Asthma Health Article

Personalities with asthma

The symptoms of asthma have been observed and recorded in the medical literature since the time of Hippocrates, a famous doctor living in ancient Grecian times. The National Library of Medicine-Breath of Life Exhibit identifies many well known personalities who had a medical history of asthma. Despite their illness, they pursued their chosen professions with great vigor and energy. The prolific American musician, Leonard Bernstein, who composed West Side Story as well as many other celebrated scores, struggled with asthma throughout his life. Another classical composer from a much earlier era, Ludwig von Beethoven, wrote some of history's most memorable music while coping with chronic asthma and without the benefit of modern medical treatment. Robert Joffrey, founder of the avant-garde Joffrey Ballet, pursued an active dancing career in spite of his asthma. Contemporary individuals with asthma include the folk singer Judy Collins, track and field champion Jackie Joyner-Kersee, and professional basketball star Dennis Rodman.

John Kennedy, 35th president of the United States, developed asthma from allergies to dogs, horses, and other animals. Some of his predecessors, including Theodore Roosevelt, Woodrow Wilson, and Calvin Coolidge, also had asthma.

Signs and symptoms

The symptoms experienced by patients with asthma are caused by "hyper responsiveness"—an overly sensitive response—of the body's immune system to environmental or behavioral factors, such as allergies and exercise. Asthma patients are encouraged to learn to recognize their own special pattern of early warning signs that signal the start of an asthma episode. Asthma symptoms can be quite variable and are usually reversible. It is possible to classify individual cases of asthma as mild, moderate, or severe. Classification is based on the severity and frequency at which symptoms are experienced. The typical characteristics of each category are:

Mild persistent asthma

Children who experience symptoms of wheezing, coughing, or breathing difficulty less than once a day but more than twice a week.

Moderate asthma

Patients who experience asthma symptoms each day and require daily medication. Symptoms may persist for many days and may interfere with normal physical activity.

Severe asthma

Patients with severe asthma have ongoing, persistent symptoms of this disease. Severe attacks are rare, but much more serious, and can be life threatening.

Asthma episodes can vary from mild to severe attacks. The first signs of a mild or moderate attack could be a slight tightening of the chest, coughing, and spitting up of mucus. The patient may start wheezing as a result of trying to inhale and exhale through constricted air passageways.

Severe attacks can bring on a feeling of extreme tightening of the neck and chest, making breathing increasingly difficult. Patients may struggle to speak or breathe. In advanced stages of severe attacks, lips and fingernails may take on a grayish or bluish tinge indicating declining oxygen levels in the blood. Such attacks can be fatal in the absence of prompt medical attention.

Diagnosis

Medical diagnosis for asthma involves a complete physical checkup. One of the most important tests is the measurement of pulmonary (lung) function—the volume of air a patient can inhale (breathe in) and exhale (breathe out). Peak flow meters and spirometers are devices that are used to measure breathing efficiency and lung capacity.

The patient's history can also provide critical clues that can confirm a diagnosis of asthma and can help to identify the factors that contributed to the development of the disease. Doctors need to know about any patterns in the occurrence of symptoms (such as seasonal variations), when asthma symptoms first appeared, any connection between symptoms and exposure to possible allergens, any disturbances in sleep patterns, and the nature of previous illnesses. Other diagnostic tests may include x rays to eliminate other possible causes of airway obstruction (blockage) and allergy tests. Various blood tests may also be performed.

Early clues that indicate a patient may have asthma include difficulty in breathing, restlessness or persistent coughing while sleeping, general feeling of tiredness and lack of energy, a persistent stuffy nose, and frequent sneezing. Other signs are coughing or wheezing during or after physical activity and frequent colds that often involve chest congestion. Asthmatic patients are also more likely to develop other respiratory diseases such as pneumonia.

Asthma triggers

Asthmatic patients are surrounded by an environmental minefield. Many indoor and outdoor factors can trigger or initiate typical symptoms of asthma, including allergies, viral respiratory infections, weather changes, and exercise. Medications containing aspirin also act as an asthma trigger in about 10–20% of adult asthmatic patients. Allergens, such as inhaled dust particles and plant pollen, are substances that can stimulate an allergic response.