Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What do all of these individuals have in common? An
active 13-year-old becomes breathless shortly after her soccer games and coughs
on a cold winter's night. A young woman has a dry, hacking cough that has
persisted for a year after her last "cold." A teenager sleeps poorly and is
awakened early every morning with chest tightness and difficulty breathing. What these individuals
have in common is the possibility that they all may have asthma.
Scientists and physicians have noticed that the rates of asthma have
been increasing in recent decades. This has been especially true in
developed countries such as the United States. In fact, the American
Lung Association has reported that asthma prevalence has risen from
34 cases/1000 people in the general population in 1982 to 56
cases/1000 in 1994.
Research into the causes of this striking increase in asthma has led
to a number of possible explanations being proposed, but there has yet
to be unanimous agreement on the reasons.
A study reported in the American
Journal of Respiratory and Critical Care Medicine (1999; 159:125-29)
evaluated a group of patients at two points in time, 30 years apart.
The study performed by doctors in Scotland detected a significant
increase in symptoms of allergic asthma and levels of antibodies to
environmental allergic factors, such as dust mites, pets, and air
pollutants over the three decades. Importantly, the researchers
noted that there was an increase in the signs and symptoms of
allergy, even in people without a family history of allergy!
Patients suffering from episodes of asthma do not always have the
typical symptoms of asthma such as shortness of breath, chest tightness, and
wheezing (symptoms of airway narrowing). Instead, patients can have symptoms
that may not appear to be related to asthma. These "unusual" asthma symptoms
include
noises emanating from the chest usual during exhalation.
To complicate matters, symptoms of asthma are not consistent and often vary
from time to time in an individual. In some patients, symptoms are influenced by
diurnal factors; for example, some patients experience asthma primarily at night
(nocturnal asthma) rather than during the day. Furthermore, episodes of asthma
can be triggered by many different factors such as allergens, dust, smoke,
perfumes, cold
air, exercise, infections, medications, and acid reflux. Finally, other illness
such as heart failure, bronchitis, and dysfunction of the vocal cords can cause
symptoms that mimic those of asthma. For these reasons, accurately diagnosing
and treating asthma can be a challenge.
For a comprehensive review of symptoms, causes, and treatments of asthma, and
for a better understanding of the normal anatomy of the airways (trachea,
bronchi, bronchioles and the lung), please visit the asthma article.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Emphysema is a progressive disease of the lungs. The primary cause of emphysema is smoking. Alpha 1-antitrypsin deficiency is a rare disorder that has a genetic predisposition to emphysema. Aging, IV drug use, immune deficiencies, and connect tissue illnesses are also risk factors for emphysema. Emphysema is a subtype of COPD (chronic obstructive pulmonary disease, COLD). Symptoms include shortness of breath and wheezing. Management of symptoms may be achieved with medications, quitting smoking, pulmonary rehabilitation, or surgery.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
Corticosteroid drugs such as prednisone and prednisolone are commonly used to treat asthma, allergic reactions, RA, and IBD. Steroids such as these do have serious drawbacks such as steroid withdrawal symptoms such as: fatigue, weakness, decreased appetite, weight loss, nausea, vomiting, abdominal pain, and diarrhea. Speak with your healthcare provider prior to tapering off steroid medications.
Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.
Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing, complaints of chest "hurting," wheezing while breathing, shortness of breath, and feelings of tiredness. Treatment will involve a doctor creating an asthma action plan which will describe the use of asthma medications and when to seek emergency care for the child.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC drugs like Primatene Mist and Bronkaid.
Acid backing up into the larynx (voice box), it causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and throat can lead to esophagitis, sinusitis, strictures, hoarseness, throat clearing, swallowing problems, asthma, chronic cough, and more. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with OTC medication, prescription medication, and lifestyle changes.
Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
Exercise-induced asthma is asthma triggered by vigorous exercise. Symptoms include coughing, shortness of breath, chest tightness, wheezing, and fatigue while exercising. Preventing exercise-induced asthma attacks involves using inhaled medicines before exercising, performing warm-up exercises and cooling down afterward, avoiding exercising outdoors when pollen counts are high, restricting exercise when you have a viral infection, and wearing a mask over your nose and mouth when exercising in cold weather.
Secondhand smoke can cause illness and disease in nonsmokers. Some of these conditions include lung cancer, heart disease, respiratory illnesses such as asthma, SIDS, bronchitis, and pneumonia. Learn how you can protect yourself and your family from secondhand smoke exposure in the home environment and workplace.
What are biologic rhythms? In essence, they're the rhythms of life. All forms
of life on earth, including our bodies, respond rhythmically to the regular
cycles of the sun, moon, and seasons.
For example, as night turns into day, vital body
functions, including heart
rate and blood pressure, speed
up in anticipation of increased physical activity. These and other predictable
fluctuations in body function, taking place during specific time cycles, are our
biologic rhythms. They are regulated by "biologic clock" mechanisms located in
the brain.
Although biologic rhythms can be "reprogrammed" by environmental influences
(such as when a person regularly works the night shift and sleeps during the
day), they are genetically "hard-wired" into our cells, tissues, and organs.
Medical chronobiologists have found that biologic rhythms can affect the
severity of disease symptoms, diagnostic test results, and eve...