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Asthma: Take Control - Don’t Let Asthma Control You!

Asthma: Take Control- Don't Let Asthma Control You!

A diagram of the human respiratory system

When you breathe, air travels through tubes (bronchi , bronchioles) in your lungs
to reach tiny air sacs (alveoli) so that your body can get the oxygen it needs.

What Causes Asthma?

Asthma is a chronic condition in which the lining of the airways, or bronchial tubes, is inflamed and overly sensitive to many factors which "irritate" them. Exposure to one of these irritating factors can cause symptoms in a person with asthma.

What Are "Asthma Triggers"?

Factors which irritate the airways and cause asthma symptoms arc called "asthma triggers." Many substances or events can trigger chest tightness, coughing, and wheezing. Some triggers are common for many people including:

  • Respiratory infections
  • Exercise
  • Cold Air
  • Cigarette smoke
  • Odors, perfumes, aerosols
  • Air pollution
  • Allergens
  • Emotional stress
  • Fatigue
  • Weather changes
  • Gastroesophagcal Reflux Discasc/LPR

What are Early Warning Signs?

Many patients notice a variety of symptoms that occur before the onset of chest symptoms. Examples include:

  • Fatigue
  • Irritability
  • Itching of chin or back
  • Dark circles under the eyes
  • A drop in your peak flow values

It is important to identify and recognize these early warning signs and to intervene before asthma symptoms progress.

How Do My Asthma Medications Help?

Medications used to treat asthma can be grouped into two broad categories based on how they work to relieve or prevent asthma symptoms.

Quick -Relief (Rescue) Medications: Bronchodilators

Rescue medications open the airways by relaxing the muscles surrounding the bronchial tubes.

  • Beta-agonists: inhaled short acting beta-agonists include albuterol (Proventil HFA, Ventolin HFA, ProAir), pirbuterol (Maxair), levalbuterol (Xopenex HFA) and alupent. These are taken "as needed" for quick relief of asthma symptoms and may be used before exercise to prevent exercise induced symptoms.
  • Anticholinergics ( e.g., Atrovent=ipratropium bromide): Used to open the airways and are many times used with beta agonist to improve bronchodilation. May also be helpful when cough is prominent symptom.

Long-term, Controller Medications:

Anti-inflammatory Drugs: control inflammation of the bronchial tubes. Prevent asthma symptoms by reducing the ever- present inflammation of the airway lining. They take time to work, and must be used on a regular basis. There are three families of anti inflammatory drugs.

  • Steroids: Inhaled steroids are "cortisone like" steroids which work locally in the lungs to decrease inflammation. (e.g., Asmanex, Azmacort, Vanceril, QVAR, Aerobid, Flovent, Pulmicort). Systemic steroids (e.g. prednisone, Medrol) are strong inflammatory drugs most often used in short courses (about 3-7 days).
  • Leukotriene blockers: Medications which block the receptors for leukotrienes (Accolate, Singulair) or block the synthesis of leukotriense (Zyflo ). Leukotrienes are cellular mediators which lead to bronchial inflammation and narrowing, and cause an increase in mucus production in the bronchial tubes.
  • Combination Inhaled steroid/ Long-acting Bronchodilator (e.g. Advair Diskus, Advair HF A, Symbicort)
  • Cromolyn (Intal) and nedocromil (Tilade)

Bronchodialators:

  • Long-acting bronchodilators ( e.g. Serevent, Foradil) Should not be used as "rescue" medication or alone as controller.
  • Theophylline (e.g. , Theo-24, Uniphyl ): oral bronchodilator to be taken on a regular, longterm basis.

Potential Side effects

  • Bronchodilators: increased heart rate, jitteriness
  • Inhaled steroids: thrush, hoarseness
  • Long-acting bronchodilators: potential increased risk of rare, serious life threatening asthma attacks
  • Oral steroids (short term use) increased appetite, weight gain, water retention, moodiness, irritability, insomnia, stomach upset
  • Oral steroids (long term use), growth suppression, cataracts, glaucoma, osteopenia/osteoporosis

What Happens During An Asthma
Flare-Up?

Asthma symptoms occur when there is blockage of the bronchial tubes, causing a whistling noise called "wheezing", cough, shortness of breath, and/or chest tightness. This blockage is caused by three things:

  • Swelling or "edema": the lining of the bronchial tubes swells, expanding inward, making the size of the airway smaller. This swelling is caused by increased inflammation of the bronchial tube lining.
  • Mucus secretion: the tissues that line the bronchial tubes secrete extra mucus which can plug the narrowed air passages even further.
  • Bronchospasm: the muscles that surround the bronchial tubes tighten and make the airway even smaller.

Together, the swelling, mucus, and bronchospasm in the airways make it harder to move air through the bronchial tubes. The person with asthma must work harder and breathe faster to move air through these narrowed airways.

How Can I Prevent Asthma Symptoms From Becoming More Severe?

  • A void the asthma triggers that may be causing the symptoms.
  • Learn to recognize early warning signs
  • Stop what you are doing, rest, and take slow deep breaths.
  • Sip warm fluids to help relax
  • Take two puffs of your bronchodilator inhaler to help relieve your symptoms
  • Follow your asthma management plan

When Do I Call the Doctor's Office?

Sometimes asthma episodes become more severe despite your best efforts to treat them early. A change or increase in medications or further medical treatment may be needed. Call your doctor's office or seek medical help if:

  • Asthma symptoms continue or worsen despite all treatment steps that your physician has given you
  • The medicines are not helping or not lasting as long as they should.
  • You have any doubt about the severity of an attack

Recent News

SuperUser Account
/ Categories: News

Not a Cold. Not the Flu. It’s Cedar Fever! Who Knew?

Runny nose, coughing, watery eyes – These are the symptoms Tess (not her real name) just couldn’t seem to shake.

The congestion set in after raking leaves.  Her first thought was, “Wow, I have caught a cold.”

But those pesky cold symptoms lingered.  She worried that perhaps she had contracted Covid, as some friends had tested positive for it recently. She felt fine but tested anyhow. Five negative Covid tests later, she was finally convinced it was not Covid.

So, it was not Covid. It was not a cold, and it was not influenza either. What was it?

It turns out the culprit was not a virus at all.  Tess was suffering from something called Cedar Fever.

“Cedar Fever is not really a fever and it is not a virus,” said Maya Gharfeh, MD, FACAAI, FAAAAI. “It is an allergic reaction to pollen from cedar trees, which do grow in abundance in this state and region. For some, the pollen triggers an allergic reaction.”

Most people worry about allergies in the spring and summer, but for some people, like me, allergies can also occur and sometimes be severe in the winter months too.

Cedar Fever

If you live in Oklahoma, Texas, Arkansas or Missouri or somewhere where these trees are common and have a sensitivity to the pollen, you may notice seasonal allergy symptoms from these trees in the winter months.

Millions of cedar trees release large amounts of pollen each year, with pollen production typically reaching a peak in mid-January.  Tree experts know that when it is dry and windy, pollen cones open and release pollen grains. Some people have even captured video and pictures of the pollen clouds blowing off trees. 

What Are the Symptoms of Cedar Fever?

Dr. Gharfeh explained cedar fever is often confused with a cold or flu because of the time of year when it is most prevalent.

Cedar Fever symptoms are like many common allergy symptoms, and may include a runny nose or nasal congestion, itchiness, and sneezing. As the name suggests, some people may notice a warmer body temperature as part of their symptoms.

“We are talking about a mildly elevated body temperature or feeling slightly warm,” Gharfeh stressed. “If you are experiencing a high fever, it is likely that it is something more than allergies and you should see a primary care provider if those symptoms don’t fade.”

Here are a few other symptoms that sometimes occur with Cedar Fever:

  • Sore throat
  • Coughing
  • Difficulty smelling
  • Plugged ears
How Do You Treat Cedar Fever?

Cedar fever should not put you at risk for any health complications, but the symptoms can be uncomfortable.

“As with so many allergies, the appropriate treatment depends upon the patient and the severity of his or her symptoms,” Gharfeh explained.

Common treatments at home may include:

  • Prescription medications
  • Over-the-counter antihistamines
  • Over-the-counter medications

“For some simple over-the-counter medications are sufficient, but if you find that those medications are not enough, it might be time to talk with your doctor or an allergy specialist,” Gharfeh said. “At the Oklahoma Allergy and Asthma Clinic, we have 100 years of experience helping people navigate life with allergies. We are able to help determine the best treatment for your allergies, which may include stronger prescription medications.”

Prevention of Cedar Fever

Gharfeh explained that for those most susceptible to Cedar Fever, avoiding pollen as much as possible can help.  Here are a few strategies that may help:

  • Avoid outdoor activities when tree pollen counts are high
  • Close windows and change air filters often to reduce pollen levels in your home
  • If you need to do yard work, wear a mask to reduce exposure to cedar pollen
  • Vacuum and clean your home regularly to reduce indoor allergens

Tess has learned to watch the pollen counts displayed daily by the official Oklahoma Allergy and Asthma Clinic website, taking precautions when the tree pollen counts elevate, especially to medium (yellow on the graph) or higher.  The clinic’s pollen count is posted daily Monday through Friday and can be found here: https://oklahomaallergy.com/allergy-report/

With a simple pollen count check daily and some allergy medications, Tess finds she is better able to maneuver Cedar Fever season.

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Oklahoma Allergy and Asthma Clinic celebrates its 100th Anniversary this year. Founded in 1925, the clinic has a century of patient-focused, state-of-the-art allergy and asthma care. Today, the clinic is home to 13 allergy and asthma specialists, caring for tens of thousands of patients a year from across Oklahoma, the region and nation.  OAAC also has earned the Better Business Bureau’s Torch Award for Business Ethics, the Oklahoman’s Community’s Choice Award for Top Allergy Clinic, 405 Magazine’s Best OKC Allergy Clinic and the Journal Record’s Reader’s Rankings Award, among others. In addition, the clinic remains a staunch supporter of the community through organizations such as Allied Arts, United Way, the Oklahoma City Philharmonic and Museum of Art, Ronald McDonald House Charities of OKC, Toby Keith Foundation, Positive Tomorrows and more.

The post Not a Cold. Not the Flu. It’s Cedar Fever! Who Knew? appeared first on Oklahoma Allergy and Asthma Clinic.

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