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Asthma

Asthma

June 14, 2011
12:00 p.m. – 1:00 p.m. (EST)

  • Ozzie Delgado, PharmD, BCSP - Director of Respiratory Therapy

Instead of simply focusing on the treatment of asthma symptoms, our allergists search for and treat the root causes of airway inflammation. This not only decreases symptoms and improves quality of life, but can also prevent an irreversible decline in lung function.

Cleveland_Clinic_Host: Today's Live Web Chat, "Asthma" with Osmel Delgado, PharmD, BCSP and Director of Respiratory Therapy will begin at 12 noon EST. Please submit your questions by typing them below and then clicking 'Ask'.

Cleveland_Clinic_Host: Welcome to our Online Health Chat "Asthma" with Osmel Delgado, PharmD, BCPS. We are thrilled to have him here today for this chat. Let’s begin with the questions.

Minmom68: My 10 yr old son was on a high jet ventilator when he was born, which is what I am being told that could be the reason why he has asthma. When he was younger he was only affected by the asthma when he would get sick. At about age 6 the asthma starting affecting him during illnesses, but also became exercise induced. He has been very well controlled in both aspects with daily 5mg of Singulair and using Xoponex and Pulmicort respules when sick as a safety measure. Is this something he could eventually grow out of and would being on track team be a viable sport for him? Could he be less bothered by exercise induced if he practiced more and more running? Thank you!

Osmel_Delgado_PharmD_BCPS: I can appreciate your son's asthma background and what you have gone through to care for him as a parent. I, myself, had asthma at a young age and eventually was able to wean off my medications as I got involved with sports. Every one will react differently to certain levels of activity. My suggestion would be to start slowly and consult with your physician regarding the increased level of activity for your son.

Cmd357: I am taking Ventolin, Atrovent and Beclovent and my physician told me two years ago when I began taking these steroid medications that I would have to stay on them for the rest of my life. Am I literally chained to these medicines or can I wean myself off of them?

Osmel_Delgado_PharmD_BCPS: Everyone responds differently to medications. Chances are that your physician added a steroid to your regimen because of an increased worsening of your asthma. You won't necessarily have to be dependent on steroids forever, but you would need to wean off of them should you and your physician decide to do so.

RonB2423: I have unremitting coughing and spasms of coughing for asthma. I started using Serevent and Azmacort, but continued to worsen for 10 days. Then, I had an "attack" of violent coughing which led to me not being able to breathe. The doctor put me on prednisone. My chronic cough is diminished, but my throat spasms and gasping for breath have continued. I think it is the inhaler. The spasm is high in my throat and it closes off, making it very difficult to breathe. This is always preceded by coughing from deep in my chest. The pharmacist told me the propellant could be a problem. Can the inhalers be causing the problem?

Osmel_Delgado_PharmD_BCPS: There are many mechanisms to deliver medications for the treatment of asthma including metered dose inhalation by a propellant. There are other alternatives available such as dry powder inhalation and nebulizer solutions that may be more tolerable for you.

Runfan47: I am gearing up to start training for marathon #5 and I have questions about long-run pace. I run most of my long runs pretty slow - though I tend to speed up on the later part of the run. I try to keep to a conversational pace, but here is the problem - on days when my asthma is giving me trouble, even 10:30 miles leave me somewhat winded - definitely not conversational at 10:00 miles. So - since the breathing issue is asthma related and not fitness related - does it make sense to continue to run my long runs at my typical 9:30+/- pace, even if I am winded (not anaerobic, but not conversational) - or should I just roll with the limitations of the asthma - i.e. - if I am winded at 10:00 miles, slow it down to 10:30 or slower?

Osmel_Delgado_PharmD_BCPS: The limitations of asthma could be part of the problem as your fitness level does not seem to be the root cause. Taking your medications at the appropriate times may help to minimize feeling winded. Another recommendation could be to have your VO2 max levels measured to gauge your pace when running marathons.

RefSteph: I have a slight case of asthma. I use a nebulizer as needed a couple of times a year. Sometimes, when I cough at night due to having a cold, I take cough medicine, which helps but for only half the night or so. I am wonder if it would help to use a humidifier. I have heard it brings relief, but it also can produce mold. What is recommended?

Osmel_Delgado_PharmD_BCPS: A cold environment can cause bronchoconstriction, which may be precipitating the cough at night. A humidifier could help, but I'd first recommend a warmer environment to assist with the cough at night.

Cmd345: If my asthma medicine isn't working, is it possible that I don't really have asthma? Are there other diseases and illness that look like asthma?

Osmel_Delgado_PharmD_BCPS: There are assessments and parameters that your physician uses to diagnose asthma. If your medication regimen doesn't seem to be working for you, I would recommend consulting with your physician or obtaining a second opinion.

Jillybean: I have always thought of asthma as the kind of illness that is identified in childhood. I’m 34, and I was recently diagnosed with asthma. Is it possible to suddenly start suffering from asthma so late in life?

Osmel_Delgado_PharmD_BCPS: Asthma can unfortunately be diagnosed at a later stage in life due to many reasons, or could have gone undiagnosed for years. There are different stages of asthma, and while there are preventive mechanisms used to avoid an attack it cannot be prevented 100% of the time. Using your inhaler could be causing some itchiness due to the remnants of the propellant. I'd recommend rinsing your mouth after taking a puff of your inhaler.

Cmd357: I am not experiencing any relief from my asthma symptoms with my medications. Could I be taking my medications wrong?

Osmel_Delgado_PharmD_BCPS: I recommend checking your schedule of medications and ensure that you're spacing them apart properly. You want to ensure adequate coverage throughout the day.

Rozaline: What is asthma and how is it diagnosed beyond just a bad cold or allergies?

Osmel_Delgado_PharmD_BCPS: Asthma is a condition where your bronchial tubes swell and tighten. Your caregiver may use a series of tests to diagnose it including peak flow testing, bronchoprovocation, and pulmonary function tests.

Buster: I was diagnosed with asthma about 5 years ago and it was very bad for a while. I was put on the highest strength of the advair diskus and this helped tons. Since I moved, however, I have not been having any problems with my asthma. I have stopped taking the twice a day doses of the Advair and have been just fine but have my emergency inhaler just in case. I have been told that it is bad to stop the daily meds even if I am not having any symptoms, but it seems silly to take meds I don't seem to need. Is it bad to stop these meds to reduce the amount of chemicals in my body that I don't seem to need or could it be dangerous?

Osmel_Delgado_PharmD_BCPS: If you have been on steroids (Advair) for a while, I wouldn't recommend abruptly stopping your medication but instead would recommend working with your physician to potentially wean you off your dose.

Cleveland_Clinic_Host: We have approximately 12 minutes left in the chat. We received a large amount of questions and we will continue to answer as many as possible. We apologize if we did not get to your question. If you have additional questions after the chat, please use our contact link clevelandclinic.org/webcontact to submit your questions.

RFerran3120: My girlfriend has asthma and she says that applying vapor rub or Vicks inside her nose helps her breathe better. Is it dangerous?

Osmel_Delgado_PharmD_BCPS: Menthol based products act as counter-irritants. I recommend using the menthol-based products as indicated in the package labeling.

Ronb2423: What is crab asthma? Is this a real kind of asthma?

Osmel_Delgado_PharmD_BCPS: Crab asthma is a condition where the patient develops a hypersensitivity (allergy) to crab or crab products.

Janb123: I heard a rumor that coffee can help asthma. Is that true?

Osmel_Delgado_PharmD_BCPS: There are some anecdotes reported that it has helped, but nothing concrete within the medical literature of its use.

RefSteph: My husband and I want to have a baby, but I have asthma. We are afraid my symptoms will get much worse. How safe or unsafe is going through pregnancy and labor while having a moderate case of asthma?

Osmel_Delgado_PharmD_BCPS: There are some limitations with the medications used to treat asthma during a pregnancy. I would recommend consulting with your OB physician to identify the best option to manage through your pregnancy.

Rozaline: What are the long-term affects of asthma? Will you have these effects forever, even if your asthma has gone away?

Osmel_Delgado_PharmD_BCPS: If asthma goes uncontrolled for a long time, your airways may thicken causing more difficulty in breathing. The changes to the airways over a period of time would be permanent.

Cleveland_Clinic_Host: I am sorry to say that our time with Osmel Delgado, PharmD, BCPS is now over. Thank you again, Osmel, for taking the time to answer our questions today about Asthma. To make an appointment with any of the specialists in our Pulmonology Department at Cleveland Clinic Florida, please call 954.659.5450. You can also visit us online at vanity clevelandclinicflorida.org.

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