Asthma

Homeopathy has an important part to play, writes Mabel Aghadiuno Asthma is a very common condition affecting five per cent of the population at one stage of life. In the Western world, up to ten per cent of children have the disease. It is certainly not confined to our epoch Seneca the younger, a powerful Roman leader and historic figure of the theatre, described his asthma as his last gasp. However, he was something of a celebrity during his age and his demise was certainly not due to asthma! In asthma the bronchial tubes narrow and this makes it more difficult to breathe. Symptoms that occur in asthma are chest tightness, coughing, wheezy breathing and shortness of breath. These symptoms may simply occur when the body has to work harder such as on walking quickly, going upstairs or running. House dust may provoke an asthma attack if there is a history of allergy as may exposure to cat, dog or horse hair. People who suffer from hay fever may find that they get asthma-like symptoms too. It is helpful to find out if the asthma is caused by an allergy as this can offer some direction that treatment with homeopathy may pursue. Asthma patients may have a personal or family history of hay fever and/or eczema, as these conditions tend to exist together. Conventional treatment In terms of conventional treatment, the medication available can offer reasonable control of symptoms. Bronchodilator inhalers (available on prescription) such as Salbutamol (Ventolin) and Bricanyl (Terbutaline) are designed to act on the muscles of the airways and help the air flow through. You could think of the airways as tunnels, which narrow down when there is asthma. The bronchodilators are the workmen which widen the tunnel allowing greater flow of air (the traffic). There are also steroid inhalers such as Becotide (Beclomethasone) and Pulmicort (Budesonide) which you could imagine to be the workmen who do the maintenance work in the tunnel preventing the build up of debris or do things which keep the tunnel nice and wide they act by reducing the inflammation. If used well and if the asthma is not severe, inhalers such as Becotide can do a good job. If someone has asthma and they are already on conventional medicine I would strongly recommend that they do not stop their medication or alter it without deciding this together with a doctor. Stopping medication can result in a flaring up of the asthma and this may be confused with a homeopathic aggravation, or worse, it could be potentially very serious. Nevertheless sometimes people do not like the thought of taking these drugs and of the side effects that can occur. The side effects of Salbutamol are generally mild and steroids used short term rarely cause problems but the long term use of steroids even if inhaled may lead to potential problems if large doses are used. Initially homeopathic treatment may be used alongside conventional treatment but eventually we wish for a reduction in inhaler use and hopefully we can wean the patient off them provided that homeopathy gives a result as good or better than that obtained with inhalers. Homeopathic treatment So what homeopathic medicines are available to treat asthma? Asthma like any other condition can be treated with homeopathy at various levels. The ideal would be to find the treatment, which reflects the Similimum of the case (or as near to the Similimum as possible). By Similimum, I mean the remedy that best matches the person not just in terms of his symptoms but also in terms of his psyche and the way that he relates to other people and to life generally. This would offer a deeper prospect of healing. However finding the Similimum may not always be possible and there are many remedies which may be given for the symptoms of asthma. There are also remedies that can be given for the causes of allergic asthma (homeopathic preparations of house dust mite, grasses and pollens etc). Asthma is a condition for which I would highly recommend professional treatment I would not advocate selftreatment. Here are the outlines of a few remedies, which may be helpful in the treatment of asthma. Blatta orientalis This is the large dark Oriental cockroach. As a species, cockroaches are night-active insects and most live in damp places. Interestingly, asthma sufferers who benefit from this remedy may complain that their condition is worse in mouldy, damp environments. There may also be an allergy or sensitivity to moulds, mildew and rotting leaves. This group of people comment that exertion and ascending tend to aggravate their symptoms although this can be a general finding in asthma. The combination of obesity and asthma indicates that Blatta orientalis is a remedy worth considering. Ipecacuanha If asthma is associated with nausea and/or vomiting then Ipecacuanha could be indicated. This remedy is obtained

from the dried roots of a creeping shrub, Cephaelis (or Psychotria) ipecacuanha, which is native to Brazil but cultivated in other tropical climates. Emetine, the active principle of Ipecac, is obtained from the bark or the root. It is a powerful poison that produces vomiting and is sometimes prescribed to relieve the stomach of some other poison. Traditionally Ipecac is used as an expectorant in the treatment of bronchitis or croup, stimulating bronchial secretions to make coughing easier. In terms of homeopathy Ipecac patients present with a constant cough with gagging and vomiting. The chest may rattle and the patient complains that the symptoms are worse in warm humid weather and that heat generally makes her feel worse. She therefore may prefer sitting up by an open window to get some air. The hands and feet are cold and perspire profusely. Ipecac is recognised as a remedy for childhood asthmatic crisis. Prompt medical intervention is obviously indicated well before a child reaches this stage of illness. Lobelia inflata Lobelia inflata (Indian tobacco) derives from a common American plant, which has small blue flowers and inflated capsules. The inflation of the capsules could serve as a symbol of the type of asthma that this remedy helps. Asthma can be a frightening experience especially when you feel that you are not getting enough air into your lungs. As with many other conditions, this can lead to hysteria and panic. Panic can lead to working unnecessarily hard to breathe and this can result in over-inflation of the lungs. With this type of asthma, the shortness of breath is far out of proportion to the wheeze and therefore the amount of narrowing of the airways that there actually is. The patients who need Lobelia can feel a sensation of constriction or a lump in the chest. It can also be helpful when an asthma attack occurs during labour. Drafts and cold or damp tend to make the asthma worse while slow deep breathing make it better. Strangely, rapid walking also improves things. Antimonium tartaricum This, like Ipecac, was used traditionally in medicine as an emetic. It was also used as an expectorant helping the production of catarrh from the chest. It was used in the treatment of several diseases. but because the side-effects were frequent and toxic this eventually limited its use. Fortunately, the doses that are used in homeopathy are infinitesimally small so it can be administered with some benefit. This remedy can be useful in children and in the elderly, especially where the asthma is associated with infection and a lot of mucus. The mucus causes a coarse, wet sounding rattling noise both on breathing in and out. The patient may say that he feels generally better when he is fanned but he also might be rather irritable and wish to be left alone. There are also some other symptoms such as breathlessness, which is worse from heat and lying, but these are not really very specific. Sambucus nigra This can be helpful particularly in childhood asthma. The elder is one of the most mysterious plants in British folk tradition. Traditionally feelings about the elder were ambivalent some considered it the friend of witches and were extremely superstitious about even bringing the wood into the house. However, the elder was also used for its protective and curative effects protection against witches, for warding off flies and curing warts. The remedy Sambucus nigra is prepared from a tincture of the leaves and flowers. There was a legend that if you fell asleep under elder flowers, the scent would poison you and you would never wake up. Perhaps there is some truth in this if homeopathy will cure what it will cause. The patient who might benefit from Sambucus wakes up in the night with a frightening sensation of suffocation and may even have cyanosis (blueness of the face). There can be severe spasms of the respiratory airways so it is very frightening. These patients are worse at midnight or from midnight to 3am. The asthmatic attack may be associated with marked perspiration, especially on waking. Natrum sulphuricum This is a very useful remedy for asthma in both children and adults. The asthma may stop at puberty and reappear later from the 30s onwards. The asthma may even appear in association with a period of grief. It tends to be worse at 4am or between 4 and 5am. Damp weather be it cold or warm makes it worse, as does fog and storms. It may also be worse before menstruation. At times, there can be rattling and greenish mucus. Medorrhinum This can be very valuable in the treatment of childhood asthma, particularly where asthma and eczema may also be combined. The shortness of breath is reputed to be better when the child kneels on the bed curled up with the chest touching the knees (knee-chest position). Wet weather makes the asthma worse but being at the seaside improves it. Tuberculinum This is a useful remedy for asthma sufferers as it helps build up the immune system to try to prevent recurrent colds and chest infections which may precipitate asthma attacks. One-liners, which may direct towards a particular remedy, are:

Wheezing improved by belching: Carbo vegetabilis Cough improved by taking cold drinks: Cuprum metallicum Asthma symptoms improved at night by lying: Euphrasia Cough worse from eating: Kali bichromium Marked sneezing that makes asthma attack worse or provokes an attack; coughing causes tears: Sabadilla.

Finally asthma sufferers include many famous people from the past and present day. Beethoven, Charles Dickens, Che Guevara, John F Kennedy, Elizabeth Taylor and Judy Collins number in their ranks. Besides having asthma in common, they all led or lead active, full, varied and energetic lives the ultimate aim for all asthma patients.

Symptoms and cause of asthma. Homeopathic remedies are very commonly used to treat asthma. Find more information on homeopathy treatment for asthma.

Asthma is a chronic disorder in which there is inflammation of the bronchial tubes with prominent eosinophil infiltration causing variable airflow obstruction. It affects the airway that carries air to and from our lungs. Swelling and inflammation makes the airway extremely sensitive to irritation and increases susceptibility to an allergic reaction. As inflammation causes the airway to become narrower, less air can pass through them both to and from lungs. The condition is clinically characterized by variable cough, chest tightness and wheeze. Physiologically asthma is a complex cascade of conditions and interactions that lead to acute airflow obstruction, increased mucus production, bronchial hyper responsiveness, and airway inflammation. Each of these interactions and their manifestations can be slightly different depending on the individual and can even vary in severity in the same individual due to their internal physiological environment and external factors. It is these physiologic interactions that result in the wheezing and breathing difficulties that the individual experiences and we call asthma. The clinical characteristics of asthma are defined as the occurrence of symptoms and the presence of airway obstruction, inflammation, and hyper responsiveness. (Margaret A. Clark; Asthma: A clinicians Guide 2010; 15-16)

Difficult breathing (dyspnoea) which produces shortness of breath, with or without tightness in the chest (a feeling of pressure on the chest), is

caused by the narrowing of the bronchi and bronchioles. In young children who are unable to express what they feel, parents may sometimes notice fast breathing and retractions (the chest being sucked in as the child inhales). Whistling sounds, or wheezing, may occur because of the decreased size of the bronchi. Coughing can be severe. In some asthmatic patients, it is the main and sometimes the only symptom. Typically, the coughing occurs mostly at night or early in the morning. Finally, asthma is often accompanied by bronchial secretions (coughing up mucus and phlegm) Asthmatic patient do not all experience symptoms in the same way or to the same degree. If asthma is well managed, symptoms can be minimized or eliminated. In severe asthma or when asthma is inadequately treated, symptoms can be continuous.
Symptoms of asthma can be summarized as:

Cough Wheeze Shortness of breath Chest tightness Rapid pulse Cyanosis Shallow breathing Feeling of suffocation Restlessness Drowsiness Sneezing Anxiety Perspiration Cold extremities Short inspiration Prolonged expiration

Finding its causal agent is the single most important step you can take toward controlling your asthma. Unless and until you know exactly what brings on your wheezes, you will have trouble treating them and you will always be troubled with them. A multitude of substance or bodily conditions precipitate asthma attacks. The most important once are: - Cold or upper respiratory infections, especially in children

- Allergens (dusts, pollens, molds, animal dander, and so on) - Foods, especially food additives - Vigorous exercise - Hyperventilation (fast, shallow breathing often associated with emotional or stressful experience) - Certain drugs or medication, especially aspirin and ibuprofen (such as Advil and Nuprin) - Air pollutants, including tobacco smoke, smoke from woodburning stoves, and the by-products of automotive of industrial combustion like carbon monoxide, ozone, nitrogen dioxide, sulphur dioxide, and particular matter. (M. Eric Gershwin, Ed L. Klingelhofer; Asthma: Stop Suffering, Start Living 2001; 66) Along with medical history and physical examination, diagnosis mainly includes pulmonary function test, chest radiograph, full blood count, skin test, provocation or challenge test, IgE and IgE specific test. Homeopathic treatment of asthma Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which a patient is suffering. The aim of homeopathy is not only to treat asthma symptoms but to address its underlying cause and individual susceptibility of the patient, in an effort to cure asthma. The aim is to cure the patient and not just palliate the symptoms of asthma. For this, patients current symptoms, past medical history and family history are taken into account. There are many homeopathic remedies which cover the symptoms of asthma and can be selected on the basis of cause, location, sensation, modalities and extension of the symptoms. For

individualized remedy selection and treatment of asthma, the patient should consult a qualified homeopathic doctor in person. Some important remedies are given below for the treatment of asthma: Aconite, Kali Carb, Thuja, Natrum Sulph, Belladonna, Ipecac, Aspidosperma, Blatta O, Kali Bi, Kali Phos, Sulphur, Lycopodium, Lachesis, Arsenic Album, Bryonia, Antim Tart, Medorrhinum and many other medicines.
Aconite

excellent remedy during acute attacks of asthma, which will ease the breathing and cough. Symptoms of dysnoea are often accompanied by marked anxiety, fear and restlessness. Arsenic alb Asthma with great anxiety and restlessness, often worse around midnight and lying down, better by sitting up and warm drinks. Antimonium tart - is a good asthma remedy for children and the elderly especially useful when the asthma has been caused by an infection. The cough will have coarse rattling in the chest on both inspiration and expiration. The patient will be worse lying down and at night generally. They may be irritable and want to be left alone. Ipecac -Asthma patients who suffer from coughing spasms resulting in vomiting or retching. Its also greatest for asthma that comes with mucus or phlegm within the breathing tubes. Carbo veg - Severe acute attacks of wheezing with significant belching and flatus. Patient feels very weak and may collapse. Kali carb this remedy often indicated in asthma, especially when the attack comes at night, after midnight, from 2 to 4 am. Belladonna this remedy works when there are violent spasms of asthmatic breathing attended by constriction of chest. Redness of face during acute bout of cough. Aspidosperma an effective remedy in asthma with difficult respiration. It is often used as palliative. Blatta orientalis -remedy for asthma with or without bronchitis. It is often used as palliative. Lycopodium asthma due to excitement by anger or emotion with fanlike motion of ala nasi.

Pulsatilla - Cough

with green discharge. The patient must sit up during the asthma crisis and is better for fresh air. Even fanning may help them feel better. Sulphur this asthma remedy acts well when asthma is due to suppression of eruptions. Natrum Sulph attacks during wet weather or in rainy season. This asthma remedy acts well when the patient gets attacks every change of season.

A New Approach to Asthma With Homeopathy and Diet

Like eczema, asthma is an inflammatory disease. In asthma the airways become constricted by swelling, making breathing difficult. In developed countries 1 in 4 children have asthma as opposed to 1 in 18 people 40 years ago. Corticosteroids such as Flixotide and Pulmicort in the form of puffers are widely used to treat asthma but these pharmaceutical drugs do nothing to change the progression of the disease. A broader, nutritional and environmental approach is required, and when combining this approach with Homeopathy, significant improvements or cures can be achieved.

Pharmaceutical medications
According to a study published in the New England Journal of Medicine, there was no difference in rates of asthma or morning breathing between those individuals using their medications daily as prescribed, and those using them intermittently.(1) This study suggests that daily use of corticosteroids may not be necessary and this is good news as these medications have some serious side effects. These longer term side effects include reduction of 1 inch of height per year in children and loss of bone density in later life. This does suggest that it would be worth exploring with your GP whether you can safely reduce the use of your puffer.
(1) H Boushey et al., 'Daily versus As-Needed Corticosteroids fro Mild persistent Asthma' New England Journal of medicine, vol 352 (15), 2005, pp1519-28

Environmental Load
An effective approach to asthma treatment is to reduce the total 'environmental load' that an asthma sufferer is experiencing. This includes identifying food, chemical and environmental allergens, decreasing inflammatory agents in the diet, and reducing stress which is a well established asthma trigger. Reducing this load as well as introducing important nutritional and Homeopathic measures can have a highly positive effect on an asthma sufferer, sometimes eradicating asthma altogether!

Nutritional Self-Help Guidelines for Asthma

Increase your antioxidants intake of fresh fruit and vegetables especially increase your intake of broccoli, apples, berries, peppers (capsicum) and citrus fruit. Antioxidant vitamins such as Vitamin C and A have been shown in studies to have some positive results and I suggest combining them with Vitamin E and Selenium. Take an Omega 3 supplements 1000mg of combined EPA/DHA daily (adult dose) Reduce meat and dairy content of the diet to reduce the intake of arachadonic acid which contributes to inflammation. If you are a severe asthma sufferer remove all wheat and dairy from your diet for 6 weeks to see how you improve:) Take an MSM supplement as it decreases allergic responses and provides intestinal flora with the requirements to make anti-allergy and anti-inflammatory amino acids. Increase intake of Zinc, magnesium and Qercertin East plenty of organic free range eggs

The Homeopathic Approach to Asthma

Homeopathic medicines can be a viable alternative to steroid medications. They can be given as an acute treatment in place of puffers but more importantly, Homeopathic professional treatment working with the whole person can cure asthma entirely. Please remember that although you may be keen to try some natural and effective alternatives, you must consult your doctor before you take any steps to reduce your asthma medications. When treating asthma patients I always wait until significant positive changes are observed and then suggest the patient pays their GP a visit to discuss whether a reduction in medications might be viable.

Some Homeopathic medicines for acute asthma

The following medicines are a few of the many Homeopathic prescriptions for an acute asthma episode. If one of these medicines fits your asthma symptoms, you will find it highly effective. If you can't find a good fit here see your local Homeopath (or book a skype consult with me) because there are too many options to include in this post!

Antimonium Tartaricum 30 This is a good asthma remedy for children and the elderly particularly when the asthma has been caused by an infection such as bronchitis or obstructive pulmonary disease. The cough will sound wet and there will be coarse rattling in the chest on both inspiration and expiration. The patient will be worse lying down and at night generally.They may be irritable and want to be left alone.

Apis Mellifica 30 Use Apis for an asthma attack in an acute allergic reaction. Breath feels tight and painful with dry wheezing. The patient will feel better in open air and much worse for heat or hot drinks.

Carbo Vegetalis 30 Severe acute attacks of wheezing with significant belching and flatus. patient feel very weak and may collapse.

Arsenicum Album 30 Short, dry asthmatic cough with a wheeze.

Phosphorus 30 use this medicine when every infection goes to the chest with a wheeze and cough. Worse in the morning, at twilight and especially at 10pm or with sudden changes in temperature. Better for lying on the right side.

Pulsatilla 30 This patient has both forms of asthma: wet acute infections with greeny discharges and also allergic asthma (often hayfever related). In both cases the patient must sit up during the asthma crisis and is better for fresh air. Even fanning may help them feel better.

Natrum Sulph 30 Asthma worse in damp conditions often with morning diarrohea.

Asthma

What is asthma? Asthma is an episodic constriction of the bronchial tubes. It is a common disorder of both children and adults, often regarded as mysterious and frustrating to treat.

What are the symptoms of asthma? The condition is marked by wheezing (especially on expiration), coughing, and difficulty in breathing. Asthma can appear and disappear without warning. If an attack is severe enough, it can kill. What are the causes of asthma? The immediate cause of an asthmatic attack is tightening of the muscular bands that regulate the size of the bronchial tubes. These muscles are controlled by nerves, but what triggers the nerves to make airways constrict inappropriately is not clear. The triggers for asthma can be primarily allergic or primarily emotional or induced by exercise or respiratory infection, or it can occur with no obvious causes. It is now being considered an inflammatory disorder. The "hygiene hypothesis" is a proposed explanation for why allergies and asthma are now epidemic, especially in developed countries. The hypothesis holds that children who grow up in crowded and dirtier environments are less likely to develop these ailments than youngsters raised in cleaner, more protected environments. The idea is that the developing immune systems of less privileged kids are exposed to lots of germs from an early age and so become stronger and more protective of health. The hypothesis recently got a big boost in credibility. Researchers at Duke University Medical Center compared the antibodies in the blood of laboratory rats and mice, which grow in a virtually germ-free environment, with those of wild rats and mice. All of the wild rodents had higher levels of IgG and IgE, classes of antibodies associated with immune and allergic diseases, but the wild rodents' antibodies did not tend to bind to the rat's own cells, as did the antibodies produced by the hygienically raised rodents. Instead, the wild rodents' antibodies efficiently and effectively attacked invading organisms. The research was written up in the August, 2006, Scandinavian Journal of Immunology. Despite this intriguing evidence, we need a lot more proof from human studies before the hygiene hypothesis makes the leap from theory to fact, and I wouldn't worry about a home being "too clean." In fact, random pollution of the home environment has its own drawbacks. Children who breathe secondhand smoke are more likely to develop asthma, and among all youngsters with asthma, those who breathe secondhand smoke have more frequent attacks). What is the conventional treatment of asthma? Treatment of asthma has two aspects: management of acute attacks and long-term control or prevention. Conventional treatments are sometimes the best choices for acute attacks, where immediate relief can be a life-anddeath matter. For allergic asthma, one of the safest and best drugs is inhaled cromolyn sodium. Most bronchodilating drugs are stimulants that increase sympathetic tone and anxiety. Theophylline, derived from tea, has a long history of use, but may not be as safe as doctors used to think. It can cause dramatic personality changes. Other drugs of this class can be inhaled to relieve and prevent attacks. These inhalers work, but they are often addictive, since the bronchial tubes are likely to become constricted again when one dose wears off (the same pattern occurs when these drugs are sprayed into the nose to relieve nasal congestion). Newer drugs - the leukotriene inhibitors are useful for some patients and less toxic. Other inhalers contain steroids. If the steroids are not absorbed into the system, they can be safe and effective. Different products vary greatly in efficacy and absorbability. At this writing the best are Flovent ( fluticasone) and

Pulmocort (budesonide), both safer than older versions. Steroid inhalers should always be used immediately following inhalation of a bronchodilator. In my view, conventional protocols for long-term control are more problematic. Oral steroids (prednisone is the commonest) are very dangerous for asthmatics, because it is too easy to become addicted to them, and toxicity from long-term steroid use is devastating. Try to avoid ever going on oral steroids. If you do have to take them, get off as soon as possible. In general, the less medication you can take, the better. Allopathic drugs, being suppressive in nature, tend to perpetuate asthma and may reduce the chance that it will disappear on its own What therapies does Dr. Weil recommend for asthma? For acute attacks, try lobelia, or Indian tobacco (Lobelia inflate). Mix three parts tincture of lobelia with one part tincture of capsicum (red pepper, cayenne pepper). Take twenty drops of the mixture in water at the start of an asthmatic attack. Repeat every thirty minutes for a total of three or four doses. For long term control and prevention:

Decrease protein to 10 percent of daily caloric intake. Replace animal protein as much as possible with plant protein Eliminate milk and milk products, substituting other calcium sources. Eat organically grown fruits and vegetables as much as possible. Eliminate polyunsaturated vegetable oils, margarine, vegetable shortening, all partially hydrogenated oils that might contain trans-fatty acids, all foods that might contain trans-fatty acids (such as deep-fried foods). Use extra-virgin olive oil as your main fat. Increase intake of omega-3 fatty acids. Always drink plenty of water to keep your respiratory tract secretions more fluid. Experiment with eliminating (one at a time) wheat, corn, soy and sugar for six to eight weeks to see if the condition improves. Eat ginger and turmeric regularly for their anti-inflammatory effects. Have some manipulative work done on the chest to break up restrictive patterns in nerves and muscles that develop in chronic asthma. The best systems I know for this are osteopathic manipulation, especially from a practitioner of cranial therapy, and Rolfing, a form of deep-tissue massage. Minimize contact with respiratory irritants, such as smoke, dust, molds, and volatile chemicals. Remove sources of offending materials from your home, install a good air filtration system, or consider moving if the air is generally bad where you live. Experiment with living in other locations: in high mountains, the desert, or near the seacoast. Asthma may improve greatly with a change of climate. In adults, GERD (acid reflux disease) may be an underlying cause of asthma. In such cases, successful treatment of the digestive problem will often clear up the asthma. Experiment with traditional Chinese medicine and Ayurvedic medicine (the traditional healing system of India). These systems are sometimes able to offer significant help through more specific dietary adjustments and herbal treatments.

Here are some specific recommendations for exercise-induced asthma: 1. Warm up very slowly to the point where you almost feel the "tightness" associated with exercise-induced asthma. Then stop and stretch or, if you're exercising vigorously, slow down. By taking this break, you often can block the development of asthmatic symptoms. You can then go back to your normal pace. This may take some getting used to, but can sometimes eliminate the need for medication. Try breath work. The most effective approaches are pranayama techniques (breath control exercises taught in some yoga classes). You can do these after the initial warm-up when symptoms are almost felt. For beginners, start with "The Relaxing Breath," a technique I describe in my books and on this Web site. Find a form of physical activity that minimizes your exercise-induced symptoms. Sports or activities that have intermittent rest periods (such as tennis, softball, and golf) can allow you to regain control of your

2.

3.

breathing. Swimming may be better than running outdoors in cold weather, but no type of exercise is offlimits with proper treatment. In fact, some of the world's top athletes have exercise-induced asthma, and they're still able to compete successfully in Olympic-level events.