Health for a Lifetime

Asthma

Three Angels Broadcasting Network

Program transcript

Participants: Don Mackintosh (Host), Victor E. Herry

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Series Code: HFAL

Program Code: HFAL000194


00:01 The following program presents principles designed
00:03 to promote good health and is not intended to take
00:06 the place of personalized professional care.
00:09 The opinions and ideas expressed
00:10 are those of the speaker.
00:12 Viewers are encouraged to draw their own
00:14 conclusions about the information presented.
00:49 Welcome to Health For A Lifetime.
00:50 We're glad you joined us today.
00:51 Our program today is about asthma and asthma impacts
00:55 many people with their breathing.
00:57 Talking with us today about this is Dr. Victor Herry.
01:00 He is a specialist in internal medicine.
01:03 Before he took that residency he did,
01:05 had training in allergies and the immune system
01:08 which is of course directly related to asthma,
01:10 isn't it doctor? That's correct.
01:12 We're glad today we're gonna talk about this
01:14 and hopefully you can increase our breath,
01:17 our breathing help people may be you know,
01:19 avoid this or I don't know.
01:21 We're gonna learn a lot of things
01:22 I'm sure from you today.
01:23 First of all we wanna learn what is asthma?
01:26 What's our working definition? What's asthma?
01:29 Asthma is the inability to breath well resulting
01:35 from two things, one inflammation
01:38 in the lungs and spasms in the lungs.
01:43 So that what happens in that case is the patient
01:46 who does have the disease has difficulty in breathing
01:51 and unable to catch his breath.
01:53 It manifests itself in different ways.
01:55 It might manifest as a cough, as chest tightness.
01:59 It might manifest itself an audible
02:02 wheezing or shortness of breath.
02:05 So you've talked also-- So the component,
02:07 the two main components are inflammation
02:10 and we cannot forget that because that's the most
02:13 important part of its treatment.
02:15 And the other part is spasms where the tiny muscles
02:21 of the bronchial tree go into tremors
02:24 as a result of the environmental changes.
02:28 So those two things and then you started to hint
02:30 to what the symptoms are of course
02:32 shortness of breath, what else?
02:34 Cough, shortness of breath, cough, audible wheezing,
02:38 tightness in the chest, any of those things
02:41 may be manifestations of asthma.
02:43 So going back to your first point then
02:45 the definition was of course some kind
02:48 of process inflammatory process--It's the process
02:51 in the lung that is--that consists of inflammation
02:56 and at the same time hyper responsiveness of the lung
03:01 and we say hyper responsiveness because
03:04 the tiny muscles, the smooth muscles
03:09 in the lung tree grow into the spasms and prevent
03:13 the person from breathing freely,
03:15 so that not enough air is going in
03:17 and not enough air is going out.
03:19 So that would be the causes of asthma.
03:21 The real cause or we're talking about causes
03:24 that's different than this, isn't it?
03:26 Well, that's what it is.
03:27 The cause can be, can vary from the environment.
03:31 For instance there are people
03:32 who have allergies and allergy may be a cause,
03:36 a precipitating factor, so that things
03:39 in your environment bothers you.
03:40 First of all you begin by sneezing and then wheezing.
03:44 See what happens in the lung there're some cells,
03:47 there're some mast cells or some T cells
03:52 which tend to break up.
03:54 When these cells break up they release substances
03:56 into the body and these substances into the body
04:00 that they release cause the inflammation
04:03 and in addition to causing inflammation
04:05 they cause the spasm.
04:07 So that's the simple physiology,
04:10 so that when the air goes in, the person,
04:14 the air is going in but the person can't
04:16 breath properly and what happens
04:18 is that the air way constricts.
04:22 So the normal air gets smaller and smaller
04:25 and the person has difficulty breathing.
04:27 Probably one of the most alarming things
04:29 that can happen to someone.
04:30 It does and there is an increase
04:32 in asthma and the increase happens in areas
04:36 of high pollution because we find that the presence
04:39 of pollution in the air sulphur dioxide
04:41 and carbon dioxide. Those act as irritants.
04:46 People who work in dusty areas
04:48 and may have some predisposition
04:50 to the problem.
04:51 We find that they end up having those problems.
04:54 Now there's the asthma resulting from allergies
04:58 especially in the spring when the flowers come up
05:00 and the tree pollens come up.
05:03 Now those things are inhaled and as they enter
05:06 the system the body tries to fight it.
05:10 Very interestingly and the body's trying to fight it,
05:13 the body produces substances
05:15 that are deleterious to the body itself.
05:17 So in other words this is really it's healthy
05:19 in one sense because the body's saying wait
05:21 this is a toxin let's not, let's get rid of it
05:24 but then it gets as too much of the good thing.
05:27 That's right and so what happens it overwhelms the body,
05:30 because the antihistamine mast.
05:32 These are protective cells that we have called mast cells
05:36 and these mast cells when they split up,
05:39 they release histamines and the histamine
05:42 and other substances that are released
05:44 by these cells cause the problem that we see.
05:48 You've already kind of answered these questions
05:49 but talking about who can develop asthma.
05:51 Of course someone in the polluted area,
05:53 someone in an area where there's lots of pollens
05:55 and these different things you've mentioned
05:57 but are there other people that are prone.
05:58 Predisposition. Yeah, what is that?
05:59 Now if there--if there's a family history
06:02 and it goes back to the family chief,
06:04 there is a family history of asthma.
06:06 Then one must consider if you have a son for instance
06:09 if you're an asthmatic or your grandmother
06:10 was an asthmatic and your son starts coughing every night.
06:13 It's not just simple, a simple cough you must explore
06:17 whether or not that child has asthma.
06:19 And one of the things that happens is that asthma
06:24 tends to occur primarily into the,
06:27 may be in the early morning hours when you notice
06:30 that your child is just coughing every night.
06:32 So parents will bring their children and say, John,
06:34 coughs every morning around 2 or 3 o'clock,
06:37 coughing all the time and that's an indication, that's asthma.
06:42 Now why early in the morning? Yeah, why is that?
06:44 Now the reason is that based upon the body circadian rhythm.
06:49 The cortisol level of the body drops early in the morning.
06:53 And the cortisol is a treatment for--
06:55 And the cortisol is a treatment for asthma
06:56 because the body produces it's own cortisol.
06:58 Okay. And helps you
07:00 to overcome those kinds of things,
07:02 but when the level drops people who have predisposition
07:05 to the disease and have irritants may be dust mites
07:11 in the house where there's dust.
07:13 So the, the internal pollution by internal I mean
07:16 in the house pollution molds, dust, dust mites
07:21 those are things on the inside that people who have asthma
07:24 need to be very careful about and on--I'm sorry.
07:27 Excuse me. What about a person that has like eczema
07:30 or other types of allergy type things.
07:32 Are they more predisposed to asthma?
07:34 Yes, there're certain percentage of people
07:36 who have eczema and eczema is a skin allergy.
07:40 So certain percentage of people who do have eczema have asthma.
07:43 That's because they're susceptible to allergies.
07:46 And it's I guess a higher percentage.
07:49 A higher percentage than the normal population.
07:51 So the people that are at risk or who can develop asthma
07:55 are those with the family history,
07:57 those in the right in or right or shall we say
07:59 wrong environment and those that are anything else.
08:06 Yeah, now I want to make this one point
08:08 as I'm answering your question.
08:10 Now asthma manifests itself as wheezing.
08:13 Okay. But all wheezing is not asthma.
08:15 Okay. And the reason I'm saying
08:17 that is because the story is told of little boy
08:20 who was wheezing and his parents thought that he has asthma,
08:24 only to find out when he went to the doctor
08:26 even though they gave him medication.
08:28 He continued to wheeze because a small object
08:31 went into his lung and that caused the wheezing.
08:34 So all wheezing is not necessarily asthma.
08:38 That's why they got a chest x-ray.
08:39 That's why they got a chest x-ray
08:40 and they did a chest x-ray on that kid
08:42 and as a result found that object in there.
08:46 So we talked about the causes and who can develop it.
08:49 What are some risk factors or is that already
08:51 been covered in what we talked about.
08:52 Well, the risk factors we talk about that people
08:56 who are predisposed, people who have allergies.
08:58 If you have allergies, it means that you should
09:01 have your allergies treated because
09:03 there's a continuum between allergy and asthma.
09:08 So we've found that kids who have allergies
09:11 may move on to develop asthma
09:13 if the allergies are not taken care of.
09:15 So if you see kid that has eczema
09:20 or other allergies of any kind. Right.
09:22 They don't get better, they sometimes can get worse
09:25 and one of the things is asthma.
09:27 That's right, that kid should be taken to his physician,
09:30 his or her physician, so that steps could be taken
09:34 to reduce the possibility, because the irritants
09:37 on the outside that causes the allergic response.
09:42 Remember that asthma also is an allergic response
09:46 and as the body response to that offending allergen
09:51 and I use a word offending because it causes
09:53 a negative response in the body.
09:56 So with the pollens of the air pollens,
09:58 the grass pollen, the tree pollen,
10:01 the dust in the house, the molds, leaking roofs,
10:05 any of those kinds of things that you have
10:08 in your household that should be gotten rid off,
10:10 because they can predispose a person
10:13 to having, to develop an asthma.
10:16 So why would a leaky house do that?
10:18 The mold, molds spores grow, yeah.
10:21 I see. And by inhaling those spores
10:24 it irritates causes the inflammatory process
10:28 and then the response to that would be wheezing or asthma.
10:32 I mean it's fascinating to hear that as nurse
10:34 and also a minister, because you know,
10:35 in Old Testament they have a whole chapter
10:37 about sick houses and they get so sick sometimes they say,
10:40 ye they have this much and it knock it over
10:43 and he was allergist, God is an allergist too.
10:47 So what are the affects of asthma on your body?
10:52 Now, I'm glad you asked that question
10:55 because for children it affects their concentration.
11:01 So that's one of the, the other thing
11:04 is certainly it can result in death because
11:07 the death rate of asthma is increasing
11:10 because people take it so lightly.
11:13 Okay, so those who have allergies need to make sure
11:17 that the allergies are taken care
11:20 of to prevent the continuum into asthma.
11:23 So allergies can lead to asthma, asthma can lead to death.
11:28 Asthma can lead to behavior problems
11:32 because the child who has asthma all the time
11:35 he can't concentrate and a result of that
11:40 he manifest bad behavior because of his
11:43 inability to concentrate and he's pushed aside.
11:48 So he starts to have act out as a result.
11:50 Act out as a result.
11:51 So how does it really work that he can't concentrate,
11:54 because he is wheezing, he's doing this,
11:56 he's doing that, or he's because
11:57 the oxygen level is low in his brain or what?
12:00 You've raised a good point because the presence of asthma,
12:06 active asthma in the system reduces the oxygen level.
12:10 It certainly does because that's the whole thing
12:12 when you're wheezing you're not getting enough air,
12:14 you're not getting enough oxygen
12:16 and because you're not getting enough oxygen
12:18 it's been choked off your brain
12:20 therefore it's not at its maximum.
12:22 So you can result in death.
12:25 Right, so the concentration goes down and there's an
12:28 increase in irritability because of that and so it's not,
12:32 you don't spank the child, you say wait a minute
12:34 there must be something more.
12:35 That's right, that's right.
12:37 Okay, now you keep bringing up death
12:39 going from concentration to death.
12:41 I mean I know there's an intermediate stage,
12:43 but the reason you do that is because there can just be
12:45 sudden death from some, you know,
12:48 an asthma attack, I'm sure you've--
12:49 That's right. The reason I bring death
12:51 because that's the ultimate and because the death rate
12:54 of asthma in the United States is increasing.
12:57 Even though we have medications
13:01 that can treat the disease, okay.
13:03 So it means then that we are not paying enough attention
13:07 and so we need to pay more attention to the asthmatic,
13:11 to the children who may be a child who has asthma
13:14 may be extremely quiet one day
13:15 and you wonder why the child is quiet.
13:17 The child may not be able to breath properly,
13:19 but he's just been quiet because of the inability to breath.
13:22 I see. Okay.
13:23 And so we must pay attention.
13:25 Are there population or ethnic groups
13:28 that are most acceptable to asthma than others?
13:30 What we do find this in that the central cities,
13:36 asthma is increasing in the central cities,
13:38 and those populations who live in the central cities
13:41 in Los Angeles, in Washington D.C.
13:43 Baltimore, Maryland.
13:45 We find there's an higher incidence of asthma
13:48 and the factors are many, number one pollution.
13:52 Right, in the city area. In the city area, you know,
13:54 the cars, the carbon monoxide,
13:56 the carbon dioxide, all of those things.
13:58 Secondly the housing nature of those in the cities,
14:04 how it acts, because of the poor housing you have irritants,
14:10 I've mentioned molds earlier on,
14:12 cockroaches that can cause asthma.
14:15 Is that right? That's right.
14:16 So if your house is infested with cockroaches,
14:19 then you need to get rid of it because that can cause asthma.
14:22 So we found that mites which was in the dust,
14:25 dust mites, cockroaches, those are thing that you find
14:31 in particularly in the city places
14:34 or places that are not well kept.
14:36 We're talking with Dr. Victor Herry.
14:38 We're talking about asthma
14:39 and we're learning some very interesting things.
14:41 We're starting to get a hint that though it's a bad problem,
14:44 there're some things you can do to, you know,
14:47 slow it down, perhaps stop it.
14:49 We're gonna talk about how you can prevent it perhaps treat it,
14:53 control it, turn it around when we come back.
14:57 Are you confused about the endless stream of new and often
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15:53 you'll be glad you did.
15:56 Welcome back. We've been talking with Dr. Victor Herry.
15:59 Dr. Herry is a specialist in internal medicine.
16:02 Before he did that residency however he did study
16:05 in allergies and the immune system
16:08 which is directly related to asthma
16:10 as we saw in the first half of our program.
16:12 We saw that this is a huge problem in America
16:15 and you said it's only increasing.
16:17 Yes. People don't take it seriously enough.
16:19 They don't recognize the connection between
16:21 the allergic system or allergies and how it can lead onto asthma
16:26 and you really have a burden for this and rightly so.
16:28 You live in inner city, you talk with people
16:31 that are in poor houses and all these different things
16:33 we talked about in the first half.
16:35 We wanna talk about detecting asthma
16:39 and then perhaps treating it, turning it around
16:41 and what types of thing we can do.
16:43 You've hinted some of these things to us focusing on it.
16:46 Now how do you detect it?
16:49 Now talking to the parent if you notice that your child has
16:56 some difficulty in breathing or if you notice that
17:00 your child has shortness of breath or if you perhaps notice
17:04 that your child may have excessive runny nose,
17:07 take the child to the doctor, that's the first thing.
17:10 Now the doctor then makes the diagnosis by doing
17:13 a special test call pulmonary function test
17:16 that is with the doctor ask to have that child breath
17:21 into a machine and then based upon the breathing test,
17:26 the doctor can determine certainly that this child
17:29 or this person or this adult has asthma.
17:33 Now we talked earlier on of the components.
17:36 Now in the two components that I mentioned earlier,
17:39 one is the inflammatory component and the other one
17:42 is the irritable component,
17:44 there are the hyper irritability component
17:46 which with the muscle fibers just going to spasms.
17:50 It is an important to note that in treatment in today,
17:54 we have found out that the most important component,
17:58 both components are important.
17:59 But the most important one is the inflammatory component
18:03 and so in the treatment of asthma one uses
18:07 corticosteroids as the main stay of the treatment
18:09 of asthma today, because it takes care
18:12 of the inflammatory component of the disease.
18:15 Is there any down side to taking corticosteroids?
18:19 Generally speaking no. There is a down side if you take
18:23 high dosage for long periods of time,
18:26 but at the low dosage and which those steroids
18:31 are inhaled they're virtually no down side.
18:34 Studies have been done on the growth of children
18:37 and we find that in taking
18:39 the appropriate amount they grow normally.
18:42 Suddenly if you have to use high dosage over long periods
18:44 of time that can affect the growth
18:46 in children or in adults who have very bad asthma.
18:51 They can develop as part of the secondary cause
18:54 of using high corticosteroids.
18:56 You can develop cataracts.
18:58 You can develop diabetes as a result of
19:01 taking high dosage of corticosteroids.
19:04 You can develop hypertension because corticosteroids
19:06 tend to increase blood volume.
19:09 But we're talking about the extreme here.
19:12 Right. That's very, very high dosage
19:14 but on the normal circumstances no.
19:17 Okay, so the detection we've talked about that.
19:19 Now, you know, some people are very interested
19:21 in plant sterols when they have their kids
19:24 that are have access to more different things.
19:26 There's a lot of these substance you can buy
19:27 in this health food stores and what not.
19:31 My feeling is that you need to go to a trained,
19:34 professional and then get it checked out.
19:37 How do you feel about this? That's very important.
19:40 Go to the trained professional have it evaluated
19:44 and diagnosed and treat it,
19:47 because it is too serious a disease to play around with.
19:50 So the treatment then you've alluded
19:52 to can be the you know, steroids.
19:54 I've mentioned one of the treatments
19:56 and that is the use of inhale corticosteroids
19:59 and the other is the use of some beta genetic agents
20:05 which are use in inhalers
20:08 and that is more further rapid response.
20:13 So if a person is wheezing you need a rapid response
20:16 and in times pass you give an injection of adrenaline.
20:19 Now we have other substances
20:21 that you can use and inhale them.
20:24 You can use a metered dose inhaler
20:26 or you can use through a nebulizer that's a little cup
20:31 in which you put the medication
20:33 and the person inhales that back and forth.
20:35 So those are things that we can do to treat
20:37 the disease in the active state.
20:40 And in that active stage, lets say you're up on
20:42 the mountain and you don't have
20:44 your medicine with you, what you do then?
20:46 Oh, you better have your metered dose inhaler,
20:48 but I understand that in some cases people are told that
20:54 if one has an acute wheezing process,
20:58 they can use the Heimlich maneuver to enable
21:00 that person to breath better,
21:02 but I have not started that to a large extend.
21:06 But I understand that's, that's one of the things
21:07 that could be done, but get down the mountain
21:10 as fast as you can, get yourself to a doctor.
21:14 And if your child has asthma and he or she is going on a camp
21:19 or an outing be sure that you have the medication.
21:22 You know, sometimes you know, you've got the inhaler,
21:24 is there any oral medication people take that,
21:28 you know, to deal with this.
21:29 There are oral medications that can be used for it,
21:32 but we're moving, we tend to be moving away
21:36 from oral medications more to the inhale,
21:39 because what happens with the inhalers,
21:41 you provide the medication directly at the point of need.
21:45 I see. By taking a lot of
21:47 oral medications what happens and we still use
21:50 oral medications, but those are oral medications
21:53 that you systemically and we are moving away from that now.
21:57 Is that right? So they don't,
21:58 they don't check their blood levels and all that stuff-
22:00 No those things, those things are-
22:02 We're moving away from them. Yes, we are.
22:04 Now what about then, I mean we've done
22:06 a lot of education in this program,
22:08 but what additional things do you tell
22:10 your patients when they come?
22:12 Now one of the things that we need to keep in mind
22:16 is that the environment must be clean
22:18 and so a dusty environment to an asthmatic
22:22 is a gun to a person's head.
22:25 So which means that the environment
22:27 must be free of dust, free of inhalants,
22:31 right free of molds, we talked about
22:32 molds spores and how they act as irritants.
22:35 Cats? And pets in some cases,
22:38 it's very hard to get rid of pets,
22:41 but one of the things that we do today
22:43 is that we skin test that person for allergy to the pets
22:48 be the dog or cat and then provide immunotherapy.
22:51 If that child or that adult
22:53 doesn't want to part with that pet.
22:57 So we try to give him immunotherapy to that person
23:00 hopefully that they can overcome
23:04 the offending nature of the allergy to the pet.
23:07 So you know, allergy testing I mean
23:09 they have hundreds or thousands of things you can test for.
23:12 Do you run those kind of things in your office?
23:14 Yes, but what happens is depending on.
23:17 If you're dealing with internal in house allergies
23:21 as oppose to out, allergies on the outside.
23:25 I see. So you can test for pollens
23:26 in different regions of the country or of the world
23:29 you test for different things.
23:31 So the trees that grow up in Northern Canada
23:33 are not the same trees that grow in Florida
23:36 or the trees that grow here in Southern Illinois
23:38 and now the same thing that may grow in California.
23:40 So you test for things in your environment.
23:43 What's the best place to live in America if you're an asthmatic?
23:47 Wherever you can live.
23:49 So you just have to test this out.
23:51 Some people move to Arizona for instance
23:54 because they have asthma when they are in
23:55 the Northeast or some place else.
23:57 But sooner or later because they have that
24:00 predisposition to allergies, sooner or later they develop
24:03 the allergies in the area that they moved to.
24:05 So in another words, you can run but you can't hide.
24:12 You know, you practice lifestyle medicine,
24:16 I mean you're board certified internal medicine,
24:18 you practiced with a group of physicians
24:20 there in the D.C. area.
24:23 But you always try to address things
24:25 through lifestyle type things, changes.
24:28 And a lot of these things had to do with that,
24:31 I mean looking at your environment, your housing,
24:33 looking at the different things you come in contact with,
24:36 treating allergies you've talked about.
24:38 Any other lifestyle type things that you would say
24:42 in a general sense than more specifically with asthma?
24:45 It's important to, not to change activities.
24:49 In other words, a person who is asthmatic should exercise.
24:52 Okay. There should be no reason
24:54 why the person should not exercise.
24:56 And also there's exercise induced asthma
24:59 and people who are prone to that.
25:00 But these people can take the medication before the exercise,
25:04 so that during the exercise they do not get the asthma attack.
25:07 So don't stop exercising, but make sure
25:10 you're equipped for the exercise.
25:11 That's correct. And what else?
25:13 So exercise, take care of you environment,
25:16 remove any offending agents in your house and eat properly.
25:21 It's important to eat properly too,
25:22 because there's somethings that do predispose.
25:25 I think earlier on we might have spoken about the ability
25:30 of white blood cells to phagocytes
25:34 or to carry out its function. Okay.
25:37 And you know, if you eat certain diets
25:40 that prevent white cells from carrying out its function,
25:43 that predisposes you to other things.
25:47 Now why am I mentioning that with the asthma,
25:49 because in the case of asthma you need white blood cells too
25:54 and those white blood cells do release
25:57 certain substances that may cause problems.
26:00 Okay. So diet is important even in this.
26:03 All right, what about fluids?
26:05 You must drink a lot of fluids.
26:07 It's always important to drink a lot of water.
26:11 Water because water keeps your body hydrated.
26:14 The person who is asthmatic,
26:16 the person who is wheezing loses a lot of water.
26:20 Remember just from regular respiration we lose
26:23 approximately 600 cc of water which is about two eight ounces
26:27 glass of water, two and half eight ounces
26:29 of glass of water just from ordinary respiration.
26:32 Imagine if you're breathing faster
26:34 as if you're running so you need to be in hydrated.
26:38 What about anxiety as it relates to asthma anything about that?
26:42 Stress, now that's one of the things that can.
26:46 As a matter of fact I was reading recently about
26:50 the effect of stress on children who are asthmatics
26:55 or on anybody for that matter, so that can create anxiety.
26:59 So as much as possible relieve the stress sores.
27:04 Get rid of those so that your life
27:08 can be healthier and you can breath better.
27:12 Dr. Herry, we're delighted that you could spend time with us
27:15 at 3ABN and do this program on asthma
27:18 as well as the others you've done with us.
27:20 And this has been very meaningful work.
27:23 We wanna give our special thanks also to your wife,
27:26 the other physicians there that allowed you
27:27 to have the time off.
27:28 We're glad you could join us. Thank you for calling me.
27:30 And we're grateful that you could join us
27:32 as well today for this important program.
27:34 We've learnt a lot today about breath
27:37 and as it relates to asthma you know underneath
27:42 all this are thankful to God who gives us the ability to breath
27:46 to begin with and has set us up to learn about Him through that.
27:50 We're really dependent for every breath
27:52 on our Maker and our King.
27:54 And we hope today as a result of this program,
27:56 you have many more breaths and can serve the Master.


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Revised 2014-12-17