Treatment

The best way to diagnose and follow the evolution of an asthma attack at home is with a device that helps us measure the patient’s lung capacity. In other words, we need to know what percentage of the lungs is working. This can be measured with a peak flow spirometer. The small spirometer measures one of the parameters included in the general test, specifically the airflow through the bronchi and thus the degree of obstruction in the airways. Currently these types of home devices have a special technology that measures value through special applications that help make the value more accurate. Thanks to this, you can know not only if the person is having an asthma attack, but also their response to treatment and its progression over time. Obviously, it’s ideal to have a complete pulmonary evaluation with a more accurate pneumological evaluation. But in some cases, that is not possible, and this device can save lives. Remember, an asthma attack cannot wait.

For the treatment of asthma, there are two types of inhaled medications, slow-acting and fast-acting. Slow-acting ones are those used in patients diagnosed with asthma who are keeping their inflammatory hypersensitivity under control. It is used as recommended by the treating physician, either daily or every two or three days. It will always depend on the number of attacks the patient has had and the symptoms he or she presents in his or her daily life. On the other hand, fast-acting treatments are the ones used in acute asthma attacks. These are medicines that are in charge of relaxing the bronchial muscles and decreasing the inflammatory response, eliminating the blockage and improving breathing immediately. The principal ingredients in fast-acting medication are albuterol (ProAir HFA, Proventil HFA, Ventolin HFA) and levalbuterol (Xopenex HFA), which you can use every 12 hours for a maximum of two days. Give yourself two puffs with the inhaler, keeping the medication in for ten seconds before exhaling it. These kinds of inhalers are prescribed medicines.

OTC options are limited but effective. Although they should not be used as an ongoing treatment, they are very useful in the case of asthma attacks, especially when they occur sporadically and the person does not have a fast-acting medication on hand. Ephedrine or epinephrine are the active ingredients in these medications, and they come in vials for inhalation or in tablet or syrup form. Another medicine widely used in asthma attacks is an expectorant called guaifenesin. It helps to fluidize the phlegm that forms inside the airways. This makes it possible to expel this mucus when coughing, leaving the bronchi free to breathe.

Until I was 12 years old, I had asthma attacks, although none required hospitalization. I really wouldn’t know though because my mother, despite being a doctor, is reluctant to go to the emergency room, so most of the time we treat these attacks at home. My experience with epinephrine is very good; it is an excellent treatment for asthma attacks that has some unpleasant side effects such as increased heart rate, hand tremor, insomnia and anxiety. It is not a medicine that you will use all the time, only in cases of emergency. Symptoms are quickly relieved. Within 20 minutes to half an hour, you can feel that you are breathing well and without difficulty. Guaifenesin is a product I have never liked. Expectorants make me cough a lot, and yes, a lot of phlegm is expelled, a lot more than you think you have. It helps because all that mucus is accumulated inside the bronchial tubes and is helping the obstruction, but I must say that it is not my favorite product. When my asthma attacks improved, my mother continued with natural treatments, such as the steam baths I explained earlier, sometimes using some essential oil; the one we liked best was eucalyptus. I also drank black Chinese tea, which is supposed to help dilate the bronchial tubes. My mother never let me get cold drafts, much less the cold of the night which, according to popular Venezuelan belief, is very dangerous to the point of making anyone who receives it seriously ill. They call it "sereno" and although nobody knows well what it is, it refers to a very dangerous entity that is around late during midnight; it has to do with the cold or the dew, and it can even kill. Doing some research, I found that in the days of Venezuela’s colonization there was a person who was in charge of watching the streets and the lighting at night, and also announcing the weather reports.

These watchmen were called "serenos" and being state workers, they were in charge of guaranteeing public order until sunrise. Therefore, whoever went out during the hours they were out could not return home, given the unorthodox methods they used at the time to keep the antisocials out.