Open Airways marking World Asthma Day at Victoria Park last year (File photograph by Akil Simmons)

Conditions are ripe at this time of year for asthma flare-ups, but prevention techniques can help to keep episodes at bay, the education director of a respiratory care charity said.

Lindsay Bishop, of Open Airways, added that triggers are “not a big issue” if people affected by the condition have the appropriate education and treatment options.

The registered nurse explained: “We always notice an increase in symptoms of asthma and allergies at this time of year.

“Along with prolonged rain and increasing heat and humidity, triggers also include dust mites, exercise, air pollution, smoke, chemicals, such as paints, perfume and cleaning products, year-round.

“In addition to pollen counts, cockroaches, mould, mildew, construction work and other things, this time of year in Bermuda is ideal for asthma to flare up.”

Ms Bishop said that “fixable” reasons for episodes included patients not using preventer-type inhalers daily because they have had no problems for some time.

She added: “It then takes about a week for these to work well.

“The preventers treat the swelling and excessive mucus found in asthma airways.

“This anti-inflammatory is vital to prevent asthma exacerbations or flare-ups.”

Ms Bishop said: “Any person with asthma who is over 12 years old should not use Ventolin, a reliever inhaler, as their only medication.

“This is very out-of-date treatment.

“It has been shown repeatedly in massive studies that this inhaler, when used on its own without a daily preventer, causes an increase in sensitivity in the airways, increased hospital admissions, ER visits and deaths.

“Patients love to use this inhaler as it immediately relaxes tight muscles around the airway, providing instant relief. But it does nothing for the swelling and mucus, therefore it helps but does not treat and so the cycle repeats again where cough, tightness and breathing issues occur when in contact with a trigger.

“Using just Ventolin and without a spacer device is the main cause of exacerbations, hospital visits, admissions and deaths.”

She said that anyone aged over 12 who has only a blue pump for asthma treatment could speak to their doctor or Open Airways about switching to another regime.

Ms Bishop said: “Everyone over four years old with asthma should use an adult spacer device with push-down, spray-type inhalers. Many do not.

“The mask types deliver far less medication to the lungs, and adults often think spacers are just for kids.

“Without the correct spacer, most medication does not reach the lungs.

“Open Airways will provide these free of charge for those who cannot afford them.”

She added: “Everyone with asthma should have an action plan.

“This provides leeway to increase and decrease inhaler use as environmental and health issues arise.

“Best practice for everyone with asthma over 12 years old, according to most medical organisations, is a Smart inhaler.

“This combines both preventers and relievers in one device.

“It is available as a powder Turbohaler or as a familiar spray device.

“Most of our GPs are up to date in asthma treatment and are now prescribing these very often.

“This change has seen huge improvement in quality of life for many.”

Ms Bishop said: “Second-line treatment would be to use a preventer, such as Becotide or Flixotide, together with Ventolin as a combination reliever when asthma symptoms occur.

“In the past, we would advise children ‘orange by your toothbrush for morning and night and blue for school’.

“This is now considered third-line treatment, but if this works well for you, it is fine to stick with it.”

Asthma patient queries impact of wildfire smoke

An intermittent asthma sufferer spoke to her doctor about the possibility that she was affected by drifting smoke from wildfires in Canada.

The woman said her condition recently flared up, despite not having an episode for over a year.

It was confirmed earlier this month that smoke from wildfires raging in Canada and choking parts of the northeast United States was reaching the island.

Last week a map from the US National Oceanic and Atmospheric Administration showed an offshoot of smoke — designated “light” — extending over the Atlantic, including Bermuda.

The 38-year-old woman said yesterday: “I was diagnosed with asthma in my 20s after several incidents where I found myself struggling to breathe and could not figure out why.

“After seeing my doctor and doing some testing on-island, I was diagnosed with intermittent asthma, which means that I have an asthmatic reaction based on certain triggers, one of which is smoke.

“Over the past week, I found myself having asthma symptoms for the first time in over a year, and I could not figure out why until I saw the news about the smoke in our atmosphere.”

She added: “When I spoke to my doctor she confirmed that it might be serving as an environmental trigger since I am particularly sensitive.”

A spokeswoman for the Bermuda Hospitals Board said last week there had been no “significant emergency asthma cases”.

She pointed out that hospital attendance figures for asthma and chronic obstructive pulmonary disease throughout the first half of June were typical when compared to monthly totals for January to May.

She highlighted: “With appropriate treatment and education, triggers are not a big issue.

“Open Airways provides free hour-long education sessions, no referral needed.

“We will come to your home or office, provide education on asthma or COPD, medication, their uses, demonstration of best technique, advice on triggers, what to do in emergencies, and we will liaise with your doctor to provide an ideal asthma or COPD action plan.”

The nurse said that workshops were also offered for health professionals, as well as lunch-and-learn sessions for organisations.

Ms Bishop pointed out that people with asthma or chronic obstructive pulmonary disease should make sure that they are up to date with vaccinations.

She added: “Pre-Covid we were told masks were of limited value, but asthma exacerbations were much lower due to mask wearing, therefore N95 masks may be worth using when air quality is poor as it is a barrier to some particulate matter and viruses.

“We have had an increase in calls from people unable to afford their inhalers; we also help with this.

“Many are un or underemployed with no insurance. Some are insured and cannot afford the copay. Thanks to our local donors, we can help.”

King Edward VII Memorial Hospital (File photograph by Akil Simmons)

A spokeswoman for the Bermuda Hospitals Board said last week that there had been no “significant emergency asthma cases”.

She said that the figure for attendance at hospital as a result of asthma or COPD by mid-June was 40.

For more information about Open Airways or its services, call 536-6060 or e-mail [email protected].

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