Asthma
Asthma
Of the 13 million Americans who have asthma, 1.5 million of them are 65 or older. Asthma in the over-60 set doesn’t pose any more health dangers than it does for the rest of the population. In fact, when asthma is controlled with medication and lifestyle changes, people of any age should be able to lead full and active lives.
But the risk that asthma poses to older folks is that it can mimic and complicate other serious health problems. The symptoms of asthma—wheezing, coughing, shortness of breath, and chest tightness—are similar to symptoms of emphysema, bronchitis, and even heart disease, which may also cause breathing problems.
Without tests, it may be difficult for the doctor to diagnose asthma in people over 60. One tip-off is that the symptoms occur after someone is exposed to a trigger, says Henry Gong Jr., M.D., professor of medicine in the division of pulmonary and critical-care medicine environmental health service at the University of Southern California School of Medicine in Downey. A trigger is something that irritates the airways, causing them to get inflamed and swell, which narrows the air passages.
Try This First
Know your enemy. Strong odors and exposure to chemicals tend to cause more problems for older people with asthma. Whatever aggravates your asthma, stay away from it, says Karin Pacheco, M.D., physician in the division of occupational and environmental medicine at the National Jewish Center for Immunology and Respiratory Medicine in Denver. Although every person may have a different set of triggers, some common potential problems include cold air, tobacco and wood smoke, perfume, paint, hairspray, room deodorizers, cleaning chemicals, and talcum powder.
Other Wise Ways
Follow pollution reports. For older people with asthma, pollution is more likely to trigger an episode, explains Dr. Pacheco. Many television and radio stations now track pollution and air quality. Use these reports and then plan your day accordingly.
If the pollution is high, stay indoors and keep the air conditioner on (weather permitting), says Dr. Pacheco. You may not get asthma symptoms on the very day that pollution is high, she warns. Pollutants can take two to three days to trigger an asthma attack.
Roam the produce aisle. Eat at least five servings of fruits and vegetables a day. Have one or two servings with each meal, and you’ll reach five easily. Fruits and vegetables are loaded with antioxidants including vitamins C and E, chemicals that may protect your lungs from an asthma attack, says Gary E. Hatch, Ph.D., researcher and pharmacologist in the U.S. Environmental Protection Agency Pulmonary Toxicology Branch in Research Triangle Park, North Carolina.
Seek supplements for extra protection. To be sure you keep those antioxidant levels up, take 500 milligrams of vitamin C and 400 international units (IU) of vitamin E a day, Dr. Hatch says. These supplements may be especially beneficial as you get older, especially if you have asthma, according to Dr. Hatch. Researchers at the University of Washington in Seattle found that taking 500 milligrams of C and 400 IU of vitamin E helped people with asthma breathe easier when exposed to pollutants. Although vitamin E is generally sold in doses of 400 IU, one small study showed a possible risk of stroke in dosages higher than 200 IU. Consult with your doctor if you are at high risk for stroke.
Deactivate the acid. When stomach acid backs up into the esophagus in a process called acid reflux, it causes heartburn. It may also cause an asthma attack. The esophagus contains nerves that connect to your lungs and airways. Researchers think that those nerves may send signals that unleash an asthma attack when the reflux triggers the symptoms. “If you take care of acid reflux, asthma gets better,” Dr. Gong says. To keep acid reflux to a minimum, follow these simple tips.
• Eat smaller but more frequent meals throughout the day.
• Don’t eat heavy late-night snacks before bed.
• Put bricks underneath the bed legs near your head so you lie at a 45-degree angle while sleeping. Lying flat causes acid to work its way back into your esophagus.
• Ask your doctor about over-the-counter acid-suppressing drugs such as famotidine (Pepcid AC) and ranitidine (Zantac).
Dust out dust mites. Among older people, allergies caused by dust mites aren’t a common problem, yet they can still trigger asthma in some cases, Dr. Gong says. These barely microscopic bugs thrive on dust and humidity. To keep their numbers down, follow these basic tips.
• Clean often with a damp mop or cloth.
• Wash your bedding in water that is at least 130°F.
• Encase pillows and mattresses in airtight covers that keep dust mites out.
• Use window shades or blinds instead of curtains.
While you’ll never be able to completely get rid of the dust mites, these practices can help keep them under control and may rescue you from an attack of asthma.
| Managing Your Meds Many medications can help treat asthma. The key approach to treatment of persistent asthma is the use of anti-inflammatory agents, especially cortico steroids. These include triamcinolone (Azmacort) and beclomethasone (Vanceril), drugs that prevent the asthma attack and the airways from closing up. But these medications have many possible side effects, says Michael S. Stulbarg, M.D., professor of clinical medicine and director of the clinical pulmonary center at the University of California, San Francisco. For some people, the medications may speed up the onset of osteoporosis—bone loss—and also glaucoma. Two other classifications are leukotriene antagonists such as zafirlukast (Accolate), and mast cell inhibitors such as cromolyn (Intal). These medications do not have significant side effects and may be used over the long term to manage asthma. But they are not useful to stop an asthma attack. Another group of medicines are inhaled bronchodilators such as albuterol (Proventil) and salmeterol (Serevent), which are used during an asthma attack to open the airways by relaxing the bronchial muscles. Some people may experience nervousness or trembling with these medications. Other kinds of medications can actually make asthma worse. Talk to your doctor before taking the following: • Aspirin • Blood pressure medications known as beta-blockers, such as propranolol (Inderal) • Beta-blocker eyedrops such as betaxolol (Betoptic) and carteolol (Ocupress) that are used to treat glaucoma |
Vacuum into the light. When trying to figure out what triggered his own asthma, Dr. Hatch suspected that his old vacuum cleaner might be a culprit. So he turned his vacuum cleaner upside down under a strong light in a dark room and hit the power switch. Clouds of dust and irritants spewed out. “Under the light, you can see all of the dust blowing out into the air,” he says.
Try this light test with your own vacuum. If you see dust spurting out, change the bag. If that doesn’t help, it may be time to invest in another vacuum cleaner. Look for one that has anti-allergenic features like special bags or a HEPA filter, says Dr. Hatch.
