CBS News Correspondent Harold Dow Dies of Asthma

Veteran CBS News reporter Harold Dow,62, has died. The cause of his unexpected death on Saturday morning has been determined to be asthma. Dow has been a reporter for CBS for nearly 4 decades, working for the CBS News Sunday Morning, and as a correspondent for “48 Hours” since its premiere in 1988. He became a permanent correspondent on the show in 1990. On Sunday, his family released this statement:

“At the time of Harold’s death, he was suffering from adult onset asthma. On Monday, Aug. 16, 2010, Harold checked himself into the Valley Hospital emergency room in Ridgewood (N.J.) for severe asthmatic symptoms. According to the Hackensack Police Department incident report, an inhaler was found on the floor of Harold’s vehicle. Therefore, it is believed at this time that Harold succumbed to an asthma attack while behind the wheel.”

Asthma is a chronic disease of the lungs which affects 22 million Americans. Of these, nearly 6 million are children. Asthma causes recurrent episodes of wheezing (a whistling sound with breathing), chest tightness,shortness of breath, and coughing. The coughing often occurs at night or early in the morning. The symptoms of asthma are caused by narrowing of the airways, making it more difficult to get air into the lungs. There are two components that contribute to the narrowing of the airways: tightening of the muscles that surround the airway walls, and swelling of the lining of the airways. The swelling is an inflammatory response by the body which also produces an increased amount of mucus in the airways.

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Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms. (Source: NHLBI)

We have touched on some of the triggers for asthma in our story about Theodore Roosevelt. In today’s blog we will talk a little about asthma treatment.

Asthma is a long-term disease that can’t be cured. The goal of asthma treatment is to control the disease. Good asthma control will:

* Prevent chronic and troublesome symptoms such as coughing and shortness of breath

* Reduce the need of quick-relief medicines (see below)

* Help  maintain good lung function

* Allow patients to maintain normal activity levels and sleep through the night

* Prevent asthma attacks that could result in  emergency room visits or being admitted to the hospital for treatment

Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or “rescue,” medicines relieve asthma symptoms that may flare up.

Long-Term Control Medicines

Most people who have asthma need to take long-term control medicines daily to help prevent symptoms. The most effective long-term medicines reduce airway inflammation.These medicines are taken over the long term to prevent symptoms from starting. They do not give quick relief from symptoms and are not to be used in an acute attack .

Long term medications:

Inhaled corticosteroids are the preferred medicines for long-term control of asthma. These medicines are the most effective long-term control medicine to relieve airway inflammation and swelling that makes the airways sensitive to certain substances that are breathed in.

Reducing inflammation helps prevent the chain reaction that causes asthma symptoms. Most people who take these medicines daily find they greatly reduce how severe symptoms are and how often they occur.

Inhaled corticosteroids are generally safe when taken as prescribed. Inhaled corticosteroids aren’t habit-forming, even if taken every day for many years, and are very different from anabolic steroids taken by some athletes.

In patients with severe asthma, corticosteroid pills may need to be taken for short periods to get an asthma attack under control. If taken for long periods, these medicines raise your risk for cataracts and osteoporosis. A cataract is the clouding of the lens in your eye. Osteoporosis is a disorder that makes your bones weak and more likely to break.

Your doctor may have you add another long-term control asthma medicine to lower your dose of corticosteroids. Or, your doctor may suggest you take calcium and vitamin D pills to protect your bones.

Other long-term control medicines include:

  • Inhaled long-acting beta2-agonists. These medicines open the airways and may be added to low-dose inhaled corticosteroids to improve asthma control. An inhaled long-acting beta2-agonist shouldn’t be used alone.
  • Leukotriene modifiers. These medicines are taken by mouth. They help block the chain reaction that increases inflammation in your airways.
  • Cromolyn and nedocromil. These inhaled medicines also help prevent inflammation and can be used to treat asthma of mild severity.
  • Theophylline. This medicine is taken by mouth and helps open the airways.

These medications must be taken every day to control asthma. Asthma symptoms will likely return or get worse if the medicine is stopped.

Quick-Relief Medicines

All people who have asthma need a quick-relief medicine to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonists are the first choice for quick relief. These medicines act quickly to relax tight muscles around the airways during a flare-up. This allows the airways to open up so air can flow through them. Quick-relief medicines should not be used in place of prescribed long-term control medicines because they do not reduce inflammation!

Quick-relief medicine should be taken when asthma symptoms are first noticed. If used more than 2 days a week, you should talk with your doctor about how well controlled your asthma is. You may need to make changes in your asthma action plan.

A person with asthma should have a quick-relief inhaler with them at all times in case it is needed. For children with asthma, make sure that anyone caring for him/her and the child’s school has the child’s quick-relief medicines. They should understand when and how to use them and when to seek medical care for the child.

Source: NHLBI

For more information, click here for the Resounding Health Casebook on Asthma.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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