October 7, 2002 - Country diva Wynonna Judd's life has been a winding trail to uncertain destinations - with one exception.

"We were really gypsies when I was growing up," says Wynonna, who prefers using just the single name, "and I went to 13 different schools, but I could pretty much be certain of one thing - my asthma."

According to the American Academy of Allergy, Asthma & Immunology (AAAAI), approximately 24 million in the USA suffer from asthma, a chronic inflammatory disease that causes airways to narrow.

"Most people move to Los Angeles and learn how to surf, but when I moved there I learned I had asthma. I was 12," adds Wynonna. "By the time I signed with RCA Records when I was 18 I had been in and out of hospitals several times. But I still didn't quite fully understand how serious the disease can be if you don't pay attention to it and keep current with your treatment. Each year about 5,000 people die from asthma, but I was living pretty fast, pretty young, and thought I could go on living forever."

Now a mother, Wynonna knows differently.

She's teamed up with the AAAAI, the American Lung Association (ALA) and 16 other major health organizations as spokesperson for Asthma Action America to make sure people with asthma keep current in their treatment. The program is underwritten by GlaxoSmithKline.

But Wynonna's health epiphany did not come easily.

A country-style work ethic and loyalty to her fans formed a duet that made denial about her illness all too convenient. Wynonna was determined to perform despite her health - or the possible consequences.

"You don't call in sick when 25,000 people are waiting at a state fair to hear you," explains Wynonna. "I figured a lot of those folks came through a lot more than I did just to hear me sing, so I wanted to make them happy."

Despite asthma symptoms, she says found a way to keep performing. "Between songs they would just lower the lights a little, I'd turn around briefly and take a dose from my inhaler and then I'd start singing again. You kind of overcompensate - think maybe it's just a little cold or mild bronchitis - because you're passionate about the performance."

Breathing problem

"The asthma attacks were so serious that twice they rushed me to the hospital," says Winnona, "and boy, I'll tell you, spending nights in a hospital room gives you lots of time to think."

But it wasn't until her son Elijah was born and Wynonna was 30 that she decided things had to change. And Wynonna had a second impetus to change: her cousin died from the disease.

"I just didn't think that I was that sick," says Wynonna. "It's like the person with a drinking problem - it was absolutely stupid to put it off, but that's what I had been doing. Then all of a sudden I was pregnant and became very aware that it was getting worse. I worried about myself - but I really worried about my unborn child."

With good reason.

Mother and unborn child share oxygen, and when asthma makes breathing and full oxygenation difficult both mother and baby can suffer as both struggle to take in the 20% increase in oxygen demanded by the fetus. But asthma causes airways to narrow and make the lungs less elastic, making deep inhalation insufficient.

Typical asthma symptoms include:

• Coughing
• Wheezing
• Shortness of breath
• A constricted "tight" feeling in the chest

Most people control asthma by avoiding "triggers" - irritants such as smog, dust mites, cold air, exercise, and other allergens - and by taking prescribed medications. Anti-inflammatory medications - which may contain steroids - reduce airway and lung inflammation. Bronchodilator inhalers usually provide nearly instantaneous emergency relief. But misuse of these emergency inhalers and lack of proper treatment combine to make relief for people diagnosed with asthma an often hit-or-miss proposition.

Women and asthma

Women seem to have a tougher time with asthma and its treatment than do many men:

• Frequency - According to a recent study by the American Lung Association, 9.5 percent of women and 8.7 percent of men will have asthma at some point in their lifetime. In 1999, an estimated 6.2 million females had an asthma attack compared to 4.3 million males.
  
  
• Hospital admissions - "Women between 20-50 have three times the hospital admissions for the disease than do men," says Dr. Carlos A. Camargo, assistant professor of Medicine and Epidemiology at Harvard University, and a spokesperson for Asthma Action America.
  
  
• Emergency care - Twice as many women as men go to an emergency room for critical asthma treatment, according to Women's Health Matters Newsletter.
  
  
• Menstrual involvement - Scandinavian asthma researchers presented a study earlier this year to the European Respiratory Society's 12th Annual Congress that showed young women with irregular periods had a 61% higher risk of developing asthma and were 38% more likely to experience wheezing and shortness of breath. Other studies have shown that about one third of women experience worse symptoms immediately preceding or during menstruation.
  
  
• Pregnancy complications - Between 20-30% of women who are pregnant report either a worsening - or improvement - of their asthma during pregnancy. "This is still an area we don't completely understand," says Camargo. "Why do some women get better during pregnancy, while asthma almost kills others?"
  
  
• Treatment - According to the report in the Archives of Internal Medicine , the proportion of women adhering to the established medication guidelines was only 32% among women with severe persistent asthma.

Staying healthy

"For many women who take care of the family and work, they just don't have time," says Wynonna. "At the end of the day we're just too dog-tired to do anything but fall into bed. It's the same for dads who run single-parent households too."

These lapses in treatment bother Wynonna. "This is exactly why I'm so passionate that women and men realize this disease is serious and take care of themselves," she says. "When the parent is well, the children are better off too. You don't do anybody any good by not taking care of yourself."

Relying on emergency inhalers instead of following a comprehensive treatment plan can be dangerous. Lungs can remain chronically inflamed. "Everybody has a treatment plan that is specific and suitable for them," she notes.

"That's one reason why I say only that I participate in planned treatment," says Wynonna, "but I don't tell a lot of details about it - I don't want people to think that what I do works for them because everyone is different. And I especially don't want people with this disease to do what I did when I was younger, which was to rely on my inhaler instead of getting a handle on the disease."

To help people get a handle on asthma, Asthma Action America has a website with a simple 30-second Asthma Control Test.

"It's easy, it's private, and it gives you valuable feedback you should share with your doctor," says Wynonna. "It's the type of information I wished I had been aware of and listened to before."

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 10/30/2002  -  Mike Falcon and Stephen A. Shoop, M.D.