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.
Food intolerance is very common but is not food allergy since it does not
involve the immune system. Often this can present with abdominal discomfort
after eating the certain food. Lactose intolerance is a classic example and
occurs when dairy products are eaten and the individual does not have the proper
digestive enzyme for these diary products. Food allergy on the other hand
involves the immune system and the production of specific antibodies to
components of the food. These antibodies are usually of a specific type called
immunoglobulin E (IgE). The most common food allergens are the proteins in
cow's milk, soy, fish, shellfish, eggs, and peanuts.
Usually, the symptoms of food allergy relate to problems with the skin. Hives,
which are raised, red, warm and itchy lesions, can develop suddenly. Atopic dermatitis
(eczema) is more chronic and appears as raised, itchy, scaly lesions.
Gastrointestinal symptoms can also occur. Severe reactions can occur rarely and
result in failure of the respiratory system and/or cardiovascular collapse.
This is referred to as anaphylaxis. Asthma, too, can occur following exposure to
a food substance to which an individual is allergic. The optimal management of
these food allergies is avoidance of the offending food if possible. When one
discovers or suspects that a food allergy may be present, an evaluation and
testing by a professional with expertise in allergies (allergist, immunologist)
is recommended. These professionals will often perform a variety of skin tests
and blood tests looking for evidence of IgE antibodies to the suspected
offending substance. A food diary involving a detailed record of all substances
consumed can be helpful in discovering the offending food. Once discovered,
complete avoidance of these foods is recommended.
Unusual symptoms of asthma include cough, rapid
breathing, fatigue, sighing, difficulty sleeping, anxiety, and difficulty
concentrating. These symptoms can mimic other illnesses.
Asthma can be mimicked by other conditions, such as
heart failure, bronchitis, emphysema, bronchiectasis, bronchial obstruction,
vocal-cord dysfunction, and hypersensitivity reactions.
Exercise is a common trigger for asthma and may cause
symptoms in 80%-90% of asthmatics.
Exercise-induced asthma is managed by choosing an
appropriate sport, controlling the asthma prior to events, warming up,
avoiding cold, stopping exercise during an asthma attack, cooling down after
exercise, and preventing episodes with the use of inhalers and
bronchodilators.
Some conditions can cause asthma to worsen, including GERD, allergic rhinitis, sinusitis, food allergies, and air pollution.
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.
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