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.
Over the years, physicians have noted an association between asthma and
sinusitis. In fact, 15% of patients with sinusitis also have asthma (as opposed
to 5% of the normal population). An astounding 75% of severely asthmatic
patients also have sinusitis. Additionally, asthmatic patients often report that
their symptoms worsen when they develop sinusitis. Conversely, when the
sinusitis is treated, the asthma improves.
The reasons behind the association of asthma and sinusitis are similar to
those suggested for the association between asthma and allergic rhinitis.
The infected mucus from the sinuses may drain into
the bronchial tubes, thereby causing bronchitis (sinobronchitis). The
inflammation caused by the mucus may worsen asthma.
The best evidence to date seems to support the idea of neural reflexes
in the linings of the nose, sinuses, and airways. Sinusitis may activate a
"sinobronchial reflex" and worsen asthma.
Greater insight into how these two conditions are related may allow better
control or even cure of these common conditions.
Air pollution
Poor air quality is known to worsen asthma symptoms and increase
exacerbations. Diesel emissions are associated with asthma and increased
symptoms. Living closer to freeways may result in more frequent exacerbations.
Patients with asthma are at increased risk for symptoms when smog, soot, or
ozone levels are significantly elevated. Children with smaller body size and
developing lungs are at increased risk for breathing problems. Indoor air
pollution may also be a contributing factor. In the third world, indoor fires
used for cooking are often associated with respiratory illness. In the
industrialized world, formaldehyde, tobacco smoke, dust mites, and other
particles can worsen asthma.
Air filters are suggested by some to help minimize their effects on asthmatic
patients. Research studies would suggest that maintaining adequate ventilation
and modifying the household (removing carpets and drapes, using hypoallergenic
mattress covers) may be enough. Some air-filtration systems may reduce some
secondhand tobacco smoke, but no system can remove all the harmful components
from this smoke. There are no standards for air filtration approved by the Food
and Drug Administration (FDA). It does rate some portable air-filtration systems
as Class II medical devices, indicating safety and medical benefit. If one of the
devices is being considered for personal use, it is important to check that the
device has this Class II approval. There are several different types of air
filters. Mechanical filters force air through a mesh trapping particles. HEPA
(high efficiency particulate air) are mechanical filters that capture at least
99.97% of all particles 0.3 microns or larger. Electronic filters use electrical
charges to attract and deposit allergens and irritants on collecting plates.
There are also hybrid systems that contain both mechanical and electronic
filters. All of these can produce some ozone but usually at acceptable levels.
Gas phase filters can remove odors and gasses such as cooking gas, fumes from
paints and building materials, and perfume. They do not remove any allergenic
particles. Ozone generators are ozone producers. This gives the "smell of clean
air." Unfortunately, the ozone levels produced are often higher than acceptable
levels. These devices are not recommended.
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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