'Journey from Asthma to Emphysema'
3rd of the Four-Part Series

Asthma has many faces, histories and lives. Some individuals only experience childhood asthma, showing up for the first time during infancy and ending in childhood never to come back. Some will have childhood asthma, live many years of asthma-free life but later would encounter asthma as a result of exposure to chemicals, toxins or disease. Some would experience single or recurring episodes of asthma for the first time during their adulthood. Then there are those (and I am one of them) who would never experience a full blown attack of asthma but share the vulnerabilities, problems and consequences of asthma. The name given for it is "sub-clinical" asthma. It is my hope that future medical tests would be able to identify sub-clinical asthma before it insidiously results into full-fledged Chronic Obstructive Pulmonary Disease (COPD).

In a longitudinal study, "Tucson Epidemiological Study of Airway Obstructive Disease" adults with asthma were found to have a twelve-fold higher risk of acquiring COPD over time than those without asthma.

GOLD experts say individuals with asthma who are exposed to noxious agents may also develop irreversible airflow limitation and a mixture of "asthma-like" and "COPD-like" inflammation. Furthermore, longstanding asthma on its own can lead to irreversible airflow limitation. However, there is no conclusive evidence that chronic asthma in adults would lead to COPD.

Whether asthma would be followed by COPD or not could depend on a combination of special circumstances and lifestyles. People with long-term asthma, regular or sub-clinical should view themselves "at-risk" for COPD. You have to be particularly watchful because the process of COPD can be deceptive and misleading and can delay proper diagnosis and care.

Here is an example of how the combination of "asthma-like" and COPD-like" symptoms can be misleading: I dismissed the idea of pulmonary tests for many years in spite of shortness of breath and exertion-related discomfort because at such times I would REMEMBER how good my breathing was at other times. I would ignore the present breathing difficulty and remember my breathing of the times when allergies, pollen, climate, temperature, air quality were ideal, airways were open, inflammation was at the minimum and I could fully utilize remaining lung capacity.

Though I received yogic breath training in my early years and had fair degree of breath awareness, I thought my shortness of breath and discomfort even during moderate exertion was due to the lack of conditioning and exercise. To use an analogy, because I would see sun come out for few seconds, I would dupe myself believing it's going to be a sunny day! Had it not been for those occasional good breathing "episodes," perhaps I would have investigated the possibility of advancing lung disease. Likewise, if it was common medical knowledge in the sixties and seventies that continuing elevated levels of esnophils in the blood may be indicative of lung inflammation, appropriate treatment could have been initiated earlier. As they say, 'Forewarned is forearmed." Even my lifestyle choices and decisions for relocation would have been different in the knowledge of a dangling sword of COPD over my head. The sword was hanging right over my head all that time and I didn't know it.

As a lay person without any pretense for medical expertise I want to say you are at risk for COPD if you have or had:

• Long-term history of asthma
• Childhood asthma only to re-surface later in life with recurrent episodes
• Developed asthma in teenage or adulthood
• Tested positive for ongoing constriction and/or inflammation of the airways

* Next article will present tips for self-care for people with asthma who are at risk for COPD *

Copyright 2009, Mind Publications 
Posted April 2009