PM2.5 and Asthma

PM2.5 and Asthma

PM2.5 and Asthma

* PM2.5 is a tiny particle suspended in the air.

* It is present in hot, dry, and polluted environments.

* When inhaled, PM2.5 triggers inflammation in bronchi, driving bronchospasm and asthma attacks.

* How do you protect yourself?

 

PM2.5: This Tiny Particle

Is A Big Asthma Problem!

You have asthma.  You go to work, drive with the windows down, walk outside, or perhaps even run or bicycle outside on a hot smoky or dusty day.  Next thing you know, your chest is tight, you are coughing, and you can feel that you are wheezing.  What happened?  There’s a pretty good chance the trigger is something called PM2.5.

Time to learn about PM2.5! Where does it come from, how it moves, and why does it make your asthma go crazy?

What Is PM2.5?

PM2.5 is Particulate Matter that is smaller than 2.5 micrometers. It a very small particle,  1/30 the diameter of a human hair!  Particles this small are invisible to your eyes but there is one organ that is very good a deteting them:  Your lungs!

Particles this small stay suspended in the air and when inhaled, move down your trachea, bronchi, all the way to your alveoli, and even into your blood stream!  Not good!  But if you have asthma lungs that are queued up for bronchospasm, this can be really bad.

What is the source of PM2.5?

PM2.5 is generated in many ways including:

  • Car and truck exhaust
  • Motor vehicle tire wear
  • Factories and power plants
  • Fires (like wildfires, campfires, and even fireplaces at home)
  • Construction sites (dust and debris)
  • Cigarette and vape smoke
  • Burning garbage

We now know cooking (especially frying or grilling) can also generate PM2.5, right in your kitchen or on the patio!  Oh brother!

There are some natural, non-man-made sources of  PM2.5 such as volcanoes or dust storms but most is created by human processes.

Spreading PM2.5.

The size and lightness of PM2.5 particles allows them to easily float in the air, setting them up for many miles of movement on the wind.  That means you could be miles from where the PM2.5 particles are being generated and still have an effect on your breathing!

Even non-wind climate conditions can worsen the reaction to PM2.5.  Hot, dry conditions allow PM2.5 to accumulate to high levels, reducing air quality and in cities in particular, leads to air quality alerts for people with asthma and other lung conditions.

Asthma and PM2.5: Not a good mix!

PM2.5 creates several problems in the airways and lungs of people with asthma:

  • Irritation: Generally, asthma causes bronchi and bronchioles (breathing tubes) and you’re your lungs to be very sensitive to irritants of any kind. The size of PM2.5 particles makes them particularly good at stimulating irritation of airways.  In this way, they act as a trigger for airway constriction.  Even if you are taking daily medicine to reduce trigger effects, PM2.5 can overwhelm these medicine and next thing you know:  you will cough, wheeze, or feel short of breath.
  • Inflammation: As you know in your study of asthma, it is a disease of heightened inflammation in your airways. When PM2.5 lands on the lining of your airways, it stimulates a reaction that does what you need least: More inflammation.  And that’s true even when you are taking a daily controller medicine aimed to control inflammation.
  • Long-term damage: Here is where we are learning the most of long-term asthma effects. Through its trigger and inflammation effects, PM2.5 can drive irreversible damage in your airways, progressively destroying the ability of the lungs to move oxygen.  Next thing you know, you’ll have emphysema with your asthma!

Asthma sufferers and those with established lung disease aren’t the only ones affected.  Even healthy people experience airway problems when exposed to PM2.5.

Protecting Your Lungs?

PM2.5 is everywhere, worse in cities, and worse in hot, dry, dusty and smoky conditions.  You can’t always just avoid such places, so what to do.

  • Monitor air quality: With most weather apps and television weather reports, air quality is rated and warnings are issued when there are dangerous levels of PM2.5.
  • On bad days: Stay indoors with the windows and doors closed and when you need to go outside, wear a mask that can block PM2.5 such as our old friend, the N95.
  • In the house: Use an air purifier and a quality filter to keep the PM2.5 level low.
  • Avoid smoke: Avoid all smoke and anything that creates smoke-like particles.  Outside, that’s campfires, auto exhaust, factory exhaust, grass- or forest-fires, and any open burning.  In your personal space, cigarettes, vapes, and any smoking apparati will be creating PM2.5.  Just say no!
  • Action Plan:  If you get exposed, and your airways begin to spasm, activate your asthma action plan and don’t hesitate to call for help if your rescue and control measures arn’t working!
  • Monitor Your Breathing:  Use the Asthma Control Test to track your symptoms.  An uptick in your score is an early clue that that your asthma is getting out of control

Wrap Up

PM2.5 is tiny, easily moved, concentrated in hot, dry and urban evironments, and can be a big trigger for your airway irritation and inflammation.  Avoid it where possible, block it when you can, and remember your action plan if things go off the rails.  If you are still struggling, make the call and go to the ER or call 911.  Don’t wait until your irritation and inflammation become very advanced!  Instead, be aware of PM2.5, be smart, understand your asthma, and breathe best!

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

 

Asthma Rescue Inhalers Are Crucial in Asthma Control!

What is a Rescue Inhaler? * Rescue inhalers are an essential tool in responding to your asthma! * The albuterol in rescue inhalers opens breathing tubes quickly. * If it doesn’t quickly improve your breathing, go to the ER. * A spacer should be used with...

Asthmaniac Blog

Asthmaniac Blog

* Asthmaniac.com is my online asthma clinic 

* Asthmaniac is designed to be affordable, convenient, and reliable.

* Asthmaniac follows national quality standards developed at NIH

* Asthmaniac uses your phone to make your care convenient and engaging

Children and Asthma: Different from Adult Asthma?

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

 

Asthma Rescue Inhalers Are Crucial in Asthma Control!

What is a Rescue Inhaler? * Rescue inhalers are an essential tool in responding to your asthma! * The albuterol in rescue inhalers opens breathing tubes quickly. * If it doesn’t quickly improve your breathing, go to the ER. * A spacer should be used with...

Asthmaniac Blog

Asthmaniac Blog

* Asthmaniac.com is my online asthma clinic 

* Asthmaniac is designed to be affordable, convenient, and reliable.

* Asthmaniac follows national quality standards developed at NIH

* Asthmaniac uses your phone to make your care convenient and engaging

NEVER run Out of Asthma Inhaler Medicine!

NEVER run Out of Asthma Inhaler Medicine!

NEVER run Out of Asthma Inhaler Medicine!

* Finding your inhaler empty when the tightness starts IS NOT A GOOD FEELING!

..You need your rescue inhaler

..When you need it!

..Without it, it is probably a trip to the ER and

..a few days of having messed up breathing.

* Asthmaniac delivers quick doctor visits for inhaler refills and

*sends all orders for prescription medication to the pharmacy of your choice.

 

Asthma is one disease that cannot be controlled without medication.

When your wheezing kicks in, you need a rescue inhaler NOW!

And to keep your wheezing suppressed, you need a controller medication.

Since these medications are so important to keeping you breathing well, I have designed a online ‘clinic’ that makes it possible for you to never run out!

Running out is usually from:

… The discouraging cost of the medicine

…  The discouraging inconvenience of finding a doctor appointment to get the medicine ordered

… The discouraging cost of the doctor appointment.

Well, I have good news!

  1. Albuterol (your usual rescue inhaler) is now generic, and priced as low as $20/inhaler in some pharmacies!
  2. You have already ‘found’ the doctor that will take care of you (that’s me!).
  3. You can ‘see’ me online (on your phone) to get your refill ordered NOW!

I send your prescriptions electronically to your preferred pharmacy.

That doesn’t matter where you are or where I am.

All electronic.

No paper prescription to lose,

Even better: now that Amazon is in the pharmacy game, there’s a pretty good chance you can get more affordable inhalers delivered right to your door!

Ok, to be sure, getting your asthma under control is not ONLY about getting your inhalers.

But making sure you have your rescue medicine is my First priority.

Affordable

Convenient

Inhaler Refills.

A CORE philosophy of Asthmaniac!

Remember our hashtag: asthmacarenow! And keep Breathing Easy!

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

 

Asthma Rescue Inhalers Are Crucial in Asthma Control!

What is a Rescue Inhaler? * Rescue inhalers are an essential tool in responding to your asthma! * The albuterol in rescue inhalers opens breathing tubes quickly. * If it doesn’t quickly improve your breathing, go to the ER. * A spacer should be used with...

Asthmaniac Blog

Asthmaniac Blog

* Asthmaniac.com is my online asthma clinic 

* Asthmaniac is designed to be affordable, convenient, and reliable.

* Asthmaniac follows national quality standards developed at NIH

* Asthmaniac uses your phone to make your care convenient and engaging

Do You Need an Affordable Doctor?

Do You Need an Affordable Doctor?

Do You Need an Affordable Doctor?

WE ALL DO!

What does “affordable” mean?

It could be what you pay out-of-pocket before you have met your deductable (assuming you have health insurance).

Or,

If you don’t have health insurance, you probably think of affordability in the following ways:

… what it costs to go to the ER (thousands?!!),

… what it costs to see a regular doctor (assuming you can find one that will give you an appointment, around $150)

…  what it costs to go to an urgent care (around $150).

Well, I can do better than that.  I keep my per visit price to nearly half of an urgent care or regular office visit. 

With Asthmaniac, it is all online/on-the-phone, and all about asthma.  

If you are looking for top quality asthma care at an unbeatable price with back-pocket convenience, Asthmaniac is your ‘clinic’!

As with other chronic diseases, affordability is important for Asthma Control

* The cost of asthma control can be a barrier:

* Many costs of asthma care can exceed what those without insurance can afford.  These include:

* The cost of asthma medication.

* The cost of doctor visits

* The cost pulmonary function testing.

I endeavor to keep my consults to you AFFORDABLE.

And, I am constantly looking for the best way to get you medication that fits your budget. 

 I am committed to designing a method that asthma patients can actually afford to use.

A method that keeps them breathing deeply, sleeping soundly, and striding through their days with new confidence in managing their asthma.

Asthmaniac is that method.

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

Asthma Rescue Inhalers Are Crucial in Asthma Control!

What is a Rescue Inhaler? * Rescue inhalers are an essential tool in responding to your asthma! * The albuterol in rescue inhalers opens breathing tubes quickly. * If it doesn’t quickly improve your breathing, go to the ER. * A spacer should be used with...

Asthmaniac Blog

Asthmaniac Blog

* Asthmaniac.com is my online asthma clinic 

* Asthmaniac is designed to be affordable, convenient, and reliable.

* Asthmaniac follows national quality standards developed at NIH

* Asthmaniac uses your phone to make your care convenient and engaging

Your Asthma Control Is Our Mission

 Same Day Appointments are Available.

720-900-0943

Telemedicine for You!

Asthma Attack Triggers:  Keep a Lid On It!

Asthma Attack Triggers: Keep a Lid On It!

Asthma Attack Triggers: Keep a Lid On It!

Triggers for wheezing (bronchoconstriction) include:

* Pollen

* Dust Mites

* Cockroaches

* Mold

* Pet dander

* Tobacco Smoke

To prevent wheezing, you need to avoid these triggers.

If avoiding them isn’t possible, I can prescribe medicine suppresses the effect of triggers.

 

As you have learned, asthma symptoms occur when the breathing tubes or bronchi, clench down.  

This is called bronchoconstriction.

Bronchoconstriction blocks the flow of air to your lungs, creating labored breathing, shortness of breath, and chest pain..

In most patients with asthma, this bronchoconstriction is ‘triggered’ by something outside of your body.  

Quite often, this ‘something’ is a breathable, microscopic particle.  When these particles land in your airways, they launch an allergic reaction in your airways.

These particles are called allergens.

There are a number of natural and man-made allergens that can trigger wheezing and asthma attacks.

Pollen from trees and plants that you inhale is one of the most common and difficult to avoid when you are outside.

The most problematic indoor allergen is dust mites.  These microscopic white insects eat the dead skin cells we humans shed.  These skin cells build up in carpet, upholstery, and bedding and sure enough, that’s where the mites will be.

Bronchoconstriction is triggered when microscopic parts of mite skeletons and mite fecal droppings are inhaled. 

Cockroaches are another big problem for asthma patients.

Cockroach fecal droppings can be inhaled in the same way as dust mites, leading to bronchoconstriction.

Another indoor allergen is mold .  A mold grows, microscopic spores are released and can be inhaled.  In some patients with asthma, these spores can trigger wheezing.

Some of our favorite pet companions can trigger wheezing.  The hair fiber of dogs and cats is composed of microscopic flakes called dander.

Dander is a powerful allergen in some people. 

Fortunately for us and them, bathing dogs and cats weekly dramatically reduces how much dander they release.

It comes as no surprise that Tobacco smoke is a powerful trigger of bronchospasm.

With short-term inhalation, tobacco smoke irritates the lining of the bronchi causing bronchospasm.  

With repeated inhalation, permanent damage occurs to the lungs, leading to emphysema and lung failure.

Other irritants that can trigger bronchospasm include: wood smoke from wood stoves, heaters and fireplaces, and, 

strong chemical odors released from perfumes, solvents and paint.

 

My Strategy for Handling Triggers

Every patient has a unique response to triggers.

Usually, the most powerful trigger can be identified by you through past experience .  

The most important thing you can do to limit these trigger effects is to avoid the source of the trigger.  

While this sounds simple, it can be difficult to achieve in daily life.  

There are specific strategies that I will recommend for trigger avoidance.

But, when avoiding the trigger is not possible, I will prescribe medicine designed to help your airways resist bronchospasm from inhaled triggers.

As you can see, controlling triggers is a really important part of keeping your asthma controlled.

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

 

 

Asthma Rescue Inhalers Are Crucial in Asthma Control!

What is a Rescue Inhaler? * Rescue inhalers are an essential tool in responding to your asthma! * The albuterol in rescue inhalers opens breathing tubes quickly. * If it doesn’t quickly improve your breathing, go to the ER. * A spacer should be used with...

Asthmaniac Blog

Asthmaniac Blog

* Asthmaniac.com is my online asthma clinic 

* Asthmaniac is designed to be affordable, convenient, and reliable.

* Asthmaniac follows national quality standards developed at NIH

* Asthmaniac uses your phone to make your care convenient and engaging

SMART: Smart and Simple Asthma Care!

SMART: Smart and Simple Asthma Care!

SMART: Smart and Simple Asthma Care!

* SMART means:

..simple ..control & ..rescue!

SMART therapy stands for Single Maintenance and Reliever Therapy.   At Asthmaniac, we the words “maintenance” and “controller” mean the same thing.  Likewise, “reliever” and “rescue” are interchangeable.

SMART therapy is for patients with moderate to severe asthma who need a combination treatment. This combined treatment consists of an inhaled corticosteroid (controller ) and an inhaled long-acting beta-2 agonist (LABA) (bronchodilator). The SMART therapy program simplifies things by having patients to use one inhaler for both! The maintenance dose can be adjusted based on the needs of the individual, but it is typically at least two doses a day (either two at once or one dose twice a day).

What medicines are in SMART therapy?

SMART therapy is a combination of an inhaled corticosteroid and an inhaled LABA. Currently, this combination is available in two medications:

  • budesonide/formoterol (Symbicort®)
  • mometasone/formoterol (Dulera®)

In asthma guidelines for SMART therapy, the budesonide/formoterol combination is the recommended first treatment for moderate to severe asthma.

How does SMART therapy work?

SMART therapy allows people with asthma to use just one medication to control asthma symptoms. They use this single medication for both control and rescue therapy.

Typical rescue inhalers contain only a bronchodilator. Controller medications often include an anti-inflammatory inhaled corticosteroid. But with SMART therapy, the inhaler has both an anti-inflammatory inhaled corticosteroid and a LABA. This is helpful as it means people are getting daily medicine to keep their airways open. And when they are experiencing symptoms, they are getting extra anti-inflammatories. This helps to reduce airway inflammation.

Who can receive SMART therapy?

Under asthma guidelines, SMART therapy is recommended for people with moderate to severe asthma, including children ages 5 and older. In general, SMART therapy is considered an easier treatment plan to follow. A SMART therapy plan can also be used as an as-needed treatment for mild asthma. Formoterol is a long-acting inhaled medication but it works quickly, similar to quick-relief albuterol. .

What is moderate to severe persistent asthma?

People with moderate asthma have daily symptoms or wake up at night due to symptoms at least once a week.

People with severe asthma have symptoms throughout the day despite following their treatment plan. They also report waking up at night with symptoms, even after taking treatment. Learn more about understanding asthma severity.

How will I know if SMART therapy is right for me or my child?

To determine if SMART therapy is right for you or your child, consider Shared Decision-Making. In Shared Decision-Making, you and I decide the right treatment approach fo you. The best is based on your asthma control, lifestyle and other healthcare needs and preferences. Then you and I work together to develop an Asthma Action Plan so you know what to do for treatment when symptoms occur.

Ready for a SMART plan?

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

 

Asthma Rescue Inhalers Are Crucial in Asthma Control!

What is a Rescue Inhaler? * Rescue inhalers are an essential tool in responding to your asthma! * The albuterol in rescue inhalers opens breathing tubes quickly. * If it doesn’t quickly improve your breathing, go to the ER. * A spacer should be used with...

Asthmaniac Blog

Asthmaniac Blog

* Asthmaniac.com is my online asthma clinic 

* Asthmaniac is designed to be affordable, convenient, and reliable.

* Asthmaniac follows national quality standards developed at NIH

* Asthmaniac uses your phone to make your care convenient and engaging