Asthma is a very common lung problem that causes shortness of breath, wheezing and coughing. In general, symptoms are intermittent but when severe, they can be continuous. For some people, environmental triggers such as cigarette smoke, pets, dust or pollens can cause symptoms to flair. Exercise and cold temperatures may also cause increased symptoms.
Asthma is disease of the bronchial tubes or airways. Inflammation and constriction of the airways result in symptoms. Patients complain of wheezing, chest tightness, shortness of breath and difficulty breathing out. For some, cough and sputum can be an important symptom. If you are unable to speak a whole sentence because of your symptoms, this is an emergency and you should be seen by a doctor immediately. Waiting too long to see your doctor can result in life threatening asthma.
Asthma is diagnosed by taking a history, doing breathing tests (spirometry) and sometimes a chest X-ray. There are many effective therapies for asthma. Inhaled medications are usually tried first. Pills are also used. Most patients do not require long-term steroid pills to control their symptoms. There are two types of medications used to treat asthma:
1) Disease controllers: These medications are used on a regular basis and do not work immediately.
2) Rescue inhalers/nebulizers: These medications work quickly to relieve symptoms and open the airways. If you are using your rescue inhalers more than a few times a week, your asthma is not under good control.
Refractory asthma is difficult to control despite several medications. Patients may require treatment with an injected medication that is administered in the office. We expect several new therapies to be approved in the near future that will be effective in difficult to control asthma.
Bronchial Thermoplasty is a special procedure that has been shown to help reduce exacerbations and improve asthma control in patients with difficult to control asthma. Patients undergo a thorough evaluation and medication optimization. Next, patients undergo a series of three special procedures whereby low level heating of the airways takes place through a bronchoscope. This results in decreased airway smooth muscle mass. Patients are carefully selected based on their symptoms, pulmonary function tests and need for multiple therapies. Many patients are able to reduce their doses of medications required for asthma control. There are risks associated with bronchial thermoplasty. The most important is temporary asthma exacerbation.
The lung doctors at Arizona Pulmonary Specialists are experts in the diagnosis and management of asthma. We will work to ensure you have the correct diagnosis and create a treatment plan to keep your asthma in excellent control. Our respiratory therapists and nurses are available to ensure that you are using your medications correctly and answer questions.