If Asthma management is dog cheap, why pay through nose

On World Asthma Day experts advise patients and people to err on the side of caution

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New Delhi: If your child coughs even when he laughs, it is not a laughing matter, he may be asthmatic.

Other symptoms like coughing without rhyme or reason (fiver of cold), coughing when he walks or scales stairs, coughing when caught in breathing in dust or dirt or shows breathlessness in such situations, should also alert parents. As management of Asthma costs a peanut, experts have advised parents to be watchful of such symptoms and to ‘err on the side of caution.’  If you do, Asthma can neither endanger the life of your child nor can burn a hole in your pocket.

Talking to Medicare News, Dr Gaurav Sethi, Paeditrician, In Good Hands Clinic in Delhi, said, ‘Waiting for asthma attack to happen is no wisdom at all. If vigilant, Asthma management is dirt cheap. In fact, the cost of regular Controller medication is as low as Rs 5 per day (less than a cup of tea). Talking to Medicare News, Dr Anant Mohan, Head of Department, Chest (Pulmonary Medicine) said, ‘Being on guard not only saves hard earned money, it also saves the life of the asthmatic. Asthma can be tamed without much of an expense. Expense exacerbates only when it is allowed to assume emergency situation. If asthma is treated as per guidelines provided by various national and international organizations, costs can be reduced tremendously both by the individual and government.’

Arvind Kumar, Chairman, Centre for Chest Surgery and Founder of Lung Care Foundation has played crucial role in creating Asthma Manual for Schools in 11 Indian Languages. Talking to Medicare News, Dr Arvind Kumar said, ‘Cost of Asthma management is no issue at all. It is less than cost of even one cup of tea, if we keep the Asthma attack at bay. The question is if Asthma management is so dog cheap why pay through nose. The Asthma Manual for Schools will go a long way in saving the lives of school children.’

Neither is there loss of man days provided if vigil is kept as per guidelines. An asthma patient can lead quite a normal and productive life with no burden on the family. Asthma is not a curable disease but because of newer medicines and newer delivery systems most people can lead an active and normal life in which the disease is well controlled.

Unlike other chronic conditions such as hypertension and diabetes, there is minimum compromise and virtually no restriction on diet and lifestyle for an asthma patient. Asthma is a silent condition and therefore even if there are no symptoms like wheezing, coughing or breathing trouble, regular use of Controllers is mandatory. Controllers are medicines available in inhalers and when used regularly over a long period of time, they help control asthma better. Controller drugs improve symptoms, prevent attacks and help one lead a good quality of life.

However, in case there is an attack, Reliever medicines are available which when inhaled provides rapid relief. Relievers act for a maximum of 4-6 hours.

Emergency treatment of asthma which needs a visit to the hospital is expensive and if hospitalization for a few days is required, the cost shoots up. In addition, this leads to loss of work, and in some cases death.

Asthma is a public health problem not just for high-income countries; it occurs in all countries regardless of the level of development. In fact, asthma in countries like the UK, Australia and New Zealand is higher than the global average, which could perhaps be attributed to the factor of ‘Hygiene Hypothesis.’ This means that those living in cleaner environments have greater chances of developing asthma than those living in less clean surroundings. This is because children with no exposure to infections leads to their immune system more provoked by allergens in the environment while those who have repeated exposures to infections develop immunity towards the infections and not to allergens.

However, most asthma-related deaths occur in low- and lower-middle income countries. This is due to the fact that asthma is under-diagnosed and under-treated in these countries. It creates substantial burden to individuals and families and often restricts individuals’ activities for a lifetime.

Asthma is often incorrectly associated with considerable reduction in productivity and overall fitness, increased requirement for health care support, and morbidity in acute cases. However, the problem of asthma can be easily managed when it is in the mild stage. In fact, 90% of these cases are mild and can be successfully handled at primary healthcare centres. The prognosis of asthma remains good with as many as 60%–80% of patients being able to lead normal lives without much disruption.

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