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This study has several other limitations. First, we studied acute asthmatic responses, so it remains unclear whether our findings would apply to chronic asthma or to other conditions. Even with respect to the treatment of acute asthma, it is important that the findings from our study be replicated to assess their reliability and robustness. In addition, we measured outcomes using a single subjective measure and a single objective measure (FEV1). Future research should investigate whether our findings can be generalized to other subjective and objective measures of acute asthma. Finally, we did not assess subjective symptoms before each visit’s intervention; therefore, the severity of subjective symptoms before each treatment remains unclear. Assessing subjective measurements before and after interventions could have yielded other differences. Although it is possible that the degree of physiological deficit in these patients was not sufficient for them to have symptoms at rest, it is increasingly recognized that not all patients with asthma who have deficits in lung function fully appreciate the degree to which their asthma limits airflow until they are given bronchodilators that result in improvement in lung function, symptoms, or both.26-28 In this study, there was a significant improvement in lung function with the genuine bronchodilator (about 20%) that coincided with an improvement in symptoms, whereas treatment with placebo had no effect on measurable biologic factors but was indistinguishable from medication with regard to subjective outcomes.

Our research has important implications both for the treatment of asthma and for clinical-trial design in general. Many patients with asthma have symptoms that remain uncontrolled, and the discrepancy between objective pulmonary function and patients’ self-reports noted in this study suggests that subjective improvement in asthma should be interpreted with caution and that objective outcomes should be more heavily relied on for optimal asthma care. Indeed, although improvement in objective measures of lung function would be expected to correlate with subjective measures, our study suggests that in clinical trials, reliance solely on subjective outcomes may be inherently unreliable, since they may be significantly influenced by placebo effects. However, even though objective physiological measures (e.g., FEV1) are important, other outcomes such as emergency room visits and quality-of-life metrics may be more clinically relevant to patients and physicians. Although placebos remain an essential component of clinical trials to validate objective findings, assessment of the course of the disease without treatment, if medically appropriate, is essential in the evaluation of patient-reported outcomes.

Although placebo effects may differ according to the specific disease, our study has implications for understanding placebo effects in general. Our findings are consistent with those of a meta-analysis involving multiple conditions, in which the placebos, as compared with no-intervention controls, had no significant effect on objective measures but did have significant effects on subjective outcomes (e.g., pain). Also, our data support recent systematic reviews of studies that involved specific conditions, suggesting that placebo effects are primarily detectable in subjective outcomes; when objective changes occur, they tend to be well within the range of the natural history of the condition. Furthermore, our findings do not contradict recent laboratory studies showing that placebo treatment elicits quantifiable changes in neurotransmitters and regionally specific brain activity that influence symptoms.1 The bifurcation of placebo effects between objective and subjective outcomes that we observed in this pilot study may represent the distinction that social scientists make between treating disease (objective physiology) and treating illness (subjective perceptions). Although effective medications target and modulate objective biologic features, the mere ritual of treatment may affect patients’ self-monitoring and subjective experience of their disease.

Our subjective measure deserves comment. Since there were no preexisting subjective measures for the acute asthma response, we constructed our own metric for global subjective assessment of improvement in dyspnea; as a result, its reliability and validity can be questioned. However, our measure had good face validity. Even though similar measures are common in medicine and have been shown to have good reliability and validity (e.g., the Borg scale, which is used to assess dyspnea), none have been validated for use in assessing either asthma or the acute bronchodilator response.25 In addition, patients used the entire range of the measure, and there were no ceiling or floor effects. The broad range of responses and roughly normal distribution argue against the existence of strong acquiescence (tendency to agree regardless of the content of a question) or central-tendency biases. Our subjective scale did not encompass worsening of symptoms (i.e., the scale measured improvement, from none to complete); thus, it could indicate a perceived lack of improvement but not a perceived worsening. This limitation could potentially create a floor effect and underestimate the degree of subjective deterioration for some patients. However, there was no floor effect observed in the distribution of assessment scores for the active or placebo interventions. In contrast, there was, as expected, a floor effect with the no-intervention control, since patients assigned to this control overwhelmingly reported no improvement. This floor effect serves to strengthen our findings concerning the discrepancy between subjective and objective outcomes. It does so because the only significant difference with respect to the subjective outcome was the lower degree of improvement in the no-intervention condition as compared with the other three conditions. Thus, the floor effect for the no-intervention control would, if anything, have served to diminish the difference between no intervention and the active and placebo interventions and would have decreased our ability to detect such a difference.

However, for the subjective outcome, both placebos had a greater effect than no intervention. This may have been due to the effect of the patient’s expectation on the patient-reported outcome or to reporting bias (e.g., the wish to please the investigator). We consider the latter influence unlikely because the patients receiving no intervention also reported subjective improvement, even though they presumably had no expectation of improvement and their wish to please the investigator would have made a report of no improvement more likely. Our findings might have been influenced by possible weaknesses in the scale used to assess subjective responses (which lacked prior formal validation). However, it is unlikely that the findings were due to the instrument used, since patients receiving no intervention did not show such an effect.

The subjective responses to placebo were equivalent to the subjective responses to the active drug, even though the active drug produced a marked increase in FEV1. Thus, the administration of a placebo did not affect the objective measure (placebo as compared with the natural history of asthma), and the effect of the active medication did not exceed that of the ritual of the treatment itself (albuterol as compared with either placebo). The fact that the patient-reported outcome was independent of the physiological outcome suggests either that patients with asthma poorly perceive changes in FEV1 or that use of subjective assessment may have some limitations in the interpretation of physiological outcomes in asthma and may have upper limits, possibly explaining why asthma symptoms in many patients remain uncontrolled. Furthermore, it can justly be asserted that for self-appraised symptoms, placebos can have a powerful effect.

It is notable that the two placebos had similar effects on both the objective measure and the subjective measure. Since all the patients had prior experience with active inhalers, one might have expected better outcomes with the placebo inhaler than with sham acupuncture, owing to classical conditioning. One possible reason for the apparent equivalence of the two placebo interventions is that the patients may have become conditioned to the setting and personnel at a well-known hospital as much as to the inhaler itself. Another possible explanation is that the remarkably high credibility of sham acupuncture in our study (85%, vs. 66% for the placebo inhaler), which is consistent with the findings in previous studies, might have resulted in a greater expectation of improvement with sham acupuncture.

Our findings complement the results of a recent randomized, controlled trial that examined the effects of optimistic drug presentation (enhanced positive expectations) on outcomes with placebo or active medication (montelukast) in 610 patients with asthma. Placebo given with enhanced expectations significantly increased subjective outcomes but had no effect on objective measures, whereas enhanced expectations for medication influenced neither subjective nor objective outcomes. Although another study of asthma reported objective improvement with placebo,8 it lacked a no-intervention comparison, so it is not known whether the reported improvement reflected an actual effect of placebo or simply the natural history of asthma. Our findings strongly contrast with a series of studies in which placebo interventions plus strong suggestion resulted in marked changes in FEV1 in patients with asthma. In these studies, the patients were deceptively told that they were receiving “powerful” medication, whereas our study was conducted with neutral double-blind instructions. Most of these other studies lacked no-intervention controls, and the two studies that included them showed no placebo effect.

Patients reported substantial improvement not only with inhaled albuterol (50% improvement) but also with inhaled placebo (45%) and with sham acupuncture (46%). In contrast, the improvement reported with no intervention was only 21%. The difference in the subjective drug effect between the active albuterol inhaler and the placebo inhaler was not significant (P=0.12), and the observed effect size was small (d=0.21). With respect to the placebo effects, however, the difference between the two placebo interventions and no intervention was large (d=1.07 for placebo inhaler and d=1.11 for sham acupuncture) and significant (P<0.001 for both comparisons). Treatment credibility was high, and most patients believed that they had received active treatment (73% for double-blind albuterol, 66% for double-blind placebo inhaler, and 85% for sham acupuncture). The two double-blind conditions did not differ significantly from each other, but sham acupuncture was significantly more credible than both inhaler conditions (P<0.05).

Discussion

In this repeated-measures pilot study in which active-drug and placebo effects were assessed in patients with asthma, two different types of placebo had no objective bronchodilator effect beyond the improvement that occurred when patients received no intervention of any kind and simply underwent repeated spirometry (no-intervention control). In contrast, the subjective improvement in asthma symptoms with both inhaled placebo and sham acupuncture was significantly greater than the subjective improvement with the no-intervention control and was similar to that with the active drug. Thus, even though there was a large, objective drug effect (mean percent improvement in FEV1, 20%) that was nearly three times the effect of the two placebos and the no-intervention control (mean percent improvement in FEV1, approximately 7% for all three), patients could not reliably detect the difference between this robust effect of the active drug and the effects of inhaled placebo and sham acupuncture (mean subjective improvement reported by all patients, regardless of intervention, ranged between 45 and 50%).

For the objective physiological outcome (change in FEV1), there was a powerful medication effect (drug vs. placebo) but no placebo effect (no difference between placebo and the no-intervention control). For the subjective outcome, the placebo effects were equivalent to the drug effect, and all were greater than the no-intervention effect. The two placebo interventions had a strong effect on the patient-reported outcome but had no effect on the objective outcome; the active drug had a strong effect on the objective outcome but had no incremental benefit with respect to the subjective outcome.

Most randomized, controlled trials and laboratory experiments have not included a no-intervention control. Our inclusion of a no-intervention control — the control for the placebos — allowed us to detect subjective placebo effects. We found that the results of placebo interventions did not differ from those of the no-intervention control when an objective measure of airflow was used (FEV1).

Objective and Subjective Outcomes

At each of the 12 visits, spirometry was used to obtain a baseline measurement of FEV1, after which patients received the intervention for that particular visit (as randomly assigned within the four visits of that block of visits). Spirometry was then repeated every 20 minutes for 2 hours. Also at each visit, patients were asked to score any perceived improvements in asthma symptoms on a visual-analogue scale, with scores ranging from 0 (no improvement) to 10 (complete improvement), and were also asked whether they thought they had received a genuine therapy or placebo (to assess blinding). These subjective responses were then converted to percent improvement in FEV1 during the 2 hours by multiplying each score by 10.

Statistical Analysis

Drug and placebo effects were assessed by means of repeated-measures analysis of variance. If significant main effects were found, we compared each intervention with the use of two-tailed, paired t-tests. We used a Bonferroni correction to control type I error, and only those effects with P values of less than 0.008 were considered to be significant. (See the Supplementary Appendix for details.) The magnitudes of the effects were assessed with the use of Cohen’s d statistic, which provides a measure of the differences in the mean values of changes in symptom severity between groups in relation to the pooled standard deviation.

Patients

Objective Physiological Outcome

Percent Change in Maximum Forced Expiratory Volume in 1 Second (FEV1) with Each of the Four Interventions. shows the mean physiological responses to each intervention (albuterol inhaler, placebo inhaler, sham acupuncture, and no intervention) across the three study visits. At the initial screening visit, the mean (±SE) percent improvement in FEV1 in response to open-label albuterol was 21.9±1.6%, and all patients had an improvement in FEV1 of at least 12%. During the double-blind test series, the mean percent improvement in FEV1 was 20.1±1.6% with inhaled albuterol, as compared with 7.5±1.0% with inhaled placebo, 7.3±0.8% with sham acupuncture, and 7.1±0.8% with the no-intervention control. There were no significant differences between the three inactive interventions, none of which resulted in the degree of improvement observed with active albuterol. The difference in drug effect between the albuterol inhaler and the placebo inhaler, as indexed by the difference in mean percent improvement in FEV1, was significant (P<0.001) and large (d=1.48). In contrast, the placebo effects did not differ significantly between the two placebo interventions and the no-intervention control (P=0.65 for the comparison of placebo inhaler with no intervention, and P=0.75 for the comparison of sham acupuncture with no intervention). In addition, the sizes of these effects were negligible (d=0.07 for placebo inhaler and d=0.04 for sham acupuncture). With the use of the standard definition of treatment response (≥12% improvement in FEV1 13), patients assigned to the active albuterol inhaler had a response 77% of the time, whereas patients assigned to the placebo inhaler, those assigned to sham acupuncture, and those assigned to no intervention had a response 24%, 20%, and 18% of the time, respectively.

Placebo effects (i.e., benefits resulting from simulated treatment or the experience of receiving care) are reported to improve signs and symptoms of many diseases in clinical trials and in clinical practice. On this basis, the accepted standards for clinical-trial design specify that the effects of active treatment should ideally be compared with the effects of placebo. Despite this common practice, it is unclear whether placebo effects observed in clinical trials (or those that presumably occur in clinical care) influence both objective and subjective outcomes and whether placebo effects differ from the natural course of disease or regression to the mean.

In patients with asthma, the administration of an inhaled bronchodilator can result in rapid increases in expiratory airflow that can be measured with spirometry. Since repeated lung-function assessments can be performed over short periods of time, asthma is an excellent model for the study of placebo effects. Although many studies suggest that such effects occur in patients with asthma, these studies have generally not controlled for the effects of variability that can occur over the period of observation without treatment.

In this pilot study, we compared acute changes in lung function that occurred after repeated administration of four interventions: a masked bronchodilator (inhaled albuterol), two different types of placebo (an inert inhaler and a validated sham acupuncture needle), and a period of no intervention. By using different placebos and a no-intervention control, we were able to determine whether placebo interventions in asthma can lead to objective changes in airway caliber, self-reported subjective improvements, or both beyond the changes in lung function and symptoms that are attributable to the natural history of the disease.

Patients and Study Design

Between January 2007 and December 2008, we conducted a randomized, double-blind, crossover pilot study with the use of a block design to determine the short-term responses to an inhaled bronchodilator and placebo treatments in patients with stable asthma. At the initial screening visit, 79 patients completed questionnaires and, having had short-acting bronchodilator therapy withheld for a minimum of 8 hours and long-acting bronchodilator therapy withheld for at least 24 hours, underwent bronchodilator reversibility testing with open-label inhaled albuterol. The 46 patients who had a response, defined as a forced expiratory volume in 1 second (FEV1) that was at least 12% higher than the baseline value, were eligible to continue in the study.

These patients returned within a week and were assigned to a randomly ordered series of four interventions — active albuterol inhaler, placebo inhaler, sham acupuncture, or no-intervention control.

This procedure was repeated in two more blocks of four visits each (blocks 2 and 3), during which the interventions were again randomly ordered and administered. Thus, each subject received a total of 12 interventions. Albuterol and the placebo inhaler were administered in a double-blind fashion and sham acupuncture in a single-blind fashion, and the no-intervention control was not blinded. As before, short-acting and long-acting bronchodilator therapy was withheld for 8 hours and 24 hours, respectively, before each intervention. The no-intervention control condition differs from the natural history of asthma, since it controls for nonspecific factors such as attention from study staff, responses to repeated spirometry, regression to the mean, natural physiological variation, and any effects arising from the hospital setting. Nonetheless, no-intervention controls are the best approximation of no treatment in an experimental design.

While no one knows the exact cause of asthma, it is believed to be caused by two main factors, family genes and environmental exposures. These two factors interact to cause asthma, most often in the early years of life. It has more of an effect on children because their body has not developed enough to combat the exposures they come in contact with.
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There are some things to be said about family genes. Family genes contribute to an inherited tendency to develop certain kinds of allergies. Just because your parents have asthma or allergies doesn’t mean you will automatically have them as well. Your family genes will play a part in how bad your symptoms might be if you do end up with asthma or allergies.

If you do have asthma and it runs in your family genes, exposures to airborne allergens such as house hold dust mites, cockroaches, and pet dander from your family pet can cause a more severe asthma attack. Other irritants like second hand smoke from tobacco and smoke from a wood burning stove may make your airways constrict and be more reactive to the pollutants in the air. Everyone seems to react differently to the pollutants they come in contact with. You need to make notes as to the thing that causes your asthma to flare up.

I believe that asthma attacks will have more to do with environmental exposures than your family genes. Where you live and the things you are exposed to will play a major role in how you or your child is affected by asthma. The more airborne pollutants and environmental toxins you come in contact with will cause you to have more asthma attacks. There is research that has been done that says environmental toxins and airborne pollutants may cause a healthy person to develop asthma. This may be due to the ever increasing industry that drives our economy. Car and trucks are also on the rise, making the air we breathe even more toxic.

Some other causes of asthma are inhaling irritants like perfumes or cleaning products. Cleaning products can be especially harmful because they are used in the house where the air stays stagnant and may be breathed in for long periods of time. Cleaning products have been known to cause asthma attacks. Mold is another cause of asthma attacks. Mold grows in almost every home in the United States. Molds grow in damp dark places and can spread very quickly. The mold can be breathed in and cause your airways to constrict and become inflamed.

Exposure to cold or dry weather can also cause asthma attacks. Other causes may be emotional excitement, stress, physical exertion, and exercise. Our skin absorbs 60% of what it comes in contact with. You need to very aware of what you put on your skin. There are a lot of toxins in the skin care industry. Skin care products and cosmetics have potentially harmful ingredients that can cause our bodies to react in the form of asthma attacks and other allergies.

The best way to improve your condition and live life on your terms is to learn what you can about asthma. Become aware of your asthma triggers and try to avoid them. Follow the treatment recommendations of your health care provider. Understand your treatment and how every drug you take will affect you. Report any changes to your health care provider. If you have any reaction to the medications, report them as soon as possible.

There are ways to remove toxins and pollutants naturally, that you may come in contact with. Just because you can’t avoid them doesn’t mean they have to make your life difficult. Prevention is always the best medicine.

Asthma is a condition affecting many people all over the world. Most being affected are our children. It’s a disease that causes your airways to swell, making the air going back and forth to the lungs to be hindered and unmovable depending on the severity of your condition. These are triggers that cause you to have difficulty breathing. During an asthma attack you’re very susceptible to all sorts of allergens and air pollutions. Mostly these types of breathing problems happen at night and sometimes early in the morning. Times depend on the person and their environment, like pets and smokers in the house.

Here are some signs to watch for, first determine if the signs you’re seeing could be Asthma. Make an appointment with your doctor so he can do some tests to find out what types of triggers that cause your asthma to flare up. Some things like exercise, running, swimming, pollens and allergens can cause an asthma attack. Your doctor will find ways of getting your asthma under control, but to do this takes some time and patience. Your doctor will tell you that asthma attacks can vary in strength and length. Some attacks are mild and don’t require immediate attention. Moderate attacks are the next to increase, then you may have a severe attack if not kept in check. Severe attacks means you need medical attention right away. The oxygen going from your mouth to your lungs could be blocked completely resulting in hospitalization and even death.

There are things you can do to make Asthma more bearable at home. When weather conditions outside worsen and wind gusts and pollen becomes an issue. The first thing you do is close your windows and have your air conditioning system set to re-circulate so the air inside the home stays less contaminated, instead of bringing in the air from the outside where it can be worse. Check and clean your air filters. Change them often to keep dust and allergens from being spread throughout your home. Keep your pets groomed and clean. If you live with smokers, they should smoke outside if someone with Asthma lives in the same home. Second hand smoke can be one of the biggest triggers for an asthma attacks. Here is another trigger and it is one that is more frequent than smoke, it is Air pollution. Our skies are filled with harmful particulates and they are very hard to avoid. We recommend using an air filter inside your home to take out as much of the pollution as possible.

If you or someone you love has Asthma, here are some things you can do to deal with it and in some cases overcome it! Work with your Doctor to work on an action plan. No one has the same exact asthma or severity of symptoms. We are all different, so our bodies deal with things in different ways. Someone that suffers from Asthma may treat it differently than you. Your Doctor can help you get an action plan in place for your particular asthma symptoms. He may use a peak flow-meter to see how well air moves in and out of your lungs. This can help him understand when you are having a serious asthma attack. Eat healthier, drink lots of water, avoid triggers and your life with Asthma could be a lot easier to cope with.

Asthma affects many people all around the world. It can be a very distressing condition which can lead to death if left too long, or is too serious. This article is written to give you a run down of the early symptoms of asthma that may help you recognize this condition and get treatment for it. Here are the symptoms you need to be on the look out for if you suspect you have asthma developing.

One of the first warning signs that may develop when it comes to asthma is an increased nighttime cough. This cough will start to worsen as the days and weeks move on. If you are experiencing an annoying cough of a night, that is getting worse you may need to see your local doctor.

One of the next symptoms is a certain wheezing or cough after physical activity. This means that after you exercise or do anything that may quicken your heart rate and breath, you will start to cough uncontrollably, or wheeze with each breath you take.

Tiredness when doing normal activities is another sign that you may be developing asthma. If you are struggling to complete normal activities that you used to be able to do with ease, then you may need to look into this and see whether it is something like a deficiency, for example iron deficiency. If it is not, then you should really get it looked at.

Although this can be associated with many other conditions, having a restless sleep or waking up extremely tired can be another early sign to look out for. This may be a result from a different breathing pattern when asleep that you may not know of. If you are experiencing this and you are constantly tired, you may want to see your doctor.

One of the last early signs of asthma is a persistence with allergies becoming worse. If you have allergies that seem to get worse as the days go on, and you cannot explain why, this may be the developing stages of this condition that should be looked at. These allergies may be a constant running nose, circles under the eyes which are darker than normal, and itchy and inflamed skin.

Asthma is something that no one would like to get, unfortunately there are people who do develop it. If you have one or more of these signs, then the best thing to do would be to see your practitioner. This condition is treatable, and when treated you can really get back to a normal and healthy lifestyle.

We all have to use cleaning to keep our homes clean, but did you know how harmful some cleaners and disinfectants can be to children and adults. If you like to use cleaners that come in an aerosol spray cans, then you could be exposing your loved ones to a barrage of air born toxins that could bring on an asthma attack. Spray cans that have fragrances in them are by far the worst. Use your own nose to select cleaning products without harsh scents. When possible, choose simple, natural products whose labels do not carry serious hazard warnings.

Cleaning products are used everywhere, in schools, offices, by janitors and hospital workers to clean, disinfect, control dust and mold on surfaces. When adult’s work around these cleaners and children are exposed to where these cleaners are used, they can develop breathing problems. Some of the most chemical exposed jobs seem to be hospital workers and hotel housekeepers due to the constant cleaning with harsh cleaners after every visitor.

If you are around cleaning products and start to feel your chest tighten or you begin to wheeze or cough and have shortness of breath, you should call your doctor. These kinds of symptoms are not normal and you should talk to your doctor even if you were not the one using the cleaners or doing the cleaning.

The types of cleaners that can be harmful and should be avoided by adults and children are:

• Carpet cleaners
• Disinfectants
• Floor wax strippers
• Glass cleaners
• Tile cleaners
• Toilet cleaners

If you have asthma already, you should talk to your doctor before using these kinds of cleaners. If you don’t have asthma or breathing problems, you should read the MSDS (material safety data sheet) associated with the chemicals you are using or search the net for the hazardous substance fact sheet before using harmful chemicals. You should also request breathing masks and other protective gear, for you and anyone else who might come into contact with the chemicals or the fumes.

The very process of cleaning itself can stir dirt and dust up into the air, so you may want to do heavy cleaning when your son will not be around during or immediately after the clean up. You should only use harmful chemicals in ventilated areas away from children and pets. Your house can trap these air born toxins inside, where they can cause breathing problems for your loved ones. One thing you can do to minimize the exposure is clean when no one is in the home. Keep the home well ventilated by opening doors and windows. You can also use fans to control airflow throughout the home.

If you have someone in your home that has asthma, you should talk to your doctor to find out what kinds of chemicals might cause them problems. For example, if your child is not allergic to dust mites. There is no reason to use harmful or harsh cleaning agents to aggressively eliminate them. The same should go for mold or pet dander. The better informed you are about your asthma the easier it will be to control the triggers that can cause asthma attacks. Colds and flu can also trigger asthma attacks, so keeping kitchen and bathroom surfaces clean is important. However, it is not necessary to use antibacterial soaps or cleansers. Your goal is to remove or wash bacteria down the drain, not kill them on the spot using harmful chemicals.

It may be surprising to hear that ingredients from solid and liquid cleaners can actually get inside our bodies. Yet, many liquids and even some solids give off vapors that we inhale, and some of these substances actually enter our body tissues. The National Institute of Environmental Health Sciences did a study of almost a thousand adults, showing a link between a chemical called 1,4 DCB (dichlorobenzene) and lung function. Those who had the highest levels of this chemical in their blood had worse lung function.

It is best to use all natural things to clean with. Plain soap, water, salt, baking soda, vinegar and lemon juice are best to use with some plain old elbow grease. The use of a scrubbing sponge can take the place of chemicals used to remove tough stains. Make sure you follow the instructions on the cleaning products to ensure they are not used improperly. Simple things can go a long way in keeping your family safe.

Your asthma is starting to dictate your life. You are wheezing and coughing so much that your work colleagues always know where you are. That attack you had last year where you ended up in hospital for a few days has left you fearful and frustrated for your future. The amount of medication you are taking is scary and you cannot even get through the night without waking up and needing a few shots from your puffer. You have become tired and exhausted all the time, your allergies, hay fever and colds have all become worse and now you are finding it a struggle to take your dog for a walk each evening.
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You also notice that your children are developing breathing problems and this is your worst nightmare. You do not wish your children to go through the terrifying experience of a severe asthma attack but what can you do about it. You know that despite all the asthma medications that you take, your asthma is not really under control and in fact is getting worse.

As if that is not enough, the cost of all this medication is killing you and you suspect that someone else is making a killing off you.

Then you get told that you are allergic to your pets – to your much loved dog and cat and that you should get rid of them. “Should what?” you say. But they are treasured members of the family and you would no more get rid of them than you would get rid of your child. But if they are triggering asthma attacks, what are you to do.

And do you know what? Despite all the literature you have read on asthma, none of it actually makes sense. Breathing is so integral to life how can it all go so wrong? So get this. Asthma is not a disease; asthma is your body’s natural defence against chronic over-breathing. We all understand that just the right amount of food is good for us and more is not better. And so it is with breathing. Just the right amount of breathing is good for us and more is not better. Both too much food and too much breathing can rapidly lead you down the path of chronic and debilitating illness.
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