Preventing Long-Term Effects of Asthma

And I was grossly incorrect.

I learned [this] by having the privilege of following patients for over for two decades and seeing that at the end of that time, some of them develop chronic lung disease that I couldn’t reverse – even with the most potent agents available to me at that time.

This concept, which our medical profession knew about as long as 20 to 30 years ago, is just now being recognized by the majority of us and is receiving a lot of attention at this time.

The concept is known as “remodeling.”

Just like a house – which as the family grows may change shape as you build a new room [or] redecorate – the lung, when faced with inflammation, tries to restructure itself in response to that inflammation.

Sometimes in the course of that restructuring, scars form. And that scarring can reduce and permanently reduce the individual’s ability to get air in and out of their lung. This permanent reduction in that capability is known as “pulmonary remodeling.”

Although we don’t have definitive proof that we can favorably affect this response, there are at least five and perhaps now six good studies indicating that the [use] of proper therapy early in the course of the disease can prevent remodeling – and therefore permanent lung damage.

This has been shown in children who have been studied with early intervention versus late intervention, showing that those kids who received early intervention failed to develop permanent lung disease to the same extent as those children treated late. In adult populations, we’ve also shown the same thing.

The key to control of this remodeling process, therefore, is to get proper care – which is the use of an anti-inflammatory agent – and to stay with this care daily.

Now, this is hard for people to do because when you feel well, you can’t remember to take the medication. I’m the same way. However, we have to understand that our body pays consequences when we don’t stay on treatment.

And the difficult thing is that you can’t sense that this is happening.

The people who undergo remodeling don’t necessarily feel themselves worsening. So over a period of five to ten years, you can develop permanent lung damage unbeknownst to you.

The only way that you’re going to affect this favorably is to stay with a proper medication regimen on a daily basis – regardless of how you may feel at that moment.