Aligning Medication with Asthma Subtype

Aligning Medication with Asthma Subtype

Aligning Medication with Asthma Subtype

Subtyping Asthma: The New Direction for Asthmaniacs!

Asthmaniac has launched a new approach to the management of asthma.

This change is driven by a more refined understanding in the science of asthma about the existence of different asthma subtypes, each  requiring unique strategies for successful control.  The science-driven modification will eventually be adopted by all practitioners, but Asthmaniac will be among the first!

What Changed in the Science of Asthma?

The symptoms of asthma have not changed.  Night cough, wheezing, and shortness of breath are still the problems that wreck a normal life for asthma sufferers.

The reliever or rescue medicines have not changed either.  Bronchodilator medicines such as albuterol and  ipratropium will still be needed to reduce the wheeze and shortness of breath that is central to asthma.

What has changed is the range and types of control medicines along with a more detailed understanding of which medicines are effective for each subtype of asthma.

This more advanced understanding explains why some controllers we have prescribed heavily in the past simply don’t work in some people.  Getting a person’s asthma subtype aligned with a medicine that is laser-focused on the underlying problem makes all the difference.

This new understanding has emerged along with the development of medicines that are actually designed for each subtype.  This means your treatment plan will be more personal than ever before.  Instead of lumping you with asthma sufferers of the same age and clinical background, this new approach digs deeper for “markers” of how your asthma is different and how best to treat it.

How will this shake out practically? 

Here is what I expect to happen.

The world of asthma sufferers is divided as follows:  Those that know and have been diagnosed with asthma and those that have asthma symptoms but have never been diagnosed.  In both of these groups, special testing in individual patients will show differences in markers that will lead to classification according to an asthma subtype or “endotype”.  With each endotype comes a set of proven interventions along with a new appreciation that some standard treatments won’t be helpful.

The result will be that each asthma sufferer will have better short-term control of wheezing, night cough and shortness of breath.  In the long term, the superior treatment plan with lead to reduced long-term, permanent lung damage (we call that “remodeling”).  The sooner we get this new approach going, the better it will be for preserving best lung function for life!

 

Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac to Find Your Best Asthma Control Asthmaniac.com is a fully digital asthma clinic designed to deliver physician consultation, disease assessment, patient education, medical refills, and follow-up care.  This is different than making an...

Asthma and COVID19

* Asthma is a chronic disease that places you at higher risk of serious illness with COVID19 infection. * Keeping your asthma well controlled will give you the best protection against serious COVID19 illness. * Controlling your COVID19 exposure should be a...

Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac to Find Your Best Asthma Control

Asthmaniac.com is a fully digital asthma clinic designed to deliver physician consultation, disease assessment, patient education, medical refills, and follow-up care.  This is different than making an appointment in a traditional clinic for asthma care.  So, how does it work?

Navigate to the website

Asthmaniac.com is a website that contains the links and information you will need to manage your asthma.  Simply navigate to Asthmaniac.com in your browser.  Once you are on the webpage, there are several areas you will likely use frequently.

Book Now

Pressing this button takes you to the scheduling page where you can choose from two selections: Inhaler Refill or Asthma Consultation.

If you are an established patient and simply need a refill of your rescue or control inhaler, select Inhaler Refill.  You will be taken to the calendar where you select the day and time of your appointment and make payment.  A confirmation will arrive in your email inbox along with a link to measure and report your ACT score and Peak Expiratory Flow.

If you are a new patient (new to Asthmaniac.com), select Asthma Consultation.  You will be taken to the calendar where you will select the day and time of your appointment and make payment. A confirmation will arrive in your email inbox along with a link to a medical history form that collects information about your past problems with asthma and any other health disorders.

Menu Bar

The row is directly below that Asthmaniac Motto: “Your Asthma Control is Our Mission”. 

The Menu Bar contains links to the most important areas of Asthmaniac.com.

Home:  This selection takes you back to the home page from your current page.

Blog:  This section is loaded with patient education covering a wide and ever-expanding number of topics essential for obtaining and keeping control of your asthma.  A list of blog posts is stacked along the right side of this page, along with live links to corresponding podcasts.  These podcasts are also available on major podcasting platforms like Apple Podcast and Spotify, making them easy to consume and share!

Your Online Asthma Doctor:  This section describes the very simple structure and focus of Asthmaniac.com.  The components Asthmaniac delivers to you are described in six blurbs with links to pages with more information about each.

About:  This section describes the concept of asthma primary care – the core medical solution to assisting you to keep your asthma controlled.

ACT:  This link takes you to the Asthma Control Test page where you will learn about this test, how it is used to assess your asthma control, and contains a link that walks you through the test.  The Asthma Control Test (ACT) score is used at every appointment and between appointments to give you feedback on your disease status.

Social Media Links

Links to Facebook, Twitter and Instagram appear in the top tab.  You can jump to each of these social media sites by clicking the icon for each.

The twitter feed is loaded with the latest research articles about asthma.

Footer

At the bottom of each page, you will find links for:

The Asthmaniac phone number; and

The Asthmaniac email  link;

In addition, there are links for:

The Home page;

The “Your Online Asthma Doctor” page;

The “Established Patient Process” page which describes how established patients receive their interval care;

The “New Patient Process” page which describes how new patients receive their first medical session;

The “Blog” page, which is filled with patient education materials;

The “Privacy” page which describes the Asthmanic privacy policy;

The “ACT” page which jumps you to the Asthma Control Test page.

Asthmaniac is Online Asthma Care

Asthmaniac is designed to deliver everything you need to achieve your best asthma control and with it, the best lung function, greatest exercise capacity and more quality sleep.  Doctor consults, digital disease assessment, prescription refills, and patient education, right on your phone, puts you in the most powerful position to keep a lid on wheezing for Life!

Are you ready to take control of your asthma?  Book an appointment today!

#asthmacontrolnow
#telemedicineasthmacare
#backpocketasthmadoc
#asthmaactionplan
#asthmacontroltest
#asthmacontroller
#rescueinhaler
#asthmacovid19
#childrenandasthma
#eprescription
#easthma
#peakexpiratoryflow
#peakflowmeter
#asthmaniac

 

Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac to Find Your Best Asthma Control Asthmaniac.com is a fully digital asthma clinic designed to deliver physician consultation, disease assessment, patient education, medical refills, and follow-up care.  This is different than making an...

Asthma and COVID19

* Asthma is a chronic disease that places you at higher risk of serious illness with COVID19 infection. * Keeping your asthma well controlled will give you the best protection against serious COVID19 illness. * Controlling your COVID19 exposure should be a...

Asthma and COVID19

Asthma and COVID19

Asthma and COVID19

* Asthma is a chronic disease that places you at higher risk of serious illness with COVID19 infection.

* Keeping your asthma well controlled will give you the best protection against serious COVID19 illness.

* Controlling your COVID19 exposure should be a high priority.

Does Asthma make you more vulnerable to COVID19?

Patients with chronic disease including chronic lung disease are having much more trouble with COVID19.

Many are dying when they become infected.

To be sure, having advanced age and asthma is a very concerning combination, but even young people with asthma should be concerned.

This is the time to get serious about asthma!

Your best defense is a strong offense.

Compared to the lungs of a person without asthma, your asthma lungs experience inflammation much more easily.

This tendency toward inflammation can be controlled by inhaled steroids and in some cases, new immune modulators.

Keeping a lid on this baseline inflammation should be our top priority all the time!

How does the COVID19 virus interact with your asthma lungs?

When it enters your body, the COVID19 virus attaches to the lining in the back of your throat.

From there, it moves to the airways of your lungs (bronchi and bronchioles). 

Once there, virus particles attach to and hijack the manufacturing processes of airway cells.  The result is that these cells pump out a continuous stream of virus particles.

When your immune system spots airway cells that have been taken over by the virus, it attacks them with a vengeance!  The result is inflammation.  

If your airways are already experiencing out-of-control inflammation, this is a disaster!

The addition of virus invasion and immune attack blows holes in tiny blood vessels, causing the lungs to fill with blood.   Airflow is blocked and then you have a life-threatening inability to breathe.

The amount of virus matters.

The more virus particles that get into your mouth, nose or eyes, the more likely you will develop a severe infection with a dangerous inflammatory reaction.

Look, it is virtually impossible for every person on the planet to completely avoid COVID19.

But, getting the smallest amount of exposure at any time should be your goal.

Washing your hands is a basic and effective way reduced the amount of virus you are handling.  Here’s how to wash!

Since virus are carried the the air, it is smart to keep a distance from people who might be carrying virus.  This includes people that aren’t having fever or cough at all!

And,

Mask UP!

And get the most current vaccine.

In the mean time, let’s keep your asthma under control!

#asthmacontrolnow
#telemedicineasthmacare
#backpocketasthmadoc
#asthmaactionplan
#asthmacontroltest
#asthmacontroller
#rescueinhaler
#asthmacovid19
#childrenandasthma
#eprescription
#easthma
#peakexpiratoryflow
#peakflowmeter
#asthmaniac
Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac to Find Your Best Asthma Control Asthmaniac.com is a fully digital asthma clinic designed to deliver physician consultation, disease assessment, patient education, medical refills, and follow-up care.  This is different than making an...

Asthma and COVID19

* Asthma is a chronic disease that places you at higher risk of serious illness with COVID19 infection. * Keeping your asthma well controlled will give you the best protection against serious COVID19 illness. * Controlling your COVID19 exposure should be a...

Steroids in Asthma: Why We Need Them?

Steroids in Asthma: Why We Need Them?

Steroids in Asthma: Why We Need Them?

Why do we use steroids in asthma?

* Inflammation of the airways is the underlying problem in asthma

* Steroids like Prednisone and Decadron are taken by mouth

* Steroids like betamethasone and fluticasone are inhaled like albuterol.

* Steroids shut down inflammation in asthma

* Lung inflammation in moderate asthma can be controlled but not cured.

 

The basic problem in asthma lungs is inflammation.

Inflammation means swelling, oozing, and fragility of the lining of breathing tubes.

This inflammation leads to extra mucus production and this mucus, along with swelling in the walls of these tubes, creates a extra resistance to air flow.  

When these breathing tubes are inflamed with swelling and mucus, the effort to move air, especially out of the lungs, can be exhausting.

My goal is to help you keep a lid on this inflammation.  In asthma, there will always be a tendency for it to get out of control.

But, with the right controller medication and avoidance of triggers, you can stay out of the ER, get restful sleep, and be as active as an Olympic athlete!

Now, when the inflammation is out of control, we have only one choice.

SHUT IT DOWN.

The most potent and fast acting medicine we have for this is corticosteroids.  

We say steroids for short.  

This isn’t the type of steroids injected by weight lifters to make big muscles – those are called anabolic steroids..  

Corticosteroids work inside the walls of breathing tubes to block the inflammation process.

They work, but their action is not immediate.

Prednisone and Dexamethasone are the most common forms used in non-hospitalized asthma patients.

These steroids are taken by mouth, or if your breathing is really bad, they are given intravenously.

Either medicine must be taken for 3-5 days straight for the full effect.

After these medicines shut down the inflammation process in the breathing tubes, we are in a position to launch a new asthma action plan that includes stronger controller medicine in the form of inhaled steroids, also called controllers.

For more moderate and severe asthma sufferers, there are new medications – biologics, that make even more dramatic improvements in severe asthma control.    

For most moderate asthma patients, inhaled corticosteroids will be a cornerstone of their asthma action plan.

Finding the right type of steroid, the frequency that works, and the one that you and your insurance company accept is a really important part of asthma care.

If you are using your albuterol rescue inhaler daily and aren’t using a steroid inhaler, you need one.  

If you are using your albuterol rescue inhaler more than two times per week and you ARE on a steroid inhaler, you need a change that delivers more steroid either per dose or more times per day.

If you are ready to make a change, grab an appointment and lets talk!

#asthmacontrolnow
#telemedicineasthmacare
#backpocketasthmadoc
#asthmaactionplan
#asthmacontroltest
#asthmacontroller
#rescueinhaler
#asthmacovid19
#childrenandasthma
#eprescription
#easthma
#peakexpiratoryflow
#peakflowmeter
#asthmaniac

 

 

Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac to Find Your Best Asthma Control Asthmaniac.com is a fully digital asthma clinic designed to deliver physician consultation, disease assessment, patient education, medical refills, and follow-up care.  This is different than making an...

Asthma and COVID19

* Asthma is a chronic disease that places you at higher risk of serious illness with COVID19 infection. * Keeping your asthma well controlled will give you the best protection against serious COVID19 illness. * Controlling your COVID19 exposure should be a...

Your Asthma Control Is Our Mission

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Aligning Medication with Asthma Subtype

Children and Asthma: Different from Adult Asthma?

Children and Asthma: Different from Adult Asthma?

* Asthma is present in about 10% of children.

* Asthma in children is diagnosed when your child has recurring episodes of wheezing that are relieved by rescue medicine such as albuterol

* Asthma in children is treated with the same medicines and treatment plans as in adults with adjustments for their size and metabolism.

 

Children have a lot more wheezing than adults.

A simple upper respiratory infection or common cold causes many children to wheeze.

But, a single episode of wheezing while ill doesn’t mean a child has asthma.  A key feature of asthma is the recurrence of wheezing, along with its reversibility by a bronchodilator/inhaler like albuterol.

How many children who wheeze when sick go on to have recurrent wheezing and asthma?  We don’t know for sure.  But we do know that infection with the respiratory syncytial virus (RSV) early in childhood is associated with the appearance of asthma.

The bottom line: asthma in children is a very big problem.

In 2016, about 6 million children were diagnosed with asthma.  That makes it  the most common chronic disease of childhood.

Untreated, asthma in children threatens them with death, emergency room visits, hospitalizations, and school absenteeism.

Childhood asthma is treated with the same medications and strategies as in adults. Since they are kids there are adjustments in medication dosage, and some differences in severity classification.

Unfortunately, like adults, children are often not treated according to the National standard of care.

Asthmaniac is designed to serve them as well.

At Asthmaniac, pediatric expertise is always on-deck to make sure our approach to children with asthma is aligned with National standards.

#asthmacontrolnow
#telemedicineasthmacare 
#backpocketasthmadoc
#asthmaactionplan
#asthmacontroltest
#asthmacontroller
#rescueinhaler
#asthmacovid19
#childrenandasthma
#eprescription
#easthma
#peakexpiratoryflow
#peakflowmeter
#asthmaniac

 

Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac to Find Your Best Asthma Control Asthmaniac.com is a fully digital asthma clinic designed to deliver physician consultation, disease assessment, patient education, medical refills, and follow-up care.  This is different than making an...

Asthma and COVID19

* Asthma is a chronic disease that places you at higher risk of serious illness with COVID19 infection. * Keeping your asthma well controlled will give you the best protection against serious COVID19 illness. * Controlling your COVID19 exposure should be a...

Phone Doctor Visits: They Work For Asthma Control!

Phone Doctor Visits: They Work For Asthma Control!

Phone Doctor Visits: They Work For Asthma Control!

*  Quality Asthma care depends on self-management by you – the patient.

*  A large part of my role as your physician is teaching you these self-management skills.

*  The techniques you will use to assess your breathing are:

*  The Asthma Control Test – to track your symptoms.

*  Your Peak Expiratory Flow – to track your lung function.

*  We will “meet” regularly to discuss your self-assessments by phone rather than in-person.

*  These phone visits and your frequent use of the Asthmaniac website are designed to keep your asthma controlled.

*  Phone consults helps you avoid illness exposure and is more conveient than driving to sit in a waiting room!

 

Asthmaniac is based on the National standards for asthma care.

Those standards tell doctors to teach their patients how to assess their everyday symptoms and lung capacity.

Years of research has led to the creation of a solid symptom assessment tool (Asthma Control Test or ACT).   This is a survey that you can complete yourself and then report to me.

Research has also shown that lung performance, or how well you are able to breath out (Peak Expiratory Flow or PEF), can be measured using a simple, pocket-sized flow meter.

In my Asthmaniac clinic, I will ask you to use a simple flowmeter to record your number several times each week.

I will teach you how to use this number in conjunction with your Action Plan to best manage your symptoms.

I use ACT scores in planning updates to your medications, dosages, and your Action Plan.

The great thing about having these two proven methods of assessing your asthma is that we can conduct our entire asthma appointment on the phone!

Yes!

On the phone!

That means you can get your Asthmaniac appointment on a lunch break, walking down the street, or wherever you are.

One place you won’t be is sitting?

A doctor office waiting room – waiting to catch a virus!

Phone appointments: a key convenience of Asthmaniac!

Grab an appointment and we can get your asthma care optomized!

#asthmacontrolnow
#telemedicineasthmacare
#backpocketasthmadoc
#asthmaactionplan
#asthmacontroltest
#asthmacontroller
#rescueinhaler
#asthmacovid19
#childrenandasthma
#eprescription
#easthma
#peakexpiratoryflow
#peakflowmeter
#asthmaniac
Navigating Asthmaniac.com!

Navigating Asthmaniac.com!

Navigating Asthmaniac to Find Your Best Asthma Control Asthmaniac.com is a fully digital asthma clinic designed to deliver physician consultation, disease assessment, patient education, medical refills, and follow-up care.  This is different than making an...

Asthma and COVID19

* Asthma is a chronic disease that places you at higher risk of serious illness with COVID19 infection. * Keeping your asthma well controlled will give you the best protection against serious COVID19 illness. * Controlling your COVID19 exposure should be a...