Asthmatic Conditions

Asthma

Asthma is a chronic condition in which your airways narrow and swell due to inflammation and increased production of mucus. This narrowing can make it difficult for air to circulate into and out of the lungs, and the resulting symptoms include shortness of breath, wheezing, difficulty catching your breath, chest tightness or pressure, and/or coughing. While there is no cure for asthma, it can be controlled and managed with medication prescribed by your physician. Symptoms of Asthma An individual’s asthma can range from mild to severe, depending on the severity of symptoms, how often they occur, or if they are persistent and/or sudden. Symptoms of asthma include:

• Chest tightness
• Shortness of breath
• Wheezing (a whistling sound located in the chest while exhaling)
• Coughing
• Fatigue or feeling out of breath

Because asthma often changes over time, regular physician visits are necessary to track your asthma signs and symptoms and to adjust treatment as needed. Your asthma may be worsening if you begin experiencing:

• Increased frequency and severity of asthma symptoms.
• Increased difficulty breathing, which can be measured and checked with certain devices.
• Reduced effectiveness of your current asthma medication(s) and increased use of an albuterol or levalbuterol (quick-relief) inhaler.

Asthma symptoms that require emergency assistance during a severe asthma exacerbation may include any one of the following:

• Chest pain
• Extreme difficulty breathing
• Cyanosis (when the skin appears blue-ish and pale in color)
• Rapid, weak pulse
• Mental confusion or dizziness
• Fever
• Difficulty walking or talking
• Lethargy

Causes of Asthma Asthma triggers may vary from person to person and it is important to discuss potential triggers in detail with your physician so that they understand how to proceed with your asthma maintenance. Allergic asthma triggers are typically airborne substances that include:

• Any type of plant pollen
• Airborne dust mite particles
• Cockroach waste
• Mold
• Pet dander

Asthma can also be exacerbated by non-allergic triggers such as:

• Exercise (which can make symptoms worsen when performed in cold, dry air)
• Weather
• Stress
• Pollution, fumes, smoke, or gases
• Household or workplace cleaners and detergents
• Respiratory illnesses such as the common cold or flu
• Certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs)

Asthma Diagnosis and Treatment If you are experiencing any of the signs and symptoms of asthma, our asthma specialist at Frontier Allergy Asthma and Immunology can help you reach a proper diagnosis and recommend a long-term treatment plan. At our clinic, you will undergo a physical examination and perform one or more of the pulmonary tests we provide. Pulmonary function tests such as a spirometry test or a nitric oxide test can help determine whether you may be suffering symptoms due to asthma or due to another underlying condition, such as a chest infection or chronic obstructive pulmonary disease (COPD). In addition to the diagnostic process, your allergist will ask a series of questions to determine what triggers may be the cause of your asthma symptoms. If your allergist believes you may be suffering from allergic asthma, they may recommend a skin test or blood test for environmental allergens. If your allergist determines your asthma to be non-allergic, they will work with you to find specific triggers. Once your allergist has identified the triggers that are most likely contributing to your asthma symptoms, they will work with you to devise a personalized plan of care with the goal of complete or near-complete maintenance of your asthma symptoms over time. Your allergist will likely recommend ways you can avoid the factors that aggravate your asthma and/or prescribe medication that can drastically improve your symptom management. For those who are suffering from allergic asthma, immunotherapy (allergen desensitization) has shown to be greatly effective at reducing asthma symptoms in patients over time, especially in children.

Childhood Asthma

It is important for parents to know that childhood asthma is the same disease that occurs in adults. The causes and triggers are similar and still vary among individuals. However, diagnosing children with asthma can be difficult, as signs and symptoms of breathing troubles in children may be a result of other underlying causes, such as recurrent bronchitis or Eustachian tube dysfunction. As in adults, childhood asthma cannot be cured, but rather, can be controlled and managed by your child’s pediatrician. Symptoms of Childhood Asthma The symptoms of childhood asthma can be the same as those found in adult asthma and may differ from child to child. Some particular signs to look out for include:

• Whistling or wheezing sounds from the chest
• Increased coughing, wheezing, or catching the breath during or after expressive crying, yelling, or laughing Difficulty sleeping due to shortness of breath, coughing, or wheezing at night
• Fatigue due to poor sleep
• Frequent disruptions in play or exercise due to difficulty breathing or catching the breath
• Frequent coughing and wheezing that worsens with the cold or flu
• Long-lasting respiratory infections, or respiratory infections that develop into bronchitis
• Difficulty breathing or catching the breath with exposure to cold air

Childhood asthma is unique to each individual. It is important to look out for any changes in your child’s signs and symptoms, as a child’s symptoms may improve, worsen, or change as they grow older. Causes of Childhood Asthma Childhood asthma triggers and causes are very similar to those found in adults with asthma, but still are not fully understood. Some risk factors physicians look out for include:

• Parents with histories of asthma or environmental allergies
• Previous allergic reactions due to food, pet dander, or pollen
• Frequent exposure to environmental pollutants, such as tobacco exposure
• Certain viral infections during infancy or toddlerhood
• Comorbidity with obesity or gastrointestinal issues

Complications of Childhood Asthma If left untreated, childhood asthma can be a very serious and potentially life-threatening disease. Complications can include:

• Recurring hospital or emergency care
• Missed days at school
• Fatigue
• Reduced quality of life
• Permanent decrease in lung function

With proper treatment, prevention, and asthma specialist guidance, childhood asthma can be very well-managed, allowing severe complications to be easily avoided. Childhood Asthma Diagnosis and Treatment If you believe your child is experiencing symptoms of asthma, it is imperative that they receive appropriate treatment and that preventative measures are put in place at home and at school. Your child’s pediatrician will work with you to obtain a detailed family and medical history. They will also perform a physical examination. If your child is older, they may undergo a pulmonary function test. At Frontier Allergy Asthma and Immunology, our pediatric asthma specialist can help you and your child receive a proper diagnosis, recommend long-term treatment, and devise a specialized asthma action plan.

Chronic Obstructive Pulmonary Disease (COPD)

Patients with chronic obstructive pulmonary disease typically experience similar symptoms as observed in asthma patients. Individuals can also be comorbid for both asthma and COPD. However, while asthma patients may see improvement in their symptoms over time, COPD is a progressive disease that gradually worsens over time. It is vital that an individual with COPD work closely with their physician to slow the progression of their disease and manage their symptoms. Symptoms of COPD The symptoms of COPD are characterized by a slow progression over time. This means that what may appear to be asthma symptoms, such as cough, wheezing, shortness of breath, or chest tightness, overall worsen with age. Most patients with COPD do not realize they have it until they reach their late 40s or 50s. Common symptoms of COPD include:

• Shortness of breath, wheezing, chest tightness
• Increasing breathlessness over time
• A persistent, productive cough that does not completely resolve
• Frequent or recurring chest infections

Less common symptoms of COPD can include:

• Weight loss or fatigue
• Swollen ankles due to a build-up of fluid (edema)
• Chest pain and bloody phlegm produced while coughing (though these are usually signs of other serious conditions)

Causes of COPD The symptoms of COPD arise from a loss of elasticity of the parts of your lungs that expand and force air out of the body. As a result, your bronchial tubes and alveoli (air sacs) over-expand, causing get trapped in your lungs, preventing a full exhale. Causes and risk factors of COPD include:

• Long-term tobacco smoking (from cigar or cigarette smoke) or long-term second-hand exposure to cigarette/cigar/marijuana smoke.
• Occupational exposure to dusts and chemicals. Long-term exposure to fumes, vapors, and/or dusts can irritate and inflame your lungs.
• Exposure to fumes from burning fuel if living in buildings with poor ventilation.
• Emphysema (a lung disease that destroys the alveoli in the lungs)
• Chronic or recurring bronchitis (contributes to the increased narrowing of the bronchial tubes and increased mucous production, which can add to airway obstruction)
• Alpha-1-antitrypsin deficiency (a genetic disorder that can cause damage to the liver and the lungs that affects about 1% of people with COPD)

Diagnosis and Treatment of COPD If you believe you may have or may be at risk for COPD, it is important to discuss this with your doctor as soon as possible for a proper diagnosis. At your visit, your physician will review your symptoms, discuss family history, and ask about any previous exposure to lung irritants. They may also decide to order several tests to diagnose your condition. Common tests that your doctor may recommend include:

• Pulmonary function tests. The most common test is a spirometry test. These tests measure the amount of air you can inhale and exhale (measures your lung capacity). Another common test uses a pulse oximeter, which is a small device placed over a finger that measures your heart rate and your blood oxygen level.
• Imaging, such as a chest x-ray or CT scan. These can help your doctor visualize your lungs and surrounding organs to detect any issues, such as emphysema or other lung problems.
• Blood tests or laboratory tests. A blood test known as an arterial blood gas analysis (ABG) measures how well your lungs exchange oxygen and carbon dioxide in your blood. Lab tests can help determine the cause of your symptoms or rule out other conditions that may involve similar symptoms.

While there is no cure for COPD, there are effective therapies available that can help you control your symptoms, slow the progression of the disease, and reduce your risk of complications that you and your doctor can discuss. One of the most important steps you can take if you have COPD is to quit smoking. This can help slow the progression of your COPD and reduce future exacerbations. However, quitting smoking can be very difficult. Ask your doctor about ways you can start your smoking cessation. There are replacement products and medications available for individuals seeking help, and there are many support groups available where you can work with others to reduce smoking and avoid relapses. In addition to smoking cessation, your doctor may prescribe you medications to treat the symptoms of COPD. Some medications require regular, daily use, while others can help you alleviate symptoms in the event of an exacerbation. Your doctor will work closely with you to help control symptoms, prevent flare-ups, and work on improving your quality of life.

Next steps

If you are interested in further discussion about your specific needs, Dr. Reshamwala is happy to see you and answer any questions you may have. Please call 512-382-1933 or email clinic@frontierallergist.com to schedule an appointment today! Book an appointment

FAQs

What happens during an asthma attack?

• During an asthma attack, the sides of the airways in your lungs become swollen and inflamed. The muscles around the airways to your lungs contract and the airways can produce excess mucus resulting in breathing tubes (or bronchial tubes) to narrow. This can results in some or all of the following symptoms: coughing, wheezing and trouble breathing.

Who gets asthma?

• Anyone can get asthma at any time during their lifetime. There is a genetic component to asthma: meaning your child is more likely to have it if it runs in your family or if both parents have asthma. Many people with asthma tend to have environmental allergies or eczema or a family history of eczema or environmental allergies.

Can asthma be cured?

• Asthma cannot be cured but there are some very effective treatments to keep it under control and lead a completely normal life. Some kids outgrow asthma by adulthood but for most people this is a lifelong condition.