Illustration: Flickr/Creative Commons, Alanna Rose Whitney.

Chris Haromy has lived with asthma since childhood. He is also a registered respiratory therapist and certified respiratory educator with The Lung Association – Ontario. “I’ve learned to stay on top of my asthma, constantly monitoring my health, taking all of my medication as prescribed, and living a healthy lifestyle.” When he’s not in the office, he is often out jogging or playing soccer.

Haromy has spent the last 21 years or more developing and providing patient education programs for children and adults to help them manage the vagaries of life with asthma, including the swelling and inflammation in the lining of airways (sometimes leading to extra mucus), the coughing attacks, and the muscle contractions that narrow the airways – all of which make breathing difficult.

In this country, 12.2 percent of children have the chronic disease, but it’s not limited to young people. About 6.3 percent of adults live with it, too – many of whom were diagnosed after age 50, according to data from the Ontario Ministry of Health and Long-Term Care.

“it’s a big adjustment for someone to be diagnosed with asthma as an adult.”

“Of course, it’s a big adjustment for someone to be diagnosed with asthma as an adult,” says Haromy. “But there’s a lot they can do to ensure they continue living a full, active life. But the reality is, half of the people who have asthma don’t manage it well. So many people with asthma seem resigned to ‘just putting up with it.’”

He addressed some of the most common questions about late-onset asthma for YouAreUnltd:

What is late-onset (adult) asthma?
When a person older than 20 is diagnosed with asthma it’s called adult-onset asthma – or late onset asthma. About 50 percent of adults who have late-onset asthma also have allergies, but adult-onset asthma may also be the result of irritants (chemicals, molds, etc.) in the workplace or home, in which case the asthma symptoms can come on suddenly.

What are the common signs and symptoms of late-onset asthma?
Some of the common symptoms include: feeling short of breath, frequent coughing, especially at night, wheezing, difficulty breathing, tightness in the chest, increased mucus in the airways, congestion and delayed recovery from a cold or flu.

Is there a cure for asthma?
“There is no cure, but there’s a lot individuals can do well with the support of their healthcare team,” says Haromy. “Our goals are to help you live an active, normal life; ensure you attend work everyday; perform regular life activities without difficulty, prevent chronic symptoms that hinder your daily life; minimize or stop urgent visits to the emergency room, hospital to to your doctor; and to use and adjust medications with minimal side effects.”

Being exposed to cigarette smoke increases the risk of asthma. Photo: Flickr/Creative Commons, Philip Bitnar.

Are some people at a higher risk for developing adult-onset asthma?
Known risk factors for asthma include:

  • occupational exposures (fumes, dusts, etc. at one’s workplace)
  • rhinitis (nasal congestion)
  • women are more likely to develop asthma than men
  • obesity
  • smoking

Can my job or workplace cause late-onset asthma?
“Yes, up to 20 percent of new adult onset diagnosis are due to occupational factors such as exposure to chemicals in the workplace, pollution, allergens from animals, wood, dust, chemical-based treatments used in hairdressing salons, exposure to fumes, sawdust, etc.” explains Haromy.

The Lung Association web site maintains a directory of occupational health resources for specific professions, such as forestry, mining, healthcare, education and manufacturing.

What medications are available?
Specific medications can vary depending on one’s severity of asthma and their symptoms, explains Haromy.

There are two main types of asthma medications. Anti-inflammatories, such as inhaled steroids, reduce swelling and mucus production in the airways, and are typically taken daily. The benefits? Better airflow, less sensitive airways, less airway damage and fewer asthma episodes.

Bronchodilators are medications that help relax muscle bands that tighten around the airways, and thus open the airways lets more air in and out of the lungs.

Some asthma medicines can be inhaled. Photo: Flickr/Creative Commons, Stuart B.

Asthma medications can be taken by inhaling (using a metered dose inhaler, dry powder inhaler or asthma nebulizer), by swallowing oral medications (pills or liquids) or by injection. “It’s always imperative to monitor how asthma medications react with other drugs an individual is taking for other conditions,” says Haromy.

“The biggest downfall for people living with asthma is compliancy – failure (sometimes resistance) to take all medications as prescribed,” says Haromy. “People occasionally stop taking medication once they begin to feel a bit better – but it’s vital to continue taking the medication for it to be fully effective. Others forget – and others simply resist. In some cases, they’re frightened by the word ‘steroids.’”

What lifestyle changes can I make to alleviate my symptoms?
“There are many variables that people can manage and control themselves,” says Haromy. Among them:

  • reduce the risk of infections by getting the annual flu shot
  • minimize exposure to dust, molds, pollens and, if necessary, pets
  • consider getting rid of carpeting
  • avoid exposure to second-hand smoke
  • don’t smoke
  • reduce the use of household and workplace products that releases odours and gasses (such as air fresheners, scented candles, hair sprays)
  • avoid eating late at night as GERD (acid reflux) can trigger asthmatic reactions
  • maintain a healthy weight
Exercise for those with asthmatics is recommended. If it’s problematic, better management strategies can be used. Photo: Flickr/Creative Commons, Mike Baird.

What about exercise?
“If exercise triggers asthma symptoms, it’s likely your asthma is not well-controlled,” said Haromy. “Speak to your doctor and see what changes to medications can help you exercise without experiencing symptoms.”

I’ve heard about the Asthma Action Plan. How can it help me?

The Asthma Action Plan helps people self-manage their asthma. It’s a plan that specifically outlines what medications to take on a daily basis when feeling well – and which medications and actions (such as a hospital visit) are necessary, if symptoms worsen.

“The purpose of the Asthma Action Plan,” said Haromy, “is to enable people with asthma to live a full, active life with minimal disruption.”

 

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Doug O'Neill
O’Neill, formerly Executive Editor of Canadian Living, writes on all manner of topics for a variety of Canadian publications – but has a preference for storytelling that gets to the heart of things. “Writing about journeys has always fascinated me,'” says contributor Doug O’Neill, “whether I’m scribbling about my own travels around the world or about other people’s inspiring journeys as they navigate from one life stage to another.”