When it comes to asthma, it’s not easy fighting the myths of Facebook, Google, or e-mail campaigns. And why are we so resistant to the diagnosis of asthma for our kids and ourselves? For asthma, if you don’t make the correct diagnosis, you’ll never implement the proper treatment. By that I mean, you’re not likely to use prevention, but instead will wait for an asthma attack and then rush in to treat the symptoms. Health care providers are responsible for this phenomenon just as much as patients. Go to any emergency room or urgent care with an asthma attack and you’re likely to receive steroids, antibiotics and the admonition to “see your primary care doctor”. The problem is that patients feel better after steroids and guess what? they never seek medical attention for the prevention of #asthma. After practicing asthma medicine for over 25 years, consider the following reasons for why our asthma treatment often fails to meet the “standard of care” according to published #asthma research:
Asthma attacks don’t happen all at once. If I can get through an asthma attack in September, what’s the big deal of one course of steroids per year? This paroxysmal nature of asthma makes proper treatment very difficult because we tend to have a very short memory about our last asthma attack.
As a general rule, we all resist preventive care. Do you miss a regular dental floss or exercise session? As difficult as it seems to continue with good preventive care, think how much more difficult it is to take an inhaler everyday to prevent asthma! Antibiotics are so successful after 10-14 days that we can stop therapy and recover back to our original health. Asthma isn’t the same disease process and many times one attack leads to never ending asthma.
Can I get over asthma? The short answer is usually not. Asthma is a disease of inflammation which means the airways over react to allergy, infections, or irritation. In short, this means lungs with asthma are forever inundated with “triggers” that cause wheezing, coughing, and typical asthma symptoms. If you don’t use preventive inhalers for the next attack, you can be assured it will come.
I for one am tired how my health score is tied to my existence as a person rather than who I really am. “How to keep up your credit score, what income bracket I’m in, what’s my IQ” are nagging reminders that I may not be anything more than just a number and not a unique person on this planet. Health care is fast approaching this same pigeonhole similar to banks and retailers, but it’s not all bad. Ever heard of personalized medicine?
#Personalized medicine has some pretty awesome benefits on the horizon, but “what’s the catch?” My cholesterol has to be below 120, cigarettes at zero, and my daily cups of coffee can’t be over 5 if I have any hope of living past 80;you just can’t get away from numbers.
According to Wikipedia, Personalized medicine, also termed precision medicine, is a medical procedure that separates patients into different groups—with medical decisions, practices, interventions and/or products being tailored to the individual patient based on their predicted response or risk of disease. So if numbers and health are an integral part of the future of health care, is there such a thing as an allergy or asthma number? Wouldn’t it be nice to find out which asthma inhaler is best for you based on “personalized medicine?” Or what if you suffer from chronic hives and can’t find the cause? Personalized medicine involves many more diseases that just asthma and allergy–just look at the link below, but I have a list as well. Continue reading Something about numbers→
Ever notice how everyone has #allergies these days? I kid you not, almost everyday, a patient will tell me that #Tulsa (where I practice) has more allergies than any other place in the country. The irony of it all, is so did patients in Kansas, and patients say the same thing in Virginia and Texas. You get my point–we all love to be known as the Allergy Capital of the World!Maybe it’s because allergies make us feel so miserable, and we love to hear stories about how to deal with the nemesis. Or maybe we want some “inside information” to share with our friends & family who also suffer from allergy. Whatever the reason for our obsession with allergy, you can’t argue with the fact that good allergy advise is not only helpful for better quality of life, but it’s crucial in making sure that allergy sufferers avoid heeding the WRONG advice for treating #hay fever. This is the passion I experienced in order to complete a fellowship training in allergy– I wanted to be able to interact with patients about their #allergic symptoms on their journey to good health. But wait, why practice a specialty that has so much incorrect information on-line and no doubt, “everyone’s an expert in allergy” when you could be doing real medicine to treat someone’s heart attack? Here are four reasons I still practice allergy for your consideration:Continue reading Four reasons I still practice Allergy in the Information Age→
I know you’ve been there before….waiting in the doctor’s office for your appointment and some smartly dressed man or woman barely has to say hello to the receptionist and walks right by your seat, straight to the doctor’s office. “Hey, that’s not fair,” you say to yourself as you dig your nose into that outdated magazine trying to mask the irritation. “My time is just as valuable as theirs is, put me to the front of the line!” As a patient, my frustration with the #health care system only percolates at the injustice. Isn’t the cost of #medication so high in America because of all the drug companies? If there were no drug reps, wouldn’t my doctor have a better and certainly more unbiased selection of medications? Granted, the goal of any #pharmaceutical company (employer of drug reps) is to make profit, but they can’t do that unless a product (medication) works well and is taken as directed. In the end, drug companies want you to be adherent to medications prescribed so they’ll work, you get better, all of which is good for the bottom line. Almost sounds too good to be true when everybody wins, but hang on and I’ll show you how this is possible. Continue reading Drug Reps Will Give You Asthma→
At first glance, I thought to myself, do we really need another quick acting inhaler? As I thought about inhaler technique and how we use our Ventolin MDI’s, most of use suck on the end of the inhaler which is the wrong technique to use. (all of the medication deposits on the back of the throat) Why not use the appropriate inhaler that’s meant to actuate with your breath anyway? ie, sucking on the inhaler is what you’re supposed to do!
If you have asthma, certain things can cause you to have an asthma attack. These triggers include things like cigarette smoke, pollen or air pollution, cold air, mold, animals, and dust. To help control your asthma, stay clear of these triggers.
Also, learn how to spot the early signs of an asthma attack. When you know the signs, you can stay in control. Early signs can be different for each person, but here are common ones:
A long lasting cough
Chest tightness or discomfort
Becoming out of breath more easily than usual
Frequent clearing of the throat
A written asthma action plan spells out how to use your drugs. If you don’t have a written asthma action plan, ask your doctor for one.
Remember: If you don’t have a written asthma action plan, ask your doctor for one.
Sinus pressure can be a real problem during the cold, winter months. Do I take decongestants or antihistamines? Sudafed or Zyrtec? Are my allergies acting up?
Here are some pointers on dealing with sinus infectionsand sinus pressure with some really cool slides at the end:
Most allergens are gone in December-January, so the statement “my allergies are bothering me” is actually misplaced. You are meaning to say that sinus pressure is causing congestion and runny nose. Inflammation and swelling definitely exist in your sinuses, it’s just that your symptoms during the winter are not caused by allergy, but rather sinus infection.
Treatment of a sinus infection is “all or nothing”. In other words, if you only remove 50% of the infection, it is likely your symptoms will quickly recur. Your body requires a mucociliary blanket in the sinuses to gradually remove bacteria and excessive snot. This protective blanket is destroyed during any infection, and won’t grow back until the inflammation subsides. Often it takes 30 days of antibiotics and prednisone to restore the sinuses back to their original condition.
One of the pictures in your slide set (slide 3 of 15) shows what normal mucociliary blanket looks like under the microscope. If this giant vacuum sweeper was operating normally all of the time, you wouldn’t have to use all your medication.
Make sure you eliminate nasal congestion. For the short term, use Afrin or similar equivalent (OTC) if you limit to < 1 week per month. This allows the nasal airflow to drive away the excessive mucous in your nose which would otherwise become a great meal for hungry bacteria. Sick but true!
Find out if you have allergy! The winter season gives you a reprieve from outdoor allergens, but during the spring, summer, and fall, tree pollen, Bermuda grass, and ragweed are more than willing to invade your sinuses and cause irreparable damage to your mucous membranes and make you always sick.
Use your prescribed nasal spray EVERYDAY as prescribed by your doctor. I know, Americans hate to put anything in their nose (except your finger), but regular use of nasal steroids and antihistamines will reduce the swelling in your sinuses and guess what? You got it, fewer infections.
Get smart! Go through the slides below, and if you don’t learn anything new, I’ll buy your favorite drink at Starbucks.
An apple a day might keep the doctor away, but what is modern hospital medicine really like? Follow Dr. Benjamin Kirkland - a Doctor working in Australia - through the pinnacles and pitfalls of everyday hospital medicine!