Kill the Cat or Your Child!

By Dr. W. Gifford Jones

Why are so many people suffering from asthma being rushed to emergency rooms or dying? Is it the fault of the doctor, the patient or both? And what is so sacred about the family cat when a child's health is at stake?

It's estimated that 10 million North Americans suffer from difficult breathing. Or what's called "reversible bronchospasm". During an acute attack the airway constricts, bronchial tissues become swollen and increased mucus production clogs an already narrowed airway.

Twitchy airways are caused by allergic reaction, respiratory infections, air pollution, cigarette smoke, exercise, certain foods and animal dander.

The time©honoured treatment for asthma involves the use of drugs to dilate the bronchial tree. Bronchodilators quickly relax the constricted airway and remove the terror often associated with the struggle for air.

But it's become too easy for patients to use the "little puff" to obtain speedy relief. Yet it's natural for a patient to conclude, "Surely a drug that provides quick results must be good for me".

Even doctors fall into this trap. For years physicians believed that bronchial spasm was the primary problem of asthma. And that relieving it was the be©all©and©end©all of treatment.

There's a hitch, however. Researchers in Canada and New Zealand found that the excessive use of bronchodilators was associated with increased asthmatic deaths.

It was the old story that you can whip a tired horse only so long. Like a weary horse, the bronchial tubes eventually fail to respond to excessive stimulation. What was an initial blessing becomes life©threatening when the medication fails during a severe attack.

In recent years doctors have discovered there's more to asthma than bronchospasm. Biopsies of bronchial tubes reveal that virtually all asthmatics have chronic inflammation throughout the airways. This inflammatory reaction triggers asthmatic attacks.

Now the emphasis has switched to prevention with the use of inhaled steroids which helps to "cool" the underlying inflammation. It's then possible to use bronchodilators less often. Œ Dr. Meyer S. Balter, Director of the Asthma Clinic, Mount Sinai Hospital, Toronto, maintains that patient education is the key to successful treatment.

He claims his patients can recite in their sleep that, "bronchodilators treat symptoms, but not the disease". They also understand that although inhaled steroids do not give quick results that doesn't mean they're not working.

All too often patients believe inhaled steroids act as fast as bronchodilators. When they get short of breath while exercising, they use the steroid and failing to get relief, switch back to using bronchodilators.

Dr Balter finds that younger asthmatic patients are more likely to develop complications due to peer pressure. In this age group, having a disease or taking regular medication is cause for scorn. The usual scenario is that young patients start under©using inhaled steroids and abusing bronchodilators.

He also stresses that it's important to treat asthmatic children aggressively at the start. Evidence shows this approach decreases their lifetime need for medication and later complications of asthma.

Dr. Louis©Phillipe Boulet, Head of the Asthma Clinic, Laval University, in Quebec City says children's asthma can often be relieved by getting rid of household animals. But some people would rather get rid of their spouse or physician than the cat!

I find it hard to condone the irrational behaviour of some parents. One Australian study showed that 31 percent of parents knew their child was allergic to animals yet kept animals in the home. And 44 percent of children admitted to hospital in acute respiratory trouble had been exposed to animals in the home.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod