The following article was printed in the June 2011 edition of the Positive Community. Horizon NJ Health is proud to support New Jersey publications and community partners.

On Call by Philip M. Bonaparte, MD Vice President Clinical Affairs/Horizon Blue Cross Blue Shield of New Jersey

Chief Medical Officer/Horizon NJ Health

Dear Dr. Bonaparte:

Every spring, I look forward to opening my windows and airing out the house. After dinner, my husband, children and I enjoy getting outside while there is still daylight and bicycling, swinging and skateboarding. When we come inside, my kids start getting ready for bed. Before going to sleep, they start coughing, wheezing and rubbing their eyes. They take their allergy and asthma medicine every morning and at night. What can we do to take better care or our allergies and asthma?

Thanks, from Sarah in central New Jersey

Dear Sarah,

There is much to learn about taking care of your allergies and asthma. Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 22 million people are known to have asthma. Nearly 6 million of these people are children. People suffer from allergies caused by everyday exposures to agents, such as dust mites, cat dander and pollens.

Young children who often wheeze and have respiratory infections--as well as certain other risk factors--are at highest risk of developing asthma that continues beyond 6 years of age. The other risk factors include having allergies, eczema (an allergic skin condition) or parents who have asthma.

Among children, more boys have asthma than girls. But among adults, more women have the disease than men. It is not clear whether or how sex and sex hormones play a role in causing asthma.

Most, but not all, people who have asthma have allergies. Some people develop asthma because of contact with certain chemical irritants or industrial dusts in the workplace. This type of asthma is called occupational asthma.

Common signs and symptoms of asthma:

• Coughing: Coughing from asthma often is worse at night or early in the morning, making it hard to sleep.
• Wheezing: Wheezing is a whistling or squeaky sound that occurs when you breathe.
• Chest tightness: This may feel like something is squeezing or sitting on your chest.
• Shortness of breath: Some people who have asthma say they cannot catch their breath or they feel out of breath. You may feel like you cannot get air out of your lungs.

Not all people who have asthma have these symptoms. The best way to diagnose asthma is to use a lung function test, a medical history (including type and frequency of symptoms) and a physical exam. The types of asthma symptoms you have, how often they occur and how severe they are may vary over time.

Sometimes your symptoms may just annoy you. Other times, they may be troublesome enough to limit your daily routine. Severe symptoms can be fatal.

It is important to treat symptoms when you first notice them, so they do not become severe. With proper treatment, most people who have asthma can expect to have few, if any, symptoms. Stay on your maintenance treatment that your doctor prescribes for moderate or severe asthma. This includes steroid inhaler even when you are asymptomatic.

Things that set your asthma off can worsen asthma symptoms. Your doctor will help you find out, which things (called triggers) may cause your asthma to flare up if you come in contact with them.

Asthma Triggers may include:

• Allergens from dust, animal fur, cockroaches, mold and pollens from trees, grasses and flowers
• Irritants, such as cigarette smoke and the effects of second-hand smoke
• Air pollution, chemicals or dust in the workplace, home air sprays and hairspray
• Medicines, such as aspirin or other nonsteroidal anti-inflammatory drugs and nonselective beta-blockers
• Sulfites in foods and drinks
• Viral upper respiratory infections, such as colds
• Physical activity, including exercise

Other health conditions can make asthma harder to manage. Examples include a runny nose, sinus infections, reflux disease, psychological stress and sleep apnea. These conditions need treatment as part of an overall asthma care plan.

Asthma is different for each person. Some of the triggers listed above may not affect you. Other triggers that do affect you may not be on the list. Talk with your doctor about the things that seem to make your asthma worse.

Source: Bonaparte, P.M (2011). Philip M. Bonaparte M.D on call. Allergies and Asthma. The Positive Community - June 2011.