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Asthma

The untimely death of freelance journalist Terry Mayers which was triggered by a violent asthma attack should serve to raise the national discussion about asthma. The increasing numbers of people who suffer from the condition has made asthma a household word.

How many of us are educated to what is the condition?

Asthma is a chronic condition involving the respiratory system in which the airways occasionally constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers.[1]allergen, environmental tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, or emotional stress. In children, the most common triggers are viral illnesses such as those that cause the common cold.[2] This airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators. Between episodes, most patients feel well but can have mild symptoms and they may remain short of breath after exercise for longer periods of time than the unaffected individual. The symptoms of asthma, which can range from mild to life threatening, can usually be controlled with a combination of drugs and environmental changes. These episodes may be triggered by such things as exposure to an environmental stimulant such as an

Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children

Source: Wikipedia

We have verbal confirmation from a medical source that the cost to Barbados linked to asthma has been rising at a rapid rate. Maybe GP, a member of the BU family can produce the numbers to paint the exact picture regarding how this ailment has taken root in Barbados. World Asthma Day is highlighted during the month of May, and World Asthma Day was celebrated on May 06, 2008. Our thanks to BU family member Adrian Hinds who provoked this blog. As you would expect the local media has been low-keyed by the lack of hype which that have given to World Asthma Day.

To quote Adrian Hinds:

It is Ironic that Terry Mayers died of an asthma attack in the month of May. I believe they are a lot of persons who suffer from Asthma and other allergies. I think you should propose an annual remembrance and or memorial to Terry Mayers by way of raising awareness about Asthma and allergies during the month of May.

We can see no reason why Adrian’s suggestion should not be implemented. The Terry Mayers Annual Memorial to highlight asthma awareness during the month of May would be a constructive exercise. We have heard our authorities in recent years lament high absenteeism which in their view is negatively impacting national productivity. The BU household is of the unscientific view that a significant percentage of our workforce is afflicted by asthma. The fact that occupational health issues is a low priority item in most workplaces around Barbados is instructive. Although it is not made explicit in the Wikipedia definition above, mold and dust are triggers which can escalate the condition.

It is interesting to note that whilst union members are led by their respective unions to fight to the death for a 4% over a 3% wage increase, low priority is usually given to demanding average environmental quality in the workplace. Is it a stretch to believe that the employee is a net loser given the money which Barbadians currently spend to treat the asthma ailment?

It is the norm even as medical advancements are taking place in the world that too many babies before they leave the womb are suffering from respiratory problems. Then to compound matters the doctor or clinic prescribes one of many drugs (steroids) available, the body’s immune systems becomes forever affected by the medicines and the natural behaviour of God’s most complex but beautiful invention is troubled forever.

We agree with Adrian H to publicize his wish that we create the Terry Mayers Annual Memorial to bring awareness to the plight of Asthmatics. Here is an opportunity for the dormant or should we say defunct Barbados Association of Journalists (BAJ) to do something constructive for a change.


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54 responses to “Call For Terry Mayers Annual Memorial Day To Heighten Asthma Awareness In Barbados To Be Established”


  1. Fantastic idea Adrian and BU. We need to start looking at the illnesses that are killing our people. Another one is the ‘silent killer’ – Stress.


  2. Not a bad idea but why pull the MD’s down?

    “Then to compound matters the doctor or clinic prescribes one of many drugs (steroids) available, the body’s immune systems becomes forever affected by the medicines and the natural behaviour of God’s most complex but beautiful invention is troubled forever.”

    this statement seems rather naive and sensationalist!
    Nebulizers are given by the same doctors often in a timely way to treat those with naturally malfunctioning creations of ‘God’


  3. me it was not our intention to pull down the doctors. We wanted to stress the point that an asthmatic can rely on prescribe drugs from an early age. Consuming foreign substances like steroid drugs can’t be all that good for the body.

  4. Straight talk Avatar

    I will never again be so harsh on bright Barbadians taking up what once were considered cushy government funded positions.

    These are obviously very high risk jobs.

    May you all rest now in peace Ian, Terry and Michael,

  5. Georgie Porgie Avatar
    Georgie Porgie

    David

    When I was at home there used to be meetings for asthmatics to discuss treatment and avoiding attacks, spearheaded by one of the local GP’s whose son died from asthma.

    When I was a school boy in the 60’s I cant once remember any of my classmates ever having asthma. By the nineties it was not uncommon to see at least one person daily in the public clinics. Of course the asthma bay was often always full in those days.

    One of my mates from UWI says he did not see it in St Kitts when he first returned home there to practice in 1981, but that the incidence in that country has also steadily increased.

    There is a theory that children are not playing in the mud and outdoors as we did, and becoming infected with “germs” that produce antobodies that offer some protection.

    There is a theory too that the prevalence of the use of antibiotic soaps and the sanitzers that we use to prevent this and that in the home are making our folk more susceptible.

    We certainly have more carpets in our homes as we have become more affluent. Carpets certainly attract and store allergens. We are using more preservatives as we use more package food and drink, including food colourings. We had to remove all carpets from our home to assist in the treatment of one of my sons who is asthmatic. We had to stop him from using corn curls and all drinks with food colouring.

    Just think when we went to school in the 60’s it was lemonade. mauby and JuC. Kool Aids and Tang etc appeared around 1966.

    Let me get back to you on this but that been some of the current issues.

    Over the years we have developed a lot of very useful drugs.

    Basically there are BRONCHODILATORS which dilate the bronchi and TOPICAL STEROIDS which dampen the inflammatory exudate in the bronchioles. In treatment you need to BOTH dilate the bronchi and reduce the secretion of the the inflammatory exudate in the bronchioles.

    In addition the patient must understand what medication their doctor is giving them for RESCUE or ACUTE ATTACKS and what medication their doctor is giving them for MAINTENANCE to prevent attacks.

    It is not uncommon for asthmatics to die at home especially in the colder parts of the country like St Thomas and St Andrew when the temperature drops just before morning. Thats similar to the attacks one often sees in sportsmen over here when they are exposed to cold air in spring training.

    It might be helpful to call BAMP or the local polyclinics to ascertain what educational programs are currently available for asthmatics.


  6. This would be a move in the right direction. I hope the authorities would set up this soon. I think though that Terry did get good attetion at the hospital. we have very good doctors here.

  7. Georgie Porgie Avatar
    Georgie Porgie

    David I cant report on the figures for asthma attacks in Barbados these days, but if you know a Health Sister in the Polyclinics, they ought to find it in the Annual Report of the CMO.

    I agree with you that mold and dust are triggers which can escalate the condition, and that occupational health issues is a low priority item in most workplaces around Barbados.

    Topical steroids when given by inhalation does very little harm, because the dose is very low, is applied directly to the site of action and eliminated there and is basically not absorbed, in contrast to giving the steroids by mouth or injection (as is necessary in some conditions).

    Re
    Then to compound matters the doctor or clinic prescribes one of many drugs (steroids) available, the body’s immune systems becomes forever affected by the medicines and the natural behaviour of God’s most complex but beautiful invention is troubled forever.

    Well David, the principle in using drugs is to use them only when necessary, to consider benefits over the adverse effects when deciding to use them. Once doctors obey this principle we tend to do little harm.

  8. Georgie Porgie Avatar
    Georgie Porgie

    The scout wrote

    I think though that Terry did get good attention at the hospital. we have very good doctors here.

    I agree with you, and was surprised to hear that he was in ICU and for so long. I wonder what trigger that he was exposed to that caused such a nefarious acute attack, that caused him not to respond to immediate or early rescue therapy.

    I wonder if he was exposed to a new chemical on the golf links or what. Or if he was exposed to some new but powerful trigger of which he was not aware.


  9. […] John wrote an interesting post today onHere’s a quick excerptThe untimely death of freelance journalist Terry Mayers which was triggered by a violent asthma attack should serve to raise the national discussion about asthma. The increasing numbers of people who suffer from the condition has made … […]


  10. David FYI…..steroids are also naturally occuring and produced by the body, the MD will ( should ) only prescribe a steroid if he/she feels that the immune/operating system needs the additional help. This is sometimes the case with asthma. Steroids like almost all other drugs are good things IF USED CORRECTLY!


  11. Thanks for the clarification me. For some reason we were under the impression that prolong and heavy use of steroids by asthmatics can weaken the heart arteries.


  12. I think it’s a wonderful idea, Dr Malcolm Howell has some very frightening statistics of asthmatic development in Barbados – it’s more like an epidemic!

  13. Keith Headley Avatar

    The Caribbean cure for asthma (used most often in St. Vincent) is: take just over half a pound of ganja (weed – illegal) and boil it in as little water as possible to create a strong thick-ish liquid.

    Drink ALL the liquid without removing the leaves.

    This knocks the drinker out for about 24 hours.

    My present (people I know personally who have done this) count is 7 people.

    Two of the I have been able to confirm from medical persons (with their consent) were diagnosed with asthma, one of those two was severe.

    None of the seven have suffered with asthma or asthma like symptoms since.

    There is not enough data though, to positively conclude that it’s a cure for asthma – though a great many in St. Vincent swear by it.

    I think we should at least do a survey, and find out what experiences people have had.


  14. I am asthmatic and keep my rescue inhaler with me whereever I go, including the beach and long walks, but I have come across some asthmatics who do not do this and sometimes their medication is expired or used out and they have not replaced it. I am not sure if they realise how serious a bad asthma attack is.

  15. Georgie Porgie Avatar
    Georgie Porgie

    Me
    The fact that steroids are also naturally occuring and produced by the body means nothing at all. Many naturally occurring substances are dangerous and poisonous.

    Re the MD will ( should ) only prescribe a steroid if he/she feels that the immune/operating system needs the additional help

    THIS IS ACTUALLY FALSE! STEROIDS ARE ACTUALLY IMMUNOSUPRESSANTS AND ARE ACTUALLY USED FOR THIS PURPOSE IN ASTHMA. STEROIDS ARE NOT USED TO ASSIST THE OPERATION OF THE IMMUNE SYSTEM.

    Steroids suppress the anti-inflammatory response, and are used for this purpose in asthma. In asthma release of antihistamine by mass cells causes the release of chemo-attractants and a particular type of white blood cell called esosinophils into the bronchioles as a normal anti-inflammatory response. However, this is overdone in asthmatics and other atopic persons. This results in a lot of sticky secretions in the bronchioles which decreases gaseous exchange in the alveoli of the bronchioles.

    By applying very small doses of steroids directly (locally rather than systemically) to the membranes of the bronchial tree the hypersensitivity of the area is reduced or suppresed greatly. The over active anti-inflammatory response in the asthmatic must be suppressed for the treatment of asthma.

    Steroids like almost all other drugs have there purpose. All drugs are potential poisons and the benefit over the adverse effects must be assessed when they are used.

    David You now have the correct clarification. The doses of steroids given to asthmatics has been greatly reduced over the years with the advent of the inhaler and nebuliser. We have gone from using hundreds of milligrams to micro grams. We have gone largely from giving the steroids intravenously and orally (systemically) to locally by inhalation. By giving the drug locally thus not only do we reduce the dose but also its side effects.

    Ian Bourne is correct. Dr Malcolm Howitt is the man to contact about asthma in Barbados or/and Dr Timothy Roach.

    Keith Headley. Perhaps you should stick to your field. Asthmatics are atopic persons. Should we also give ganga to folk with allergic conjunctivitis, and allergic rhinitis too. Such prescribing habits does not consider either the causation of the disease, or the adverse effects of the drug in comparison to the so called benefits.

    Re a great many in St. Vincent swear by it.

    A great many also swore by using leaches and blood letting in medieval times too.

    Kay is correct. All asthmatics should keep their rescue inhalers with them at all times, and should ensure that it is not used up.

    Ideally you should have a beta agonist and a steroid plus or minus atrovent


  16. If steroids suppress the immune system is that not assisting in the operation of the immune system. All humans have steroids which in a healthy person help ( assist ) regulation of the immune response among other things. In persons who have immune related conditions inparticular auto-immune conditions such as Lupus and Rhumatoid arthritis steroids are given to supress the immune system. In asthma steroids work on the inflammatory response. Sorry if I over simplified but I assumed I was speaking to an audience of lay people.

    Thanks for further elucidating the use of setroids in ensuring that the immune response benefits rather than harms the patient.

  17. Georgie Porgie Avatar
    Georgie Porgie

    Asthma is an inflammatory disease associated with bronchial hyperactivity bronchospasm, increased mucus secretion, edema, and cellular infiltration.

    Early asthmatic responses lasting from 30 to 60 minutes are associated with bronchospasm from the actions of released histamine and leukotrienes.

    Late asthmatic responses involve infiltration of eosinophils and lymphocytes into airways à bronchoconstriction and inflammation with mucous plugging.

    Management of asthma includes ronchodilators to provide short-term relief and antiinflammatory agents that reduce bronchial hyperactivity and protect against cellular infiltration.

    In asthma ,steroids block mediator release and decrease bronchial hyperactivity via decrease prostaglandins (PGs), leucotrienes (LTs), and inflammatory interleukins (ILs).

    Surface-active drugs (beclomethasone, flunisolide) are used via inhalation for both acute attacks and for prophylaxis

    They may cause oropharyngeal candidiasis and systemic effects with excessive use, including decreased long bone growth in children.

    Low dosage may also prevent the desensitization of beta receptors that can occur with overuse of beta 2 agonist

    Prednisone (oral) and IV steroids are now generally reserved for severe acute attacks, because of its side effects.

  18. Georgie Porgie Avatar
    Georgie Porgie

    me
    If steroids suppress the immune system is that not assisting in the operation of the immune system. TECHNICALLY NO. THEY BLOCK THE ACTIVITY OF THE IMMUNE SYSTEM

    It is true that steroids are used in persons who have immune related conditions to suppress the immune system. Asthma is one of these immune related diseases. In asthma steroids work to suppress an overreactive (hyperactive) inflammatory response.

    •Mechanisms of action of the endogenous cortisol made by the body:

    A-Cellular effects on adhesion molecules include
    •Decrease leukocyte migration
    •Increase lysosomal membrane stability —> Decrease phagocytosis
    •Decrease capillary permeability
    •
    •B- Biochemical actions include
    •Inhibit phospholipid A2 (PLA2) (via lipocortin expression) —> Decrease prostaglandins (PGs) and Decrease leucotrienes (LTs)
    •Decrease expression of COX 2
    •Decrease platelet-activating factor
    •Decrease interleukins (e.g., IL-2)

    It is certainly geting very complex!

  19. Keith Headley Avatar

    I freely admit this is not my field.

    But to all persons who think I should stick to my field I have two words.

    Louis Pasteur.

    “Such prescribing habits does not consider either the causation of the disease, or the adverse effects of the drug in comparison to the so called benefits”.

    Ah, doctors.

    Only doctors can solve your health problems.

    Yes DOCTORS recommended leeches and bloodletting.

    In early America Indian proponents of natural medicine opposed this and were decried by doctors of the time.

    1) I am not “prescribing” anything. If you read to the end of my entry I am enjoining us to find out more about traditional medicines which, according to oral traditions, have been effective for generations, and one such remedy in particular.

    2) I freely admit you know more than me about asthma as described by modern medicine. The problem is 50 years of modern medicine always trumps 300 years of traditional medicine.

    For example – the Native Americans KNEW from over 300 years of traditional medicine that leeches and bloodletting don’t work.
    I can give you 50 years of peer reviewed and authoritative articles that say ( from that time) that it did.

    Later on scientists said they were wrong.

    This is the way of science – where we treat it as a religion – it’s right until we say it’s wrong – and then we’re still right.

    A thousand experiments proved the Bohr model correct – until we discovered orbitals. 10,000 proved that right – until we discovered Schrödinger’s equation.

    I have never heard a doctor say; “I was wrong”.

    Well, I will say it.

    I was wrong to step on your toes as a medical professional. I don’t claim to have your knowledge.

    I was wrong to suggest we put more research into utilizing natural plants and herbs – we should use pharmecuticals refined from those plants – they have a more precise dosage.

    I will be wrong to suggest that vegetables and medicinal plants have anything in common; that the same way we can make tasty dishes from potentially fatal plants; is the same way those who spend their lives learning to heal people without a single machine have a role to play in modern medicine.

    And I will be very, very wrong to suggest that we investigate further things like almond seeds, which have been used for centuries to cure the symptoms of cancer. I would be very wrong to say that it cures cancer, because the oral traditions don’t talk about cancer, only symptoms that can be considered similar.

    I am so very wrong to have an opinion on, or to speak about anything other than Solar Energy.

    So very wrong.

    So very Louis Pasteur.

    How dare a chemist change everything every doctor has ever done.

    All I have to say is, I am open to learning about new things, whether they be right or wrong. I am willing to investigate first, and pass judgment after.

    I don’t KNOW if marijuana works, but I’d like to find out. I might someday have an asthmatic child. I’ll tell you something else, sometimes NONE of what doctors do now works – and someone dies.

    We call that a tragedy.

    Do we lose confidence in doctors? No.

    I remember solving one of my most complex problems building a Solar Thermal device by listening to someone who had no idea how it worked – and after explaining it to them they said;

    “Well; why not put that “thing” there in the other way around?”

    We had spent three years designing that part; it was difficult to manufacture; and what do you MEAN put it in . .

    But the power of prayer is wonderful. A little voice said to me “why not try it?”

    Madness! Years of experience told me.

    But I did try it. It solved our biggest problem. We use it still today.

    The person who told me is still clueless . .

    But God can use anyone.

    So you have a choice GP about listening to those who know less about something than you do.

    Dismiss or listen.

    The choice is yours.


  20. Asthma is not the only disease which seems to be becoming more prevalent as we become more developed a nation. Other auto-immune diseases like Type 1 Diabetes, M.S., etc. all seem to be on the increase not only in our developing nation but all across the world. Perhaps one day science will work out why, maybe it would help if we looked at all these types of diseases together rather than some people concentrating on asthma , some on M.S. etc., etc. as the rising incidence seems to be tied to improved standards of living.


  21. good idea

    good idea

    this thing really needs some attention

    100% support for the idea

    i understand there is something called exercise induced asthma

    i understand too that people can developed asthma as adults

    any info on this

  22. Georgie Porgie Avatar
    Georgie Porgie

    Keith Headley you are good at sarcasm in addition to solar issues, that is very obvious.
    Like you, I am a chemist.

    I wrote that “Such prescribing habits does not consider either the causation of the disease, or the adverse effects of the drug in comparison to the so called benefits” This is sound advice that cannot be condemned whether you are dispensing modern drugs or cannibis.

    All I implied is that when using any chemical substance in the body; from common salt to marijuana one should consider the benefits to be derived compared to the adverse effects. This is actually plain common sense, actually.

    I have taken courses in alternative drugs, and read texts of alternatives drugs which are written by alternative doctors and set out just like any pharmacology text. I have myself used and recommended the use of saw palmetto and Chromium picolonate, and tumeric etc

    Unlike you, I am not an expert on traditional medicine or oral traditions but I have listened for hours to my cousin who is a doctor also, but who is deeply into traditional medicine ……and from whom I seek an opinion periodically.

    Certainly, though imperfect, the Bohr model correct and the discovery of orbitals both contributed to our understanding of Chemistry. However, I don’t seem to recall that Manley West and others at Mona found any great use for cannabis in the treatment of asthma, and they did extensive research to put both their names and UWI out their in Pharmacology in their work on this prized drug in St Vincent.

    I am all for utilizing natural plants and herbs, but I and others have found that the purification of the active agent from the puree is difficult, and that the other substances in the brew often cause more harmful effects than the useful active agent that we seek to extract. We all know that pharmecutical companies add moieties to some natural products so that they can patent them and make money in large amounts. This is sometimes the reason

    I have all ready pointed out that I experimented and got good results using tumeric for pain. This is the same root that my mom puts in her hot sauce in the powdered form. It is also a component in curry and mustard as you know. Saw palmetto works just as well as the two “terides” on the market, as it has the same mechanism of action, as worked out by the alternative medicine scientists. So I am on the same page as you- and without the sarcasm. You will notice that having done some investigation myself, and used alternatives agents ( and note that some like St John’s wort are as dangerous as the MAOI’s that they mimic) I can now pass judgement.

    It is quite true sometimes NONE of what doctors do now works – and someone dies.

    I really cant understand how someone with your brilliance and investigative skills could not understand that you ought to have tried putting that “thing” there in the other way around, until some one who is still clueless figured it out or suggested it. I cant understand how you didn’t see, that you ought to have tried the thingy in different ways.

  23. Georgie Porgie Avatar
    Georgie Porgie

    Kay & ROBOT
    Actually much research is being done at QEH by UWI on all these diseases. I think Prof Hennis is in charge.

    Exercise induced asthma occurs during exercise when cold air triggers a hypersensitivity response in the bronchi. I think that a similar thing can occur in the colder parts of the island when the temperature drops at “fore day morning.”


  24. Pollution is the root of the problem.As nations develop, one can see this problem occuring again and again.
    The vehicles we drive, herbicides,pesticides,and contamination of the water table from cattle dosed with antbiotics, harmones etc. and chemicals used to treat lawns and golf courses, occuring in our environment, all can have a debilitating effect on the human body,especially the young as their immune system is not yet developed.
    Stress in our society can also be a contributing factor.
    Some things mentioned in the above comments might help towards relieving the symptoms in the short term but we need to look at the causes and preventative measures.
    Now would be a good time to work on this.—ACTION NOW.


  25. Why do we have to wait unitl a socialite (No disrespect intended to the late Terry or his family) is affected for attention to be paid to serious issues?
    Every night at the QEH’s Asthma Bay scores of ordinary Barbadians turn up with severe asthmatic attacks. No mention has ever been made of them. But now Terry has passed on we now appreciate the seriousness of the disease.

    Is it that the poor man is not recognised?


  26. Paradox

    There is no hard evidence to suggest that “pollution is the root of the problem” with respect to ashthma.
    As you mentioned above and from the comments of others, there are many other causes.
    Sadly, even medical doctors are at divergence on the ashthma paradox. Some of them don’t have a clue on how to keep it away.
    They will recommend Becotide, Ventillin and a host of steroids, but these are just band aids.
    What we need to do is get to the root of the problem. There are low cost solutions to marginalise the disease, but it calls for sacrifice on the part of the patient. It also takes time.


  27. Paradox: You beat me to the punch. I have posted on the issue of rampant pollution in Barbados before. The spewing of diesel and unleaded petrol, pesticides used in the home, and chemicals released into the atmosphere by factories are the culprits in triggering asthma attacks.
    Until the government and the ordinary citizen in Barbados takes this issue seriously there will be more unnecessary deaths. Barbados does not live in a vacuum or a glass house and it is time that it recognized that they (Bajans) have a responsibility to the environment and the citizens that dwell in that environment.

  28. Georgie Porgie Avatar
    Georgie Porgie

    Asthmatic
    One simple way to keep all those folk at the QEH’s Asthma Bay every night might be to give all asthmatics aminophyline suppositories to use when they feel an attack coming on.

    In the eighties many of my asthmatics used to come back to me just to get a script for aminophyline suppositories. They claimed that their use significantly reduced their visits to the QEH. Then the director of the drug service, who had never treated an asthmatic in his life, took aminophyline suppositories of the Drug formularly.

    His rational was that drugs given by the rectal route are not absorbed uniformly. It is true that drugs delivered high in the rectum is absorbed at a different rate to drugs delivered lower in the rectum because of the difference in the blood supply. But I got very good results with aminophyline suppositories


  29. Exercise induced asthma occurs during exercise when cold air triggers a hypersensitivity response in the bronchi. I think that a similar thing can occur in the colder parts of the island when the temperature drops at “fore day morning.”
    ————————->

    break it down for me nuh

    i listening to admiral nelson talking so much shoooo that muh head confused right now
    admiral want tekking off the radio though-some very racists and elitists comments about survival of the fittest–give an idiot a microphone on a radio station and see how much damage he does-

    so brek it down for muh g p


  30. Dear Dr. Georgie Porgie,
    Do you believe that there are simple natural things that a person can do to keep asthma at bay? I’m no doctor, but I believe there are things we can implement


  31. It is interesting to read of the allergens and triggers which can set the asthmatic off, yet smoking in many places in Barbados where people congregate is still a feature of our landscape.

    To those who feel we are making a fuss because a popular person has died with the condition, what should we have done?

  32. Keith Headley Avatar

    GP I too have seen that Mona report – I find it interesting that if you know any Rasta with an advanced degree in the Natural Sciences who has seen it, they deride it for two reasons.

    1) Manley West totally ignored the advice of these “non-scientists” (local healers) (the word I think he used) on how the drug should be used.

    2) They think, to put it mildly, that he was bought and paid for (which I don’t agree with, but I respect their position).

    To put a chemist’s spin on it – one Rasta told me “Put it dis way; if we in ah lab, he wud nah ask yuh, if yuh add de strong acid to water or water to de strong acid. An’ vex wid we when we tell he de results nah valid.

    Which is why I suggested what I did. Talk to the people.


  33. the most photographed person in barbados is esther byer-suckoo

    can some one keep her off my television

    oh my !`~*&%$*

  34. Georgie Porgie Avatar
    Georgie Porgie

    Friends, in this note I will report some findings from a few abstracts of papers I found online.

    One Australian study suggests……. that high house dust mite allergen levels in a humid, subtropical region act to significantly increase bronchial responsiveness in sensitized children, and that allergens have a similar but less potent action in a dry, rural regions

    One study from Finland states that ….. Although possible mechanisms exist to explain how smoking could have a role in the aetiology of asthma, this study suggests that smoking is not a strong risk factor for asthma.

    Another study points out that …. There is increasing evidence that inflammatory mechanisms other than eosinophilic inflammation may be involved in producing the final common pathway of enhanced bronchial reactivity and reversible airflow obstruction that characterises asthma. A review of the literature has shown that, at most, only 50% of asthma cases are attributable to eosinophilic airway inflammation. It is hypothesised that a major proportion of asthma is based on neutrophilic airway inflammation, possibly triggered by environmental exposure to bacterial endotoxin, particulate air pollution, and ozone, as well as viral infections. If there are indeed two (or more) subtypes of asthma, and if non-eosinophilic (neutrophil mediated) asthma is relatively common, this would have major consequences for the treatment and prevention of asthma since most treatment and prevention strategies are now almost entirely focused on allergic/eosinophilic asthma and allergen avoidance measures, respectively. It is therefore important to study the aetiology of asthma further, including the underlying inflammatory profiles.

    Yet another study asserts—- Despite considerable research, the aetiology of asthma and allergic disease remains poorly understood.
    There is evidence pointing to the role of exposure to allergen, various aspects of diet and hygiene-related factors in the aetiology of asthma.
    There is also evidence that heritable factors influence the impact of hygiene-related exposures on the risk of having asthma. At present there is no unifying theory to explain the childhood origins of asthma and, hence, no solid basis for developing preventative interventions. Progress towards this goal requires better understanding of the heterogeneous nature of the disease in early childhood, improved characterization of relevant environmental exposures and long-term follow up of birth cohorts with reliable and valid measures of allergy and asthma outcomes.

    And finally …..

    The prevalence of asthma, in particular atopic asthma, has markedly increased in recent years. Accumulating evidence suggests that environmental factors associated with allergic sensitization and exposure to microbial stimuli during infancy and early childhood, are associated with these changes in prevalence. However, considerable controversy surrounds the role of microbial agents, as evidence has been presented for both positive and negative effects in this context.

    Asthma is thought to result from both genetic and environmental influences. The genetic component is most obviously seen in patients who are atopic and have allergic responses to common antigens.

  35. Georgie Porgie Avatar
    Georgie Porgie

    Ok Mr Headley
    I agree with you completely that if one is not supervising one’s staff properly or listening to thier ideas or the findings, that I canot take the results of your research seriously.


  36. On the treatment side the QEH, FMH and Sandycrest in Holetown are a long drive if you live in St. Philip, St. Andrew, St. Joseph and St. John. Maybe it is time that small asthma bays were placed at strategic points around the island.


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  38. Georgie Porgie Avatar
    Georgie Porgie

    Kay

    It might surprise you to know that it was suggested to this new Government that all polyclinics be converted into emergency units with asthma bays and observation wards, and that at least 2 other centres be built at Hothersal Turning and below the junction of Highways 4 & X in St George.

    These centers would address the catchment areas of your concern.


  39. I think it would be a very good idea. It would take some of the strain off the QEH, be much better for the people needing the care, and in the case of a major disaster there would already be centers set up around the island.


  40. However Hothersall is not that far from the QEH, or the polyclinic at Warrens. There needs to be something in either St. Joseph or St. Andrew. Speaking from experience it is a long drive to St. Michael when you are having trouble breathing.

  41. Georgie Porgie Avatar
    Georgie Porgie

    In my plan Warrens covers St Thomas & St Andrew among others. Hothersol covers St Joseph parts of St Thomas, St John St George.
    My plan is based on the major highways and public transport.

    Even at peak hours I guess you can still get to these shosen emergency points within a short time from the periphery of their catchment areas. Note that these areas were chosen for all emergencies, and chosen to take the pressure of the QEH emergency services 24/7.

    I agree that its a long way to St Michael when you are having trouble breathing, but you would use your aminophyline suppositories before leaving home. Aminophyline is a potent bronchodilator used to be the major drug we used before the advent of the beta agonist and steroid inhalers or atrovent. I used to get very good results with my outpatients using aminophyline suppositories because it decreased symptoms, such that in acute cases it reduced the times they had to go to casualty. But Lennox Prescod took them off the formulary, when he was directory.

    Aminophylline IV is still sometimes used in bronchospasm for status asthmaticus in some parts of the world. We used to give a loading dose of 500 mg slow “IV push“, and then adjust the dose carefully because theophyllines have a very narrow therapeutic window or low margin of safety that predisposes to toxicity- i.e. toxic blood levels are not at all far above the therapeutic range. I have never seen a lot of side effects in those days, but the drug used to work like magic.


  42. There will always be people, often children, having their first asthma attack. They will not have aminophyline suppositories. Also there are other illnesses with difficulty breathing. So I repeat that as it is at least 20-30 min drive to St. Michael from St. Andrew and St. Joseph and they need a treatment center also. Also if the patient has no transport and has to call for help that could double the time untill treatment.

  43. Georgie Porgie Avatar
    Georgie Porgie

    Kay
    You have valid points, but no national health system can provide for all contingencies. Indeed I am not even sure if aminophyline suppositories are still available in Bim. I certainly could not get any for my son in 1994.

    My plan is certainly better than what exists now, dont you think? I understand how you feel, because it is clear that the Dr who is the minister is clueless.

    Note that even in the developed countries, healthcare delivery is often more than 30 mins away (unless you are in a city) and you have to have insurance etc to get it.

    At any rate my ideas are not important to the current government, so all of this is moot. If I had a say, I would distribute the healthcare to the periphery as much as possible using the existing highways to determine my catchment areas. I would use the existing facilities as much as possible and build two others. These centers would be at the apex of a wedge that brings traffic into town.

    Though sighted fortuitiously and not by design initially, you will notice that Warrens is perhaps the best sighted of our clinics.


  44. Wildey and Six Roads are also good sites. But sadly the people in the two parishes I mention are always forgotten. It seems that many Bajans think this side of the island is just for picnics and party monarch. We don’t want a 4 lane highway or concrete jungle but easy access to the healthcare that the rest of the island takes for granted should not be that difficult to achieve. Also I do not think that we should base our developement on what other countries have, we want to treat our people better than many developed countries treat theirs. Because we respect human rights more than many countries which might be considered more developed than us, and access to health care is an important right.

  45. Georgie Porgie Avatar
    Georgie Porgie

    Kay wrote
    I do not think that we should base our development on what other countries have, we want to treat our people better than many developed countries treat theirs. Because we respect human rights more than many countries which might be considered more developed than us, and access to health care is an important right.

    I agree with you wholeheartedly Kay. We probably have a greater access to free healthcare than most developed countries as it is right now. Attempts to make it better are just being ignored, that’s all. I guess that money spent for 4 lane highways could be put into healthcare.


  46. Yes, then maybe some of the centers around the island could be dedicated in the memory of people like Terry Mayers rather than just an annual observation as was origionally suggested.
    Maybe we need to work together as citizens to get the first one up and running, maybe in the Oistins area or at the airport, I believe someone died there a few years ago of an asthma attack.


  47. I have been seriously athsmatic since childhood.
    My last major attack was 20 years ago.
    Since then I have been taking Flovent continuously until about 2 years ago when I switched to Advair.
    I occaisonally use Ventolin as rescue medication if I am outdoors in smog or on very cold winter days.

    I have not had an attack in 20 years because of the continued use of these drugs.

    I am wondering if people who take these corticosteroids are still having attacks.

    Maybe I am just lucky so far but I am inclined to think that most athsma sufferers do not take medication continuously like I do.

    I expect I may develope problems from the use of the drugs but it is worth it to me to live a relatively normal life for the past 20 years.

    I also notice that Advair alone is enough to keep me breathing normally with little need for Ventolin.

  48. Georgie Porgie Avatar
    Georgie Porgie

    Hants
    It is possible that you have not has a major attack for 20 years because you changed your environment.

    I have heard of folk whose attacks diminished when they went abroad, and vice versa.

    I had a friend who moved from the city to a suburban area in the early 60’s, and had no attacks for 17 years or so until he moved to an area where his new home was virtually surrounded by canes.

    You are wise to take your topical steroids often, and it is probably the reason that your asthma has been so well controlled. You are correct in opining that most athsma sufferers do not take medication continuously like you do.

    You will probably not develop problems from the use of the fluticasone, that you have been using (Flovent and a constituent in Advair) because this steroid is applied in very small doses to your bronchioles, and is cleared from the body immediately with very little of it being absorbed—compared to folk taking oral or intravenous steroids.

    FYI Ventolin is albuterol sulfate ( a beta agonist) and advair contains fluticasone and salmeterol ( a beta agonist).

    Persons who take their medication can still have attacks if they are heavily exposed to allergens and other precipitating factors, and who are not as prepared as you are. First, you seem to take your maintenance medication, and you have your rescue medication for both the cold and the smog. You are proactive about your treatment, rather than being passive and playing catch up when you are in the presence of precipitants. Seems you have been creating your good luck Sir!


  49. I think that is a very good idea. Me having a daughter with asthma, I knew nothing about it, and to this day I dont know much.

    The good thing about A&E is that the treat those patients as soon as they come, but the wait to see the doctor is so dreadfully long, and when u do get the chance to see the doctor he is so caught up with his “serious patients” that he doesnt answer any question with details. Just to make u comfortable with a young lady with a young sick baby who knows nothing about it.

    But I took it upon myself to do my research and I know now alot i didnt know before.

    Thank God for goggle.

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