“Ngik … NGIK … ngik”, Malik breath sounds breath, his speech was broken. This morning was forced to miss school Malik again. Yet this is the first day of the exam grade increase. “Hmh longer follow-up exam,” Malik muttered to himself. Malik’s mother immediately drove to the hospital and was receiving treatment Malik. How long ago crowded decreases, and talked incessantly no longer heard. However, the new boy is leaving teenagers began complaining, “Mom, when am I able to recover. I’m ashamed to miss on. Trials aftershocks continued.” He said with exasperation. Her mother tried to explain, “Patience yes dear, your friends and your teacher will understand, you’re missing work because of illness, why should be ashamed?”
Malik still looked upset, “I’m bored, each changing season crowded, cramped eating shrimp, exhausted crowded, when I am free from all this is not?” Malik said a little angrily.
“All right son, you should ask yourself the clarity doctor and follow his advice, so you lost and resentment sesakmu not come often.” Mother said Malik calm.
**
Often complained of shortness of asthma sufferers is irritating. Especially if the recurrence more than 1 or 2 times a week. Asthma can interfere with the performance and activities of a person that was frustrating for the sufferer. The disease is even said to be the main culprit for absenteeism in the workplace and in schools. Besides disturbing activity, asthma is not curable, can even cause death. But if the disease is controlled, death can be prevented and the symptoms are not often arise. To find out how to control asthma, asthma sufferers need to know first.
Asthma is a disease of chronic respiratory inflammation due to increased respiratory sensitivity to various stimuli. In patients who are sensitive, this will cause coughing, wheezing sound, a lot of phlegm, shortness of breath, and discomfort in the chest, especially at night or early morning. Yet known for certain why some people get excited and breathing channels to others normally. But these events are usually found in atopic families (family allergy) which can pass on the nature of this allergy to derivatives.
The main abnormality was asthmatic respiratory tract inflammation, so that its management is not intended to relieve shortness of breath, but also the following purposes namely, that patients can perform physical exercise, including running and other sports, has a near-normal lung function and asthma symptoms disappear or at least . Another goal is for a minimum of asthma attacks, use of drugs to attack less crowded, and found no side effects.
In the GINA guidelines (Global Initiative for Asthma) 2002 made by the National Heart, Lung, and Blood Institute & World Health Organization (NHBLI / WHO), said to achieve these goals, physicians and people with asthma are encouraged to learn, understand, and do what called “seven powerful tactics to overcome asthma. First, extension (education) of asthma in people with asthma and their families. Proverb says, “do not know it was love”. Like a young couple who first met, you do not want to love and sacrifice themselves, before the more familiar partner. Similarly with asthma. Introduction about the ins and outs of asthma, how the treatment and prevention is right, would make the patient and his family understand so strongly motivated to try to overcome the illness. Therefore, education becomes a key factor in the treatment of asthma.
Second, knowing asthma drugs, both utility and side effects. There are two types of asthma medication, drugs work quickly to resolve the attack immediately shortness of breath (reliver), and preventive medications long term, to overcome respiratory inflammation (preventer / controller). Which includes drug is reliver drugs such as bronchodilators work faster, salbuterol Albuterol, metaproterenol, terbutaline and procaterol. In addition, anti-drug groups cholinergik, fast work theophylline, adrenaline, or epinephrine injection can also be an option.
Research experts recently stated that the chronic inflammation may alter the structure of the respiratory tract wall, resulting in remodeling the respiratory tract wall. Therefore, long-term preventive treatment is recommended. Long-term preventive medications that can be used is corticosteroids, cromoglycate, nedcromil, long working B2 agonist, theophylline off slow, and leukotrien. Of all the types of drugs are available, the use of inhaled medications are preferred since the effect of rapid, small doses and side effects are minimal, although given the long term.
Third, treat or manage asthma. Treatment is not only done when an asthma attack in progress, but also when not in the attack. Management of asthma during the attack was not carried through preventive medicine and guided exercise. With asthma with intermittent type (very light) which kekambuhannya within 1 week of less than 1 or 2 times, does not require preventive treatment. However, the type of asthma with persistent mild, persistent moderate or severe persistent, preventive therapy should have gradually adapted to the classification.
To facilitate handling, patients who are experiencing an asthma attack, divided into 3 criteria, namely patients with mild asthma attack, attack and attack was severe. One sign to see the distribution of severity of attacks is to look at how to talk. If the patient can speak complete sentences, classification is given a mild asthma attack. When the patient speaks, his voice falters, then the patient is classified in an asthma attack is. But if the patient is having difficulty talking because of shortness, patients included in the severe asthma attack. Patients who experience mild attacks can be treated at home. However, patients who have moderate or severe attacks should be treated in the hospital.
Fourth, learn and understand the factors trigger asthma attacks (allergen), and knowing how to control it. Trigger factors may vary between patients with one another. The factors that are often said to be the trigger factors include allergens, emotional stress, infections, foodstuffs, chemicals, physical factors such as weather changes, physical activity, and medications. Work of this trigger was different, there are factors that can trigger respiratory cause constriction (bronchospasme), such as emotions, cold air, exercise, and others. There is also a particular trigger inflammation such as acute respiratory infections, allergens, chemicals, and cigarette smoke. Most asthma attacks can be prevented by avoiding factors that trigger. Patients who likes to avoid or change the behavior to avoid trigger factors, will easily reach the goal of asthma treatment. In contrast, patients who “ignore” never abstinence with trigger factors will be difficult to make progress in treatment.
Fifth, the emergency plan (Action Plan). Action plan needed especially when an asthma attack will recur, and the patient needed help immediately. Handling quickly and precisely can be done if the patient and his family make a written emergency plan with your doctor, and knowing when asthma getting out of hand. However, if the patient does not have the action plan, given the management will take longer, even underdiagnosa or may occur to the detriment of the patient overdiagnosa. Uncontrolled asthma began to appear when the patient and his family found the circumstances as follows: increased asthma symptoms, medication use bronchodilators more frequently, symptoms of asthma can not be reduced or eliminated with bronchodilators, and if a flow meter Peak tool, the tool will show a decrease peak expiratory flow (APE) and the increase Variability. When these circumstances arise, action must be taken to the disease back under control.
Sixth, rehabilitation and improvement of physical fitness with sports or physical exercise guided. People with asthma often experience shortness of so many respiratory muscles are often used, while some other muscles do not. Respiratory muscles which are used to dilate and the rarely used will weaken. As a result, efficiency and coordination of respiration becomes less good, lung function and lung defense was decreased. Also sometimes people with asthma also have physical limitations or limiting physical work for fear of being crowded, so the reduced physical fitness. By doing regular physical exercise are guided, respiratory muscle will return to normal operation, the increase in lung vital capacity and increased physical fitness was better.
Seventh, monitor and follow the developments (follow up) asthma disease on a regular basis. Until now the disease can not be cured of asthma, and asthma symptoms often vary. Therefore, treatment should be monitored for life and development and continuous diiikuti. It is necessary to see whether or not appropriate given the drug in controlling asthma. Your doctor will evaluate whether the drug needs to be supplemented, reduced or terminated. If the circumstances and the patient’s physical fitness has improved, treatment can be stopped.
Given the socio-economic situation in Indonesia is quite diverse, the doctors are expected to adapt the management of asthma in accordance with the circumstances that exist. But the most important basic principles should remain the same treatment. Patients are encouraged to be proactive and spirit in overcoming the disease, and continue to work together with physicians to asthma treatment goals can be realized. One thing to remember with asthma attaining these goals, do not let asthma control you, but you have to control asthma. (Agnes Tri Harjaningrum, dr.)
(Pikiran Rakyat, Sunday, June 13, 2004)
January 9th, 2010 
Andrew 
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