Can't shake that cough? It may be asthma

Five years ago, Patricia Scott of Cornwall, Ont., had a nagging cough that seemed like just another stubborn cold until it began keeping her awake at night. Her doctor prescribed antibiotics for "flu," yet six months later, she was still coughing.

It would take several more visits to her GP and various specialists over the next two months before Scott, at age 39, would finally be diagnosed with asthma. Suddenly, the formerly outgoing homemaker had to adjust her lifestyle to accommodate a disease that could attack with a moment's notice.

"I used to be a very socially active person," says Scott, whose asthma can be triggered by a whiff of perfume or deodorant. "It makes me cough and then vomit." Now, she has to avoid parties and large gatherings. "It's kind of hard to say to your friends, 'You can't wear underarm deodorant or perfume, or smoke around me.' "

Scott is among the estimated 6 percent of Canadians aged 15 and over who suffer from mild to severe forms of asthma. Yet because the symptoms of asthma can mimic other diseases, such as bronchitis or the flu, the disease can be misdiagnosed. Researchers estimate that about 25 percent of all nagging persistent coughs are undiagnosed cases of asthma. Says Elizabeth Kovac, executive director for the Asthma Society of Canada: "If you've had a cough for a long time and the cough is not going away, it should be looked at."

Some adults who develop asthma- technically, an inflammation and constriction of the airways- are born with a predisposition to the disease. However, the condition may lie dormant until something triggers an allergic reaction. Common triggers include: house dust; pets; strong odors, such as perfume, paint and chemicals; cigarette smoke; food preservatives; overexertion; some medications, including ASA, certain blood pressure pills and even some eyedrops containing beta-blockers.

Developing asthma often means making some major lifestyle changes to respect these triggers, says Sharon Smith, executive director of the Lung Association of Eastern Counties in Cornwall. "Yet some people resist and instead decide, 'No, I want to keep on living the way I'm living and put up with the consequences.'" The denial can run so deep for some that they refuse to follow their prescription or continue to smoke.

Besides that persistent cough, the classic warning signs for asthma include wheezing, breathlessness and sleepless nights spent hacking. Asthma is a very "surreptitious" disorder, says Kovac. "It creeps up on you. First, you just have trouble if you go up the stairs too quickly. Then, the next year you have a bit more trouble, and eventually, you have to stop halfway up the stairs."

If left untreated, asthma can be serious, even life threatening. In fact, about 10 Canadians die each week from asthma, and of the 469 asthma deaths in 1993, 432 involved people over 35. But the real tragedy is that of the 10 deaths per week, "six to eight could have been prevented," says Kovac. "Some people didn't realize the severity of their attack and waited too long to go to the hospital."

Dr. Felix Li of the Laboratory Centre for Disease Control in Ottawa confirms this delay in seeking emergency medical care is one of the most common causes of asthma death. A doctor's failure to properly diagnose the condition or failure to follow doctors' orders can also lead to a fatal asthma attack.

Following the prescribed treatment can help about 95 percent of asthma sufferers lead a perfectly normal life, says Smith. Anti-inflammatory medication, or "preventers," reduce and control the swelling and mucus in the airways. "Relievers" open the airways by relaxing the tightened muscle, making it easier to breathe just before or during a reaction. Both are inhalants, often prescribed for oral puffers.

For Patricia Scott, taking her asthma medication is not a choice. "I want to live the longest, fullest and healthiest life I can."

For more information about asthma, call the Asthma Society of Canada at: 1-800-787-3880