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By Penelope Ewbank, MD

Do you need your quick-relief inhaler more than once or twice a week? Do you avoid sports or exercise because of breathing problems? Do you miss work or school due to asthma? Do colds linger in your chest for weeks? Have you been to the ER or needed oral steroids for asthma? Do you skip visits with certain friends or family whose pets make you feel sick? Do you ever wake up at night with shortness of breath or cough? If you answered “yes” to any of these questions, your asthma is NOT controlled well. Don’t just get by with “good enough”—don’t settle for living at a lower level!

Asthma is a chronic lung condition in which patients have inflammation and tightening of the airways. It affects over 25 million patients of all ages in the U.S. Common symptoms include wheeze, shortness of breath, chest tightness and cough. Although wheeze is the most well-known asthma symptom, not all asthma patients wheeze and not all wheezes are asthma. A chronic cough with no other complaints may be asthma and is, unfortunately, often misdiagnosed. Asthma symptoms are often triggered by exposures to various factors, including allergens, cold air, exercise, irritants (i.e., smoke/pollution) and respiratory infections.

Sadly, many patients with asthma think they are well controlled when they are not. Although they feel relief from use of an emergency inhaler, they don’t realize that needing it more than twice weekly is a sign of inadequate control and may mark patients at high risk of bad attacks. So many settle for living at a lower level—feeling things are “good enough” while not realizing they are slowly becoming less active and/or losing several days per year due to exacerbations. Kids miss school and activities. Adults lose work time and productivity. Sleep is interrupted. Additionally, many patients who have been diagnosed with exercise-induced asthma in reality have persistent asthma that needs routine treatment.

Before treatment can be offered, the proper diagnosis must be established.   Lung function tests assess airflow (spirometry) and airway inflammation (exhaled nitric oxide).   Also critical is a detailed history of symptoms, triggers, and medication response.  Of particular importance is identifying allergic triggers.  Finding those external causes of airway inflammation enables non-medication treatment options.

Fortunately, there are great asthma treatments, including daily preventative inhalers, that target inflammation as well as rescue inhalers that relieve sudden symptoms. Proper inhaler technique is a must since medicines only work if they reach the airways. Highly specialized biologic medications that target specific types of airway inflammation are available for those with severe disease. Oral steroids, like prednisone, can help relieve bad flares, but have many side effects. If such steroids are required more than once a year, better maintenance medication should be considered. Optimally treating other conditions like nasal allergies, sinusitis and acid reflux may also improve asthma control.

For more information or to book an appointment, contact Springfield Clinic Peoria Allergy & Asthma at 309.691.5200. Dr. Ewbank and Dr. Smart specialize in all aspects of allergic disease and asthma. To find a location near you, click the link below.