With spring in full bloom, people suffering from asthma may feel their symptoms worsen. Fortunately, certain strategies can reduce discomfort or help with long-term control. It’s important for asthma sufferers to know what triggers their asthma, how to control their environments, which medications to take and when to consider allergy shots or other asthma therapies.
As an allergist/immunologist at Montefiore Health System in the Bronx, I see children and adults who suffer from asthma. In early April, Mr. J, a 45-year-old man born and raised in the Bronx, came to see me after he had been hospitalized for an asthma attack. His asthma was diagnosed in childhood and had been controlled until mid-March, when he started to experience daily chest tightness and breathlessness. His symptoms worsened, and he visited the emergency department, where he was diagnosed with an asthma exacerbation and admitted. He gradually improved with nebulizers and a course of steroids; on discharge, he was started on a daily controller inhaler to prevent further asthma symptoms. During the office visit, I performed skin testing and diagnosed an allergy to tree pollen. I prescribed a daily antihistamine tablet, and continued Mr. J on the controller medication. Because he has been consistent with his medications, Mr. J has been symptom-free.
Asthma is common and can be debilitating.
Recent data from the Centers for Disease Control and Prevention suggest that 25 million Americans suffer from asthma. Asthma affects 7.6 percent of adults and 8.4 percent of children in the United States, and it’s one of the most common chronic conditions among children. Underrepresented minorities disproportionately experience asthma-related emergency department visits and hospitalizations. Asthma has an extremely high prevalence in the Bronx, and almost every Bronx community has asthma emergency department visit rates triple the state average, regardless of age group. Asthma has significant economic consequences and has been linked to annual costs exceeding $81 billion and nearly 14 million lost work and school days among Americans.
[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]
There are many environmental triggers linked to asthma.
Asthma with an allergic component may be perennial or seasonal. Perennial symptoms may be triggered by dust mites, cockroaches, animal dander and/or mold spores. Seasonal symptoms can be triggered by pollen (weeds, grass, trees) or airborne mold spores. Since the predominant pollen types vary by geographic region and pollen levels can change day to day, it’s important to monitor daily pollen counts through the local weather channel, radio station and/or websites. To reduce pollen exposure, we recommend the following measures: 1.) close windows and doors when pollen counts are high; 2.) remove clothes that have been worn outside and shower to remove pollen from skin and hair; and 3.) avoid outside activity in the morning when pollen counts are highest.
Medications are effective in the prevention and treatment of asthma.
In addition to environmental control measures, oral and topical (including nasal) allergy medications can be effective in preventing or relieving allergic symptoms linked to asthma. Commonly used oral medications include over-the-counter antihistamines and prescribed drugs. Oral antihistamines work quickly and should be started before the allergy season to prevent symptoms. Due to varying side effects depending on the antihistamine being used, ask your health care provider which medication is right for you. Nasal allergy sprays for symptoms such as nasal congestion, sneezing and post-nasal drip include nasal steroids, nasal antihistamines and nasal mast cell stabilizers. Inhaled corticosteroids are effective in preventing asthma symptoms and should be used on a daily basis. You must have your “rescue” (short-acting beta agonist) inhaler available, in case your asthma flares during the season. Again, ask your provider which medication is right for you.
[See: 7 Lifestyle Tips to Manage Your Asthma.]
Allergen immunotherapy and other medications (like biologics) may be treatment options for asthma and allergies.
Allergen immunotherapy can dramatically reduce the severity and frequency of allergy and asthma symptoms over the long-term. Immunotherapy involves the administration (either subcutaneous injections or sublingual) of gradually increasing doses of allergen extracts. Immunotherapy consists of an initial build-up phase (weekly sessions over several months) and a subsequent maintenance phase (typically, monthly sessions over two to three years). Allergen immunotherapy may help reduce the long-term use of allergy and asthma medications, while decreasing costs. Recent studies suggest that approximately 85 percent of patients experience a significant reduction in allergy symptoms due to immunotherapy. If you have allergy symptoms despite medications or hope to reduce your allergy medications over the long-term, ask your health care provider if you might be considered for allergen immunotherapy. Based on your severity and type of asthma, you may be a candidate for newer asthma medications called biologics. Ask your health care provider how to be considered for these medications.
[Read: How Do I Find the Best Allergist?]
Asthma and allergy symptoms can be successfully controlled.
Through a combination of environmental control measures, medications and/or allergen immunotherapy, most individuals suffering from asthma and allergies can experience symptomatic relief. To prepare for the spring season with high pollen counts, we recommend the following:
— Monitor daily pollen counts, and close windows and doors when pollen counts are high.
— Remove clothes that have been worn outside, and shower to remove pollen from skin and hair.
— Avoid outside activity in the morning when pollen counts are highest.
— Start taking medications before the spring season starts, and continue to consistently use these medications throughout the season.
— If you have allergy and/or asthma symptoms despite environmental control and medications, consider being evaluated by an allergy/immunology specialist for allergen immunotherapy and/or biologic therapy.
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How to Get Your Asthma Under Control originally appeared on usnews.com
