As the temperatures rise and the landscape greens up, that’s a sure sign Spring is here – and with it comes allergy season here in North Texas. For folks who also suffer from asthma, this time of year can be especially triggering. That’s why May is National Allergy and Asthma Awareness Month, a time to focus on two conditions that affect many of us.
The good news is that asthma and allergies can be effectively managed. That starts by getting a diagnosis from your doctor who will work with you on a treatment and management plan.
Privia Medical Group North Texas (PMGNTX) primary care physicians, as well as our ear, nose and throat (ENT) specialists (otolaryngologists), provide testing, care and treatment for asthma and allergies to patients across North Texas.
Understanding Asthma
The most important thing to know if you have asthma is that you can control it and it does not have to be a major disruption in your life. Asthma is a serious condition, but one that can be managed through medication and precautions. The causes of asthma are unknown, though heredity and environment are known to be contributing factors.
Asthma causes the airways, the tubes that carry air in and out of the lungs, to become inflamed. When this happens, the muscles around the airways tighten, causing the passages to narrow. This process can also cause an increased production of mucus, making it even more difficult to move air. These cascading events lead to wheezing, coughing and difficulty breathing, the main symptoms of asthma. Sometimes episodes are mild and pass quickly; at other times, the symptoms persist and worsen – this is known as an asthma attack.
Asthma is very common in the United States: more than 26 million people have been diagnosed with asthma and of those, 4.5 million are children under age 18. Here in North Texas, more than one out of 10 kids have asthma. Most people with asthma developed it as a child, although it can manifest in adulthood, as well.
Diagnosis & Treatment of Asthma
“An asthma attack is frightening, particularly for someone who doesn’t realize they have asthma and they suddenly have trouble breathing,” says Dr. Jeremy Watkins, an ENT in Fort Worth. “It’s especially scary for children and their parents. If parents ever notice their child wheezing, they should make an appointment with their pediatrician right away.”
Asthma is diagnosed with a simple, painless test: the patient blows into a device called a spirometer, which measures lung function. While asthma cannot be cured, it can be treated and managed effectively to the point where flare-ups are minimal and an asthma patient can live a normal life.
Prescription inhalers can help people manage their asthma. Some patients are prescribed a maintenance inhaler – used on a daily basis – to keep airways open. This is different from a rescue inhaler, which everyone who has asthma must carry at all times. Used in the event of an asthma attack, the rescue inhaler helps to immediately open the constricted airways.
Know Your Triggers & Make a Plan
Asthma is irritated by triggers that cause the asthma to flare and make it difficult to breathe. Different people will have different asthma triggers. Some of the most common include:
- Exercise: Physical exertion may trigger an attack.
- Common cold & flu: Upper-respiratory illnesses can cause asthma to flare up. Anyone with asthma should stay current on their flu and pneumonia vaccinations.
- Allergies: Allergies can cause an asthma attack (more on this below).
- Cold air: Exposure to cold air is a trigger for some.
- Tobacco smoke: This is one of the worst offenders for patients with asthma. Anyone with asthma should avoid exposure to second-hand smoke and should certainly avoid smoking themselves.
- Dust mites: These are tiny bugs that live in mattresses, sheets, pillows and other bedding. Utilizing mattress and pillow covers can reduce exposure to dust mites, as does washing sheets with hot water. Many pillows are also washable.
- Cockroaches: These insects aren’t only gross; they can also cause asthma attacks. Keeping your home clean is an important way to eliminate these pests and reduce likelihood of an asthma attack.
- Mold: Mold triggers asthma attacks in many people. Keeping bathrooms clean and clear of mold and mildew is important.
- Pets: Unfortunately, the dander from our furry friends can cause asthma attacks in some people.
- Outdoor air pollution: Air pollutants can trigger asthma symptoms. In North Texas, ozone levels sometimes reach unhealthy levels. Patients with asthma should limit outdoor activity on those days.
- Fumes: Any type of strong fume, such as paint or perfume, can exacerbate asthma.
“Recognizing the triggers that cause your asthma to flare up is the first step in managing the condition,” explains Dr. Watkins. “Once you know what your triggers are, you can develop strategies to avoid or reduce exposure to them. Avoiding triggers is the foundation of an asthma action plan, a plan you and your provider will develop together. “
“An asthma action plan is essential for every asthma patient,” continues Dr. Watkins . “In addition to understanding triggers, an action plan will focus on how to manage the asthma, so it does not flare up as often, and how to treat it if it does. Taking medications as prescribed by your physician is an important part of following the plan. For people with allergies, allergy treatment can also be an effective part of asthma management.”
Dealing with Allergies
What does it mean exactly when someone says they “have allergies?” An allergic reaction occurs when a foreign substance enters our body and our immune system, mistaking it for danger, attacks it. This process creates a reaction in the body that people commonly refer to as “allergies.” The reaction can range from a mild nuisance, like sneezing and watery eyes, to a serious health threat, such as the throat constricting.
Allergic Rhinitis
The most common type of allergy is allergic rhinitis, also called Hay Fever. This is the type of allergy that affects many people in North Texas, especially in the spring and summer months when trees, plants and grasses are producing lots of pollen. Plant pollens such as cedar, mulberry, maple, elm and oak are some of the most common allergens in North Texas. Mold, dust and animal dander can also cause allergic rhinitis.
Common reactions to allergic rhinitis include sneezing; itchy, watery or red eyes; runny nose; nasal congestion; scratchy throat; post-nasal drip and feeling fatigued. For people with asthma, these types of allergies can trigger an attack.
“For some, allergies are an annoyance that produce occasional symptoms,” Dr. Mohamed Babi, an ENT in Denton. “In these cases, it’s often sufficient to treat allergies on an as-needed basis with over-the-counter medications, such as antihistamines, decongestants and nasal sprays. However, when allergies cause frequent symptoms that interfere with daily activities, it is best to be tested and develop an immunotherapy treatment plan.”
Allergy Testing
Allergy testing is usually done through a series of skin prick tests to determine which allergens the patient reacts to. These tests are not painful. After determining which pollens, molds and other airborne substances the patient is allergic to, the lab prepares an immunotherapy treatment in which the patient is exposed to the allergens at gradually-increasing levels. Over time, this process builds immunity to the allergen.
Immunotherapy is usually administered via a regular injection, maybe once or twice a week. This is either done at the doctor’s office or in some cases, the patient can do it at home. Some PMGNTX physicians also offer immunotherapy via a sublingual medication (a drop under the tongue), which is effective for some types of allergens.
“If you experience frequent allergic symptoms, you should visit with your doctor about allergy testing,” recommends Dr. Salim Bhaloo, an ENT with offices in Weatherford and Granbury. “We often see a positive change in patients who undergo immunotherapy for a year or longer.”
“For children with allergies, an immunotherapy treatment program may be especially valuable, making it easier to play outside and participate in school and extracurricular activities without suffering allergic reactions,” adds Dr. Bhaloo.
Allergies & Anaphylaxis
Some food, drug and insect sting allergies may cause a severe, life-threatening reaction known as anaphylaxis. Symptoms of an anaphylactic reaction include weak pulse, a tightening of the throat, shortness of breath, lightheadedness, drop in blood pressure and loss of consciousness. Anaphylaxis causes the immune system to go into shock.
“People who are prone to anaphylaxis need to take this condition seriously,” warns Dr. Bhaloo. “When someone has an allergy that could cause anaphylaxis, they must keep an epinephrine auto-injector, also known as an epi-pen, with them at all times. In the event of an anaphylactic reaction, the patient injects himself to provide immediate, but temporary, relief giving them the time to call 911 for emergency medical attention.”
Some people are allergic to certain medications, insects or foods but do not experience anaphylaxis. Possible additional symptoms of exposure include:
- Drugs: Hives, itchy skin and rashes are possible symptoms of an allergic reaction to a drug, such as penicillin.
- Insect stings and bites: Wasps, bees and fire ants produce allergic reactions in some of their victims, leading to swelling, shortness of breath, hives and itching all over the body.
- Food: Peanuts and shellfish are two common offenders, but a variety of foods can cause allergic reactions. These allergies can cause hives and swelling of the lips, tongue or throat. Dairy and gluten also cause adverse effects for some people.
Allergies & Asthma Don’t Have to Slow You Down!
People who have allergies, asthma or both don’t have to let either condition interfere with their daily activities. Through proper diagnosis, effective treatment and proactively managing the conditions, neither has to disrupt your life.
The key with both is to stay on top of them – avoiding triggers and taking steps to prevent asthmatic flareups and allergic reactions. Your doctor is there to help you do just that, every step of the way.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
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