Tag: asthma

VITAMIN D MAY PROTECT AGAINST ASTHMA EXACERBATIONS

FCAAIA Notes: I have posted a lot of articles about vitamin D. Here’s another one.

As has been pointed out before, vitamin D is likely one of numerous contributing factors for asthma control. Most of your vitamin D is produced in the skin with sun exposure.  Unfortunately, sun screens (while necessary) also decrease vitamin D production in the skin.  It is hard but not impossible to get sufficient vitamin D levels (≥ 30 ng/dl) only by diet.

Vitamin D supplements may help some people.  Continue reading “VITAMIN D MAY PROTECT AGAINST ASTHMA EXACERBATIONS”

ASPIRIN CHALLENGE AND DESENSITIZATION: How, When and Why

FCAAIA Notes: Aspirin and medications related to it are collectively called nonsteroidal anti-inflammatory drugs (NSAIDs).  As described in this article, a few different kinds of adverse reactions can occur.  The most serious is called NSAID-exacerbated respiratory disease (NERD) and is characterized by severe asthma flares. It is particularly prevalent in those with nasal polyps and a history of severe asthma.

Of great importance, patients with NERD can be desensitized to aspirin. Because NERD is triggered by all the related drugs, aspirin desensitization effectively allows tolerance of all the NSAIDs. Furthermore, patients with NERD who undergo aspirin desensitization have better control of their nasal polyps and asthma.

In the past, aspirin desensitization was done in the hospital because of the risk of triggering a severe asthma exacerbation. Newer and MUCH safer protocols are available for in-office desensitization. In fact, we are now doing aspirin desensitization in our office Continue reading “ASPIRIN CHALLENGE AND DESENSITIZATION: How, When and Why”

THUNDERSTORM ASTHMA ON THE RISE; Why? And who is at risk?

FCAAIA Notes: How often do patients tell me their asthma symptoms worsen with weather changes?  If I said nearly every day, I would not be far off.  As with most of what we as allergists do, there are probably multiple factors that interrelate.

Barometric pressure changes probably affect some people. Changes in humidity levels, precipitation, air pollution, and temperature can have direct effects on asthma control and affect changes in outdoor allergen (pollen and mold) levels.

Thunderstorm asthma was described many years ago.

The discussion that follows describes the condition in detail with a short comment about its mechanism. Continue reading “THUNDERSTORM ASTHMA ON THE RISE; Why? And who is at risk?”

WHAT PATIENTS REALLY THINK ABOUT ASTHMA GUIDELINES

FCAAIA Notes:  The first national guidelines for the diagnosis and treatment of asthma were published in 1993, with updates and revisions more recently.  Guidelines are just that-they are not rules or laws.  But, they are evidence based recommendations to help physicians maintain control of asthma, use as little medication necessary to do so, and to decrease the risk of complications of asthma.

It is important for our patients to understand the basis and rationale for our treatment recommendations.  They should ask any questions they have, but realize that “empowerment” is not just knowledge; it is in essence consent and agreement that comes from understanding.  Continue reading “WHAT PATIENTS REALLY THINK ABOUT ASTHMA GUIDELINES”

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