Alzheimer’s disease is the most common type of dementia affecting one in 11 Canadians. No one is immune. While there is no cure, some medications can slow the mental decline. Next month we’ll look at the risk factors — both those that you cannot control and some that you can — along with the medications that can help.
Breathing problems affect about 10 per cent of any population, Canada’s included. Among farmers, however, the rate seems to be higher.
A New Zealand study, for example, showed 17.6 per cent of its farmers had breathing problems. Plus, some conditions are specific for farmers, such as farmer’s lung, the allergic disease that results from breathing hay or grain dust, especially if it is mouldy.
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Your respiratory system resembles a tree with the bronchi being the branches and the sac-like alveoli the leaves. As blood passes through the alveoli it absorbs oxygen from the air that you have breathed in.
With emphysema, the alveoli are enlarged and “out of shape,” like an old elastic band that has no stretchiness left. Bronchitis is an inflammation of the bronchi with excessive mucous secretion resulting in narrowing and plugging of the bronchi. Together, these conditions are termed chronic obstructive pulmonary disease or COPD. As you can imagine, COPD occurs more often in older people.
Asthma results when the airways are overly responsive to stimuli. The bronchial smooth muscles contract, fill with fluid, and become covered with secretions. Asthma can develop at any age, but is more common among younger people. For reasons no one understands, the number of asthma cases has risen dramatically in the past 10 years. It may be due to an increase in air pollution, an increased exposure to synthetic substances, an increased ability to diagnose the condition, or even a genetic change in the population.
Inhalers are ideal in treating any breathing problem because they deliver medication directly to the disease site, right in the lungs, and they avoid effects in other areas of the body. Most medications used to treat breathing problems are available as inhalers. Corticosteroids such as fluticasone reduce inflammation, thereby opening airways. Anticholinergic drugs such as ipratropium open up the bronchi and are especially useful in older people.
Beta agonists such as salbutamol and salmeterol act on beta receptors in bronchial tissue to relax and open airways.
If you use any inhalers for a breathing problem, using them correctly is key to getting the most relief. Corticosteroid inhalers are routinely used to keep airways open and prevent problems, while other inhalers such as salbutamol are intended for acute relief. If you use more than one inhaler, you need to sort out which type you are using, follow dosing directions, and know in what order you use them.
Your inhaler technique is important because incorrect technique means the medication does not get to the right sites in your lungs. Aerosol inhalers are pressurized canisters that you need to press at the same time that you inhale. Sometimes this co-ordination can be difficult or you may not have the manual dexterity needed to press the inhaler, so you may not be getting your full dose. Holding the inhaler in your mouth will help aim the spray, tilting your head back a bit will result in a more direct path to your lungs, and a spacer device will also help.
Breath-activated inhalers are alternatives to the aerosol ones. With these it is your deep breath that pulls the medication into your lungs. Regardless of which inhaler you use, you need to remember to remove the protective cap before using it and to hold your deep breath so the medication has time to get to the right sites.
All inhalers have full instructions and pictures of their use, but checking your technique in front of a mirror from time to time will ensure that you don’t fall into any bad habits. And, don’t forget to use a clock to check for times, as what you may think is 10 seconds may not be.
While inhalers can control breathing problems, don’t forget the non-drug steps for easier breathing such as avoiding allergens (such as dust, pet dander and mould) wearing masks and breathing apparatus when appropriate, and stop smoking!
Marie Berry is a lawyer/pharmacist interested in health care and education.
