Asthma, Controlling Your (cont.)

ENRIGHT:
No. If a child or an adult has asthma which requires medication to control and if they are also sensitized or allergic to a pet that lives in the home, there are no measures which can be taken to effectively reduce their allergen exposure. Only finding another home for the pet will be effective.

MEMBER QUESTION:
How long would you have to go without flaring up before you can consider stepping down meds? I have been on Advair 250 for two years but I have months at a time that I do well and wonder if I could step back to Advair 100 and leave the 250 for more difficult times. Or is the 250 what's keeping me doing so well?

ENRIGHT:
Good question. After about three months of good asthma control (in the green zone) you should work with your physician to step down your therapy. This may involve eliminating the long-acting bronchodilator which is in Advair or reducing the daily dose of inhaled corticosteroids. Keep a daily diary of your asthma symptoms' peak flow or FEV1 to show your doctor as evidence of your asthma control. My advice is always to work with your physician to change your medications.

MEMBER QUESTION:
I noticed that in the past three weeks I am having asthma attacks more frequently. I do have seasonal allergies; I live in Texas and pollen has been high. I am using my inhaler twice a week now. I have made an appointment to see my doctor about this. Is the allergy problem contributing to these flare-ups?

ENRIGHT:
Almost certainly. Calling your doctor soon and ask her about an appointment this week or the value of starting asthma-controller medication.

"What's important to realize is that of the asthma-controller medications available, some patients do not respond to each type, and therefore if you're not responding you need to discuss with your doctor trying a different asthma-controller medication."

MEMBER QUESTION:
Are there any foods or beverages to be avoided for someone who has asthma? I am wondering if that may be some of the problem with my flare-ups as well as the weather.

ENRIGHT:
Fewer than 2% of adults with allergies are allergic to foods. Those foods are usually peanuts or foods that contain aspirin-type chemicals. Ask your doctor if she believes you are aspirin sensitive. Avoiding milk or dairy products is usually of no help for adults with asthma.

MEMBER QUESTION:
My doctor gave me Advair 100/50 to take and I noticed I'm having problems sleeping through the night. Is there something that would be better without a lot of side effects?

ENRIGHT:
Yes. Ask your doctor about giving you Flovent or Pulmicort, which does not have the long-acting bronchodilator in it -- which is usually the cause of side effects of Advair. The side effects can be insomnia, shakiness, muscle cramps, etc.

MODERATOR:
What do you see on the horizon for asthma treatment?

ENRIGHT:
There is no new class of asthma medications that will be introduced in the next three to five years that are substantially different from those already available. Xolair or anti IgE therapy for very poorly controlled asthma is the most important new asthma medication.

What's important to realize is that of the asthma-controller medications available, some patients do not respond to each type, and therefore if you're not responding you need to discuss with your doctor trying a different asthma-controller medication.

MODERATOR:
Dr. Enright, we are almost out of time. Before we wrap things up for today, do you have any final words for us?

ENRIGHT:

  • If you have asthma and smoke, stop.
  • If you smoke cigarettes and your child has asthma, stop smoking.
  • See WebMD for help.
  • Learn your asthma triggers and know the good and bad effects of your asthma medication.
  • Keep asking lots of questions.

MODERATOR:
Our thanks to Paul Enright, MD for joining us today. For more discussion on this topic, be sure to visit the WebMD message boards to ask questions of our online health professionals, such as Dr. Enright, and to share questions, comments, and support with other WebMD members.



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