Asthma is one of the most chronic medical conditions in the United States. Any age group can be affected. Common symptoms include episodes of coughing, wheezing, chest tightness, and shortness of breath. Asthma can lead to significant reduction in quality of life. “Yellow flags” for poor asthma control include symptoms that interrupt sleep that occur more than once or twice a week as well as limitations in physical activity that occur more than a couple of times per month. It is also concerning if someone has had a flare-up of asthma that has required the use of corticosteroids (i.e. prednisone) more than once a year. Of course, if someone has required an emergency department visit or hospitalization for asthma they should be further evaluated.
It is also important to have asthma properly diagnosed. Occasionally, patients with the above symptoms may have other problems such as heart issue, other lung problems, vocal cord problems, etc. Many young children will wheeze during the first few years of life and not have asthma. Frequently this occurs in children that have frequent viral illnesses, especially RSV bronchiolitis. Risk factors for young children to have asthma include a parental history of asthma, concurrent eczema, wheezing apart from infections, elevation of blood cell called eosinophil, food allergy, and environmental allergy.
Trigger factors for asthma can include allergens such as dust mites, pet dander, cockroach, and molds and pollens. Other things can trigger asthma are irritants, weather/ temperature change, exposure to passive cigarette smoke, exercise, and upper respiratory tract infections. Aspirin exacerbated respiratory disease (can also involve other medications in this group) can be seen as well.
It is important for patients to have a thorough evaluation including pulmonary function testing as well as identification of triggers and other factors that could influence asthma (chronic sinus disease, certain types of acid reflux, heart problems, and vocal cord problems.)
In addition to inhaled medications to treat asthma, there are other medications that fall in the category called “biologics” that are available (Xolair, Nucala, CinqAir, and Fasenra.) Our clinic has an extensive experience with the use of these medications.
Allergy vaccines (“shots”) are appropriate in some patients with asthma.
Our clinic is proud to have one of the few certified asthma educators in the State of Louisiana (Carol Netherland, FNP-C, AE-C.) We encourage all of our asthma patients to have contact with Ms. Netherland to develop an asthma action plan.