asthma is a condition in which the respiratorysystem, particularly the lungs, becomes over reactive to the outside world. there's reallyno cure for asthma since asthma is an exaggeration of what the lungs are supposed to do. everyone,when they breathe in air that's too cold or two smoggy or infected; everybody's lungshave a tendency to overreact to the outside world. it's just that some people's lungsreact too much. your doctor can talk to you about other causes for asthma and treatmentoptions for asthma, but what i really want to talk about is what can trigger asthma.since there's really no cause for asthma, what is critical is that the multiple triggersfor asthma are minimized. the number one trigger for asthma is coldsor infections. the number one trigger that
will put people in the hospital or make themgo to the emergency room or make them end up on cortisone for asthma is getting a badcold. so, there are several issues with colds. number one is don't get sick. hand washingis important. any child that's in school; it's very important that they wash their handsbefore they eat and everyone needs to wash their hands a lot so they don't get sick.once a cold starts however, asthma can take off aggressively. so, it's very importantthat medicines are started at the first sign of a cold if people have a history of asthma.even before the asthma symptoms start, we want to start asthma medicines as soon aspossible. sometimes that will be a medicine like abuterol that will give immediate relief,but other medicines we use are inhaled cortisone
sprays such as advair or qvar or flovent orpulmicort; these are medicines that won't work immediately but if they're started beforethe asthma starts, can work very effectively at limiting or slowing down how long an asthmaattack can occur. anybody with asthma needs flu shots in the fall at any age. and adultswho have asthma will frequently be recommended getting a pneumovax or a pneumonia shot. second trigger for asthma is exercise. whenone exercises, the nose which usually filters the air, doesn't have time to filter the airand that unfiltered air gets down to the lungs and triggers the lungs to tighten up. on theother hand, the most important thing that people can do who have asthma is to be ableto exercise. if, at any point, someone who
has asthma cannot exercise on an ongoing basis,it is critical that they talk to their doctor about being able to exercise appropriately.now, we're not talking about when you have an acute asthma flare, you don't want to exercise.but if you find well, jeez, i can't exercise because my asthma bothers me, you need a tuneup and you need to do something preventative. if you do indeed have exercise induced asthma,using this medicine called albuterol is a very safe intervention and medicine to useprior to exercising. even if you exercise and have symptoms, if you've pre-dosed, itwould be okay to take the albuterol during or after exercise. if that does not help,then you need to consult your doctor. frequently, warming up before exercise, doing a slow lapof swimming or running or jogging, can really
make a difference in minimizing exercise inducedsymptoms. third trigger for asthma is stress. there'sa direct connection between the brain and the lungs. and it's very important that peoplewho have asthma have minimal amount of stress in their life, and guess what, the best wayto minimize stress is to be able to exercise appropriately. very commonly, stress willmask as asthma. and in order to determine whether people are having trouble breathingbecause of stress or having an anxiety attack versus asthma, is there's a meter called thepeak flow meter, and that can help distinguish between what is truly asthma and what is apanic attack. in addition, it's very important that if you're taking care of an asthmaticor an asthmatic child that you don't make
them more anxious. you need to know what todo if, in the course of an asthma attack, the medicines that you've been recommendeddon't work. and what we recommend for that is a backup asthma plan. everybody who hasasthma needs this backup plan in which you know what to do if the inhaler or the nebulizerdoes not work. and most of the time in that bad situation we will recommend taking albuterol,either by inhaler or nebulizer, up to every 15 to 20 minutes, three times. if that doesnot work then you either need to go to an emergency room or urgent care or call yourdoctor right away. it's very important that we try and keep people out of the emergencyroom or urgent care if possible because the stress or anxiety of being in the emergencyroom for several hours can actually aggravate
the attack. on the other hand, obviously,if you can't breathe, you have to go to the emergency room if this backup plan does notwork. fourth trigger for asthma is what we callirritations in the air. anything you see or smell in the air that nose and lungs don'twant -- chemicals, cleaning fluids, smoke -- need to be avoided, particularly if there'sany active asthma happening. so, it' just takes common sense that if you're cleaningthe shower or you go to a place where there's a fireplace smoke, that those areas are avoidedas much as possible. the fifth trigger for asthma is what we callallergies. an allergy is when your body's immune overreacts to biologic things in theair such as pollen or dust or mold or animals.
most people ignore these things, but whenyou have an allergy, your immune system, which lines your nose and lungs, will overreactto these allergens and as a result, asthma can be flared. i'm not going to talk specificallyabout what you can do with allergies, but you can certainly talk to your doctor aboutthat. one thing i will mention however is that most allergens will accumulate in bedding.and anybody who has any sort of asthma needs to make sure that the pillows aren't too old,comforters are being washed regularly and that faces aren't going into old couch pillows.it's also recommended for most people who have asthma to get special allergy coversat least for the pillows. if needed, and you have ongoing asthma, you may want to comesee me as an allergist because we can do allergy
testing to find out exactly what you're allergicto. the final trigger for asthma is what we callacid reflux. stomach acid belongs in the stomach and if it comes up and hits your esophagus,you'll get what we call heartburn which really isn't heartburn, it's esophagus burn. butsometimes there is no heartburn, the stomach acid actually goes into your throat and youinhale it into your lungs and that can aggravate asthma. if you have asthma that worsens aftereating or especially when you lie down at night, acid reflux may be playing a role inall this. so, it's very important that you may bring this up to your doctor because thereare very safe medicines for this acid reflux as well. one final note is that the medicineswe use for asthma are very, very safe. many
of these medicines have cortisone in them,but they come in spray form. these cortisone sprays work like a shield of protection toprotect your lungs from reacting to pollens or dust or smoke or stomach acid or even infections.and these medicines don't do anything immediately, but they are the long-term treatment of choicefor asthma should environmental measures and infection control measures and other preventativeinterventions fail.