The festival of lights is approaching and many, who are away from home, clear up their schedules to make way for a few days of warmth and joyful celebrations with their families. But for Ruhi, a 20-year-old engineering student and chronic asthma patient, Diwali is the time to scurry out of the city to some faraway place.
“Ruhi turned all red, had bouts of breathlessness along with wet wheezing, like she was drowning,” recalls her mother Shalini Mathur.
The smoke from colourful crackers and increased air pollution during Diwali almost choked Ruhi’s airways last year.
“It got so bad that she had to be hospitalized,” says her mother.
Diwali is supposed to be a time of joy and celebrations for all. But for many parents like Shalini and children like Ruhi, far from being a long and happy vacation, Diwali can become a dreadful experience.
According to experts, rise in the number of patients suffering from asthma and other respiratory disorders like COPD (Chronic Obstructive Pulmonary Disease), and allergic rhinitis shows a sharp upward trend during Diwali.
In India, an estimated 15-20 million people suffer from asthma, of which 10-15% are children in the age group of 5-11 years .
As per a study conducted to ascertain the impact of fireworks on respiratory health during Diwali, it was observed that bursting crackers aggravates the condition among people with asthma. The study found that it was harmful for even people with no prior respiratory ailments. It was observed that 31.2% complained of coughing, wheezing and breathlessness during smoke emission of cracker burning .
“I attend more than 20-25 patients with asthma who experience acute exaggeration around Diwali as compared to 10-15 patients on regular days. Many come complaining of very bad cough and asthma flare-ups owing to the pollution caused by toxic firecrackers,” says Dr. Sandeep Salvi, Director,Chest Research Foundation, Pune.
“Apart from staying away from smoke, small precautions like carrying along inhalers with you can help avoid the risk of asthma episodes. The smog can be very toxic and even dangerous for people with asthma. Therefore, proper management and right treatment can go a long way in controlling your asthma,” he adds.
Experts say living with asthma becomes a challenge for many when it is poorly controlled. Most patients with asthma continue to suffer from severe exacerbations despite being on oral medications and even bear the brunt of associated side-effects of the drug taken to beat asthma attacks. To beat the problem, better and more effective alternatives, such as inhalation therapy, are being employed as the mainstay of asthma treatment. These have less systemic side-effects on patients.
The aim of any treatment is to increase its effectiveness through minimal dosage of drugs, reach the site of action (lungs, in case of asthma) faster and maintain good control over the condition.
Inhaled corticosteroids, otherwise known as inhaled therapy, has been widely accepted as a more effective treatment for asthma compared to oral corticosteroids. Inhaled corticosteroids are inhaled directly into your lungs and in much lesser quantity (about 25-100 micrograms) than oral medications (about 10,000 micrograms).
“In case of oral therapy, it is required in higher quantity since it first gets dissolved in the bloodstream and then via various organs, reaches the lungs. As a result, it is absorbed in the parts where it is not required, leaving you at high risk of systemic adverse reactions, including loss of bone density, cataracts and high blood pressure. While through inhalation therapy, corticosteroids need to be administered in much lesser quantity as they directly reach the lungs to relieve the inflammation, thus limiting the risk of side effects,” says Dr. Sandeep Salvi.
However, it is a sad fact that due to problems with medications, unguided knowledge of therapy, and myths about steroid therapy, many unnecessarily suffer the ordeal of uncontrolled asthma.
“Lots of misinformation about corticosteroid medications lead people into believing that it is the same steroid that athletes use to improve their muscle strength and performance. But they confuse the term corticosteroids with anabolic steroids – the former being used to treat the lung function, while the latter being artificially prepared steroids used by athletes. Corticosteroids in inhalers are a copy of the steroids that are naturally produced by our body and are perfectly safe to use, even for children and pregnant women,” adds Dr. Sandeep Salvi.
Due to lack of attention, improper management, and not using the correct mode of treatment, asthma turns into acute attacks at the time of Diwali.
When the white veil of smog descends on cities during Diwali, the nip in the air spells disaster for people with asthma, leaving many struggling to catch their breath. But some small precautionary steps and correct treatment modalities, such as inhalation therapy, can help you enjoy the festival with all the joy it has to offer. Blankets of smoke can’t take away your breath, if you know how to manage your asthma.
1. Bronchial Asthma, WHO Fact sheet N°206
2. Fireworks during Diwali festival have a significant impact on respiratory health: a study from India S. Salvi, et al. Clinical Research, Chest Research Foundation, Pune, India; 2Air Pollution Research, Air Quality Management Cell, Pune, India.
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