Diagnostics and Management of respiratory diseases
Spirometry offered in patients 5 years of age and older.
Asthma is a condition in the lungs where there is inflammation of the bronchi. Bronchi are also called breathing tubes or airways. The inflammation causes the symptoms of shortness of breath, chest tightness, wheezing, coughing and production of mucus or sputum. Each person has his or her symptoms and these can change over time.
In many people, the bronchi can be very sensitive to substances or events called triggers. The bronchi swell and produce mucus. At the same time, the muscles in the walls of the bronchi tighten. This makes it harder to breathe. You may also wheeze, have a tight chest, cough and bring up sputum.
HOW IS ASTHMA CONTROLLED?
Asthma is controlled by:
avoiding triggers that affect you, especially allergens and chemicals
learning how to control your asthma with medications.
taking asthma medication regularly.
These medications include “Controllers” such as inhaled corticosteroids (such as Flovent, QVar, Alvesco and Pulmicort) and a medication called Singulair. When wheezing or trouble breathing occur, a “Reliever” medication like Ventolin is used. Sometime we have to use oral steroid, such as prednisone to help with severe symptoms.
Allergy Immunotherapy (allergy shots) has also been shown to decrease steroid use, and improve asthma control.
WHAT ARE TRIGGERS?
1. Allergens that people become allergic to such as dust mites, animal dander, pollen and mould.
2. Colds or chest infections in the bronchial tubes called bronchitis.
3. Exercise and cold air.
4. Irritants such as cigarette smoke, dust, fumes, strong smells.
All of these triggers can make the bronchi narrow in people who already have asthma especially if it is not well controlled.
Allergens, chest infections and certain chemicals can cause asthma in people who do not already have it. Allergens are the most frequent cause of asthma. Allergens cause inflammation and are important to avoid when possible (even when no acute, immediate allergic reaction occurs).
WHAT ARE SIGNS OF GOOD ASTHMA CONTROL?
Signs of good control:
You have no symptoms most of the time.
Coughing, wheezing or being short of breath does not disturb your sleep.
You do not have symptoms when you wake up.
Symptoms do not interfere with day to day activities including exercise.
Symptoms are controlled with the least amount of medication.
You rarely use your Reliever rapid relief medication.
Typically, if control worsens, whether because of allergen exposure or illness, we recommend increasing the dose of the “Controller”, often doubling it. At times we will add on medication to help decrease the symptoms.
Should difficulty breathing occur, we recommend the use of Ventolin 2-4 puffs, which can be repeated in 10-15 minutes should no improvement occur. If still there is no improvement, or the symptoms are worsening, the patient should proceed to the ER either by ambulance or by car if the symptoms are not severe.
Check out our educational video series on all things asthma!