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Your Asthma Control is Our Mission

Asthma Management Guidelines 2020 Focused Update: What’s In It For You?

Asthma Management Guidelines 2020 Focused Update: What’s In It For You?

Asthma Management Guidelines 2020 Focused Update: What’s In It For You?

* The National Institutes of Health, National Heart, Lung, and Blood Institute coordinated this update

* Recommendations were published on December 1, 2020.

* It Focuses on six areas:

….Fractional Exhaled Nitric Oxide Testing

….Indoor Allergen Mitigation

….Intermittent Inhaled Corticosteroids

….Immunotherapy in the Treatment of Allergic Asthma

….Bronchial Thermoplasty

* Only four of these six areas have immediate implications for asthma disease management in primary care.

* I’ll review the recommendations briefly here.

Major Points:

  • These guidelines are not as wide-ranging as those developed and released in 2007.
  • The new recommendations are based on reviews of the scientific literature and the use of the GRADE methodology for assigning a level of certainty (Low, Moderate, or High) for each recommendation.
  • Of the six areas, only numbers 2, 3, 5, & 6 have practical implications for primary asthma care.

 

Indoor Allergens: Pillow covers and mattress bags to seal in allergens are recommended if you have symptoms.  (Moderate Certainty)

Allergy Shots: SCIT (Subcutaneous Immunotherapy) is recommended for adults and children (>5 yr) with mild to moderate allergic asthma as long as they have lab or skin testing data to support the allergy. (Moderate Certainty).

Wheezing in Kids: Children from ages 0-4 yr with recurrent wheezing (3 x /year), triggered by colds and URI’s should have a short course (7-10 days) of inhaled corticosteroid at the onset of a new wheezing episode. (High Certainty).

In ages 4+ with moderate to severe-persistent asthma, a combination inhaler containing formoterol and steroid can be used as both a daily controller and as a rescue medicine. (Moderate to High Certainty).

In ages 12 + with mild persistent asthma, inhaled corticosteroids should be used daily, either along with rescue albuterol or in a combination inhaler that includes  albuterol. (Moderate Certainty).

In age 12 + yr with uncontrolled, persistent asthma, Long Acting Muscarinic Antagonist (LAMA) medicine can be added to Inhaled Corticosteroid (ICS) for better control. (Moderate Certainty).

I have devoted a full page to discuss how these recommendations will affect my asthma care plans in further detail.

If you have questions about asthma management or want to update your asthma action plan and medication prescriptions, grab an appointment and let’s talk!

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#eprescription
#easthma
#peakexpiratoryflow
#peakflowmeter
#asthmaniac

 

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Asthma Rescue Inhalers Are Crucial in Asthma Control!

* Rescue inhalers are essential * 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 all liquid medicine inhalers * Generic albuterol is now available...

Do You Need an Asthma Controller Medication?

* Asthma controllers are medications that “control” the underlying inflammation in your breathing tubes. * Inhaled corticosteroids are the most common type of medicine used for this purpose. * In order for corticosteroids to work, they have to be inhaled...

What is an MDI Spacer and Why Do You Need One?

* A spacer is needed to hold your asthma medicine in a cloud until you can pull it into your lungs with a deep breath.

* If you don’t use a spacer with your asthma medicine, it ends up on tongue and on the walls of your throat where it can’t help your asthma and usually causes a yeast infection.

* Spacers should be used with all of your asthma medicine that comes in a metered dose inhaler (MDI).

* Medicine administered by a dry powder inhaler does not require a spacer since the design of the inhaler stirs and suspends the dry powder particles so they can be inhaled deeply.

Your Asthma Control Is Our Mission

 Same Day Appointments are Available.

720-900-0943

Telemedicine for You!

Peak Expiratory Flow Rate: How We Measure and Why?

Peak Expiratory Flow Rate: How We Measure and Why?

Peak Expiratory Flow Rate: How We Measure and Why?

* Peak Expiratory Flow is measured by you, several times a week using a small pocket-sized flowmeter

* You record the number measured by this devise.

* This number shows how well you are able to exhale and tells me if we have your lung inflammation under control

* When this number starts edging down over a few days, we know its time to take action before you start to feel symptoms of chest tightness, shortness of breath or actual wheezing.

* I use Peak Expiratory Flow measurements and ACT scores in your Asthma Action Plan to help guide you in responding to changes in your lungs.

 

In order for you to self-manage your asthma, you need a way to detect early drops in your lung function.

Peak Expiratory Flow (PEF) is that way.

It is measured using a device held up to your lips while you forcefully exhale.

This device measures how much air is exhaled and registers this as a number for you to read from the device.

When your lungs are in good control, the number reading for your PEF will be very similar to that of a person without asthma.

When your inflammation gets out of control, the swelling in your breathing tubes blocks air from being exhaled.  This results in lower numbers on your PEF device.

When this device is used daily, you will be able to detect a downward trend that is a sign of worsening inflammation days before your breathing becomes so labored that an ER trip is needed.

Peak Expiratory Flow:  Let’s make it a daily measurement!

Complete the subscription form on the left if you’d like to get an email when I post a new podcast and blog entry.

If you need a Peak Flow Meter and your pharmacy or doctor can’t help, you can order from Amazon.  I have tested the Omron and found it durable, simple, compact, and affordable.

 

I may earn commissions for purchases made through the links below.

 

_____________________

 

PEF: Omron Peak Flow Meter

https://amzn.to/3lT9R9z

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

Why no one has a PEF device

There may be a number of reasons and the reason may be different between patients but one big problem in the U.S. is that doctors don’t order them for patient use, despite the national recommendation to do so.

What does it Mean?

Regular measurements of your PEF are not only of interest to you.

I will use your measurements to decide the strength for your controller medicine.

The goal with controller medicine is to find the lowest possible dose that controls your lung inflammation.

This strategy reduces problems that can occur when steroids are overused, such as  fungus infections in the mouth, slowed growth in children, and lessening your body’s ability to withstand the stress of injury or infection.

How do you get one?

I’ll give you a doctor’s order to present to the pharmacy, or if they don’t have it, I tell you where to order from Amazon.

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Grow your asthma knowledge by getting these blog updates in your email!

Your Asthma Control Is Our Mission

 Same Day Appointments are Available.

720-900-0943

Telemedicine for You!

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 patients.

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

*  Crucial to these skills are techniques you will use to assess:

*  Your Symptoms (Asthma Control Test)

*  Your Lung Function (Peak Expiratory Flow)

*  We will 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 while avoiding illness exposure and the inconveience of travel and waiting rooms

 

I designed Asthmaniac around the National standards for asthma care.

Those standards tell doctors to teach their patients how to assess their everyday symptoms and lung 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 ask that patients use a simple flowmeter to record their number several times each week.

I instruct you how to use this number in conjunction with your Action Plan.

I use this number in planning updates to your medications, their 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 over the phone.

Yes!

Over 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!

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

Subscribe

to get Asthma Updates!

Grow your asthma knowledge by getting these blog updates in your email!

Asthma Rescue Inhalers Are Crucial in Asthma Control!

* Rescue inhalers are essential * 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 all liquid medicine inhalers * Generic albuterol is now available...

Do You Need an Asthma Controller Medication?

* Asthma controllers are medications that “control” the underlying inflammation in your breathing tubes. * Inhaled corticosteroids are the most common type of medicine used for this purpose. * In order for corticosteroids to work, they have to be inhaled...

What is an MDI Spacer and Why Do You Need One?

* A spacer is needed to hold your asthma medicine in a cloud until you can pull it into your lungs with a deep breath.

* If you don’t use a spacer with your asthma medicine, it ends up on tongue and on the walls of your throat where it can’t help your asthma and usually causes a yeast infection.

* Spacers should be used with all of your asthma medicine that comes in a metered dose inhaler (MDI).

* Medicine administered by a dry powder inhaler does not require a spacer since the design of the inhaler stirs and suspends the dry powder particles so they can be inhaled deeply.

Your Asthma Control Is Our Mission

 Same Day Appointments are Available.

720-900-0943

Telemedicine for You!