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Keeping the airways open

Pollution is one of the evil factors behind the increasing incidence of asthma, which can be managed better now, thanks to new tests and more nuanced treatment

While everybody is worried about what pollution is doing to their lungs and arteries, for asthma patients the damage to health is not unseen and unfelt — there is clear and present danger of an attack. Of course, it is not only the pollution but also so many other triggers that aggravate asthma — like pollens, dust, fungal spores, temperature variations and viral infections, to name a few.

Dr Vikram Jaggi should know, for he runs an Asthma, Chest and Allergy Centre in Delhi’s Vasant Vihar and Gurgaon’s DLF-III. So does he advise patients to avoid going outdoors in winter? “It is true that asthma patients suffer more when the pollution is high, but one can’t pause one’s life!” he says. “So a more prudent strategy is to avoid the triggers to the extent that one reasonably can, while at the same time take regular preventative inhalers.”

Among the general public, it’s the two age-groups at the two ends of the spectrum who suffer the most from pollution, he says. The children are at risk because of the larger amount of air they breathe is relative to their weight and also because their lungs are developing and growing. And the elderly because they usually have some existing lung or heart condition. These two groups need more care.

In India, 2% of children suffered from asthma 40 years ago; now it is 12%. Asthma in children is so distressing for both the child and parents, friends and well-wishers often say reassuringly that kids outgrow it after the age of 10. The truth is that only about 30-40% of the children who have asthma will outgrow it, and the chances are better if they are boys or if they suffer a milder form of the disease. You can get blood tests done to find out the prevalence of allergy markers (such as IgE levels) — the fewer there are, the better chances of kids outgrowing the affliction.

What about alternative therapy? Dr Jaggi estimates that at least 80% patients of asthma have tried, at one time or another, systems like yoga, homeopathy, Ayurveda, acupuncture or acupressure for their ailment — with mixed results. He has no problem with that, as long as the usual asthma medications continue. “If you have faith in a particular alternative system, try it., he advises. “Discuss with your doctor openly that you are doing this. Try to be on the same page.”

So is it possible for an individual to find out what is the current state of his/her lungs? Apparently, that’s easy, and also not expensive. A Lung Function Test or Spirometry will do that. So if one discovers one’s lungs are in bad shape, should one think of relocating to a place where the air is cleaner? Dr Jaggi’s answer is not reassuring. “Moving out of the polluted environment will afford some improvement or reversal. I’m afraid it may not be completely reversible if the earlier exposure was prolonged.”

For those of us who just want to get through this winter without damaging our lungs, does he recommend masks? “In the days when pollution counts are alarmingly high, I do advise people to wear masks, especially when out and doing exercise,” he says. “Good, well-fitting N95 masks are effective to some extent. What is crucial is the tight fit on the face without leakage of air — a loosely fitting flappy mask is useless. At the same time, such masks are uncomfortable to wear for a long time. That’s the paradox.”

On my part, as a believer in natural remedies, I would like to point out that dietary changes can also reduce distress. Switch to a healthy organic whole foods diet. Opt for foods high in Vitamins A and C, folates (Vitamin B9) like fruits and vegetables full of anti-oxidants and phytonutrients, Omega 3. Avoid refined and processed foods and those high in sugar and artificial colours.

Dr Reshma is an advocate of wellness, prevention and holistic health. Instagram handle: dr.reshmakhattarbhagat