Asthma Triggers You Might Miss!

Asthma Triggers You Might Miss!

Asthma Triggers You Might Miss!

ASTHMA TRIGGERS:

Less known but no less potent!

When you have asthma, you know that certain things are powerful triggers for wheeing.  A short exposure is enough to give you chest tightness, throat tightening, and soon, you’ll be wheezing.  Having your rescue inhaler at your fingertips can tamp this wheezing down, but figuring out what this triggers are and where you encounter them is a hugely important approach to preventing wheezing.  

Once you identify the trigger, we can go to work to block it’s effect, assuming you can’t just avoid it (which can be really hard to do).

Common Triggers

You already know about dust, smoke, animal dander and how they set you off.  Using an antihistamine daily is a good way to block these triggers. In some cases, a special medicine (monteleukast) is even more effective because it directly blocks of the trigger effect.  If you think you could get better control with it, let’s talk.

Less Well Recognized Triggers

Environmental triggers are usually a problem for all patients with asthma.  There are a few trigger conditions that are uniquely problematic and when identified, can be controlled with the right strategy.

  • Reflux
  • Sleep Apnea
  • Allergic Rhinitis

Let’s run through these and if you have a history of any of them or think you have one that is not better managed, let’s talk.

Reflux

Reflux generally describes the splashing of acidic stomach fluid into the esophagus at either the lower or upper end.  This occurs when the valve at the top of the stomach doesn’t clinch down tightly during digestive action.  When this acidic fluid hits the lining of the esophagus (at any level), it can trigger bronchial spasm, wheezing, and a full-blown asthma attack.  When this problem is discovered, we can control with:

  • Lifestyle
  • Acid Blockers
  • Gastric “raft”

Lifestyle intervention consists of:

1. avoiding foods that promote reflux due to their oily, greasy, high-fat content;

2. avoiding eating and then laying down, which allows stomach contents to easily move through a leaky valve into the esophagus; and,

3. avoiding large meals, which put pressure on a leaky valve, challenging its ability to stop stomach contents from entering the esophagus.

Acid blockers (famotadine, omeprazole) work to decrease the acid production in the stomach so that if contents do get into the esophagus, they aren’t able to trigger the usual bronchial spasm.  Acid neutralizers like Milk of Magnesia and calcium carbonate decrease the acid content of stomach contents to prevent the bronchial effect when stomach contents leak into the esophagus.

A gastric raft refers to an oral alginate available as either pill or gel forms that is taken after a meal to mix with stomach contacts making them thick and less prone to escape up a leaky valve.  Alginates are derived from seaweed and can be remarkably effective at controlling reflux triggers.

    Sleep Anea

    Sleep apnea, usually caused by obstruction of the upper airway, causes carbon dioxide levels to increase in the blood stream and this can be a powerful driver of wheezing.  Excess weight is a common cause for obstructive sleep apnea so weight loss is the most effective intervention.  Fortunately, new medicines like tirzepatide and semaglutide are very helpful for weight loss and have been shown to be particularly helpful in reducing obstructive sleep apnea.  I treat patients with both of these medicines so we should talk about how you might benefit.

    Allergic Rhinitis

    Though most asthma sufferers have wheezing when exposed to pollen, dust, smoke and dander, sometimes you’ll have a runny nose and post-nasal drip even when you haven’t been exposed to such triggers, and as you know, these symptoms can trigger your wheezing as well.  Sometimes an allergic cause can be identified and for that reason, we always order an allergy test.  Many times, we can find an allergic cause.  Even so, medicines that bolster the lining of the nose and upper airway can be helpful.  Such medications include: fluticasone nasal spray, loratidine, cetirizine, and monteleukast.  If you have never had allergy testing and you experience post-nasal drip, stuffy nose, or puffy eyes, you might benefit from testing and one of these medications.

    Our Goal?

    Better Breathing!

    That means:

    • Fewer asthma attacks
    • Better symptom control
    • Less need for steroids overall
    • Fewer trips to urgent care or the ER

     

    What Should You Do Next?

    At Asthmaniac.com, I offer online visits to help you achieve the best strategies for better breathing.  And when we decide on what medications might be best, I can get them prescribed online for a quick start to Better Breathing! 

    🎯 No waiting rooms. No confusion. Just better breathing. Your Back-pocket-asthma-doc!

    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...

    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

     

    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...