Asthma Blog

Exercise-induced asthma (EIA for short) is common in competitive athletes, even at the elite Olympic level. So, obviously, having it doesn't mean you can't participate in sports. In fact, as many as 20% of summer athletes suffer from allergic diseases like nasal allergies and asthma.

In addition, the prevalence of allergic disease is greater in athletes, while treatment is often lacking because of the anti-doping regulations that govern elite athletes. So, at the request of the National Olympic Committee, the Global Allergy and Asthma European Network has initiated a study of Olympic athletes. Scientists have designed the study to assess the affect that environmental pollution has on asthma symptoms and lung function, and also to help identify athletes who may develop asthma and allergy symptoms while in Beijing.

Regular exams throughout the Olympics will measure lung function and symptoms in more than 2,000 athletes. Skin prick tests will measure for allergies. It is hoped that the study will lead to a better understanding of allergic disease in top athletes, as well as better care. And that should lead to a better approach for everyday athletes and active kids as well!

Black box warnings about asthma medications such as Xolair and Advair seem to be in the news a lot lately. Should you be concerned about such black box warnings? Are the risks of taking these medications too high?

The answer is that there is no one answer that will be right for everyone in regards to these questions about black box warnings. It mostly comes down to weighing probable benefits against possible risks. But a black box warning doesn't automatically mean the medicine is going to be bad for you. Read more

The first thing many people think of after an asthma diagnosis is, will it go away? Or will my child outgrow asthma eventually? It's a valid question, but you may not like the answer...

Asthma is what is known as a chronic disease, which simply means that it usually doesn't go away once you have it. But the good news is that you or your child can still live a full and active life with asthma. Get the rest of the answer here

Welcome to the Asthma site at About.com. Maybe you're new here & this is your first visit... and maybe not. Maybe you're a regular reader of my blog or my Twitter feed, but you've never really explored the Asthma site as a whole. Did you even know there was a site? If not, don't worry -- you're not alone!

Throughout this site, I try to connect with you and help you understand all there is to know about asthma, though that is, of course, a challenging task, as there is SO much to know. Because I'm both a nurse and an asthma sufferer, I hope I have a unique perspective with which to help you.

So, I invite you to explore the Asthma site. There are many ways to do so:

• If you like moving sequentially, then look to the left if you're on the Home Page of the site, and you'll see the "Must Reads" links. These are probably the most important articles on the site. If you read all 5, you'll have a great handle on asthma and how to manage it effectively.
• Or, if you prefer, you can scroll a bit further down and look for the categories (topics) menu, where you can pick & choose your topics of interest.
• Another option is to use the Search box, which you'll find at the upper right corner of nearly every page on the site.
• One final path through the site is to use the tabs at the top. See them? They're labeled "Asthma" (that's the home page), "Symptoms / Diagnosis", "Treatment", and "Coping". Each tabl contains a number of different links to asthma information.

If you enjoy meeting other people with asthma, you can also become a part of a larger asthma community through the Asthma Forums. We're looking for new, active members. Try it out - discuss what asthma means to you. If you're interested in exchanging ideas on subjects that are important to you with others who are going through similar issues, I highly recommend the Asthma Forum.

You may not be aware that this site is just one of over 770 sites grouped under the umbrella of About.com, which, in turn, is under the umbrella of the New York Times Company. Plus, the Asthma site is one of the 70 sites of the About.com Health Channel. I think you'll find there are many sites that will be of interest, covering topics such as Patient Empowerment, Nutrition, Pediatrics, Alternative Medicine, and a whole lot more. The sites are all staffed by experts too -- Many of the Health Guides are medical professionals -- Some are M.D.'s, others like me are R.N.'s, and yet others are full time therapists, patient advocates, and authors.

Our Health Channel has been awarded an HonCode certification, which means that all the articles written for the sites have been appropriately researched and sourced, and every article is reviewed and approved by a medical professional. It's only on this blog that you'll see me expressing my own opinion, reporting on the news and research studies, asking for reader input, and posting polls and reader questions.

I want to urge readers interested in learning about asthma to go beyond this blog - and to explore the articles on this site on subjects ranging from general information about asthma to articles on asthma treatments, occupational asthma, and much more. Just as importantly, I urge readers to take a look at some of the other guides' sites, both on the Health Channel and beyond.

If you enjoy this particular site, and want updates on what's new - or a quick way to get particular information sent to your mailbox - you can subscribe to the free weekly Asthma Newsletter.

So, once again, welcome to an amazing wealth of resources at About.com. I hope you'll take advantage of some of the ideas and information available here. And please feel free to share your comments on any of the blog posts you see here. I'd be happy to hear from you.

OK, maybe that's not really news. As a nurse and a mom, that's pretty much in sync with my thinking anyway. :)

Of course, thinking that way may seem biased and not quite fair to men, right? But I have to tell you, I read this week of a study that found women doctors provided better asthma care to kids in Turkey than their male counterparts. Here were the reasons cited:

• Female doctors saw less patients, thereby giving them more time to spend with each patient.
• Female doctors were more patient-centered, listening better and attending more to the emotional & social aspects of health.
• Female docs were also more interested in getting patients' input and partnership.

It's important to note that all of the doctors studied, whether male or female, had similar educational/experience backgrounds and were of similar ages. The findings suggested that the female doctors identified chronic cough as an asthma symptom more often than men did, and also prescribed both short-acting bronchodilators and inhaled steroids more.

Researchers concluded that, "Female physicians demonstrated better asthma management than males, the reasons for which are not defined and can only be speculated." They went on to suggest further study to try to determine some of the underlying factors at work here. It's interesting to note that, although the women doctors were clearly not bringing in as many dollars because they were seeing significantly less patients, their patients were enjoying better outcomes, which would reduce overall healthcare expenditures. Hmm... I wonder which one had a more positive impact on the bottom line?

But I have to say that these findings came as no real surprise to me and echo my experiences both inside and outside of health care over the years. Just last year, when my mother was gravely ill, I experienced awful, superficial and uncaring "care" from a male physician and wonderfully thorough, caring, healing care from 3 female physicians. It was quite a contrast in approaches. I'm not silly enough to think there are no good male physicians, but I DO think that the female and male bedside manners are often quite different.

You can use the comments link below to tell us what you think about these findings and your experiences.

When you have asthma, getting the right treatment from a doctor who truly understands the ins and outs of managing asthma effectively is one of the most important factors in staying healthy. But it's also important that you feel comfortable with and trust your doctor. And that's hard to achieve sometimes in today's restrictive healthcare environment or when you feel the need to pick a doctor in an emergency, or at least highly urgent, situation.

Luckily, our Cold & Flu Guide, Kristina Duda, has written a great article on just how to do that! It's called How to Find a Doctor When You Are Sick, and I highly recommend it. If you're worried about being able to communicate effectively with your new doctor, check out my Tips for Talking with Your Doctor article.

Trisha Torrey, our Patient Empowerment Guide, has also written an article on Finding Dr. Right, about finding a doctor who is a good match for your needs and communication style.

It's important for you to recognize that you have both the right and the responsibility to become an active participant in your care. And that starts with picking a doctor who feels the same.

More on Working With Doctors:

• When to See an Asthma Specialist
• Types of Asthma Specialists

Understanding your asthma medicine is key to keeping asthma under control. But that's not as easy as it sounds, with several different classifications of asthma medicines available, along with medicines for related conditions such as nasal allergies and GERD. And that doesn't even take into account general medicine terminology, applicable to medicines for all diseases and conditions. Let's try to demystify the medical speak, shall we?

General Medicine Terminology

I've heard debate over the difference between the terms medicine, medication and drug. One thing is for sure: the 3 terms mean many different things to different people. The bottom line here is that they all basically mean the same thing, a man-made chemical you put into your body to treat a symptom or a disease (or to prevent it). None of them specifically mean prescription and / or illegal. They're just catchall terms.

Some Other General Terms

Here are some more terms used to describe medicine:

• Prescription, which means a drug that only a healthcare professional can authorize for you to take
• Over the counter, a medicine that you can buy off the shelf in a pharmacy without a doctor's prescription
• Generic, meaning a new version of an established brand name drug, that is identical in terms of the active ingredient, dosage, safety, strength & other factors

Asthma Medication Terminology

Then, as mentioned, there are terms that are specific to asthma medicines, such as:

• Quick-relief, or rescue, vs. preventive, or controller
• Long-acting bronchodilator (or beta agonist) vs. short-acting bronchodilator
• Metered dose inhaler vs. nebulizer vs. dry powder inhaler
• Inhaled steroid vs. oral steroid
• Leukotriene modifiers (or agonists) vs. Combination medicines vs. Immunomodulators
• Allergy shots vs. Allergy drops
• CFC vs. HFA inhalers
• Antihistamines

Black box warning is another term you might have heard. Black box warnings for asthma medications have gotten a lot of press over the past year or two, so it's important to understand what they mean. I know all these terms may seem a bit mind-boggling if you or your child have just been diagnosed with asthma, but if you take time to read the different articles linked to above, asthma treatment should begin to make more sense.

Learn More About Medicine:

• Asthma Med Profiles
• Reducing the Risk of Drug Interactions

Experts have known since the 1970s that there is a link between asthma and gastroesophageal reflux disease, known as GERD for short. In fact, past studies have shown that 50 to 90% of people with asthma have at least a touch of GERD from time to time. I know I do; how about you?

But now a new scientific study at Duke University with mice has revealed more evidence for whether asthma causes GERD or the other way around. Here are the highlights:

• Doctors injected tiny amounts of gastric fluid into the lungs of mice, mimicking humans' aspiration of tiny droplets of gastric fluid
• The immune systems of those mice were compared to those of mice exposed to allergens, but not gastric fluid
• The mice exposed to gastric fluid had changes in their immune systems typical of asthma

From these results, scientists concluded that chronic micro-aspiration of gastric fluid can drive the immune system toward an asthmatic response. If it holds up under further study with humans, it's an important study because GERD is considered largely a lifestyle disease, meaning it can be treated and controlled fairly easily with changes such as better diet, regular exercise and reducing obesity. It is thought that today's lifestyles, with GERD becoming more common, may also help to explain the increases in numbers of adults with asthma.

This also means that in people who know they have GERD, by reducing gastric reflux, they can also reduce their risk for developing asthma down the line. Here are some ways to do so:

• Eat smaller meals
• Eat several hours before going to bed
• Raise the head of the bed a few inches
• Maintain a healthy weight
• Limit fatty goods, coffee, tea, caffeine and alcohol

Poor air quality is a known asthma trigger, and concerns have been raised for months about the thick clouds of smog that hang over Beijing much of the time. With the Summer Olympics kicking off on August 8th, elite athletes who have asthma (and there are many) have to be worried that the poor air quality in that section of China will affect not only their health, but also their athletic performance.

Because of such concerns, Chinese authorities recently decided to institute odd-even driving restrictions from July to September. Not only will that inconvenience Beijing drivers, it will also cost the government an estimated $186 million. They have also spent more than $17 billion cleaning up their environment. So, it seems this is a country that really wants to host the international games and provide a positive athletic experience for participants.

They'll also be providing estimates of air quality for up to 3 days in advance of events.

So, what does all this mean to those of us who are not elite Olympic athletes, other than a passing interest? Well, to my eyes, it raises awareness of the fact that air quality can have a powerful impact on people with asthma, making control difficult. It's also important to note that asthma is common in athletes, but it does not have to be a barrier to participation in sports, not even at the elite level required in the Olympics.

Related Articles:

• Exercise-induced Asthma
• Air Pollution as Asthma Trigger
• Asthma Control & Management
• Sports & Asthma

Pregnant women who have asthma that flares during the first trimester of pregnancy may have a baby with a higher risk of birth defects, according to a new study published in the June Journal of Allergy & Clinical Immunology. Here are the highlights of the study:

• 3,477 women with asthma who had given birth at least once between 1990 and 2000 were included
• Researchers found that women who had an asthma attack, or flare, during the first 3 months of pregnancy were 48% more likely to have a baby with a birth defect
• 13% of babies born to those women had problems with the heart, facial structures, spine or digestive system
• Only 9% of babies born to women with well-controlled asthma had these issues

Poorly controlled asthma is not good for mom's or baby's health. It results in a decreased flow of oxygen to the airways and in the blood for mom and to the placenta for baby. Experts believe that this loss of flow of blood and oxygen through the placenta, along with the fact that the first trimester, when much of a fetus' development is happening, is a sensitive period, may be the explanation for these birth defects.

So, if you have asthma and are thinking of becoming pregnant, it's important to make sure your asthma is under control first, if you want to give your baby the best chance for good health possible. And during pregnancy, take care to follow your asthma management plan so that control doesn't slip.

To learn more about the risks associated with pregnancy and asthma, visit our Asthma & Pregnancy article.