Coughing. Wheezing. Shortness of breath. Feelings of panic as it becomes more and more difficult to breathe. Rushing to the hospital, perhaps in the middle of the night, for yet another round of emergency treatment.

In the end, this endless cycle of attack-treatment-attack becomes trying -- both for the sufferer and family members who become inextricably involved in the crisis.

Asthma is, for many, a difficult cross to bear because they let it restrict their lifestyles. This needn't be. Asthmatics can lead problem-free lives, claims Mrs. Liz Boden.

"When asthma is properly managed, asthmatics can lead normal, unrestricted lives. They can do everything a normal person can do,'' she assured. "That means no hospital admissions, no crises, no deaths from asthma.'' However, proper treatment and management requires team work, involving doctors, support groups and educators like Mrs. Boden.

"Basically, it is the patient taking control of the problem,'' she said.

An asthmatic herself, Mrs. Boden is not only a paediatric nurse (she trained at the Hospital for Sick Children at Great Ormond Street, London), but earned a diploma in asthma care from Britain's Royal College of General Practitioners.

She puts her training to active use in a busy local medical practice, and numbers hundreds of success stories among the many asthmatics she has counselled.

While asthma treatment remains the doctor's province, Mrs. Boden said the nurse's role is "to educate the patients and their families, to help them understand asthma and its treatment and be involved in self-management''.

"There are several parts to the nurses's role in asthma care,'' she said.

"The asthmatic and his or her family must know: What asthma is; why they get it; what treatment the doctor has prescribed; what the different prescriptions are for and when to use them; what inhalers are appropriate and how to use them; how to fine tune their treatment; and what can be done to prevent asthma.

"Education takes a long time, and this is where the nurse is helpful. An average doctor's visit lasts ten minutes, whereas I spend hours educating patients and their families. The first visit, for example, takes at least 45 minutes.'' Nurse Boden's education programme also includes practical training in the correct use of inhalers, checks to see that patients are complying with their prescribed treatments and generally giving lots of advice and encouragement.

Best of all, perhaps, Mrs. Boden tries to make the learning experience fun, particularly with children, to help patients achieve a normal lifestyle.

"The aim is to have fewer emergencies and no hospital admissions or deaths,'' she explained. "We must be realistic. People do die from asthma, but all asthma deaths are preventable.'' Asthmatics must work for the gift of life If this is startling news to asthmatics and their families, Mrs. Boden means it to be, for she is incredibly up-beat about the increasing number of success stories among those she has assisted.

Five-year-old Keirston Samuels is a case in point.

"He's my star,'' Mrs. Boden enthused.

An asthmatic from age one, Keirston spent so much time in the hospital that the children's ward virtually became his second home. His mother was in despair and overwhelmed by her son's affliction.

Typically, Keirston was small for his age, and didn't get much fun out of life. Today, he is a happy, active child who does well in school and who hasn't been in hospital since last December. His mother has changed, too. Now she is bright and confident and full of praise for Mrs. Boden's care and support in dramatically changing Keirston's and her life.

"I could never have made it without her,'' Miss Samuels says.

There was no magic formula. The great transformation came about through education.

"Keirston and his parents were taught to understand that the key to successful treatment is prevention,'' Mrs. Boden stressed.

For his part, Keirston learned the difference between his inhalers and when to use them.

"One prevents asthma, the other relieves it,'' Mrs. Boden explained. Keirston also learned to use a special device with his inhaler which allows him to get the full measure of his medication.

For her part, Miss Samuels made significant changes at home to avoid as many trigger factors as possible, and follows through on her son's medication/maintenance programme.

"I clean the house every day to keep him safe from getting sick,'' Miss Samuels said. "It's worth it to see him so happy and well. It took me a long time to get used to the programme, but I can cope now thanks to Mrs. Boden's training.'' Like Keirston, five-year-old Calae Steede has also been asthmatic from babyhood, and spent much of her tender years in and out of the hospital's emergency department. Meeting Mrs. Boden also changed her life dramatically.

"She's very different now,'' her father Calvin said. "I've seen a big change in her. She uses her inhalers and we have learned how to keep her calm when an attack occurs.'' Mrs. Boden admitted that children were much easier to educate on asthma management than teenagers and some adults.

"Children are wonderful patients. They are keen and want to feel better. They hate going to hospital during attacks and they learn fast,'' she said. "I can honestly say that every child who has followed through with the education programme is not only better but enjoying a normal life. That's why I love looking after them so much.'' Teens, on the other hand, were generally less diligent, believing themselves to be invincible. They were also impatient and fell prey to such triggers as smoking.

Noting that there were two types of asthma -- one hereditary, the other late onset -- Mrs. Boden said the former was much easier to treat.

"Children get asthma because it is hereditary,'' she said. "Late onset asthma, which is the result of smoking, is not.'' Asthma is a condition wherein lung airways have a tendency to become narrow, making it difficult for air to move in and out. Typical symptoms include coughing, wheezing and shortness of breath.

The narrowness results from a combination of muscle spasms and inflammation in the airways, which leads to swelling and excessive secretion of mucus.

Treatment is in three categories: reliever or broncho-dilator drugs, preventers and protectors.

Relievers ease the symptoms of asthma but do not treat the underlying cause.

Preventers reduce the amount of swelling and mucus in the airways. Protectors are long-acting medicines which reduce asthma symptoms and work by keeping the air passages of the lungs open and relaxed.

Preventers and protectors must be taken daily for the best effect. They should not be used to relieve sudden attacks of wheezing or breathlessness because they do not provide immediate relief of symptoms.

Preventers and relievers commonly come in inhaler form, for which proper instruction is required to achieve the best result. A variety of adaptors for children and adults are available to increase the medication's effectiveness.

Also available are deep breathing exercisers and a device to help the asthmatic keep regular track of lung capacity and prompt early warning problems so that swift preventive action may be taken.

BREATHING DEEPLY -- Five-year-old Keirston Samuels demonstrates a spacer. Used with an inhaler, it delivers the full dose of medication to the bottom of the lungs.

STAR PATIENTS! -- Paediatric nurse and asthma care specialist Mrs. Liz Boden (second left) is proud of the progress that (from left) Calae Steede, Chris Pullen and Keirston Samuels have made in managing their asthma. Thanks to a structured programme, the youngsters now lead normal, healthy lives.