Treatments for Better or Worse
Successful treatments for asthma have always been elusive. Remedies changed little through the ages and have 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 beta-agonist drugs (the most popular is albuterol) bring rapid relief from 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 they have a downside. 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 can also mask 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. According to the Canadian Respiratory Journal (July/Aug 98), "regular use of short-term beta-agonists as maintenance therapy for chronic asthma is no longer recommended." Articles in several other prominent medical journals have also documented that even normal use of albuterol eventually worsens asthma. 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 an asthmatic's 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.
Every Breath You Take
Like 90 percent of diagnosed asthmatics, I relied upon popular medications, using a combination of inhalers and prednisone to prevent and relieve symptoms. I also tried a number of alternative therapies like herbs, acupuncture, and dietary supplements, which were of some help. I was vigilant about avoiding the common triggers of asthma attacks. But none of these strategies provided long-term relief from my symptoms, nor did they free me from drugs and hospital visits, which came to average about five a year.
Most perplexing, the pPranayama techniques that I had practiced for years, and that I thought would help me, actually triggered symptoms (especially those exercises which emphasized the inhalation or its retention). Later I would understand why, but at the time I felt helpless. I was afraid to take less medicine, as my situation was deteriorating.