DOC TALK
Stick to the plan
DR.R. NARASIMHAN
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There is an urgent need to educate the public about self-management strategies when dealing with asthma.
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Learn about the disease: Keep your inhaler handy.
Bronchial asthma is a frightening disease for the patient even when he is not acutely ill. Because the diagnosis of asthma causes an uncomfortable feeling in the patient’s mind.
There have been many occasions when people have asked if patients can go abroad or to other places for higher studies. This question arises because many patients get psychologically attached to the doctor.
Learning to deal with it
While it is good for the physician to have patients who will not doctor shop, it is not good for the patient. This is where self-management strategies in asthma management come in handy. But then, this does not mean walking around with a bronchodilator or steroid injection.
I still remember the days when my brother suffered from asthma. My father stayed in Madras for more than 15 days so that they could visit the doctor daily. Now in most cities, drugs are prescribed for one month and the patient is advised to come back for a review.
The best practice in my opinion is to give the patient a written action plan stating what he/she should do regularly and in an emergency. Most importantly this has to be explained to the patient.
An acute bronchospasm frightens the victim and challenges the healthcare giver. Bronchial asthma causes high morbidity, threatens mortality and impacts primary care and emergency resources.
Many patients are cared for by general practitioners. There is a great need to educate the public about the self-management strategies for asthma. But there will be no need for one if the patient strictly adheres to the written action plan.
The author is a Chennai-based Senior Respiratory Physician.
Tips for asthma patients
* Bronchial asthma can not be cured but can be controlled.
* It is a chronic disease like diabetes or hypertension and medicines have to be taken regularly. The only difference is some patients get better after three months.
* Asthma is a disease of remissions and relapses. Feeling better after three months does not mean a cure. It only means the disease is in a phase of remission, which can vary from a few days or months to five years or more.
* Inhaled corticosteroids are the best means of treatment. If your doctor is not prescribing steroid inhalers for maintenance ask why.
* If your physician wants you to take drugs regularly, continue it and follow his advice.
* Relievers and inhalers can be used on a need-to basis.
* The best way to control asthma is learn about the disease.
* There is no need for regular visits to the physician’s office if you follow his/her advice. Just call to say that you are doing well.
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