Is there any cure for asthma? What are the medicines? Describe a life style for asthma patients.

There is not really a "cure" for asthma, though some children seem to grow out of it. For the rest of us, asthma can be managed quite effectively with a variety of medicines that have been developed in the last 30 years or so.

Asthma is a chronic inflammation of the bronchial tract and airways. Asthmatics have strong reactions to allergens like dust mites, cat dander and mold for starters, but the list can be anything and everything. An asthmatics airways are always inflamed or about to be inflamed. When they are inflamed they swell and thus shrink the airway, making it hard to get air in or out. This is disconcerting to both the asthmatic and perhaps more so to his or her parents, who get rattled when they see their child gasping for breath.

The severity of a persons asthma dictates what medicines need to be used. Some people who live in neat houses without dust and pets may have no regular signs of asthma or difficulty breathing, they may find the occasional use of a short acting inhaler, a bronchodilator like albuterol, is all they need.

In years past people with severe asthma had little for long term airway management except oral prednisone, which is still used for breaking severe asthmatic spells in high doses and occasionally used for longer term management, but the side effects were and still are, horrible, in that it would stunt the growth of some children if used early in life and cause weight gain and bone density issues in adults, it also gave me cataracts at the age of 17. These might be a reasonable trade off for survival, but.....they can be hard on the patient.

The major breakthroughs in controlling asthma were the developement of inhaled corticosteriods. The first of these, beclomethasone, was available in the early 70's in England and Canada and available later in the US. Now there are a variety of meds available, Flovent, Pulmicort, Vanceril, are but a few. These inhaled medicines will not stop an asthma attack, but taken regularly they may stop asthma attacks from occurring. They must be taken regularly to have a positive effect, and that can be hard for many children and parents to understand, because when taken regularly, the symptoms of asthma may be so thoroughly managed as to cause the patient and parents to feel like they are no longer ill. If the regular use of the inhaled steroid is discontinued, the airways become much more exciteable and an asthma attack again becomes likely. The medicines to treat asthma today have improved so much in the last 30 years that once diagnosed and prescribed, the biggest challenge is having the patient remember to take them. This is not a joke, children and parents too sometimes have troubledealing with an "invisible" illness that crops up only when you stop taking the meds.

In addition to the long term inhaler, there are meds for the incipient asthmatic attack, the bronchodilator albuterol being the most common, it gives you almost instant relief but it may only last for an hour or so, and there is Seravent which is a longer acting bronchodilator, several hours or more, but is not advised as usefull for thwarting an incipient attack.

How well can these medicines work? As a child I would average two or three hospitalizations per year, of a week or two duration, because a cold would turn into bronchitis or pneumonia, and I would eventually be too sick to be cared for at home. In the mid 60's I was put on oral prednisone, which somewhat stabilized me, but it eventually stunted my growth and I was always fighting weight gain and unable to participate in sports.

In my late teens I was able to begin the use of beclomethasone which we managed to procure in England. At the age of 18, I grew my final 6 inches to my now towering 5'4". but more importantly over the following years my health improved to a point that I was able to run a firewood business and I was a volunteer firefighter for 5 years as well.

Although I would have liked to be the 6' 2" I am told I was meant to be (and my brother is) I have enjoyed a rich life by following most of my Doctors advice and taking care of myself. I have not been hospitalized for an asthmatic based problem in over 30 years, I have had the opportunity to travel and sail from Boston to Cumana, Venezuela and enjoy a career in construction which I could not conceive of as a child.

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