Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

Asthma is an interesting disease characterized by respiratory difficulty - not in taking a breath, but in breathing air out. In an acute asthmatic attack, one may have difficulty breathing air in because of the thick secretions in the bronchiole, the tubes leading to the air sacs of the lungs. Asthma then must be treated from the standpoint of both the acute attack and the interval between attacks. Every effort must be made to live daily in strict accordance with the laws of health. Avoiding inciting environmental factors, skipping out of certain exercises, and practicing special breathing techniques can all be used to prevent the acute attack.

Diet and an ideal lifestyle can be helpful in relieving chronic bronchitis that often accompanies asthma. Infection, allergies, smoking, air pollution, strong odors, cold air, strong emotions, and over-exertion are all causes of asthma. Often there is a strong hereditary component. Fear and anxiety perpetuate or aggravate the condition, especially once an acute attack begins.

About 90% of asthmatics are mouth breathers, increasing the likelihood that dust and pollutants from the air and germs in the mouth and pharynx will be taken into the lungs, and that cold air and particles that could cause allergies can reach the lungs.

Infant formula with cow's milk has also been implicated as a major cause of infantile asthma. General anesthesia in infancy, especially during the first two years of life, has been reported as a factor in the production of asthma, hay fever, and other allergic respiratory diseases.

‍TREATMENT ROUTINE

Sleep on the abdomen to encourage drainage of the lungs and to encourage keeping the mouth closed while sleeping. Many asthmatic cases get tremendous help from sleeping outdoors, or on an open porch. Sleeping indoors with the doors and windows open can be of some help, but the results aren't as good as sleeping outdoors.

Good posture is essential, as proper positioning of the lungs can encourage drainage and healthy bronchi. The ideal position is having both feet flat on the floor or propped on a low stool, shoulders flat against the back of the chair. Practice breathing deeply from the diaphragm. When speaking, contract the diaphragm actively as the strain falls on the diaphragm and not on the speech organs.

A daily brush massage using a very stiff bristle brush can be helpful as stimulation both to the adrenals and to the general circulation. Begin at the fingertips and brush to the shoulders with long strokes. Cover every inch of the skin, always brushing toward the heart. Massage for 3 minutes. After the massage, have a cool or lukewarm shower, ending with a 30 seconds cold spray to the midback, just below the shoulder blades. This is designed to stimulate the adrenals and may be used for this purpose during the acute attack.

Not 1 in 1000 asthmatics understands how to clothe the extremities, as he should. Two or more layers of clothes should be worn on the arms and legs any time the temperature is below 65°. If the temperature is below 50°, then three or more layers of clothes can be worn. Feet should be kept warm and dry, even in warm weather. Ears and neck should be kept warm during cold weather. At night, special care should be given to prevent chilling the shoulders and upper arms, which can cause chilled blood to be returned to the lungs.

Avoid dust, cats, dogs, feathered pillows and upholstery, fumes, and the odor of all chemicals except natural odors of trees and outdoors. Avoid dusty rugs and draperies and even rotting leaves. Molds and fungi should especially be avoided as they are potent allergens. Rooms and closets should be scrubbed down, dried thoroughly, and aired out. Generally speaking, if it has an odor, it should be avoided. This includes cosmetics, perfumes, cleaning compounds, etc. Use plastic covers on pillows and mattresses. Air the bedrooms day and night, no matter what season it may be. Avoid drafts as they chill the skin but keep the bedrooms well ventilated.

Avoid overeating. The ciliated lining cells of the bronchial passages and the large white blood cells that form a part of the fence mechanism of the respiratory tree are inactivated by overeating, especially a rich meal. Eat only breakfast and dinner. For the asthmatic, a pure vegetarian diet is best, as animal products are more likely to stimulate allergies. Overeating can be defined as: a) eating too much food; b) eating too many times per day; c) eating too many varieties at a meal; d) eating concentrated foods which have a high calorie yield for a small amount of food.

Learn to recognize foods which cause a flare-up of asthma. Melons and bananas, for example, may need to be omitted, as the incidence of sensitivity to these fruits is high among asthma patients. Oranges, tomatoes, or wheat can cause problems. For all asthma patients it is best to avoid all foods of animal origin, cheese especially. Sugar, oil, and other fats reduce the ability of white blood cells in the lungs to protect from infection.

Drink plenty of water to keep bronchial secretions loose and easily expelled by the lungs. The amount of water needed can be judged by the color of the urine. Keep it pale! At the beginning of any attack, begin "sleep-breathing," which is a slow, deep breath with a three second pause at the height of both inspiration and expiration. Chamomile tea is reported to also have some anti-allergic and anti-bacterial action.