Asthma is very important health condition impacting on 300 million people worldwide. Asthma can be very serious and even deadly but it can be tightly controlled in almost every case with minimal to no symptoms, the ability to exercise vigorously, a normal quality life, and no attacks. Asthma is a chronic condition which means that it is there and often requires treatment even if you are not having any symptoms. Asthma is a disease in which the surfaces of your lung airways are inflamed. The airways are “twitchy” which means that they have a tendency to constrict or narrow with triggers such colds, allergens, irritants such as smoke, and exercise. Many people with asthma have allergies to such things as animals and pollen (e.g. grass, sagebrush). Dust mites and dust mite allergy are rare in southern Idaho because of the dryness.
Symptoms/diagnosis
The symptoms of asthma include wheezing (a high-pitched sound with breathing out), chest tightness, coughing, and shortness of breath. The symptoms, especially coughing and wheezing, are often made worse by triggers such as colds, exercise, cat and dog allergens, and airway irritants.
In order to diagnose asthma, your allergist will take an extensive history, examine you, and then do a lung function test (this may be repeated after a dose of albuterol, a bronchodilator), an exhaled nitric oxide test, and skin tests. Occasional other tests such as a chest x-ray or blood tests such as a CBC, and total IgE level may be needed. Your asthma will be further classified based on the presence of allergies, elevated FENO, elevated total IgE, previous exacerbations, symptoms, lung function, level of eosinophils, exhaled nitric oxide, etc. in order to allow for more comprehensive, and individualized therapy. There are a number of subtypes of asthma including allergic and nonallergic asthma, aspirin exacerbated respiratory disease (AERD), asthma in pregnancy, exercise-induced asthma, and type II asthma (characterized by the presence of allergies, elevated eosinophils in blood, and an increased exhaled nitric oxide levels). Severe type II asthma may be responsive to some of the new biological medicines for severe asthma including Xolair, Nucala, Fasenra, and Dupixent.
Management
Your BVAAC board-certified allergist will then formulate an individualized treatment plan based on a stepwise care approach which will include extensive education, attention to trigger factors as well as other conditions such as allergies or sinusitis that may make your condition worse, ongoing medications, and in some cases allergy shots.
There are two types of medications for asthma: quick-relief medications, and long-term control medications. Quick-relief medications, such as albuterol (Proair) relieve symptoms but do not have any effect on the inflammation in your airways long-term. In contrast, long-term control medications need to be used on a regular basis and control your asthma long-term. One of the most effective medications are inhaled corticosteroids, the preferred long-term control medication according to all asthma guidelines. There are several other medications available including some of the newer biological medicines for severe asthma.
Scientific research has shown that people with asthma who see a board-certified allergist have fewer asthma hospitalizations, ER visits, doctor visits, days absent from work or school, and financial costs.