Complications Involving Asthma

Unrecognized or inadequately treated asthmatics may suffer from sleep disruption, impaired concentration, fatigue and a general reduction in quality of life. Thankfully, in these days of greater awareness and better medicines, the rare complications of chest deformity and growth retardation are seldom seen. Adults with asthma may also suffer from fatigue, and in some cases this may be their only complaint.

Complications arise in several settings:

1. the unrecognized or inadequately treated asthmatic
2. the patient who gets severe asthmatic attacks
3. patients with ‘brittle’ asthma (which is extremely difficult to control)

Severe exacerbation of asthma are dramatic and alarming. The patient is, after all, unable to breathe! They may become so breathless that they cannot speak or pause for a drink. They adopt a classical forward-leaning stance to recruit more muscle for breathing. As the attack worsens they turn a shade of blue. They are now, of course, in urgent need of medical care. If such attacks are not treated, or do not respond to treatment, there is a risk of death.

Brittle asthma is very rare. It is a condition characterized by very frequent and very severe attacks.

Before we go any further, let me make a few points about asthma and death. Yes, it happens, people do die from asthma, but we must not lose sight of the fact that such deaths are rare. Nevertheless, we must continually strive to reduce asthma mor­tality. Patients should always seek medical help if they are not getting relief from their usual asthma medication, even - and perhaps especially - if this happens in the middle of the night. The most serious asthmatic attacks can be successfully handled if the patient comes forward in time.

Asthmatics have an increased risk of death if:

1. they do not take their medication
2. their asthma is severe and difficult to control, even with medication
3. they do not have access to adequate medical treatment
4. they do not come forward in time for treatment during an attack

Bear in mind that asthma is extremely common. Indeed, it is the most common chronic disease of childhood. It is also a disease with a very wide spectrum of severity, ranging from the trivial to the life-threatening. For example, 11 per cent of the 1984 US Olympic team had asthma, and it did not interfere with performance! Similarly, many other famous sporting champions on this side of the Atlantic carry an inhaler. So, if you have asthma you should strive to lead a normal life. The vast majority of asthmatics do so. There is no need for patients or their parents to be in daily fear of their lives.