What is Asthma?

Asthma is a condition that causes episodes of decreased airflow with the lungs. There is inflammation within the bronchial tubes, mucous production, and constriction of the smooth muscle around the bronchial tubes causing tightness.

Mystery #1
The frequency and severity of Asthma symptoms vary. It can occur a few times a year, once or twice a week, or daily. It can last for a few hours or be prolonged for several days. Severe Asthma attacks may require Emergency Room visits and hospital stays.

Mystery #2
The triggers for Asthma are numerous.

What are Asthma symptoms?

  • Coughing especially at night, with exercise, and/or during a respiratory illness
  • Trouble breathing
  • Tight feeling in the chest
  • Wheezing – a squeaky or whistling sound

How do we diagnose Asthma?

  • A complete medical history with emphasis on triggers, family history and severity of symptoms.
  • A complete physical exam.
  • Spirometry or Peak Flow Meter – this test measures how much air you can blow out of your lungs after taking a deep breath.

Prevention is the Key

Know your triggers

  • Allergens (pollens, animals, dust mites, mold, etc.)
    (for 60-70% of asthmatics, allergens are the main trigger)
  • Infections
  • Exercise
  • Cold air
  • Temperature changes
  • Stress and emotions
  • Tobacco smoke
  • Pollutants
  • Strong odors/scents
  • Work related exposures
  • Gastric reflux
  • Food additives

Avoid your triggers

  • This is the most important step in controlling your asthma.

Treat your triggers

  • Quick-relief medicines
  • Allergy shots
  • Flu and Pneumococcal vaccine
  • Anti-reflux medication

Take control of your Symptoms

  • Daily use of Controller medicines
  • Asthma Action Plan

How do we treat Asthma?

Quick relief medicines such as albuterol and levoalbuterol.

These medicines help open the airways quickly and treat the coughing, wheezing, and gasping for breath. However, they do not control the underlying inflammation. They can be used before exercise and before exposure to known triggers. If you need your quick relief medicine more than twice a week or more than 2 nights a month, then your Asthma is NOT controlled.

Controller medicines are taken daily for control of underlying inflammation.

Quick reliever medications only relax the smooth muscle around the airways but do not treat inflammation inside the airways. Asthma controller medications treat the inflammation inside airways daily to prevent and control symptoms. These medications will decrease the need to use quick relief medications.

Allergy shots – also known as Immunotherapy (more info here).

Allergy shots build up immunity to your offending allergens. This leads to reducing and even eliminating your allergy symptoms. It works by injecting small amounts of the allergen in gradually increasing doses over time. This should only be administered at the doctor’s office with appropriate training and experience.

Biologic Therapies

Biologic medications selectively target components of your immune system that are responsible for asthmatic inflammation and turn it down.  Most biologic medications are generally well tolerated.  They are usually given as an injection every 2-4 weeks. Common examples of biologic medications used in asthma include Omalizumab (Xolair), Dupilumab (Dupixent), Benralizumab (Fasenra), Tezepelumab (Tezspire), etc.

Vaccines

Flu vaccine helps build up immunity to the Influenza virus.
Pneumococcal vaccine helps build up immunity to the most common bacteria that causes respiratory infections (Pneumonia, Bronchitis, Sinusitis).

Asthma and Pregnancy

Asthma control during pregnancy is important to avoid low oxygen levels for both mother and baby. Increased symptoms normally occur at 24-36 weeks of pregnancy. Only 1 out of 10 patients have asthma problems during pregnancy. Management is very similar to asthma treatment in those who are not pregnant. Please discuss your asthma medications with your doctor to provide optimal benefit for both mother and baby.