Asthma

Asthma is a very common condition that affects approximately 1 in 13 people, according to the Center for Disease Control. Here are some trends regarding who asthma affects the most: 

• Gender: Asthma is more common among adult women. However, it is more common among boys than girls under the age of 18. 

• Race: African-American patients die at higher rates from asthma.

• Age: Asthma is the “leading chronic disease” in children. There are approximately 6.2 million children with asthma. 

Asthma can be triggered by different factors such as: 

• Exercise

• Workplaces that have chemical fumes, gases, or dust

• Allergens such as pollen, dust mites, mold spores, certain insect waste, particles of skin, and pet saliva (pet dander)

• Respiratory infections such as the common cold, bronchitis, or pneumonia. 

• Cold or dry air

• Smoke

• Medications (beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen sodium)

• Stress and other intense emotional states

• Preservatives in foods such as shrimp, dried fruit, processed potatoes, beer, and wine

• Gastroesophageal reflux disease (GERD)

Other risk factors can include: 

• Family history of asthma

• Medical conditions such as hay fever or atopic dermatitis

• Smoking or exposure to secondhand smoke

• Being overweight

• Exposure to pollution

• Exposure to chemicals in jobs such as farming, hairdressing, or manufacturing

Symptoms of asthma can include: 

• Shortness of breath

• Chest tightness

• Chest pain

• Wheezing

• Trouble sleeping caused by breathing difficulties

• Worsening symptoms when experiencing a respiratory virus

• Coughing

Primary Care Physician: Your general doctor can diagnose and treat asthma. Certain primary care doctors have also done additional training in allergies and immunology, giving them special expertise in respiratory conditions like asthma.

Pulmonologist: Pulmonologists are doctors who specialize in respiratory symptoms and diseases, including the lungs and asthma. 

Pulmonary Rehabilitation Therapist: Pulmonary Rehabilitation Therapists are not doctors. However, they can be a great addition to your medical team by helping with asthma treatment support.

First, a doctor will perform a physical exam to ensure your symptoms are not being caused by other conditions, such as a respiratory infection or chronic obstructive pulmonary disease. They may also perform additional tests to determine how well your lungs work. Spirometry is a test that checks your bronchial tubes by measuring how much air you exhale. Peak flow meters measure how hard you can breathe out, which can be used as a sign of suboptimal lung function.

There are two main categories of prescription treatments for asthma: rescue medications for quick relief, and control medications for long-term treatment. Rescue medications help with short-term symptoms during asthma attacks, and they include treatments such as: 

• Short-acting beta agonists: albuterol (ProAir HFA, Ventolin HFA, etc) and levalbuterol (Xopenex, Xopenex HFA)

• Anticholinergic agents: ipratropium (Atrovent HFA) and tiotropium (Spiriva, Spiriva Respimat)

• Corticosteroids: prednisone and methylprednisolone (Medrol)

Unlike Short-acting beta agonists that are taken as needed, control medications are typically taken once a day to help prevent asthma attacks long-term: 

• Inhaled corticosteroids: fluticasone propionate (Flovent HFA, Flovent Diskus, Xhance), budesonide (Pulmicort FLexhaler, Pulmicort Respules, rhinocort), ciclesonide (Alvesco), beclomethasone (Ovar REdihaler), mometasone (Asmanex HFA, Asmanex Twisthaler), fluticasone furoate (Arnuity Ellipta)

• Leukotriene modifiers: montelukast (Singulair), zafirlukast (Accolate), zileuton (Zyflo)

• Combination inhalers: fluticasone-salmeterol (Advair HFA, Airduo Digihaler, etc), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera), fluticasone furoate-vilanterol (Breo Ellipta)

• Theophylline: Theophylline (Theo-24, Elixophyllin, Thecchron)
  

If it is difficult to use an inhaler or if you have suboptimal lung function, your doctor might recommend using a nebulizer to help get medications straight into the lungs. A nebulizer is a machine that is used by people with Asthma, COPD, and other respiratory conditions such as cystic fibrosis that turns liquid medications into a very fine mist. Patients inhale the mist through a mouthpiece or mask while taking slow, deep breaths. Short-acting beta agonists, anticholinergic agents, and inhaled corticosteroids are used with the nebulizer. Often, you can combine vials of each based on your doctor's instructions to limit the amount of time you spend using a nebulizer. 

Nebulizers can often take up to 10 min or more to deliver all your medicine and aren't always portable. They usually have to be plugged and can be difficult to carry around as opposed to an inhaler that is much smaller and more suitable for travel.

It is important to learn and avoid your asthma triggers. Some tips that can help include: 

• Air conditioners: Air conditioners can help keep levels of airborne pollen low inside your home, reduce humanity, and reduce exposure to dust mites. 

• Keep dust out: Replacing your carpeting, encasing your sheets and pillows with dust proof covers, and washing your curtains frequently can help reduce the amount of dust you breathe in. 

• Dehumidifier

• Clean up mold: Frequently clean damp areas in order to prevent mold from developing. 

• Avoid pets: If you are allergic to pets, either avoid having them or regularly bath and groom them. 

• Face masks: Wear a face mask during allergy season, locations with asthma triggers, and if the air is cold or dry. 

Getting regular exercise and maintaining a healthy weight can also help reduce asthma symptoms.