Breath Retraining in the Management of Asthma
by Barbara Benagh
Medical Treatments for Asthma
Successful treatments for asthma have always been elusive. Remedies changed little through the ages and included herbal tinctures, relocation to arid climates and, believe it or not, smoking tobacco and cannabis. With the development of bronchodilators or "rescue" inhalers during the 1960s, everything changed. These drugs (the most popular is Albuterol) bring rapid relief of the most common symptoms of asthma. Airways quickly reopen, wheezing stops, and mucus clears. This lets the asthmatic relax and breathe more easily. These sprays seemed to be the big breakthrough that would banish asthma forever, but there was a down side. Many asthmatics overuse their inhalers. Though doctors warn against this, it's easy to see how such a pattern develops. People are less likely to avoid the situations that trigger asthma attacks if they know a puff or two from an inhaler will magically banish their symptoms. Inhaler overuse also masks a silent increase in chronic airway inflammation, giving asthmatics a blunted perception of how severe their asthma is, so that they put off getting further treatment until they have a real crisis. Furthermore,overuse can lead to "locked lung" syndrome, a paradoxical reaction that makes bronchospasms difficult to reverse and the British Medical Journal Chest reports that frequent use of a bronchodilator is "a dire warning of the immediate need for another kind of treatment: oral steroids or hospital rescue" and in other words, while inhalers relieve symptoms in the short term, in the long run they contribute to an overall increase in the frequency and severity of attacks.
Doctors now recognize the limits of rescue inhalers and often recommend the use of newer drugs, primarily corticosteroids, which treat asthmatics' chronic inflammation. With the development of these anti-inflammatories, medical treatment of asthma has entered a new era. Prednisone, the most popular of these drugs, is now the last line of defense against asthma and has saved many lives, including my own. Regular use can reduce the need for bronchodilators and prevent asthma attacks. However, Prednisone is a potent drug with severe adverse effects that can include dependence, hormonal changes, weight gain, glaucoma, and severe bone loss. With long term use a person can be affected by problems more crippling than asthma itself.