Asthma is a common occurrence in Bermuda that can be life-threatening. Triggers such as humidity, dust mites, cockroaches, mould, mildew and pollution are seemingly everywhere, and could bring on an attack if an asthmatic does not have their asthma under control. The good news however, is that asthma is treatable, and with the right knowledge, equipment and medication, it will not hold you back.
Lindsay Bishop is director of education at Open Airways, and a registered nurse. She sat down with RG Best Health to explain who is most at risk of getting asthma, what symptoms you should look out for, and what the latest advice is for asthma control.
There are no exact statistics for the number of asthmatics in Bermuda, however Ms Bishop has seen an “uptick in hospital visits” since the end of the Covid pandemic. This, she explained, is likely because “everybody’s mixing and getting colds again” and colds and viruses are “one of the big triggers for asthmatics”.
While asthma is treatable, it is a serious condition that, if not controlled properly, can have tragic consequences.
“In Bermuda, we do have deaths from asthma,” she said. “The reason for having the asthma attack in the first place is probably because you’re not treating your asthma well. The idea is to have good preventative medicines so that a serious asthma attack never occurs. But, when it does, if you have the right medications with you, you should survive.”
Those at highest risk of asthma are people who come from “a family that’s atopic”. This means their parents or grandparents had either asthma, eczema, food allergies or rhinitis. Babies born prematurely, children who are exposed to cigarette smoke or were exposed in utero, and people who are obese are also at higher risk of developing asthma.
Symptoms include a persistent cough, especially at night or while exercising, tiredness, shortness of breath, a feeling of tightness in the chest or an achy chest, sides or back. In babies, wheezing could be a sign that they have asthma, however doctors shouldn’t diagnose it until the age of six because very young children can have immature airways that just need to catch up.
One of the main purposes of Open Airways is to educate the community about asthma control and prevention, including the latest advice. One of Ms Bishop’s current priorities is to stop healthcare professionals using the term “mild asthma”. This is because if people think it’s only mild, they may not be as careful.
“If you have asthma, you have asthma,” she said. “It can be life-threatening. If you say that somebody’s mild, they’re less likely to have an inhaler with them. They’re less likely to pick up inhalers when they’re running short. They’re less likely to have an in-date inhaler.”
Another big change in treatment and prevention is to reduce reliance on Ventolin, which is a reliever, and promote instead the use of preventer inhalers such as Flixotide, Becotide, and, for those over the age of 12, the combination inhaler, Symbicort.
“Ventolin works in five minutes to relax the tight muscles, but it does nothing for the swelling in the airways,” explained Ms Bishop. “Flixotide, Becotide and Symbicort acts on the swelling and the extra thick mucus, but that takes eight to fourteen days to work properly. So, with the preventers, you need to be using them every day.”
She added however, that asthmatics should always carry a relief inhaler with them, in case of an emergency. This would be either Ventolin, or Symbicort.
Attack prevention
In an ideal world you want to prevent an attack altogether. For that, here is Ms Bishop’s advice:
- Correct medicine
Use the correct inhalers properly. For the spray type, stand up, shake them well, and use them with a spacer device.
- Vaccinations
Be up to date with all your vaccinations, in particular flu, Covid-19, pertussis (whooping cough), shingles, pneumonia and, if possible, respiratory syncytial virus. RSV is available in the US and Britain, but not available in Bermuda at this time.
- Fresh air
Open the windows in your home – unless your grass is being cut – and don’t exercise in polluted areas such as alongside a road during rush hour.
- Avoid allergens
Dust mites, mould, mildew, cockroach faeces and pet
dander (pet skin cells and saliva) are all common allergens that can trigger an attack. Tile and wood floors are better than carpet. Floors should be mopped, not swept, to avoid small dust particles being released into the air and surfaces damp-dusted for the same reason.
If you have a pet, keep them out of the bedrooms. Avoid dryer sheets and fabric softener. Avoid bleach and cleaning sprays. Try white spirit vinegar instead. Keep your house as dust free as possible. Wash cushions or soft toys regularly at 60 degrees Celsius, or put them in the freezer for six hours.
- Change pillows annually
All asthmatics should have a new pillow each year to reduce dust mites. If your child has asthma, sign them up to the asthma registry between September to December, and they will receive a voucher for a free pillow each January.
- Avoid products that smell
Particles in perfumes, candles, air fresheners, any kind of sprays, essential oils and even menthol can all be triggers.
- Flowers outside, plants inside
Plants with big leaves clean the air inside a home, but flowers should remain outside.
- General Health
Avoid viral infections with good hand hygiene. Eat well, sleep well and exercise regularly.
And finally…
David Beckham, the former professional footballer, had terrible asthma as a child that wasn’t treated properly. Symbicort, his spacer, and good medications helped him reach his potential.
For more information about Open Airways, or for help and advice about controlling your asthma, visit openairways.com, call 536-6060 or e-mail [email protected].
