IMAGINE feeling like you are drowning and your chest feels so constricted that you begin to cough to force air into your lungs.

Imagine feeling like you are suffocating and trying to take your next breath requires all the energy you have.

Asthma sufferers know these symptoms all too well.

An asthma attack has the person experiencing breathing difficulties as the lining of the airways is inflamed and begins to swell, narrowing the passage.

Mucus clogs up the tiny airways in the lungs and the chest muscle tightens, causing them the person to wheeze and cough.
"Asthma attacks can be a very frightening experience. It can occur at anytime and are often worse in the early morning or at night," said Prof Dr Liam Chong Kin, University Malaya Medical Centre's consultant respiratory physician.

"This is a disease which claims lives, and there is no cure. All the patients can do is to control the condition."

According to World Health Organisation, there are over 300 million asthma sufferers worldwide. The inflammatory disease of the airways claimed 255,000 victims in 2005.

It is also the most common chronic disease among children. According to the 2006 Malaysian National Health Morbidity Survey, between eight and 10 per cent of children suffer from asthma and 4.5 per cent of of those above 18 suffer from the condition.

The survey showed that over 90 per cent of asthma patients suffer from a mild form of the disease, eight per cent moderately severe and about three per cent severe.

Though asthma usually manifests in childhood, it can also be triggered in adulthood. No one knows exactly what causes asthma, but a family history of the disease increases your risk of developing it.

Pregnancy could also affect the severity of asthma attacks, and patients may require close follow-up and adjustment of medications.

Although concerns exists with the use of medications during pregnancy, poorly controlled asthma can have an adverse effect on the foetus, resulting in increased perinatal mortality, prematurity and low birth weight.

"If there is a strong history of asthma in the family, and the parents want to prevent their baby from developing asthma, the baby should not be exposed to cow's milk, because the protein in the milk is different from that of breast milk," said Dr Liam.

Though the disease is hereditary, whether or not the symptoms will surface depends on the environment a person is exposed to.

"A person may be predisposed to the disease by virtue of having parents who suffer from asthma," said Dr Liam, who is also the president of the Malaysian Thoracic Society and a council member of the Asthma Council Malaysia.

"But if he is not exposed to trigger factors such as dust mites or air pollution, tobacco smoke, food, changes in humidity, respiratory ailments, stress and certain types of medication, the symptoms may not surface."

Exercise can also be a trigger factor if the condition is not controlled. Even the weather can become a trigger factor, as changes in humidity and temperature can trigger an attack.

"Triggers may differ from one person to the next, and identifying these factors and how to avoid them is a major step towards controlling the disease.

But misconceptions, fear and phobias has led many asthma sufferers to misjudge the severity of their condition.

"They restrict their lifestyles by avoiding trigger factors. Because of this avoidance, they assume that the asthma has gone away. But it is a life-long condition.

"Some of them think that it is normal to have an attack every week. They don't realise that with today's treatment options, it is possible to go for months without an episode."

Asthma sufferers also tend to be reluctant to use preventive medication which needs to be taken daily. Instead, they would rely on reliever medication which provides quick relief and lasts for 4 to 6 hours.

"Although it is critical for everyone who suffers from asthma to have access to a reliever, having to use it more than twice a week can be a sign that your asthma is not well-controlled.

"Studies showed that only 13 per cent of asthma sufferers take comptroller medication daily.

Dr Liam recalled a recent incident of a 32-year-old patient who had died of asthma. Although the patient was supposed to be on comptroller medications, he failed to continue, preferring to use the quick-relief inhaler instead.

"The inflammation in his airways worsened and caused it to be more constricted. When he suffered a severe asthma attack, he was brought to the emergency ward.

"By the time we managed to get him on a ventilator, he was already brain-dead from the lack of oxygen."

So what can asthma patients do to manage their condition?

"They should educate themselves on the importance of avoiding triggers and the importance of taking their medication.

They need to be educated, they need to seek treatment and they need to comply with the treatment so that the frequency and the severity of their asthma is reduced.

"They should avoid smoking, and keep their home clean and well-ventilated to reduce build-up of dust and dust mites. They should change and clean bedclothes, carpeting and other upholstery regularly."

"There are many treatment options and only a doctor can recommend what is best for the individual patient.

However, inhaled corticosteroids has been proven in many studies to be the most effective remedy for the long term management of asthma, resulting in fewer and less severe attacks, and less recurrence of symptoms."

THE Global Initiative for Asthma (Gina) celebrates World Asthma Day on Tuesday and this year’s theme is “You Can Control Your Asthma”. Gina, a collaborative effort between the US National Heart, Lung and Blood Institute and WHO, works with health care professionals and public health officials around the world to reduce asthma prevalence, morbidity and mortality.

The Asthma Council Malaysia, Malaysian Thoracic Society and the Lung Foundation of Malaysia will host the World Asthma Day Jogathon 2008. It will be held next Sunday, May 11, at Padang Merbok, Kuala Lumpur from 7.30am. For further information, call 03-2715-2843.