by Tamaal Ghosh

Created on: October 02, 2009   Last Updated: October 03, 2009

There can be few things more terrifying than panicked gaspings for oxygen and wondering where your next breath is coming from.

I write from personal experience as I contracted asthma in another life, as a teenager. To make life even more fraught and spicy, I got hooked on nicotine at about the same time.


Consequently and not altogether surprisingly, I was informed much later that I also had emphysema (which is irreversible)!

Personally, the cause of the asthma attacks were and are a mystery - although smoking obviously made a good a trigger fas any. I was fully tested for all common and some uncommon allergies, uniformly with negative results. Also, although case studies and research strongly suggest a hereditary link, neither of my parents or my sister (born after me) suffered.


Regardless, I had and have asthma and, to combat it over the long years (or to at least to remit the worst symptoms), I have been provided with a veritable arsenal of therapeutic ammunition.


Way, way back when I first suffered from asthma, the first avenue I traveled entailed the use of suppositories, probably containing steroids.


For a fun-loving adolescent, this was something less than a pleasant experience - particularly as the attacks tended to occur in the middle of the night. I can't remember if metered-dose inhalers (MDIs) were available at the time but after I was prescribed them, the use of suppositories in my life went the way of the hula-hoop!


There are two forms of MDIs: fast-acting curatives and long-term preventatives.


The curatives are the almost strictly band-aids; to be used when an attack strikes, when they go to work immediately to expand constricted air passages (bronchodilators) or soothe inflamed ones (corticosteroids) and quickly improve breathing for up to about six hours.


The preventatives are, as their name suggests, used to control the frequency and severity of asthma attacks. They are pretty much impotent for immediate relief of asthma and are generally be taken regularly (probably daily) and their therapeutic effects are unlikely to kick in prior to about a fortnight of continual use.


If either or both of these types are taken in MDI form, it is advisable to use a spacer. This holds the medication after it's released in an enclosed area, making it easier to inhale the full dose. Releasing the medication into the spacer gives you time to inhale more slowly, decreasing the amount of medicine that's left on the back of your throat and increasing the amount that reaches

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