Allergy Attacks? Fight Back (cont.)

Moderator: Are those just less popular than albuterol?

Pien: Albuterol is very specific for airway muscle. Some other medications have more cardiac side effects. So sometimes it's trial and error to see which medication works best for a patient.

Member: What is the best way to prevent itchy ears and throat problems?

Pien: An oral antihistamine is a good medication to treat generalized itching.

Member: I thought the Maxair was only to be used in case of emergency. Could this be used if you feel an attack starting?

Pien: Rescue medications are bronchodilators. Maxair is a rescue bronchodilator medication just like albuterol. All bronchodilators can be used to prevent asthma symptoms from occurring, such as half an hour before known allergen exposure or exercise.

Member: Is a scratchy and hoarse throat a part of asthma and what can be done for it?

Pien: Scratchy sore throat can be a sign of nasal allergies as well as asthma. Chronic postnasal drip from allergies or sinusitis can lead to a pretty raw, sore throat. A chronic mucus production in the chest from asthma can irritate the throat. To prevent symptoms of sore throat related to allergies and asthma, those two diseases need to be controlled. If the sore throat is persistent, throat cultures can be done to determine that it's not an infection.

Member: We are buying a new house. My daughter has asthma and I have acute asthma. We are having a problem with deciding which is better for my daughter: carpet, laminate flooring, or wood flooring?

Pien: Carpeting is not a good idea for those with allergies or asthma. It tends to retain allergens and cause prolonged symptoms, especially if there is a pet in the home. Laminate flooring is fine, though some may have a problem with fumes depending on the installation process. Wood floors are great, but they are expensive.

Member: Would the weather in Florida cause any difference in types of problems?

Pien: There are different allergens present in Florida or the South than seen in the Midwest. The high humidity in Florida has been known to increase mite and mold growth. In addition, the growing season is extended in Florida so the pollen season is extended as well.

Member: Do you build up a resistance to the medications over a period of time?

Pien: There has not been any well-documented medical study showing resistance to antihistamines or steroid medications. People can have some subsensitivity to bronchodilators.

Member: I'm very allergic to pollen. In the spring my eyes water, itch, and get red with a burning sensation. I take Claritin twice a day, use Ventolin inhaler as needed, and also use eye drops and Flonase as needed. Is there anything else that can help me, other than being a hermit?

Pien: There are different antihistamines you can try that may be more effective. Singulair is an anti-asthma medication that is preventative and may be better than Ventolin. And you could consider allergy shots, too.

Member: Can hives and swelling of the lips or eyes be associated with asthma? Also, would Allegra or Zyrtec be sufficient to control the swelling? And is it safe if you have osteoporosis?

Pien: Hives and angioedema [swelling] are not always associated with asthma. Antihistamines are good preventative medications to control hives and swelling. Antihistamines do not cause osteoporosis.

Member: My husband has very bad asthma. He is using Advair but there are times he has to use albuterol as a backup. Is there another inhaler that is stronger?

Pien: There are three doses available for Advair. If your husband is using albuterol more than three to four times per week, he may need the highest dose of Advair available. Singulair is sometimes added to Advair therapy to get a decrease in symptoms.

Member: Which antihistamines are the best?

Pien: Whichever ones work! Zyrtec has been demonstrated to decrease histamine skin reactions the most. However, about 14% of patients taking Zyrtec experience drowsiness.

Member: I had asthma as a child. It disappeared at age 13, and then came back when I was 65. Is this common?

Pien: It is not unusual to have a recurrence of asthma. It is thought that the underlying hyperactivity of the airways persists throughout the lifetime.

Member: Once you are diagnosed with asthma can you expect to have it the rest of your life?

Pien: Asthma can go into remission for several years. Some do have increased symptoms after age 40.

Moderator: If you are going to suffer from asthma, is it going to hit early in life?

Pien: It can strike at any point. We have some individuals who present with adult-onset asthma. Sometimes asthma is not diagnosed for many years and is diagnosed as bronchitis.

Member: My husband has allergies and asthma. He claims that he cannot help with household chores because the dust would set off an asthma attack. I bought a vacuum cleaner with a HEPA filter that is supposed to prevent the dust from getting back into the air. Can he run it without putting himself in danger of an asthma attack? I need help around here!

Pien: I generally advise patients with asthma to avoid exposure to allergens that would set off symptoms. If your husband wants to help, he could consider wearing a mask and taking his medications preventively [beforehand].

Member: What role does stress play in asthma attacks? My husband's doctor has him on Paxil to control his stress.

Pien: Stress has been known to exacerbate asthma. Patients with asthma frequently get anxious with attacks and that causes exaggerated symptoms. Patients with asthma have also been known to be depressed due to the disease. Emotional health is important in controlling all illnesses.