Asthma Treatment Taunton MA
Get The Relief You Need With Our Asthma Specialists
Breathing is freedom, and proper asthma management can set you free. Whether you or a family member needs an asthma specialist, Allergy & Asthma Care is here to help. Our board-certified allergists are specialists in asthma management for children and adults. Both doctors are also pediatricians, so they are comfortable caring for patients of all ages.
- Dr. Donald Accetta, allergy and asthma specialist
- Dr. Deborah Pedersen, allergy and asthma specialist
Management of childhood asthma can help your child lead a full life
Asthma is the most common chronic illness among children. Untreated asthma can interfere with your child's sleep, exercise, and school attendance. Uncontrolled asthma can lead to emergency room visits, hospitalizations, and even death.
The good news is that childhood asthma can be effectively treated with medications and lifestyle management—especially avoidance of allergies and triggers. With proper treatment, children with asthma should be able participate in all sports and not be held back by their asthma.
About 17 million people in the United States have asthma.
What is asthma?
Asthma is a chronic disease of the lungs that prevents normal, easy breathing. Asthma symptoms are caused by constriction (tightening) of the muscles and inflammation of the bronchial tubes. Increased mucus along with the constriction, swelling, and irritation can make it difficult to breathe.
Do I have asthma?
You might have asthma if you:
- Often are short of breath.
- Feel tightness in your chest.
- Wheeze when you breathe.
- Cough a lot while exercising or in bed at night.
Some of these signs and symptoms may arise from other medical conditions. If you experience any of the above, it is important that you seek evaluation by an asthma specialist.
What causes asthma?
For most asthma patients, the airways are always swollen and irritated, even when they feel fine. People with asthma may feel reasonably well until they are exposed to something that triggers their asthma. Asthma triggers can be allergens such as cat dander or pollens, or irritants such as cigarette smoke. Understanding your triggers is an important part of managing your asthma effectively.
What triggers an asthma attack?
The following inhaled irritants are common asthma triggers:
- Wood or tobacco smoke.
- Vehicle exhaust.
- Air fresheners / room deodorizers.
- Scented candles and incense.
- Seasonal and year-round allergens such as pet dander, pollen, dust, mold. Cold air, exercise and respiratory infections such as the flu or common cold can also trigger an asthma attack.
How is asthma diagnosed?
A special breathing test (called spirometry) is used to diagnose and monitor asthma in patients more than 6 years old. Your asthma specialist may also recommend allergy testing. Studies show that allergies cause up to 80 percent of all asthma in children and 50 percent of all asthma in adults.
Young children can be diagnosed with asthma although there is no breathing test that can be easily done. Talk to your doctor about any concerns about your child’s breathing.
Is untreated asthma dangerous?
It is vital to seek medical attention for asthma. Airway irritation can increase in severity over time. Uncontrolled asthma can result in permanent loss of lung function and can severely impact your quality of life. Some asthma attacks can be severe and lead to hospitalization or death. Controlling asthma every day can prevent these serious events.
How is asthma treated?
Although asthma cannot be cured, the symptoms can be controlled by avoiding triggers and taking medications correctly and consistently or as needed. The goal of asthma management is to help patients live without limitations.
Most people with asthma need to take a daily medication to fight the chronic irritation and swelling in their lungs. The medication might be in the form of a pill, an inhaler, or both.
People with asthma (including children over the age of 6) should also have a breathing test at least once a year to assess their lung function.
Avoiding triggers for your asthma will help to prevent symptoms. Many people with asthma also have allergies, and controlling these allergies is an important step in controlling the asthma.
Some children “outgrow” asthma, and it is important to check in with their asthma regularly as they grow to make sure they are getting the treatment that they need but not being over medicated.
Beta-agonist drugs (ALBUTEROL, PROAIR, VENTOLIN, XOPINEX, ALBUTEROL) relax the muscles surrounding the bronchial tubes and cause bronchodilation (opening the bronchial tubes). When used as an inhaler or in a nebulizer, these drugs begin to work within minutes, have few side effects and are effective for 4-6 hours. They are the drugs of choice to treat an asthma attack. They are also used frequently to prevent exercise-induced asthma. Since asthma is due to inflammation (irritation) of the bronchial tubes, most asthmatics should use an anti-inflammatory drug daily. Also, if you find that you are using the beta-agonist inhaler routinely, this usually indicates that your asthma is not well-controlled and you should see the doctor for further evaluation.
These are usually mild: anxiety, muscle tremors, increased heart rate. There have been several reports associating regular usage (as opposed to as-needed usage) of these drugs to a worsening of asthma. The reasons for this remain unclear.
What should you do?
You should not stop using your beta-agonist inhaler, but you should periodically review your need for this medication with your doctor.
Almost all asthmatics, except those with very mild asthma, should use an anti-inflammatory medication daily. If you use these drugs daily, you will generally control your asthma better and be able to decrease your usage of the rescue medications (beta-agonist drugs). Since these drugs do not relax the bronchial tubes, you still need to have a rescue medication available to use when needed.
INHALED CORTICOSTEROIDS ("steroids"):
These are the most common types of asthma controller medicine. Some examples are Flovent, Qvar, budesonide, Asmanex and Alvesco. These are the preferred method to treat your asthma because they are very effective and cause few side effects.
Side effects: thrush ( a fungal infection in the mouth which is rare if you rinse your mouth after using the inhaler), hoarse voice, mild cough immediately after using the inhaler. High dose inhaled steroids are used for many severe asthmatics and may cause additional side effects, but these are generally fewer and less severe than when taking the medicine as a pill.
Advair and Symbicort are special types of controller medications (see below).
COMBINATION INHALERS (Advair, Symbicort, Dulera, Breo)
These medications contain 2 medicines in one inhaler – a steroid and a long acting type of albuterol (known as “long acting beta-agonist” or LABA). These medications are used for more moderate to severe asthma that is not controlled with inhaled corticosteroids alone.
LEUKOTRIENE INHIBITORS (monteleukast, Singulair, zafirleukast, zileuton):
All are alternatives to inhaled steroids, but they are not the preferred medications.
BIOLOGIC MEDICATIONS (Xolair, Cinqair, Nucala)
These medications treat asthma by targeting the cells and proteins that cause asthma and allergies. They are given in the office or hospital either by injection or IV infusion. They are only for people whose asthma is still difficult to control after trying other medications.
Points to remember:
- No drug is 100% safe
- Use a rescue inhaler (beta-agonist) when needed to control asthma symptoms
- If you have asthma symptoms more than twice each week, you should usually use a daily controller medication
- Signs of unstable asthma include frequent flare-ups or frequent usage of a rescue inhaler
Almost all asthmatics (even infants!) who have asthma should be using a daily controller medication
What are steroids?
Everyone makes steroids, which are essential for maintaining health. There are two groups of steroids: anabolic steroids, which have been abused by athletes, and corticosteroids. Corticosteroids are the type of medication used by doctors for asthma.
Steroids can be taken by mouth or injection (systemic), by inhalation into the lungs or nose, or by application to the skin. For the treatment of asthma and allergies, inhaled and topical steroids are preferred as they cause fewer side effects than taking steroids by mouth or injection.
SIDE EFFECTS OF INHALED STEROIDS:
If you develop a BLOODY NOSE while using nasal steroids, stop the medication for several days and then restart it. If the bloody nose reoccurs, call the doctor. THRUSH (a fungal infection in the mouth) and HOARSENESS are common when taking inhaled steroids for asthma, but can usually be avoided by using a spacer device and rinsing your mouth after using the inhaler. If you are taking very high doses of inhaled steroids, you may develop some of the same symptoms noted when taking oral steroids (see below).
For many years there has been a concern that children using inhaled steroids might not reach there full adult height. However, a study published by The New England Journal of Medicine on October 12, 2000 (Effect of long-term treatment with budesonide on adult height in children with asthma) followed children who took an inhaled steroid (budesonide) for up to thirteen years. The final adult height was less than one inch from their predicted adult height although some of the children reached their adult height later than others. The conclusion of the article was that the drug decreased the rate of growth but not the final adult height in most children. Keep in mind that poorly controlled asthma also will cause a decrease in a child's growth.
SIDE EFFECTS OF ORAL STEROIDS:
Mild, temporary side effects are common: increased appetite, mood swings, water retention, weight gain, acne flare-ups, muscle cramps (possibly due to loss of potassium, so drink orange juice or eat bananas), menstrual irregularities and heartburn (take the steroid with meals or use an antacid). Serious side effects can occur in patients who have diabetes, mental illness, high blood pressure or infections such as tuberculosis. Long-term usage of oral steroids can cause many side effects, including osteoporosis, cataracts, high blood pressure, diabetes, poor wound healing and in children, decreased growth and hip problems. Most of the more serious side effects can be avoided or minimized if the oral steroids are used for only a short period of time (usually less than two weeks) or taken every other day. If you notice symptoms other than the mild symptoms listed above, the steroid may need to be stopped, but NEVER STOP ORAL STEROIDS BEFORE SPEAKING WITH DOCTOR.
Steroids can be a lifesaving medication, but like all other medications, they should be used carefully and exactly as prescribed.