It was a slow day at the clinic when a 22-year-old female came in with wheezing, dry cough, chest tightness, and shortness of breath which she has been experiencing for the last few months. During the chilly days of the Christmas season, the same woman had to go to the local emergency room for asthma exacerbation when the duty doctor prescribed her two inhalers. She recalled that during her childhood she also had asthma and used an inhaler, the name of which she could not remember now. However, she was good until the last summer when she was found to have a relapse of asthma.
She moved to a new city early last year where she rented an old trailer home. After coming to the new area, she found the weather very extreme with frequent thunderstorms during the summertime and frigid temperatures in the winter. She started using an evaporative cooler which helped with the dryness she was experiencing. She also adopted a German shepherd. Day by day, she improved and accepted a job offer as a gym teacher at the local junior high school.
During the summer, she would help her dad build a cabin adjacent to a serene lake. She liked to keep busy so she would sweep all the debris around the construction site. During the summer nights, she loved to sit around an open campfire and roast marshmallows. At the end of the day, when she would return to her trailer, where she would feel suffocated by the smell of mildew. Being exhausted, she could barely vacuum her torn carpets, the old mattress or fabric sofas that she purchased from a local thrift store. When she couldn’t tolerate the odours, she would spray the whole trailer with Febreze to try reduce the smells.
She also discovered that she could not open her windows because of the black char-filled smoke that was coming out of the chimney from a local factory. A nearby poplar tree also emitted pollen during the hot summer days and she found that the trailer she was living in to be infested with cockroaches and rodents. She enjoyed cooking and would explore various new recipes which she would cook on her wood stove. All of the above worsened her chest tightness and wheezing.
The story above describes a disease named asthma. Asthma is very common in Canada; more than 3.8 million Canadian have the disease and it is the third most common disease in Canada. About 317 Canadians are getting diagnosed with asthma every day and 250 unfortunate Canadians lose their lives due to asthma. It is a respiratory system disease. It is unknown why some people get asthma while others don’t but it may be due to various factors including genetic predisposition and environmental factors. Exposure to irritants and substances or allergens triggers the symptom of asthma. When we suffer from asthma, our body’s mast cells release different mediators causing the respiratory tract muscles narrowing, at the same time, the blood vessels leaking fill up the lungs with secretions causing chest tightness, shortness of breath and wheezing.
How can we prevent asthma? First of all, we need to identify which allergens are causing asthma. Different people respond to triggers of asthma differently. When we feel that we cannot breathe properly, we should not delay going to see a doctor. After examination and some tests, if the doctor identifies the cause of chest tightness and shortness of breath is asthma, then the doctor usually prescribes an inhaler and at the same time, provide an asthma action plan. It is very crucial to learn about asthma from a healthcare provider rather than searching the internet. A physician will provide information on how to avoid all the allergens and what to do when asthma starts to occur.
The female in our story had plenty of triggers including smoking, weeds, pets, a mouldy home and belongings, carpet, wood stove, cockroaches, rodents, extreme weather and thunderstorms, nearby industrial smoke, pollen, gym activities, sweeping dust at her dad’s construction zone and campfire smoke. Given her symptoms, if she could avoid all the triggers mentioned above and use a proper inhaler, she would more than likely experience less asthma exacerbation.
(Note: The story above is fiction. The prevalence of asthma was taken from an online source. For asthma symptoms and etiology, the writer also consulted Dr. Yasmin Azher, a family practitioner practising in Thompson.)
Since completing a master’s degree in epidemiology from the University of British Columbia in Vancouver, Foyez Haque worked in northern and southern Ontario as an epidemiologist for more than a decade. During his tenure with several health units in Canada, he was involved in numerous public health research activities including publications in peer-reviewed journals. Currently, he is employed with the Northern Health Region as a planning and decision support analyst.