enough tend to do.

Most asthmatics who suffer a near fatal attack hadn’t been taking their medicines as prescribed or they delayed seeking treatment.

Both people with severe and mild asthma can die from asthma.

Don’t play with your health

Some people do not take their asthma seriously, they think they know how to take care of their asthma, but they don’t and don’t really try to learn how to manage their asthma properly. Those having asthma who do not have a proper asthma treatment and stay away from what make them ill are more likely to have asthma attacks. They are also more likely to have to go to the emergency room. After being at the emergency room they go back to doing what they use to and being unattentive to health and medicine. They maybe only take som rescue medicin onee in a while, but not all subscribed. Then they go back to having fun, until the next asthma attack. But the longer they go without proper asthma management, the more they risk permanent damage to their lungs. If your doctor do not give you the information you have to hunt it.

Another type of asthmtics are those who think they are tuffer than asthma. They do are those who do not go to the hospital whatever. They could in fact be dying but they still do not contact the emergency room. Go to the doctor? What? Those asthmatics seam to think their own toughness and sheer willpower will beat their asthma symptoms into submission. They don’t seek breathing help when they need it and may have forgotten their asthma medication. Your lungs are not protected by your toughness. Asthma is a difficult disease and it requires some toughness. But you should never ignore breathing trouble, get help immedietly when you need.

The asthmatics who care

These asthmatics are a doctor’s best patients. They have their bronchodilator with them at all times, but only use it when necessary. They religiously take their controller, anti-inflammatory medicines. These are the patients that may visit the emergency room rarely, for breathing emergencies, but they seek information and education, or take the information and education they are given and follow it, so they don’t have to return to the emergency room.

Asthma Attitude: “I have asthma. Asthma doesn’t have me.”

Take care of your asthma Stay away from what make you ill, do not let it in your life. Take your medicines as prescribed and if you still get problems breathing take contact with the health care where you are.

Remember that a asthma not controlled might be able to take your life.

Source: healthcentral.com

http://www.aaaai.org/about-the-aaaai/newsroom/asthma-statistics.aspx


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Occupational asthma – basics

(Scroll down for English)

Astma på arbeidsplassen

Astma kan utløses av stoffer inhalert i lungene på arbeidet. Det er hovedsaklig to typer astma på arbeidsplassen; yrkesrelatert astma og yrkesforverret astma.

Yrkesrelatert astma

Yrkesrelatert astma er definert som astma forårsaket av spesielle faktorer i arbeidsmiljøet. Reaksjonen på en utløsende faktor kan skje nærmest umiddelbart, eller den kan ta måneder, eller også år, før den utvikler seg. Mange personer med yrkesrelatert astma hadde ikke astma tidligere. Dette er en vanlig årsak til astma hos voksne i yrkesaktiv alder, og bør alltid overveies. Yrkesrelatert astma er viktig å gjenkjenne, for hvis den utløsende faktoren blir fjernet i tide vil astmasymptomene kunne forsvinne. Hvis eksponeringen fortsetter, kan astmaen forverres.

Gjenkjenne yrkesrelatert astma

Symptomene er de samme som ved vanlig astma, men du kan ha yrkesrelatert astma hvis du føler at symptomene dine

  • starter innen et eller to år etter å ha begynt i en ny jobb, fått en ny stilling, eller har forflyttet deg til et annet sted på arbeidsplassen
  • starter etter å ha arbeidet med nye stoffer eller prosedyrer
  • bedrer seg i helgene eller når du har vært borte fra jobben, for eksempel i ferier

Hvis du mistenker at du har yrkesrelatert astma, snakk med lege så snart som mulig.

Stoffer som forårsaker yrkesrelatert astma

Det finnes mer enn 300 stoffer som er kjent for å forårsake yrkesrelatert astma, inkludert støv, mel, kjemikalier brukt i produksjon, maling, rengjøringsmidler, metaller og lim. Yrker med en høyere risiko enn vanlig er blant annet gårdbrukere, sprøytelakkerere, rengjørere, bakere, laboratoriearbeidere, elektrikere, frisører, helsearbeidere og personer som arbeider med loddetinn.

Hvordan unngå yrkesrelatert astma

Den eneste effektive måten å unngå yrkesrelatert astma på, er å unngå den utløsende faktoren. Arbeidsgivere har plikt til å vurdere og kontrollere utløsende faktorer på arbeidsplassen. Hvis du tror de kan gjøre mer, kontakt din leder eller HMS-representant for råd.

Rettigheter for personer med yrkesastma er hjemlet i folketrygdlovens kapittel 13 og i lov om yrkesskadeforsikring.

Yrkesforverret astma

Dette er når noen som allerede har en diagnostisert astma, fra tid til annen opplever at sykdommen forverres fordi de blir utsatt for visse utløsende faktorer på arbeidet.  Det kan blant annet skyldes støv, sigarettrøyk, stress, parfyme, kjemikaler eller rengjøringsmidler.

Å velge karriere

Med få unntak er det ingen grunn til at du ikke skal være i stand til å ta den jobben du ønsker. Det er likevel fornuftig å vurdere mulige risikoer når du tenker på ny jobb. Hvis du lurer på noe i valg av karriere, snakk med legen din.

In English

Asthma in the workplace

Asthma can be triggered by substances inhaled into the lungs work. There are two main types of asthma in the workplace, occupational asthma and asthma yrkesforverret.

Occupational asthma

Occupational asthma is defined as asthma caused by special factors in the work environment. The response to a trigger can occur almost immediately, it may take months or even years before it develops. Many people with occupational asthma had asthma before. This is a common cause of asthma in adults of working age, and should always be considered. Occupational asthma is important to recognize, because if the trigger is removed in time, asthma symptoms may disappear. If exposure continues, you worsen asthma.

Recognizing occupational asthma

The symptoms are the same as for regular asthma, but you may have occupational asthma if you feel that your symptoms
• start within a year or two after starting a new job, got a new job, or have moved to another place in the workplace
• starts after working with new drugs or procedures
• improve the weekends or when you have been away from work, such as during holidays

If you suspect that you have occupational asthma, talk to your doctor as soon as possible.

Substances that cause occupational asthma

There are more than 300 substances known to cause occupational asthma, including dust, flour, chemicals used in production, paints, detergents, metals and adhesives. Occupations with a higher risk than usual, including farmers, sprøytelakkerere, cleaners, bakers, laboratory workers, electricians, hairdressers, health workers and people working with solder.

How to prevent occupational asthma

The only effective way to prevent occupational asthma is to prevent the triggering factor. Employers have a duty to assess and control the causative factors in the workplace. If you think they could do more, contact your supervisor or safety representative for advice.

Rights of persons with occupational asthma are warranted to the National Insurance Act, Chapter 13 and the Law on Health Insurance.

Asthma worsen by your profession

This is when someone already has a diagnosed asthma, from time to time find that it worsens because they are exposed to certain trigger factors at work. It may be due to dust, cigarette smoke, stress, perfumes, chemicals or detergents.

Choosing a career

With few exceptions, there is no reason why you should not be able to take the job you want. Nevertheless, it is prudent to consider the potential risks when you think of a new job. If you have any questions in the choice of career, talk to your doctor.

Kilde / Source: myasthma.com


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Occupational asthma – how to?

(Scroll down for English)

Arbeidsrelatert astma

“Hensikt og omfang

  • Hensikten med veiledningen er å beskrive utredningen av mulig arbeidsrelatert astma, primært til bruk i de arbeidsmedisinsk sykehusavdelingene.
    • Arbeidsmedisinere utenfor slik avdeling kan basert på egen kompetanse, foreta deler av utredningen der dette synes hensiktsmessig.

Forekomst

  • Arbeidsrelatert astma representerer et vesentlig helseproblem i befolkningen og antas å være ansvarlig for 5-15 % av nyoppståtte tilfeller av astma hos voksne1.
  • De arbeidsmedisinske avdelingene i Norge utreder pr 2011 ca 250 saker årlig med spørsmål om arbeidsrelatert astma.
  • Arbeidstilsynets statistikk, som er basert på melding fra leger, har etter år 2000 vist i underkant av 100 tilfeller årlig. I perioden 1995- 99 var tallet det dobbelte. Med stor sannsynlighet er det en underrapportering av tilfellene da kun et fåtall av legene benytter seg av meldesystemet.

Inndeling av arbeidsrelatert astma

  • Arbeidsrelatert astma omfatter tilfeller som enten er forårsaket av (’arbeidsindusert (yrkesbetinget) astma’) eller
  • Forverres av eksponering i arbeidet (’arbeidsforverret astma’)
  • Ved alle tilfeller av nyoppstått astma er det viktig å avgjøre om eksponering i arbeidet har forårsaket sykdommen og spesielt om det er utviklet sensibilisering (’allergisk yrkesbetinget astma’) mot allergener eller lavmolekylære stoffer som forekommer i pasientens arbeidsmiljø
  • Irritanter kan forårsake astma ved kjemiske ulykker, såkalte ’reactive airways dysfunction syndrome’ (RADS). Og trolig også ved påvirkning i lavere nivå over tid, såkalt ’lavdose irritantindusert astma’2.

Utsatte yrkesgrupper

  • Det er hittil identifisert over 475 ulike agens som kan fremkalle arbeidsindusert astma gjennom sensibilisering3.
  • Eksempler på sensibiliserende agens som kan fremkalle arbeidsindusert astma:
Planter Yrke Referanse
Kornstøv (hvete, rug etc.)

Støv fra tørkede pulveriserte næringsmidler

Bomull, flax, hamp

KaffebønnestøvTobakksstøv

Trestøv (eksotiske trearter)

Bakere, møllearbeidere

Næringsmiddelindustri

Tekstilarbeidere

Kaffearbeidere

Tobakksarbeidere

Møbelsnekkere, treindustriarbeidere

45678
Dyr
Laboratoriedyr (rotter, mus etc.)

Fugl

Katt, hund etc.

Skalldyr (krabbe, reke etc.)Laks

Insektstøv

Midd

Dyrelaboratoriearbeidere

Fjærkreoppdrettere

Dyreforhandlere

Fiskeindustriarbeidere

Fiskeindustriarbeidere

Birøktere m.m.

Hønsefarmarbeidere

910111213
Enzymer og legemidler
EnzymerPenicillin, Cimetidin Produksjon av vaskemidler, Bakere

Legemiddelindustri, helsearbeidere

14151617
Lavmolekylære kjemiske forbindelser
DiisocyanaterSyre anhydrider Epoxy resiner

Varmespaltningsprodukter av plast (syre anhydrider m.m.)Kolofonium og andre flussmidler

Persulfater, oksidative hårfargemidler

Skumplastarbeidere

Bil- og flylakkerere

Bilopprettere, malere m.m.

Kjemisk industri

Plastarbeidere

Elektrikere, elektronikkarbeidere

Frisører

181920212223
Metaller og metallsalter
Nikkel

Krom

Kobolt

Vanadium

Metallarbeidere, sveisere

Gassturbinrensere

24252627
Andre
’Hallastma’(fluorforbindelser, støv)

Dyreavl, endotoksiner, soppsporer

Smelteverksarbeidere

Gårdbrukere

2829

Utredning av arbeidsrelatert astma

Arbeidsanamnese

  • Kronologisk registrering av alle arbeidsforhold med angivelse av bedrift og yrkestittel
  • Beskrive arbeidsprosesser, eksponeringer og verneforhold med spesiell vekt på eksponering for biologisk støv/partikler og kjemiske allergener/ haptener.
  • Om nødvendig skaffe tilveie ytterligere informasjon om eksponering
    • Informasjon fra bedriftshelsetjeneste
    • Historiske data om eksponering i aktuelle bransje
    • Yrkeshygieniske målinger og vurderinger
    • Bedriftsbesøk

Miljøanamnese

  • Beskrivelse av dyrehold, teppegulv, fuktskader og andre forhold i bolig
  • Annen fritidseksponering

Sykdommer i familien

  • Familiær forekomst av allergier og lungesykdom

Allergier

  • Pollenallergi, andre allergier

Tidligere sykdommer

  • Astma, atopi eller eksem som barn
  • Lungesykdommer og andre sykdommer
  • Eventuelt skaffe tilveie kopi av primærjournal fra bedriftslege, allmennlege og spesialist

Utredning av den aktuelle lidelsen

Har pasienten astma?

  • Sykehistorie og kliniske funn
  • Spirometri med reversibilitetstest
  • PEF-registrering i arbeid og fritid
    • Prøveperioden bør være i minimum 4 uker med 4 målinger pr døgn. Slike målinger bør fortrinnsvis gjøres med elektronisk PEF-måler som lagrer måleverdi og måletidspunkt30
  • Måling av bronkial reaktivitet: Metakolintest
  • Inflammometri
    • Ekshalert NO
    • Indusert sputum
    • ECP (eosinofilt kationisk protein)

Har pasienten arbeidsrelatert obstruksjon?

  • Beskrive symptomene og deres relasjon til eksponeringer og friperioder
    • Nye prosesser eller stoffer (umiddelbart) før symptomdebut
    • Eksponering for irritanter og sensibiliserende substanser
    • Obs senreaksjon (for eksempel nattlig hoste)
    • Bedring i friperioder mer sensitivt enn forverring i arbeidet

Skyldes pasientens astma en spesifikk sensibilisering mot et allergen eller et kjemisk stoff i pasientens arbeidsmiljø?

  • Prikktest
    • Kommersielle ekstrakter
    • Egenproduserte ekstrakter
  • In-vitro diagnose
    • Spesifikk IgE på relevante yrkesallergener
    • Histaminfrigjøringstest
  • Provokasjon og elimineringsforsøk
    • Ved hjelp av sykemelding eller friperioder
    • Spesifikk provokasjon

Medikamenter/stimulantia

  • Medisinering
  • Kartlegging av røykevaner og livsdose tobakk

Oppfølging

  • Personer med allergisk astma bør fjernes fra utløsende eksponering så fort det er praktisk mulig. Det finnes klare holdepunkter for at jo verre sykdommen er ved diagnosetidspunktet og jo lengre tid det tar før vedkommende fjernes fra eksponeringen, jo større er sannsynligheten for varige astmatiske plager
  • For personer med ikke-allergisk astma kan en forsøke yrkeshygienisk sanering av arbeidsmiljøet med samtidig tett oppfølging og vurdering av om tiltakene er tilstrekkelige til å reversere sykdomsutviklingen
  • Etter opphør av eksponering
    • Gradvis bedring av lungefunksjonen over 2 år eller mer2
    • Symptomfrihet oppnås hos 32 %2
    • Persisterende bronkial hyperreaktivitet hos 73 % 2
  • Melding til Arbeidstilsynet (skjema 154b), NAV og/eller arbeidsgiver ved mistanke om yrkesskade eller yrkessykdom

Informasjon til den ansatte

  • Informasjon om hvilke allergener, evt. kjemiske eller fysiske irritanter som mest sannsynlig er årsak til plagene og må saneres fra arbeidsplass og privat
  • Tobakksrøyking kan være et fortsatt problem begge steder
  • Kombinasjon av arbeidseksponering og allergi utløst privat (katt, hund, støvmidd, muggsopp) må vurderes

Kildereferanser

  1. Toren K, Blanc PD. Asthma caused by occupational exposures is common – a systematic analysis of the  population-attributable fraction. BMC Pulm Med 2009;9:7 PubMed
  2. Tarlo SM, Balmes J, Balkisson R, et al. Diagnosis and management of work-related asthma: American College of Chets Physicians Consensus Statement. Chest 2008;134:1-41 PubMed
  3. Malo JL, Chan-Yeung M. Agents causing occupational asthma with key references.I: Bernstein IL, Chan-Yeung M, Malo JL et al. Asthma in the workplace. 3. utg. New York. NY: Taylor and Francis, 2006: 825-867 http://www.asthme.csst.qc.ca/document/Info_Me…
  4. Storaas T, Steinsvåg SK, Florvaag E, Irgens A, Aasen TB Occupational rhinitis: diagnostic criteria, relation to lower airway symptoms and IgE sensitization in bakery workersActa Otolaryngol. 2005;125:1211-1217
  5. Salvaggio JE, O’Neil CE, Butcher BT. Immunologic responses to inhaled cotton dust. Environ Health Perspect.1986;66:17-23. PubMed
  6. Larese F, Fiorito A, Casasola F, et al. Sensitization to green coffee beans and work-related allergic symptoms in coffee workers. Am J Ind Med 1998;34:623-627. PubMed
  7. Viegi G. Respiratory effects of occupational exposure to tobacco dust. Br J Ind Med 1986;43:802-808 PubMed
  8. Goldsmith DF, Shy CM. Respiratory health effects from occupational exposure to wood dusts. Scand J Work Environ Health 1988;14:1-15 PubMed
  9. Bush RK, Wood RA, Eggleston PA. Laboratory animal allergy. Allergy Clin Immunol. 1998;102:99-112 PubMed
  10. Hargreave FE, Pepys J. Allergy respiratory reaction in bird fancier provoked by allergen inhallation tests. J Allergy Clin Immunol 1972;50:157-173 PubMed
  11. Cartier A, Malo J-L, Forest F et al. Occupational asthma in snow crab processing workers. J Allergy Clin Immunol 1984;74:261-269 PubMed
  12. Douglas JDM, McSharry C et al. Occupational asthma caused by automated salmon processing. Lancet 1995;346:737-740 PubMed
  13. Lutsky I, Teichtahl H, Bar-Sela S. Occupational asthma due to poultry mites J Allergy Clin Immunol 1984;73:56-60 PubMed
  14. Flindt MLH. Pulmonary disease due to inhalation of derivates of Bacillus Subtilis containing enzyme. Lancet 1969;1:1407-1408 PubMed
  15. Baur X, Fruhman G, Haug B et al. Role of aspergillus amylase in bakers’ asthma. Lancet 1986;1,43
  16. Davies RJ, Hendrick DJ, Pepys J. Sthma due to inhaled chemical agents – ampicillin, benzyl penicillin, 6 amino penicillanic acid and related substances Clin Allergy 1974;4:227-247
  17. Coutts II, Losewicz S, Dalley MV et al. Respiratory symptoms in a factory manufacturing cimetidine tablets. Br J Ind Med 1984;228:14-18 PubMed
  18. Gandevia B Respiratory symptoms and ventilatory capacity in men exposed to isocyanate vapour. Australias Ann 1964;13:157-166 PubMed
  19. Pepys J, Pickering CAC, Breslin ABX et al. Asthma due to inhaled chemical agents – tolouene diisocyanate Clin Allergy 1972;2:189-196
  20. Fawcett IW, Newmann Taylor AJ, Pepys J. Asthma due to inhaled chemical agents-epoxy resin systems containing phtalate anhydride, trimellic anhydride and trietylene tetramine. Clin Allergy 1977;7:1-14 PubMed
  21. Pauli G, Bessot BC, Kopfersmitt MC, et al. Meat wrappers asthma: Identification of causal agent. Clin Allergy 1980;10:263-9 PubMed
  22. Fawcett IW, Newmann Taylor AJ, Pepys J. Asthma due to inhaled chemical agents, fumes from ’Multicore’ soldering flux and colophony resin. Clin Allergy 1976;6:577-585 PubMed
  23. Moscato, G, Galdi E. Asthma and hairdressers. Curr Opin Allergy Clin Immunol. 2006;6:91-95 PubMed
  24. Malo JL, Cartier A, Doepner M et al. Occupational asthma caused by nickel sulphate. J Allergy Clin Immunol 1982;69:55-59 PubMed
  25. Novey JS, Habib M, Wells ID. Asthma and IgE antibodies induced by chromium and nickel salts. J Allergy Clin Immunol 1983;72:407-411 PubMed
  26. Davison AG, Haslam PL, Corrin B et al. Interstitial lung disease and asthma in hard metal workers; brochoalveolar lavage, ultrastucture, and analytic findings and results of bronchial provocation tests. Thorax    1983;38:119-128. PubMed
  27. Browne RC. Vanadium poisoning from gas turbines. Br J Ind Med 1955;12:55-59 PubMed
  28. Kongerud J, Boe J, Søyseth V et al. Aluminium potroom asthma: the Norwegian experience. Eur Resp J 1994;7:165-172 PubMed
  29. Eduard W, Douwes J, Omenaas E, Heederik D. Do farming exposures cause or prevent asthma? Results from a study of adult Norwegian farmers. Thorax. 2004;59(5):381-6 PubMed
  30. Malo JL, Trudeau C, Ghezzo H, l’Archeveque J, Cartier A. Do subjects investigated for occupational asthma through serial peak exspiratory flow measurements falsify their results? J Allergy Clin Immunol 1995;96:601-7 PubMed

Fagmedarbeidere

  • Norsk Arbeidsmedisinsk Forening – Kvalitetsutvalget for Arbeidsmedisinske Veiledninger
  • Karl Færden, overlege, Oslo universitetssykehus, Ullevål, Miljø og yrkesmedisin
  • Tor B Aasen, spesialist i lungemedisin, avdelingsdirektør, Yrkesmedisinsk avdeling, Haukeland universitetssykehus

Datoer

  • Sist endret: 02.11.2011″

Kilde: Informasjonen her er hentet fra Arbeidsmedisinsk Forening

In English

Work-related / Occupational asthma

“Purpose and scope

■ The purpose of this guidance is to describe the study of possible work-related asthma, primarily for use in the occupational medicine hospital departments.

■ Physicians working outside such department can based on their expertise, make parts of the report where this seems appropriate.

Occurrence

■ Work-related asthma represents a significant public health problem in the population and is believed to be responsible for 5-15% of new-onset cases of asthma in voksne1.
■ The occupational medicine departments in Norway studying at 2011 about 250 cases annually with questions about work-related asthma.
■ stats Labour Inspectorate, which is based on the message from doctors, has since 2000 shown in nearly 100 cases annually. In the period 1995 to 1999 the number was doubled. With high probability there is an under-reporting of cases when only a handful of doctors uses reporting system.

The division of work-related asthma

■ Work-related asthma includes cases that are either caused by (‘work-(occupational) asthma’) or
■ aggravated by exposure at work (‘arbeidsforverret asthma’)
■ In all cases the onset of asthma it is important to determine whether occupational exposure has caused disease, and especially if they are developed sensitization (‘allergic occupational asthma’) against allergens or low molecular weight substances present in the patient’s work
■ Irritants can cause asthma in chemical accidents, so-called ‘reactive airways dysfunction syndrome’ (rads). And probably also by the influence of lower level over time, so-called ‘low-dose irritantindused astma’2.

Exposed occupational groups

■ So far identified over 475 different agents that can induce asthma through work-sensibilisering3.
■ Examples of sensitizing agent which can cause work-asthma:

Plants Profession / Occupation Reference
Dust Grains (wheat, rye, etc.)Dust from dried powdered foodstuffs

Cotton, flax, hemp

Coffee bean Dust

Tobacco dust

Wood dust (exotic tree species)

Baker, mill workers

FoodTextile Workers

Coffee Workers

Tobacco Workers

Cabinetmaker, timber workers

45678
Animals
Laboratory animals (rats, mice, etc.)

Bird

Cats, dogs etc.

Shellfish (crab, shrimp, etc.)

Salmon

Insect Dust

Mites

Animal Laboratory Workers

Poultry Breeders

Pet Retailers

Fish Manufacturing workers

Beekeepers and more

Chickens Farm Workers

910111213
Enzymes and drugs
Enzymes

Penicillin, Cimetidine

Production of detergents,

Baker

Pharmaceutical and health workers

14151617
Low molecular compounds
Diisocyanates

Acid anhydrides

Epoxy resins

Varmespaltningsprodukter (heat cleaving products) plastic (acid anhydrides mm)Rosin and other fluxes

Persulfate, oxidative hair dye products

Workers Foam

spray painters,

Panel beater,

painters etc.

Chemical Industry

Plastic Workers

Electricians, electrical workers

Hairdressers

181920212223
Metals and metal salts
Nickel

Chrome

Cobalt

Vanadium

Metal workers,  welders

Gas turbine cleaners

24252627
Other
‘Asthma’ (fluorine compounds, dust)Animal farming, endotoxin, fungal spores Smelters Workers

Farmers

2829

Investigation of work-related asthma

Arbeidsanamnese

■ Chronological record of all employment with an indication of the company and job title
■ Describe the work processes, exposures and protective factors, with special emphasis on exposure to organic dust / particulates and chemical allergens / haptens.
■ If necessary, obtain further information on exposure ■ Information from occupational
■ Historical data on exposure to current industry
■ Occupational Exposure measurements and assessments
■ Business Office

Emvironment

■ Description of husbandry, carpet flooring, moisture damage and other conditions in the housing
■ Other recreational exposure

Diseases of the family

■ Familial occurrence of allergies and lung disease

Allergies

■ Pollen allergy, other allergies

Earlier diseases

■ Asthma, atopy or eczema as a child
■ Pulmonary and other diseases
■ Alternatively, obtain a copy of the primary journal of company doctor, general practitioner and specialist

Study of the current disorder

Does the patient have asthma?
■ History and clinical findings
■ Spirometry with reversibility
■ PEC registration at work and play ■ The trial period should be a minimum of 4 weeks of 4 measurements per day. Such measurements should preferably be made with electronic PEF meter stores measuring and måletidspunkt30

■ Measurement of bronchial reactivity: Metakolintest
■ ■ Inflammometri exhaled NO
■ Induced sputum
■ ECP (Eosinophilic cationic protein)

Does the patient work-related obstruction?
■ Describe the symptoms and their relationship to exposures and free periods ■ New processes or substances (immediately) before the onset of symptoms
■ Exposure to irritants and sensitizing substances
■ Note senreaksjon (such as nocturnal cough)
■ Improvement in free periods more sensitive than deterioration in work

Due to the patient’s asthma a specific sensitization to an allergen or a chemical substance in the patient’s work environment?
■ ■ Sales Prick Test Extracts
■ Self-produced extracts

■ In-vitro diagnostics ■ Specific IgE to relevant occupational allergens
■ Histamine Release Test

■ Provocation and elimination trials ■ Using sick leave or leave periods
■ Specific provocation

Drugs / stimulants

■ Medication
■ Survey of smoking habits and life-dose tobacco

Follow-up

■ Persons with allergic asthma should be removed from the exposure as soon as practicable. There is clear evidence that the worse the disease is at diagnosis and the longer it takes before being removed from the exposure, the greater the likelihood of lasting Asthma
■ For people with non-allergic asthma, an attempt occupational redevelopment of the work environment with simultaneous close monitoring and assessment of whether the measures are sufficient to reverse the disease
■ After cessation of exposure ■ Gradual improvement in lung function over 2 years or mer2
■ Symptom Freedom achieved in 32% 2
■ Persistent bronchial hyperreactivity in 73% 2

■ Message to the Labour Inspection (Form 154b), NAV and / or employer suspected injury or occupational disease

Information to the employee

■ Information about the allergens, or chemical or physical irritants that are most likely to cause problems and must be decontaminated from the workplace and private
■ Tobacco smoking may be a continuing problem both places
■ Combination of work exposure and allergy triggered private (cat, dog, dust mites, molds) are considered

Source References

1.Toren K, Blanc PD. Asthma caused by occupational Exposures is common – a systematic analysis of the population-attributable fraction. BMC Pulm Med 2009; 9:7 PubMed
2.Tarlo SM, Balmes J Balkisson R, et al. Diagnosis and management of work-related asthma: American College of Physicians Consensus Statement Chet. Chest 2008; 134:1-41 PubMed
3.Malo JL, Chan-Yeung M. Agents Causing occupational asthma with key references.I: Bernstein IL, Chan-Yeung M, Malo JL et al. Asthma in the workplace. 3. Ed. New York. NY: Taylor and Francis, 2006: 825-867 http://www.asthme.csst.qc.ca/document/Info_Me
4.Storaas T, Steinsvåg SK, FLORVÅG E, Irgens A, Aasen TB Occupational rhinitis: diagnostic criteria, relation to lower airway symptoms and IgE sensitization in bakery workers Acta Otolaryngol. 2005, 125:1211-1217
5.Salvaggio JE, O’Neil CE, Butcher BT. Immunologic responses two inhaled cotton dust. Environ Health Perspect.1986; 66:17-23. PubMed
6.Larese F, Fiorito A, Casasola F, et al. Sensitization to green coffee beans and work-related allergic Symptoms in coffee workers. Am J Ind Med 1998; 34:623-627. PubMed
7.Viegi G. Respiratory effects of occupational exposure two tobacco dust. Br J Ind Med 1986; 43:802-808 PubMed
8.Goldsmith DF, Shy CM. Respiratory health effects from occupational exposure two wood dusts. Scand J Work Environ Health 1988; 14:1-15 PubMed
9.Bush RC, Wood RA, Eggleston PA. Laboratory animal allergy. Allergy Clin Immunol. 1998, 102:99-112 PubMed
10.Hargreave FE, Pepys J. Allergy respiratory reaction in bird fancier provoked by allergen inhallation tests. J Allergy Clin Immunol 1972; 50:157-173 PubMed
11.Cartier A, Malo J-L, Forest F et al. Occupational asthma in snow crab processing workers. J Allergy Clin Immunol 1984; 74:261-269 PubMed
12.Douglas JDM, McSharry C et al. Occupational asthma caused by automated salmon processing. Lancet 1995; 346:737-740 PubMed
13.Lutsky I, Teichtahl H, Bar-Sela S. Occupational asthma due two poultry mites J Allergy Clin Immunol 1984; 73:56-60 PubMed
14.Flindt MLH. Pulmonary disease due two inhalation of derivates of Bacillus subtilis containing enzyme. Lancet 1969; 1:1407-1408 PubMed
15.Baur X, Fruhman G, B Haug et al. Role of Aspergillus amylase in bakers’ asthma. Lancet 1986; 1.43
16.Davies RJ, Hendrick DJ, Pepys J. Sthma due two inhaled chemical agents – ampicillin, benzyl penicillin, 6 amino penicillanic acid and related substances Clin Allergy 1974; 4:227-247
17.Coutts II Losewicz S, Dalley MV et al. Respiratory Symptoms in a factory manufacturing cimetidine tablets. Br J Ind Med 1984; 228:14-18 PubMed
18.Gandevia B Respiratory Symptoms and ventilatory capacity in exposed but two isocyanate vapor. Australia’s Ann 1964; 13:157-166 PubMed
19.Pepys J, Pickering CAC, Breslin ABX et al. Asthma Due to inhaled chemical agents – Tolou diisocyanate Clin Allergy 1972; 2:189-196
20.Fawcett IW, Newman Taylor AJ, Pepys J. Asthma due two inhaled chemical agents-epoxy resin systems containing phtalate anhydride, trimellic anhydride and triethylene tetra mine. Clin Allergy 1977; 7:1-14 PubMed
21.Pauli G Bessota BC, Kopfersmitt MC, et al. Meat wrappers asthma: Identification of causal agent. Clin Allergy 1980; 10:263-9 PubMed
22.Fawcett IW, Newman Taylor AJ, Pepys J. Asthma due two inhaled chemical agents, fumes from ‘Multicore’ soldering flux and colophony resin. Clin Allergy 1976; 6:577-585 PubMed
23.Moscato, G, Galdi E. Asthma and hairdressers. Curr Opin Allergy Clin Immunol. 2006: 6:91-95 PubMed
24.Malo JL, Cartier A, Doepner M et al. Occupational asthma caused by nickel sulphate. J Allergy Clin Immunol 1982; 69:55-59 PubMed
25.Novey JS, Habib M, Wells ID. Asthma and IgE antibodies induced by chromium and nickel salts. J Allergy Clin Immunol 1983; 72:407-411 PubMed
26.Davison AG, Haslam PL, Corrin B, et al. Interstitial lung disease and asthma in hard metal workers; brochoalveolar lavage, ultrastucture, and analytic Findings and results of bronchial provocation tests. Thorax 1983; 38:119-128. PubMed
27.Browne RC. Vanadium poisoning from gas turbines. Br J Ind Med 1955; 12:55-59 PubMed
28.Kongerud J, Boe J Søyseth V et al. Aluminium potroom asthma: the Norwegian experience. Eur Resp J 1994; 7:165-172 PubMed
29.Eduard W, Douwes J, Omenås E, Heederik D. Do farming Exposures or contraceptives cause asthma? Results from a study of adult Norwegian farmers. Thorax. 2004, 59 (5) :381-6 PubMed
30.Malo JL, Trudeau C, Ghezzo H, l’Archeveque J, Cartier A. Do subjects investigated for occupational asthma through serial peak flow measurements exspiratory falsify their results? J Allergy Clin Immunol 1995; 96:601-7 PubMed

Qualified staff

■ Working Norwegian Medical Association – Committee on Quality of Work Medical Guidelines
■ Karl Færden, consultant, Oslo University Hospital, Environmental and occupational medicine
■ Gate B Aasen, a specialist in pulmonary medicine, director, Occupational Medicine, Haukeland University Hospital

Dates

■ Last Modified: 02/11/2011 ”

Source: The information here is taken from the Occupational Medicine Society


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“The Spoon Theory” on Asthma

Today I read a blog that made a big impression on me. The Spoon Theory was so cleaver written. It is about a girl who got something called Lupus. This theory of hers is actually applicable to asthma too. One have to change the point a bit but it nicely explains the strains living with asthma.

Everyone has heard about asthma but if you have never experienced it yourself you are not likely to understand what it is like to live with it, and friends need to understand what it is like to be fully able to be considerate enough to brighten your day.

The Spoon Theory on Asthma

What does it feel like? What is it like being sick? Not physically but in other ways in the ordinary life.

You get a bunch of spoons in your hand. Those are your health this day.

“I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted. Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case my illness, being in control.”

This is very applicable to asthma. For a person with Lupus you lose energy for every little thing you do. If we translate this to asthma every little thing you get exposed to that make your asthma react will take a way one spoon from your daily health.

“She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become? I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of “spoons”. But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting.”

One spoon is one part of your health, the possibility to breathe. What takes away the spoons when you have asthma is the allergens and irritants you get exposed to through the day. You start your morning with taking your medicine and you go off to meet the rest of the world. In my case I am an all year asthmatic. What does this mean? Is there any half-year asthmatic? No not really, but some having asthma got seasonal problems like with pollen. I and others have asthma to things that is all year.

Chemicals you meet all year everywhere. They are hard to avoid since you find them on people using them for beauty treatment, smelling nicely, washing and cleaning a.s.o.

If I am lucky I start my day with a hundred spoons, like in 100% ok this day, but very often I wake up with a goose nesting in my lungs and it needs to be cleared out with inhalation medicine and pills. In such days I start with about 70-80 spoons.

I leave for work, or other duties, fun and pleasures, and meet hundreds of allergens and irritants a day. For every allergen and irritant I get exposed to I lose a spoon.  I loose breathing ability. And note that the allergens and irritants are on most people using fragrance, fragrance products, smoking, and also when cleaning and washing clothes and buildings a.s.o. It is everywhere, also in the everyday air cause of fragrance, exhaust, scented candles, air-fresheners, road dust, and much more in addition to all what people wear and use. And at party’s and holiday’s there are even more of it since people tend to bathe in it, to in their minds make themselves more attractive. What they actually do is make themselves unattractive to people like me.

So without taking medicines I lose a spoon every time I get exposed to any of this. And every time I lose a spoon I get breathing problems. If I continue loosing my spoons the breathing continuously get worse throughout the day.

To help the situation I take medicine to get better throughout the day. This can give me a spoon back for a while, but only until I get exposed to allergens and irritants the next time, then it starts over again. If exposure to allergens and irritants get too much to handle then hopefully I can manage it myself by using medicine I have gotten from the pulmonary clinic at the hospital. If not I get a massive asthma attack and need to go to the hospital for help. I always need to save spoons so I do not run out of them, so I can avoid a big asthma attack. However medicine has its limits. It is only allowed to take so much of it before one get side-effects from it, and those side-effects are scary and take away a spoon too. When overusing Ventoline your heart starts ticking really hard and very fast, it is pounding and racing, and you can not take any more of the medicine. Then you start loosing spoons fast.

“I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon.”

Most people do what ever they want without even have to think of doing or not doing it? Or even am I able to do that?

For a person with asthma one has to avoid what make one sick. This actually mean you have to avoid places and situations known to you to make your asthma break out. This can be going to a public toilet because there are air-fresheners and perfumed soap installed, or pass an entrance since people are smoking in front of the door, a smoker breathing on you, a smoker kissing you, avoid go to a restaurant because of burning incense or scented candles and perfumed people there, avoid taking the bus or train since many people are perfumed, get sick from visiting the doctor’s office because the medical personnel is using fragrance products, having to deny sitting with friends in a car or letting friends sit in your car because of fragrance and smoke, avoid places where perfumed products are used, shops, planes a.s.o.

“I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s “spoons”, but just think how hard tomorrow will be with less “spoons”. I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be … dangerous. So you do not want to run low on “spoons”, because you never know when you truly will need them.”

Yes, you can deny you got asthma and try to go everywhere anyway. Maybe you manage for a while if you medicate very hard, but the truth is that it will cost you. It will make you end up sick, and all the exposure pile up and build up an asthma attack as time goes. Even not eating three meals a day and sleeping well make one lose a spoon.

“We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, …  She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.”

On a bad day I might have to avoid cooking because of fumes, avoid some people since I know that their homes hold chemicals and stuff I get sick from, I might have to avoid meeting people I know smoke or use perfume and scented products, I might have to avoid going places in all and stay home to restore myself. All to be able to end the day with as many spoons as possible.

“She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse than others; some days I have more spoons than most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared.””

Yes, just like this it is like having asthma too. Asthma force you to make changes in your life. One need to think before acting, just doing is something that is in the past. To be able to keep all the spoons to stay healthy one have to think through the actions coming. If I do this do I get sick? If I do that will that make me ill? I have to avoid that! a.s.o.

“Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. … I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, … before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count “spoons”.”

If one do not think it through one has to pay for the denial by getting ill with breathing problems and in worst case a big asthma attack with severe breathing troubles.

Take away one spoon from a person with asthma and you give one breathing problem.

Weather, this days condition, allergens, irritants, is the obstacles in the daily life. Most people got the obstacles on them, or got them in their homes, they are at work, they are at the mall, shops, food stores, public transportations, in the city, by the doors, in public toilets, restaurants, cars and places in form of air fresheners and ash trays, outdoors in form of people smoking a.s.o.

Like the girl who wrote The Spoon Theory, I do not look sick. You can not see on the outside that I got a handicap, asthma, so therefore the best thing you can do for me and others in the same situation is to avoid using fragrance products at all and stop smoking. This will help us stay more healthy so we also can live like you do without having to think of what we can do, at least a bit more.

Asthma makes you only do stuff asthma allows you to do, and avoid what you can not.

Medicines for asthma help keeping the symptoms in check, but it will not cure it. This is important to understand. It is no wonder treatment. The true wonder treatment is to not be exposed to allergens and irritants. Give a spoon and enable to keep a spoon.

Annelie

Source of quotes: The Spoon Theory written by Christine Miserandino.


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Plumbing and asthma – by Annelie Molin

(Scroll down for English)

Jeg forklarte for en jeg kjenner idag hvordan det fungerer med astma og allergi, og jeg fant ut at forklaringa var så enkel og genial at jeg velger å skrive den her også (men tilpasset for å fjerne personlige informasjon og detaljer om min venn).

Generelt hva gjelder astma så er vel svaret at “mange bekker små”… Det betyr att hyppig liten påvirkning gjør sjuk i lengda. Jeg merker av når jeg har vært hyppig utsatt for små doser. Det funker jo slik at når man bruker noe av det en med astma blir sjuk av, da gasser det av litt til en del og det puster man inn. En som har astma reagerer på stoffer helt ned til 0,02 ppm. Det er derfor jeg har vært nødt å fjerne alt slik hjemme hos meg og kun bruke Neutral som er merket som er godkjent av Astma og Allergiforbundet.

Derfor kan jeg på generelt grunnlag si at det

  • beste er om man røyker ute. Aller best er om du slutter å røyke.
  • at man kun bruker produkter som er godkjent for astma og allergi av Astma og Allergiforbundet. Mange produsenter kan hevde på pakken at det er allergivennlig, men kun det som er godkjent av Astma og Allergiforbundet er å stole på. Bruker du slike produkter da har du et astma og allergivennlig hjem for deg selv, dine kjære, og dine venner.

Fakta om astma er at det fungerer slik som med avløpsrør. De stoffene man er kjenslig for, om man blir eksponert litt og ofte, da blir det som med avløpsrør som blir tette. Og da man er blitt påvirket lenge så tetter røra. Og det løsner ikke før man fjerner det som gjør en dårlig. Medisin er bra, men det gjør en ikke frisk. Det letter bare problemen for stunden. Det eneste som egentlig hjelper er luft uten stoffene man blir dårlig av. Enkleste måten å si det på.

In English

I explained today for someone I know how it works with asthma and allergies, and I found that the explanation was so simple and brilliant that I will write it here too (some customed to remove personal information and details about my friend.)

In general terms asthma is explained that “every little bit counts” .. It does all frequent small impact does ill in the long run. I for example notice when I have been frequently exposed to small doses. It just works so that when you use any of it with allergens the asthmatic person get sick from, such gases evaporates  and it is inhaled. One who has asthma respond to substances down to 0.02 ppm. That is why I have been forced to remove everything of such chems, so in my home and only use Neutral marked approved by the Asthma and Allergy Association.

Therefore I can say in general terms that

■ it is best if you smoke outside. And very best if you quit smoking all together.
■ that you should only use products that are approved for asthma and allergy sufferers of the Asthma and Allergy Association. Many manufacturers claim on the package that it is hypoallergenic, but only that which is approved by the Asthma and Allergy Association is really trustworthy. Are you using these products then you have an asthma and allergy friendly home for yourself, your loved ones and your friends.

Facts about asthma is that it works just like the drain pipe. The material we are sensitive to, if you get a little and often, then it will be like with pipes that are clogged. And when people have been affected so long the piping clogg. And it does not come off until you remove what makes asthma breakout and give symptomes. Medicine is good, but it does not heal the person. It eases the problems for moment. The only thing that really helps is air free of material we who got asthma get sick from. Easiest way to put it.


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The backside of asthma and allergies – by Annelie Molin

Imagine you got asthma. Put yourself in the position of the asthmatic, and do this while you read this..

You got asthma. What does that mean to you? When you breathe in things that are bad for you, your immune system tells the lungs that this stuff is really bad for you, and your lungs react to the impulse and your bronchi in the lungs get filled with mucus and the muscles around the bronchi spasm and narrows the airways even more so that you get hard to breathe.

This is your position and it follows you wherever you go in life. How much you would even want to get rid of the problem this brings you, you can never really be free of it.

You are asthmatic and this is your life.

Very many things can make you sick. Some depends on what your immunesystem reacts on. You either react against one thing or several (most common is to react against several), but one thing that is sure is that if you keep the stuff around you get sick from,  then your health decline. Your declining health about asthma means that the more you are subjected to what makes  you sick, the more asthma problems you get. You use the problem solver you got, your asthma medicine, the inhalations that is your life saviour. If you are able to avoid the allergens and irritants you will not get as sick.

At home you clear out all that make you sick to have a good life, to not have to medicate so much and not have to get sick all the time.

The doctor told you to take your medicines, and you do, but you also know that it is best to stay clear of all that make you sick, since it is the only way to not become unnecessarily ill. Even so, you kan not stop using your medicines, and you know this. You can not stop because if you do you would let the chronic inflammation flare free with heavy difficulty breathing as a result.

At home you got your free haven, you managed to clear it for as many allergens and irritants as possible. The air is clear for all the stuff that you get sick from, and you are constantly aware of not bringing any “bad stuff” into your home. All to not provoke your illness.

Taking your medicines and having the free space, your home free for allergens and irritants, you can manage the illness rather good. Most days are good, even though not all.

Your biggest problem is the rest of the world. The problem is the use of others of stuff you get ill from, and they do not know  you get ill from it, and they put themselves and their preferred wants and likes first. And in this world you must join if you are not going to lock yourself inside your home and live your life alone.

Those people believe that by using all the stuff you get ill from they are more pleasing to other people, that others find them more attractive and sociable. It starts every day already in the morning. In the many thousands of homes they get up in the morning and take the daily shower  (that is good) but they wash themselves in perfume, the perfumed body and hair hygiene products, dry themselves with the perfume washed towel, remove hair with perfumed products, smear their face with perfumed products, add deodorant that is perfumed,  to avoid dry skin they smear perfumed lotion on them, and style their hair with perfumed products, spray hair spray, and many also add cosmetics that are filled with perfume (mostly women) and then add newly washed clothes washed in perfumed products, to their wardrobe and it is their choise to dress in. Rather many also add the final spray of perfume or after shave. Ah, they think to themselves each time, I smell so nicely. : ) Then they go out in the world to meet with other people in believes that it will be appreciated by all that they smell nice as they feel it.

Then they meet you in town, and they stand beside you, there where you are and where you need to go. They do not know you got asthma, and in their minds they are in their full right to smell and spread the smell to others. It is only nice they think – smiling over the thought…

But you stand there, maybe in the que in the grocery store, and need your food like anyone else. The persons in front of you and behind  you smell of all the perfumed products that they added this morning, you feel the scent in the air. In your mind you recognize that is yes smell nice, but in the same second you know this is not good for you. And in the same second as you think that you feel a raspy sensation in your lungs, and you know that this is the start of an any level asthma attack. You start to cough, first mildly, people around you look at you in pity believing you got a cold, but you have not a cold, you got something worse. Then you start coughing more and more and you cough up mucus coming from your lungs. It is there, but you are indoors and where to spit?  Start looking for paper in your pockets.  You continue coughing and your lungs work to get air. While they do that you breathe in more of the scent around you, and you get even more subjected to what you get ill from and cough even more. It becomes a bad circle and you start to get heavy breathing. Already you have started to take your medicine to get through the situation. To manage to stand there in line to be able to pay for the food you need. It lightens up a bit thanks to the medicine, but the perfume continues to hit your lungs while you breathe, and you must take more inhalations of medicines to manage to stay there. The que goes slowly. You have to breathe, it is a natural thing, everyone does, and for every breath you breathe in more of the perfume, and get affected by the asthma time by time as time pass. You take even more medicine to help the situation. People take no notice of you. It is so common to see people using inhalator that no one notice. You stand there and wish that they could stop using that awful perfume… even though it smell nice. Lines moves slowly. You get more sick and you take more medicine. Finally it is your turn. You address the cashier, and feel the smell of perfume from her too and hairspray. F…k you think to yourself. And you feel the lungs again and medicate even more. You stand there and get stressed and wish your were out of there for long time ago. – Why do the woman work so slow? – I want out of here NOW!  you think to yourself. Finally all is paid for. Finally I can get out of here! You pack the bags while you feel the scent of the person beside you packing their bags, soon you will be free of it! Walking out of the store. Soon fresh air outdoors : )) *Your happy thoughts..* You pass by the perfume and beauty shop, and the smell of all the products is spread in the air, and you go to the other side of the entrence hall to get so far away from it as possible to avoid more scents. … There is the door. : )) Outside stands several people, and you wonder if they are only talking or if they are smoking? The last thing you need right now is smoke down your longs too. You medicate even more to press down the fury in your lungs. When you get closer to the doors you see the glow from the cigarettes, people stand there talking and seem to have a good time, but you get stressed by the smoke and wish they could go somewhere else, you have to pass to get out.. You pass, and as everyone else you have to breathe, and you therefore breathe in the smoke. It takes 1-5 seconds before your lungs that are already sensitive because of the perfume before, closes up and you get heavy breathing. You stress to get pass them at the same time as you are medicating even more. After a 100 meter walking in fresh air you feel your lungs calm down a bit. Finally out of there. But your lungs are not all well yet, so you take more medicine to get better. And then you feel it. Your heart rate are getting higher and you get shaky hands. The side effects of the medicine strike you and you get that on top of a tight chest.

You think to yourself that – If they only knew, maybe then they would stop using all that stuff? Now you only need to get home and find your peace at home, and wait until the storm blows over.

Take more medicine, eat some healthy food, look at some movie, read some emails.

What would  you think if all this really was you?

Next time you need to fill you cabinet, please go for the 100% perfume free producs in bless that you do not cause pain on anyone else.

What is Asthma? Read more..

Thank you.


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The book – Environmental inhibition (Norwegian) – By prof. Kjell Aas

Now the book The Environmental inhibition is released in pdf format. The book is written by professor Kjell Aas and tell in a light digest manner information about environmental inhibition. Book in Norwegian.

Click link to read the book:
http://www.inneklima.com/pdf/miljohemming_2011.pdf


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When other people make you sick – By Annelie Molin

I blog here to inform. I hope you my reader have use of the information I give. Not too many know what asthma REALLY  is, and what those allergic,  asthmatic and sensitive people can get sick from. My hope is that if you do not know as much about asthma, that after reading my blog you are a bit better informed and care about what you use in the future.

When other people make you sick

That is a way of saying that most people take for a person who behave in a way that make the other person say “you make me sick”, the term of disgust, but this is not about that. This is about when other people makes people physically sick. Now how is that possible?

Very many persons in the world are allergic, asthmatic and sensitive against different things that others are using. To make another person sick you do not have to physically touch the person. And it is not about the mentally making someone ill either.

Lets just take a look at the daily life of just anyone.

It is socially accepted and normal amongst very many to use for example tobacco and perfume daily. They actually feel it is their human right to do so, and no one is allowed to tell them otherwise. Very many use perfume to indulge themselves, and to make them look nice to others, or even attract others. But for some people this use is a hazard to their health and possibly to their very life. And what happens when those people meet in the same room and must co-exist?

Perfume got the effect on an allergic, asthmatic and sensitive person that is repellent and off-putting. It does not have the effect that the user want. I can take an example here.

Yesterday I met a lady in the grocery shop who often travels with my bus. She is very nice and I was glad to see her. It was also an unexpected meeting since she does not live in the area. She started talking and we had a nice conversation. But in the instant I came 2,5 meters from her I could feel the stank of her perfume in far, and it was so VERY STRONG. Even if I stood 2,5 meters away it was like putting my nose right in her bottle. There were a cloud of perfume around her that reached 3 meters away. I came 1,5 meter away from her that is the normal distance to keep when socializing here, and I got ill. I felt my lungs tighten and felt it was coming that I would soon be unable to breathe. Since I got asthma I can not be around and too near people having perfume on them. I get so really sick from perfume. And I am not alone in the world to have this problem. Even if she is a nice lady to chat with, I really wanted to leave because I got ill from her use.

Another time I was exposed to perfume was in May 2011 and the evening came and I got a phone call. A friend asked if I would like to go to the restaurant? I got very glad and said Yes! I’ll pick you up in half an hour. : ) I parked outside and waited for him. When he entered the car I smiled at him and said hello, and in the same second I had an asthma attack. He forgot I have asthma and had sprayed aftershave all over him. The aftershave was so strong, the fragrance filled the whole car. I had to open all the windows same time as I was coughing badly trying to get air, and take my medicine. Did not help. The perfume stank spread in all of my car. It was cold outside and we drove with the windows open. My friend froze but I could not close the windows, because if I did I would get even more, really, really sick. I can not sit in a car with all that perfume, and it was a 15 minutes drive to the restaurant. I had to have the windows open. Only other option would have been to let him out of the car and let him walk home. At the restaurant I was sick all evening. He stank all a cross the table. I tried to medicate, it helped a bit but it never really ended. It was even possible to hear it on my talking. My breathing made my voice sound strange and raspy. After a while I needed to visit the ladies room. Took my Symbicort Turbuhaler medicine and needed to rinse my mouth. I got in to the ladies room and a wall of perfume in form of washing agents and air-freshener met me. I just took medicine and needed to rinse my mouth, and now I again got breathing problems because of the air-freshener. From the ashes in to the fire. Rinsed my mouth and then quick out again. Still sick.

It happens that I enter a store to go shopping. Such happened for example this summer. I needed new batteries for my hearing aid and entered the local farmacy to buy some, but they were sold out and I had to go to the Clock and Juwelery store to buy it. I entered the store and the lady in the store stank of perfume and I got sick. I bought my batteries, that costed about 40 NOK more than at the farmacy (robbery if you ask me) and on top of it I got sick from the staff’s perfume use. I will never enter that store again. I can not have getting sick from going shopping. There they lost a costumer. I would rather drive far to a shop that is scent free, than go shopping there.

And then you got the smoking that is a hot topic for many. Very many smokers feel they are herrassed by the anti-smokers, and then again there are us who get sick from the smoke.

An example of this is:
We stroll around. It is a sunny day and my friend suggest a coffee or a beer in the sun. Ok, I say, and think to myself that this is nice. At the same time I get worried over smokers. I look around to see if there is any clear table, a table without smokers sitting around it. Ah! There is one! We sit and order our drinks, and talks. Half way through the beer and the coffee the person(s) at the table next to me lights a cigarette. Wind drives the smoke in my direction. I feel the asthma strike my health again, just as many other times. We sit outside, the smoker is allowed to smoke there, still I get sick. It gets bad, and I have to leave.

A stroll on the docks along the canal. Some smokers walk in front of me. I have to sick- sack to avoid their fumes, still it hits my lungs. I get sick again and get breathing problems. Silently I suggest to my friend to take another road in hope of there are no smokers. We go there. It is ok for a while, so comes that smoke again. I go around it to avoid it. Worst is when they go on all sides of me. Where to escape then?

We want to enter the mall, or pass the doors to the waiting hall at the buss/train station or airport. They are either going in the mall or they are taking a bus, train, or flight. It is not allowed to smoke inside the mall and waiting hall so people stand in front of the entrance for the “last smoke”, smoking them up. The smoke is thick in front of the doors. I get scared and worried thinking I must pass that. If I want or need to get in there I have to pass it. I go through it and it takes a second or two for the smoke to hit my lungs, and then it takes a few seconds again before I feel my lungs protest and tighten, and I get trouble breathing. Sometimes i try to hold my breath to avoid the smoke because if I do not I will get sick. If there are to many standing there in front of the door I maybe can not hold my breath long enough. Then I get sick again.

Now of course this is only a few examples of what happends. I have experienced many more, and lots of people could tell you other times they got ill from others use.

You can read more and also personal true stories here:
https://anneliemolin.wordpress.com/category/health-and-wellness/true-stories/

If you want to know how many people have asthma, you need to prepare yourself for the answer! It is such a large number that you would be surprised! It has been estimated that more than twenty million people in America suffers from asthma, and Norway in the year 2011 have a total of about 4.920.400 inhabitants, out of those are approximately 1.230.100 persons with allergies, asthma and other sensitivities, and about 639.600 of those got asthma. That is roughly 7 % of the population of the US and 13 % of the Norwegian population. A report (WHO 2006) also showed that as many as 300 million people worldwide suffers from this condition. It has been estimated that by the year 2025, there will be at least one 400 million people who suffers from asthma.

I addition to those 80 million people with diagnosed moderate to severe COPD, and millions of others with mild COPD, allergic rhinitis, and other chronic respiratory diseases, which are often undiagnosed. And chronic respiratory diseases caused over 4 million deaths in 2005, including over 3 million deaths from COPD and 255,000 deaths from asthma.

Remember that you can make many people sick, but also remember that you have the power to prevent that. If you stop using fragranced products and quit smoking you help many thousands of people who get sick from the use.

Thank you

/Annelie

You can also read:
https://anneliemolin.wordpress.com/2011/05/27/an-ordinary-day-with-asthma/
https://anneliemolin.wordpress.com/2011/06/21/the-environmental-impairments/

Sources and read more: World Health Organization (WHO) http://www.who.int/respiratory/gard/events/GARD_Fact_Sheet.pdf, and professor Kjell Aas http://www.astmainfo.no/502686/?itemId=846543


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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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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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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