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18 r> Oakville Beaver Weekend Sunday, October 8, 2000 National Respiratory Therapy Week Asthma Education Program Empowers Patients to Self-Manage Their Condition By Zita Taksas-Raponi After experiencing her first episode o f asthma when she was 27, Maureen Mulligan suffered severe bouts o f asthma for years. When Maureen was handed a pamphlet about the O TM H Asthma Education Centre while visiting her doctor 2 years ago, she couldn't have known that the answers to all her breathing problems were now in her hands... Since it opened its doors 5 years ago, the Asthma Education Centre (AEC) at Oakville -Trafalgar Memorial Hospital (OTMH) site of Halton Healthcare Services (HHS) has been successfully helping patients and their families take control of their asthma. "The focus in asthma treatment has moved to active self-management by the patient," explains Dr. Graham Owen, Medical Advisor to the Asthma Education Program at Halton Healthcare Services (HHS). "O ur goal is to give patients the information and support they need to take control of their illness so they can live a normal life." Maureen's struggle with asthma started 13 years ago at the Royal W inter Fair. "Suddenly, I found I couldn't breathe. As I struggled, I realized I was making a very loud raspy sound. People were starting to stare. Scared and embarrassed, I left the building immediately," recalled Maureen. "As soon as I got outside into the fresh air my condition quickly subsided. " Shortly thereafter, Maureen was diagnosed with asthma and struggled for over 10 years. She endured 3 particularly rough winters during which her asthma deteriorated into bronchitis and triggered extremely violent coughing spells. "I coughed so hard that I actually brake ribs on more than one occasion." "M y asthma was really cramping my lifestyle. It limited my activities as I lived in fear of having an unexpected flare-up and ending up in the emergency room," explained Maureen. "W hen you are constantly worried, you're not free to enjoy yourself." "It isn't always easy to identify what is making your asthma worse. We usually ask patients to keep a diary to track their symptoms to see if there is a pattern that links a particular place or activity with the symptom," explained Eileen Gagne. "We also have a variety of easy to understand resource materials and lots of practical tips on how to avoid asthma triggers." The first step in achieving long-term control is to identify and avoid airway irritants called triggers that tend to bring on an asthma attack. Some triggers like smoke, dust, perfumes, strong fumes, and pollen are environmental and are avoidable while others like viral infections or cold air are not. In some people an emotional upset or exercise can also trigger an attack. "Since respiratory viral infections are one of the most common causes of asthma, patients should discuss getting a flu shot with their doctor to avoid any flu related breathing problems." "It can get pretty complicated, but Eileen reviewed my medication w ith me to make sure that I understood how they worked, which to use when, for how long, and how to know if my medication is working," noted Maureen. "We also discussed my activities and schedule to make sure my meds fit my lifestyle." Like most patients, Maureen found having to use an inhaler to take her medications somewhat overwhelming." Improper use of inhalers is a very common problem. Due to a lack of understanding 90% of patients do not use puffers correctly and some don't use them at all,"explained Dr. Chau. "The Asthma Education Centre's staff provide hands-on instruction in proper inhaler use and the importance of using the appropriate technique. In the event of a flare-up, it is crucial that both the patient and their family know exactly what to do. "The Asthma Education Centre also plays a very important role in working on an Action Plan with the patient and their family until the asthma is well controlled. As always, the family physician is requested to approve the plan. Today, Maureen can recognize and anticipate situationswhich may irritate her asthma. If at all possible, she avoids her triggers; otherwise she takes preventative action. "Using my puffer before starting to exercise or dance or before going into a room with a lot of smoke and perfume can be very effective in preventing an attack," noted Maureen. In the past, people like Maureen struggled w ith asthma without any support. Children were not able to participate in sports they might have really enjoyed and adults were leary of taking part in strenuous activities. "W ith the medication and knowledge we now have, I am happy to say that today both children and adults w ith asthma can have virtually normal lives," explained Dr. Owen. "W hat they can do w ill be limited only by what they can dream." Maureen went back to the Asthma Education Centre about 5 times over a two year period. Her asthma is now under control. "Thanks to AEC, I can go 3 or 4 weeks without my puffer -and I feel more confident and relaxed about my condition," said Maureen." I know how to handle a flare-up and I know the difference between a flare-up and a real emergency where I need to seek help. M y asthma is under control and I am free to live my life." v Then 2 years ago w hile at the walk-in clinic on Speers Road, Maureen was handed a pamphlet about the Asthma Education Centre (AEC) at OTM H. Through individual counselling the AEC has since provided her with the information and the coping skills she needed to get her condition under control. "Asthma is a condition in which the airways in the lungs become inflamed, swollen and hypersensitive to irritations and allergens. As the airways narrow and mucus builds up, the movement of air in and out of the lung is restricted making breathing difficult," explained Dr. Laurence Chau, Respirologist at OTMH. "Approximately 20 children and 500 adults die each year in Canada from asthma. These statistics are particularly troublesome because asthma is a treatable disease, and the majority of deaths are potentially preventable." "Knowledge dispels the mystery and fear generally associated w ith asthma and empowers the patient with effective self-management strategies," added Eileen Gagne, Co-ordinator of the OTM H Asthma Education Centre who is a Respiratory Care Practitioner and a Certified Asthma Educator. "We work together with the patient and their doctor to plan ways to control symptoms, prevent an attack, and stop an attack in progress." "I was just amazed at how thorough and comprehensive the AEC was on my first visit," explained Maureen. "We had a very in-depth, informative discussion, about how my lungs worked, what asthma was and what triggered or brought it on." Learning that she was allergic to feathers, animal dander, and dust,Maureen realized that she needed to make some changes. "Getting rid of my feather pillows and opting for hardwood floors rather than carpets was easy enough, as I was moving anyway, but giving up my cat was difficult," recalled Maureen. "I couldn't believe what a difference these few changes made! By simply avoiding my triggers I was actually able to prevent attacks." The second step in managing asthma involves the appropriate use of medication. The successful treatment of asthma usually combines two types of medications. Anti-inflammatories, known as "preventor" medications, prevent symptoms and flare-ups while bronchodilators known as "quick relief' medication, relieve any symptoms that occur. Both are most commonly administered by an inhaler or puffer. How to Access the AEC Patients are referred to the AEC by their family physicians, paediatrician, respirologist or automatically from the OTMH emergency room. W hile the centre does not take self-referrals, the AEC Co-ordinator facilitates the process by contacting the patient's doctor and arranging for a referral. The Asthma Education Centre at OTM H is open Mondays and Thursdays 12:00 to 8:00 pm and Tuesdays and Fridays 8:30 to 4:00 pm. Starting October 26th, the AEC program w ill be offered locally at M ilton District Hospital every Thursday from 3:00 to 8:00 pm. For more information about the program call 338-4691. M ilto n 1 >iM.u t H o s p ita l 30 Deny Kvl Km, Milton, ON 1T1 ' \ (90S) 8 '8 3353 iu\ (905) 8 3MM9S I I a l i o n 11 e a 1 t h c a jje Coring liuhty, Gmwing fur tomorrow Oakville Inil.ilgat Mciiunul 1losjui.il \2 Reynolds St, Oakville, ON l .(> ) 31 (005) 845*2571 Fax (905) 338*4636