Allergy Partners

Asthma

What Happens When You Move to Another Part of the Country? Coping with New Regional Allergies.

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Feeling worn out, congested, and sickly after a recent move? It might be allergies you didn’t know you had! Here’s what you need to know about managing your allergy symptoms in a new location.

The Allergy Adventure

The following is a story of a young woman. Her name is Emily.

When Emily got accepted to her dream college thousands of miles from her hometown, she could barely contain her excitement. She was leaving her sunny, sparsely populated community for the bustling city of Mugwort!

Emily was drawn to Mugwort University because of its fantastic STEM program and because the city offered urban sophistication punctuated by vibrant wild green spaces. Having lived her entire life in an arid town with more gravel than greenery, Emily was thrilled at the opportunity to go hiking, camping, and exploring the lovely verdant parks.

She didn’t anticipate how her body would react to the change in environment.

During Emily’s first week in Mugwort, she felt off. Her eyes itched, her nose ran constantly, and she felt an unusual fatigue. At first, she brushed it off. It was probably the stress of moving and adjusting to a new routine, and maybe the cold weather.

One bright and crisp afternoon while exploring the beautiful Mugwort Park, Emily found herself sneezing uncontrollably. She sat down on a bench, feeling frustrated, headachy, and horrible.   “Why do I feel so different here?” she wondered.

A friendly local, noticing her discomfort, sat down next to her. “You must be new here,” the local said with a smile. “The allergies in Mugwort can be pretty intense, especially this time of year.”

Emily’s eyes widened. “Allergies? I never had allergies back home!”

The local nodded. “Different regions have different allergens. Mugwort is known for its high Mugwort pollen count. It’s how we got our name.”

Managing New Allergies

If you’re moving to a new part of the country for work or school, you’re probably making dozens of necessary preparations. However, there’s one area you probably haven’t considered, particularly if you’re in good health: How will your body react to your new environment?

Approximately one-quarter of people in the United States experience seasonal allergies, with one-quarter of allergy sufferers first experiencing seasonal allergy symptoms in adulthood.

In Emily’s case, exposure to a specific pollen in an unfamiliar climate triggered her first symptoms. How does this happen?

New Location, New Allergens

Transitioning from a warm, dry climate to a cool, humid environment can trigger allergy symptoms in individuals who have never previously experienced seasonal allergies.

For Emily, who was used to a desert climate, being in a cooler, more humid environment caused an aggressive immune overreaction. She was exposed to a variety of previously unfamiliar allergens, including mold spores, pollen from different plants (like the ubiquitous mugwort weed), and dust mites, which thrive in humid conditions.

So, what can someone in Emily’s situation do?

Embracing New Allergy Treatment

Determined to enjoy her college experience despite this unexpected challenge, Emily decided to take action. She visited a local allergist who confirmed that she was indeed reacting to the new allergens.

Armed with a new allergy medication and some helpful tips, Emily started to feel better.

She learned to check the local pollen forecasts and planned her outdoor activities accordingly. Emily also invested in an air purifier for her dorm room and made it a habit to shower and change clothes after spending time outside. Slowly but surely, her symptoms began to improve.

Visiting an allergist was key to discovering the likely allergens and developing an effective management plan. While significant symptoms might require medications to resolve effectively, there are nonetheless numerous strategies that can help reduce the intensity of the symptoms.

Allergy Medications

A combination of nasal corticosteroids and antihistamines can provide the most comprehensive relief.

Nasal corticosteroids address the inflammatory component of allergies, while antihistamines target the histamine-mediated symptoms. This dual approach can be particularly effective for individuals with multiple or severe allergy symptoms.

Manage Allergy Symptoms at Home

The following home and lifestyle modifications are very effective allergy symptom management strategies:

  • Use Air Purifiers: Invest in high-efficiency particulate air (HEPA) filters to reduce airborne allergens like pollen, dust mites, and pet dander.
  • Keep Windows Closed: During high pollen seasons, keep windows and doors closed to prevent allergens from entering your home.
  • Regular Cleaning: Vacuum carpets and upholstery frequently, using a vacuum with a HEPA filter. Dust surfaces regularly and wash bedding in hot water weekly.
  • Control Humidity: Use a dehumidifier to keep indoor humidity levels below 50%, which helps prevent mold growth and dust mites.
  • Pet Care: Bathe pets regularly and keep them out of bedrooms to reduce pet dander. Learn more about Pet Allergies here: Frequently Asked Questions About Pet Allergies

Manage Allergy Symptoms When Outdoors

Making the following adjustments will help reduce your vulnerability to outdoor allergens:

  1. Check Pollen Counts: Monitor local pollen forecasts and try to stay indoors on high pollen days, especially during the early morning when pollen levels are highest.
  2. Wear Protective Gear: When outdoors, wear sunglasses to protect your eyes from pollen and a mask if you are particularly sensitive.
  3. Shower After Being Outdoors: Change clothes and shower to remove pollen from your skin and hair after spending time outside.
  4. Avoid Drying Clothes Outdoors: Use a dryer instead of hanging clothes outside to prevent pollen from sticking to your laundry.
  5. Plan Outdoor Activities Wisely: Schedule outdoor activities for later in the day when pollen counts are typically lower.

The above lifestyle adjustments can be highly effective for mild-to-moderate allergy symptom management. However, they do require some vigilance in terms of pre-planning and ensuring a consistently allergen-free environment. For those who’d like a more relaxed, long-term solution, immunotherapy might be a great option.

Some even say that experimenting with local honey may help. Here’s what you need to know about this debated topic: Allergies and Local Honey.

Long-Term Allergy Relief

Emily loved the great outdoors and wanted a more flexible solution for managing symptoms. She wanted to be able to go on a spur-of-the-moment camping trip without sneezing and wheezing.

After researching various options, she chose to undergo immunotherapy, a long-term treatment designed to reduce her sensitivity to allergens. The process involved regular injections of small amounts of allergens, gradually building up her tolerance over time.

The journey wasn’t easy. Nevertheless, she kept her eyes on the goal: a life where she could hike, camp, and explore without the constant burden of allergies.

Slowly but surely, Emily’s symptoms began to diminish. By the time she entered her sophomore year, her worst allergy symptoms were a distant memory, and she was able to enjoy her new home in comfort.

Immunotherapy: Allergy Shots

Immunotherapy (Allergy Shots) is highly effective, with studies showing that it successfully reduces or eliminates symptoms in approximately 80 percent of people treated. Patients often begin to notice a significant reduction in their allergy symptoms after about six months of treatment.

Beyond immediate symptom relief, allergy shots can lead to long-lasting benefits. Many patients experience a sustained reduction in allergy symptoms even after completing the treatment, as the immune system retains its tolerance to the allergens.

Allergy Partners: Your Partner in Long-Term Allergy Relief in 130 Locations

If you’re moving to a new city, there are countless details to consider. If you don’t have seasonal allergy symptoms, it probably won’t occur to you to research environmental factors and pollen counts in anticipation of allergies you have never previously suffered.

That’s where Allergy Partners comes in.

With 130 locations throughout the United States, we ensure people experiencing allergy symptoms for the first time have access to experienced allergists and immunologists. These specialists possess in-depth knowledge of the different regional allergens and their presentations, providing personalized care to help new residents manage their symptoms effectively.

Whether you’re moving across the country or just across town, Allergy Partners is here to support you with expert care and guidance, making your transition smoother and more comfortable.

Are Allergies Genetic? Exploring Allergies During Pregnancy, Childhood, and Adulthood

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Many new parents are concerned about their child’s risk of developing allergies and asthma. If you struggle with allergies, there is a strong likelihood your children will experience allergic responses, too.

When parents welcome a new child into the world, they often find themselves worrying about their child’s health and well-being. One of the most prevalent concerns that many new parents have is their child’s risk of developing allergies.

Allergies can be a debilitating condition, causing a wide range of symptoms such as sneezing, itching, skin inflammation and infection, wheezing, watery eyes, and a host of other symptoms.

While environmental and behavioral factors can make us more vulnerable to the onset of allergies, heredity plays a significant role in the development of allergic disease.

Allergies During Pregnancy

It is estimated that approximately 20% of pregnant women in the United States experience allergies, most commonly allergic rhinitis and asthma.

Pregnancy can affect hormonal balance, which can influence the immune response to allergens. Some women experience worsening allergy symptoms, though others might notice a decline in allergies.

Experiencing allergy symptoms while pregnant does not affect whether the child will develop allergies.

Will my child inherit my allergies?

Not necessarily, but if both you and your partner experience allergies, there is a significant – some studies point to a 95% heritability estimate – risk that your child will develop an allergic disease. These conditions include hay fever (allergic rhinitis) and other environmental allergies, atopic dermatitis (eczema), food allergies, and allergic asthma.

Will my diet cause allergies in my child?

Diet may play a small role in the development of allergic disease in offspring during pregnancy.

A diet rich in certain nutrients, such as omega-3 fatty acids and vitamin D, has been found to reduce the risk of developing allergic disease, while some studies found that intake of folic acid supplements during pregnancy was found to correspond with an elevated risk of childhood asthma.

However, consuming nuts, gluten, milk, or any other foods that may trigger allergic responses during pregnancy does not put a child at risk of developing allergies. These substances are commonly found in our diet and are generally safe for consumption during pregnancy.

Should I be screened for allergies during pregnancy?

If you are experiencing symptoms of allergic disease during your pregnancy, you should undergo a screening by a qualified allergist.

The diagnosis of allergy in pregnant women requires a comprehensive medical history and symptom analysis. It is essential to gather information about your personal and family medical history, as well as any previous allergic reactions.

Additionally, your doctor should assess the presence of symptoms that may indicate an allergy, such as sneezing, itching, hives, or gastrointestinal disturbances.

It is important to emphasize that a rigid elimination diet should be avoided for the diagnosis of food allergy in pregnant women. While an elimination diet can be helpful in confirming a suspected allergy, it carries the risk of compromising the nutritional status of both the mother and the growing infant.

Should I get allergy shots while pregnant?

Patients undergoing immunotherapy (allergy shots) before pregnancy may continue maintenance treatment safely during pregnancy. However, the risk of systemic reactions might outweigh the benefits of starting allergen immunotherapy after pregnancy.

Allergen immunotherapy (AIT) involves receiving injections of tiny quantities of an allergen. This treatment is administered either subcutaneously (SCIT) or sublingually (SLIT).

However, the situation becomes more complex when immunotherapy is begun during pregnancy. The immune system undergoes significant changes during pregnancy, which may affect how the body responds to immunotherapy.

Overall, initiating immunotherapy during pregnancy should be individualized and carefully considered. For those considering starting immunotherapy during pregnancy, the risks might outweigh the benefits, and alternative treatment options should be explored with a qualified immunologist.

Allergies During Childhood

For children with allergies, symptom management is an essential part of assuring optimal development. Unaddressed childhood allergies can impede school performance and hinder academic achievement.

While more than one-quarter of children in the United States have some form of allergic disease, certain types of allergies can be outgrown, sometimes well before adolescence.

Can food allergies be outgrown?

An estimated 80% of people who experienced milk, egg, soy, sesame, and wheat allergies in infancy outgrow them by their mid-to-late teens. Allergies to shellfish, tree nuts, peanuts, and fish tend to be lifelong in approximately 90% of instances.

However, whether or not a food allergy will be outgrown cannot be definitively determined. The best way to manage any type of food allergy is to develop a personalized strategy in consultation with an allergist.

Should my children be tested for allergies even though they show no symptoms?

If you have a family history of allergies, it’s a good idea to have your child tested by an allergist. Although allergy testing can be performed at any age, skin tests aren’t recommended for children under six months.

Allergies in Adulthood

Adult-onset allergies can develop at any time; it’s not uncommon to experience seasonal hay fever in adulthood and middle age, even if you’ve never had symptoms in your youth. An estimated 5% of people in the United States with a diagnosed food allergy were first diagnosed as adults.

What causes allergies to develop in adulthood?

Genetics are thought to play a role in whether allergies develop in adulthood, though identifying the reason behind a sudden onset of allergies can be challenging.

While there may be medical explanations at play, the specific reasons can vary from person to person. In some cases, allergies can develop without any known cause. In other cases, there may be underlying medical conditions or environmental factors that contribute to the development of an allergy.

Which allergies develop in adulthood?

A common type of adult-onset allergy is oral allergy syndrome.

Oral allergy syndrome is a condition where the body develops an allergic response to proteins in fruits and vegetables that resemble certain pollen proteins. So, if a person has a lifelong allergy to grass pollen, that person might develop an allergic response to a fruit or vegetable with a similar protein.

Food allergies can also develop in adults. The most common include the following:

  • Shellfish
  • Fish
  • Peanuts
  • Tree nuts

While childhood allergies can disappear, adult-onset allergies generally persist throughout the person’s lifetime.

While allergies cannot be cured, they can be managed effectively. If you are struggling with allergy symptoms, don’t hesitate to seek diagnosis and treatment from a board-certified allergist.

Asthma During Pregnancy: Common Questions Answered

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Pregnancy brings joy and anticipation, but it also brings new concerns. For women living with asthma, pregnancy can bring additional challenges.

While asthma during pregnancy can be concerning, it does not necessarily pose a significant risk to the mother or fetus. However, expectant mothers with asthma must follow their healthcare provider’s recommendations carefully to ensure the best possible outcome for themselves and their babies.

Partnering with your care team to manage your asthma, allergies, and related symptoms is key to ensuring a healthy pregnancy. Here are answers to the most common questions surrounding asthma and pregnancy.

Can asthma lead to pregnancy complications?

According to the National Institutes of Health, between 4-8% of pregnancies are affected by asthma, making the condition one of the most prevalent chronic diseases affecting pregnancy. Although allergies and asthma are highly common medical disorders affecting pregnant women, they can nevertheless cause serious complications.

Asthma is a chronic respiratory disorder marked by airway inflammation and constriction. It affects millions of people around the world and can significantly influence overall well-being. The presence of asthma during pregnancy can create additional complexities during fetal gestation.

“Pregnancy brings significant changes to your body, including hormonal shifts and alterations in lung function,” says Dr. William A. McCann, Chief Medical Officer of Allergy Partners. “Poorly controlled asthma during pregnancy can pose risks to both mother and baby.”

When pregnant women experience asthma flare-ups, the baby’s oxygen supply is compromised. Oxygen deficiency can cause significant medical complications for the baby, including premature birth and developmental disorders. Additionally, women with asthma are at a higher risk for preeclampsia, a potentially fatal medical issue that occurs in approximately 6% of pregnancies.

The severity of asthma symptoms during pregnancy tends to correspond with asthma’s overall severity, though some people – approximately one-third – experience symptom improvement during pregnancy. However, pregnant women with asthma should nonetheless follow their medical team’s asthma care plan regardless of whether their symptoms remain the same or improve.

How do I prevent an asthma attack during my pregnancy?

Proper management of asthma triggers is especially important during pregnancy. Common asthma triggers include the following:

  • Dust Mites and Household Pests: Dust mites and household pests, such as cockroaches, ants, and rodents, can trigger asthma symptoms. These small organisms can be found in bedding, carpets, furniture, and other parts of the home.
  • Pets: While pets can provide companionship and emotional support, certain animals, particularly cats, dogs, and birds, can also trigger asthma attacks. Proteins common to animal dander, skin flakes, and saliva can cause an allergic reaction in individuals with asthma.
  • Outdoor Pollution: Exposure to outdoor pollutants, such as pollen, vehicle exhaust, and industrial emissions, can irritate the airways and trigger asthma attacks. It is important to limit outdoor exposure during peak pollen seasons or when air quality is poor.
  • Mold: Mold spores can be found in both indoor and outdoor environments. When mold grows in damp or humid areas, such as bathrooms, basements, or leaky pipes, it can trigger asthma symptoms. Keeping indoor spaces clean and dry can prevent mold growth.
  • Tobacco Smoke: Smoke from tobacco products, including cigarettes, cigars, and secondhand smoke, is a known asthma trigger. Even brief exposure to smoke can cause bronchospasms, coughing, and wheezing in individuals with asthma. It is advisable to establish smoke-free environments and refrain from smoking or being around others who are smoking.
  • Respiratory Infections: Respiratory infections like common colds, sinusitis, COVID-19, and influenza can worsen asthma symptoms. Practicing good hand hygiene, vaccinating against respiratory infections, and consulting a healthcare provider for appropriate treatment can dramatically reduce respiratory infection risk.

It is crucial for pregnant women with asthma to work with their healthcare providers to develop a comprehensive asthma management plan. Regular check-ups and follow-ups are important to monitor asthma control and address any changes in symptoms during pregnancy. Proper prenatal care is essential, as it can help identify any potential complications or risks associated with asthma during pregnancy.

In addition to managing asthma, pregnant women should prioritize a healthy lifestyle during pregnancy. A healthy lifestyle includes maintaining a balanced diet, exercising regularly, and getting enough rest.

Should I continue to exercise regularly during pregnancy if I have exercise-induced asthma?

Exercise-induced asthma, known as exercise-induced bronchoconstriction (EIB), occurs when heat and water loss during physical activity cause the smooth muscles in the airway to constrict.

While exercise is a common asthma trigger, physical activity is nonetheless an important part of maintaining overall health and improving lung capacity. Exercise during pregnancy offers the following benefits:

  • Reduces back pain
  • Mitigates bloating
  • Reduces constipation
  • Improves sleep quality
  • Enhances mood
  • Helps prevent gestational diabetes
  • Increases energy

There is also evidence to suggest that exercise can help ease and even shorten labor.

Exercise-induced asthma can be managed with the help of allergy and asthma specialists. “Your specialist can assess your asthma severity and control, adjust your medication regimen as needed, and provide personalized asthma action plans to help you navigate your pregnancy with confidence,” says Dr. McCann. “It’s crucial for expectant mothers with asthma to receive comprehensive care tailored to their unique needs.”

Can I safely use asthma medications during pregnancy?

It is essential to continue taking your asthma medications during pregnancy, as directed by your healthcare provider. Some asthma medications, such as inhaled corticosteroids, are considered safe during pregnancy and can help control your symptoms and prevent asthma attacks. However, it is important to consult with your healthcare provider before starting any new medications or changing your current routine.

At Allergy Partners, we recognize the importance of providing comprehensive support to women with allergies and asthma throughout their pregnancy journeys. We have a deep understanding of allergy-related pregnancy challenges and offer the necessary range of services and resources that will help you navigate your pregnancy safely. Find a location today. 

Asthma Triggers – Common Causes of Asthma Flare-Ups

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Managing asthma requires constant vigilance in an environment overflowing with potential triggers. Microscopic dust mites and airborne pollen from blossoming trees are but a few of the numerous instigators capable of causing episodes of wheezing, coughing, and chest tightness. Understanding these triggers is the first step to managing your asthma effectively and reclaiming control of your breathing.

Asthma Triggers: The Usual Suspects

Airborne Irritants

  • Pollens: Springtime isn’t always synonymous with joy for those with pollen allergies. Trees like ragweed, birch, and oak, along with flowers like daisies and goldenrod, release tiny pollen particles that can wreak havoc on sensitive airways. Knowing your local pollen season and taking appropriate precautions, like staying indoors during peak times and using air purifiers, can be game-changers.
  • Dust Mites: These microscopic creatures cozy up in your mattress, pillows, and carpets. They’re champions at multiplying in warm, humid environments, making summer and fall their prime time to pester. Washing bedding in hot water regularly, using dust mite covers, and vacuuming often can help keep their numbers in check. Learn more about how to manage dust mites.
  • Mold: Mold thrives in damp places with poor ventilation. The spores it releases can irritate airways, leading to congestion and asthma flare-ups. Fixing leaks, using exhaust fans in bathrooms, and controlling indoor humidity can help banish mold from your home.
  • Smoke: Whether secondhand smoke from cigarettes or fumes from burning wood, smoke is a potent asthma trigger. Avoiding smoky environments and advocating for smoke-free spaces is crucial for protecting your lungs.

Food Sensitivities and Intolerances

While less common than environmental triggers, certain foods can trigger asthma symptoms in some individuals. Common foods that cause asthma flare-ups include:

  • Milk
  • Eggs
  • Shellfish
  • Peanuts
  • Soy

Paying attention to how your body reacts after consuming different foods and keeping a food diary can help identify potential dietary triggers. Consulting an allergist for food allergy testing can also provide valuable insights.

Emotional Asthma Triggers

Stress, anxiety, and even strong emotions like excitement can surprisingly trigger asthma reactions. This happens because the body releases hormones during these emotional states that can tighten airways and make breathing difficult. Mindfulness practices, relaxation techniques, and stress management strategies can help counter these emotional triggers and keep your airways at ease.

Other Asthma Triggers

  • Cold Air: Chilly weather can constrict airways and trigger asthma symptoms. Bundling up in cold weather and wearing a scarf over your mouth and nose can help mitigate this effect.
  • Exercise: While regular exercise is healthy for everyone, including those with asthma, strenuous workouts can sometimes trigger flare-ups. Choosing gentler forms of exercise like swimming or yoga, adjusting exercise intensity, and using an inhaler before exercising can help prevent asthma attacks.
  • Medications: Certain medications, like aspirin and beta-blockers, can worsen asthma symptoms in some individuals. Discussing your medications with your doctor and exploring alternative options if necessary is essential.
  • Personal Asthma Triggers: Everyone experiences asthma differently, and identifying your unique triggers is critical to effective management. A symptom diary to record trigger exposures and symptom severity can be a helpful tool.

What Does an Asthma Flare-Up Feel Like?

An asthma flare-up can feel like a sudden switch has flipped, turning breathing from effortless to demanding. Coughs punctuate every exhale, and a tightness settles in your chest, making each inhale a bit heavier. This feeling can be unsettling, a reminder of your lungs’ vulnerability. But for those familiar, it’s a landscape you’ve navigated before. A calm focus washes over, guiding you to reach for your inhaler, take a slow, controlled breath, and trust that this temporary state will soon return to open, easy air.

What is Silent Asthma?

Silent asthma, also known as silent chest or subacute asthma, is a less common subtype of asthma characterized by the absence of the typical loud wheezing and coughing associated with regular asthma attacks. Key features of silent asthma include:

  • Lack of loud wheezing
  • Fatigue and low energy levels
  • Increased susceptibility to infections

If left untreated, silent asthma can lead to lung damage and other severe respiratory complications.

Warning Signs of Severe Asthma Flare-Ups

Don’t hesitate to seek help: Call emergency services immediately if any of these warning signs arise. Every minute counts in a severe asthma attack.

  • Rapidly worsening shortness of breath: Difficulty speaking or catching your breath, even at rest, is a significant red flag.
  • Severe wheezing: Wheezing that becomes loud and persistent, even after using your inhaler, is concerning.
  • Chest tightness: A feeling of chest constriction that doesn’t improve with your usual treatment warrants immediate medical attention.
  • Blueish skin or nail beds: This blueish discoloration, known as cyanosis, indicates a lack of oxygen and requires immediate medical intervention.
  • Increased anxiety or panic: While some anxiety is normal during an asthma attack, uncontrolled panic could signify a worsening situation.
  • Confusion or loss of consciousness: These indicate a potentially life-threatening situation and require an emergency call.

Taking Control of Your Breath

Once you’ve identified your triggers, the next step is to avoid them whenever possible. This might involve adjusting your environment, changing your diet, managing stress, and adjusting your exercise routine. Your allergist can help you develop a personalized action plan to minimize trigger exposure and manage your asthma effectively.

  • Understanding your asthma triggers empowers you to make informed choices and reduce the risk of flare-ups.
  • Prevention is vital: Taking proactive steps to avoid triggers is the most effective way to control your asthma.
  • Seek professional help: Consulting an allergist can provide personalized guidance, testing, and treatment plans to optimize your asthma management. Comprehensive pulmonary function testing can also detect how well your lungs are functioning.

With the right approach and tools, asthma doesn’t have to dictate your life. By unmasking the triggers hiding in plain sight, you can breathe easier and navigate the world with confidence and control.

What Is the Difference Between COPD & Asthma?

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Let’s Break Down These Two Lung Conditions

If you or your loved one experiences shortness of breath, wheezing, or coughing, it can be difficult to tell if you are dealing with asthma or chronic obstructive pulmonary disease (COPD). Both COPD and asthma are chronic illnesses that affect the lungs and breathing. Knowing the difference between these two lung conditions is vital in determining how best to address any symptoms you may experience. At Allergy Partners, we understand just how confusing this can be—that’s why we’re here today to help explain what sets COPD apart from asthma!

A Brief Overview of These Chronic Illnesses

Although a detailed comparison is beyond the scope of this article, one can consider the basic differences between the two conditions. Both diseases are considered to be “obstructive” lung diseases, meaning that patients have difficulty exhaling completely between breaths. Obstructive lung diseases can be diagnosed by lung testing called spirometry. In this test, patients exhale forcibly into a machine that measures the amount of air they exhale in 1 second (Forced Expiratory Volume-1 or FEV1) and the total amount of air they exhale in a breath (Forced Vital Capacity or FVC).

The machine then calculates a ratio of how much air was exhaled in the first second vs. the total amount of air exhaled in the breath, which is called the FEV1/FVC ratio. Said a different way, most patients will exhale 70% or more of their breath in the first second of exhalation. If they do not, they are considered to have a form of obstructive lung diseases, such as asthma or COPD.

So Which One Do I Have?

Asthma typically, although not universally, presents at a younger age. Chronic Obstructive Pulmonary Disease (COPD) typically presents later in life (over age 40), and is also associated with shortness of breath, coughing, wheezing, and chest tightness. COPD more commonly has additional symptoms of sputum production and shortness of breath requiring short-term oxygen use. Like asthmatics, patients may feel increased symptoms when exposed to triggers such as fumes or lung infections. Also, like asthmatics, patients with COPD will have a reduction in their ability to exhale and will show reductions in airflow when tested with spirometry.

However, unlike asthmatic patients, COPD patients will not be able to completely correct their lung function, even with treatment. COPD is also associated with permanent structural changes in lung structure, which may be seen in radiological studies such as CT scans. Emphysema is one such permanent change and is a condition of the destruction of alveoli, which are the parts of the lung where oxygen is absorbed into the bloodstream.

Emphysema is often seen in the setting of COPD and is rarely seen with asthma. Tobacco use is by far the most common cause of COPD in developed countries, but other causes for COPD do occur, such as genetic conditions. Alpha-1 antitrypsin deficiency (A1AT) is an example of a genetic condition that causes COPD in patients. This condition can be diagnosed with a simple blood test, and treatment is available to allow patients with A1AT to maintain their lung function.

Understanding Treatment Options

While it can be challenging to determine whether a patient is suffering from asthma or COPD, allergists and immunologists are highly trained in determining the best course of action. Using spirometry testing as well as additional lung tests such PFTs for detailed diagnostics, patients can rest assured knowing that both conditions have effective treatments available.

Allergy Partners Has the Answers

Our team at Allergy Partners is here to help with diagnosing and managing both COPD and asthma so that you can get on the path to breathing better. We understand how overwhelming each condition can feel, but rest assured that we are equipped to provide the treatment and advice needed. If you have any questions about the differences between COPD and asthma, our dedicated specialists will be more than willing to answer them. We are ready to provide a comprehensive solution designed to meet your personalized needs while delivering lasting results.

To learn more about COPD and asthma and which treatment options may work best for you, the local team at Allergy Partners is here and ready to provide personalized guidance. Contact us today!

Exercise Induced Asthma

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Like the name suggests, exercise induced asthma or exercise induced bronchospasm (EIB) is asthma that is triggered by vigorous or prolonged exercise or physical exertion. Most people with chronic asthma experience symptoms with exercise; however there are some people without asthma who can experience symptoms only with exercise.

Symptoms

Symptoms usually start within 5-20 minutes of starting exercise or can start 5-10 minutes after completing exercise and include:

  • Chest tightness
  • Cough
  • Shortness of breath
  • Wheezing
  • Excessive fatigue with exercise

Mechanism/ Pathophysiology of EIB

There may be more than one biological mechanism that causes EIB. A change in the temperature and moisture content of inhaled air is the primary change that causes symptoms in these individuals.

During normal breathing, we inhale air through the nose which is first warmed and moistened through the nasal passages. During strenuous exercise, we breathe through the mouth and the air tends to be cooler and drier; strenuous exercise sets in motion molecular events that trigger inflammatory changes which cause narrowing of the airways and mucous production.

EIB can also be made worse when the patient is sick with a cold or when the allergens ( pollen, mold) counts are really high during the allergy seasons or when the person exercises in very cold weather.

Diagnosis

Exercise induced asthma is diagnosed on the basis of a reliable history and supportive tests like Spirometry and sometimes an Exercise challenge test.

A Spirometry is a breathing test that is done in the office to measure a patients lung capacity at baseline and to see the effect of a bronchodilator on lung function.

An Exercise challenge test is sometimes necessary in patients who have exercise induced symptoms but don’t seem to be getting better with treatment. Such patients may have other conditions which mimic EIB and may need to be treated differently.

An Exercise Challenge test is usually done in our office using a treadmill – the patient is made to undergo vigorous exercise in order to provoke the patients symptoms; Spirometry is done pre -exercise and again post exercise every few minutes to determine if the patient is showing evidence of bronchospasm.

Conditions that can mimic exercise induced asthma include:

  • Vocal cord dysfunction
  • Gastroesophageal reflux disease
  • Other lung disorders
  • Cardiac arrhythmia or other conditions

Should exercise be avoided by patients who have EIB?

No, asthma should not be used as an excuse to avoid exercise. Exercise induced symptoms can be both prevented and treated with medications as well as taking certain precautionary measures during exercise.

Treatment

Pre-exercise inhalers:

Short acting Beta2 agonists (SABA’s) like albuterol help to relieve bronchial spasm and are the most commonly prescribed inhalers for EIB -the inhaler is usually taken 10 minutes before exercise as a preventive measure and can be used additionally if a patient experiences symptoms. However, if pre-exercise treatment alone is not enough and the patient needs this inhaler regularly even after exercise, then he/ she may need a daily controller medication.

Daily controller medications:

For those patients with chronic asthma and those requiring SABA’s daily for EIB ,there are other inhalers ( such as inhaled corticosteroids and LABA’s ) and leukotriene modifiers (Singulair) which are often prescribed as controller medications. These medications help to control inflammation and can also help to prevent exercise induced symptoms.

In addition, the patient may want to take certain extra precautions like trying to avoid exercising outdoors in very cold weather and using a face mask if exercising during high pollen count days which would also help to minimize symptoms. A gradual warm up routine prior to vigorous exercise and a cooling down routine post exercise also helps.

Certain exercises like swimming are better tolerated by these individuals because it is usually done in a warm moist air environment.

Activities that involve short intermittent periods of exertion like volleyball, walking and wresting are generally better tolerated than other strenuous exercises like soccer, ice hockey and basketball but most patients with exercise induced asthma should be able to actively participate in sports and activities.

The board certified and eligible physicians at Allergy Partners offer extensive training, knowledge and experience in diagnosing and treating patients with exercise induced asthma. As the leaders in allergy and asthma care, our physicians take a detailed history, perform careful physical examination and create a patient centered treatment plan to ensure all needs are addressed thoroughly.

Mona Hirani, MD

Allergy Partners of Chicago

Asthma Therapy 101

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If you have asthma, it is important to know the role of the different medications used for asthma and how they should be used to best control asthma.

The characteristic symptoms of asthma are cough, wheeze, shortness of breath, chest tightness. These symptoms can lead to difficulty with exercise, activities and with sleep. The goals of asthma therapy are to reduce symptoms, reduce the need for rescue inhaler and reduce the risk of exacerbations (worsening asthma symptoms that may require oral steroids, like prednisone). Health care providers will assess asthma control over time and add and adjust medications, in a step-wise approach, until asthma is controlled. Control of asthma means a patient is having infrequent symptoms (<2x/week), minimal disruption in activity, no nighttime awakenings due to asthma and is not requiring rescue medication often.

Rescue medications, typically albuterol, are inhalers (medications delivered to the lungs) used when symptoms are present. When used effectively, these medications improve symptoms within minutes. They work by relaxing the muscles in the airway, which allows the airways to open. Your doctor may suggest a spacer or valved holding chamber device, which helps hold the medication so it can be effectively delivered to the lungs. Rescue inhalers should be carried by asthma patients all the time, to treat any symptoms quickly.

If an asthma patient’s symptoms are occurring often (≥ 2x/week) or if a patient is waking up at night with asthma symptoms, a controller medication is added to the regimen. Controller medications are medications patients taken every day to prevent symptoms. These medications should be taken daily or twice daily. Most of these controller medications are inhalers. The inhalers typically contain inhaled steroids, which decrease the inflammation (or swelling) in the airway. Some controller medications are combination medications, which are generally prescribed if symptoms require a higher level of treatment. These combination medications contain both an inhaled steroid as well as a long acting beta agonist (LABA) which is a long acting form of albuterol. If asthma is not well controlled with a combination medication, a separate inhaler may be added to help open the airways even more or an injected therapy may be considered (biologic medications designed to target specific pathways in asthma).

Achieving asthma control is important to help minimize disruption in activity, sleep and exercise. It is also important to understand triggers (environmental allergens, temperature, exercise, etc) for your asthma. Working with your trusted Allergy Partners physician can help you find any underlying triggers and understand how to avoid these triggers as well as manage your asthma.