Asthma Blog

There are only a few months to go before HFA inhalers are the only type of inhalers available for people with asthma. Starting in 2009, CFC inhalers will no longer be made.

But many people are complaining that the HFA inhalers don't work as well, asthma control is slipping, or they are allergic to some of the ingredients. Oh yes, the new inhalers also cost a lot more – so much so that some of us are having trouble affording them. There also are no over-the-counter HFA albuterol inhalers.

In the face of so many problems, why does the United States continue to move forward with this initiative anyway?

Get the answer to this question here

Discuss your experiences and concerns here

Get some tips on getting the most from your HFA inhaler here

There's been much in the news this past year or so about black box warnings for asthma medicines. One type of warning was applied to combination asthma medicines, such as Symbicort and Advair. These are inhalers used to treat people with asthma who haven't achieved asthma control with an inhaled steroid alone.

As such, they've been quite useful in asthma treatment. But once the black box warnings were issued, people who took these combo medicines started to worry that they might be too risky to keep taking. But it's important to note that the black box warnings were applied to the combination medicines only because one of the medicines they include is a long-acting bronchodilator (LABA) and LABAs have been implicated in a study as linked to an increased risk of asthma death. Combination medicines also include an inhaled steroid and steroids have been proved as quite safe to take.

Subsequent studies have been unable to document any serious risk of asthma death because of taking Advair. In fact, they suggested that the reason that people taking LABAs alone faced serious risk of death is because LABAs alone are not an effective treatment for controlling asthma. Now a new 52-week study also shows that Symbicort has a similar safety profile to its inhaled steroid, Pulmicort (generic name budesonide). This is good news for Symbicort users!

Should you be concerned if your medicine has a black box warning?

Asthma and allergy management in schools has been a hot topic for some time. You need to know your kids' health is protected when they're out of your sight, but with such varying (or nonexistent) policies, it's been hard to feel secure. Over the past year or so, though, many states have worked hard to pass laws that will protect your children with allergies and asthma when they're at school, including the "right to carry" laws.

Now, the Asthma and Allergy Foundation of America (AAFA for short) has just released a report that "identifies states with the most comprehensive and preferred state-wide public policies supporting people with asthma, food allergies and related allergic diseases in U.S. elementary, middle and high schools." They go on to state that the goal of creating this report is "to provide a blueprint for asthma and allergy advocates in all states to help recognize and develop better school-based policies and practices."

In fact, the AAFA created an "honor roll" of states that excel in asthma / allergy policies. To do this, they looked at 18 different policy standards in 3 categories:

• Medication & Treatment
• Awareness
• School Environment

Six states were named to the honor roll for 2008:

• Connecticut
• Massachusetts
• New Jersey
• Rhode Island
• Vermont
• Washington

If you're fortunate enough to live in one of these 6 states, then your children are well-protected. If not, it might be time to become more of an advocate for your child!

Exercise-induced asthma (EIA for short) is common in competitive athletes, even at the elite Olympic level. So, obviously, having it doesn't mean you can't participate in sports. In fact, as many as 20% of summer athletes suffer from allergic diseases like nasal allergies and asthma.

In addition, the prevalence of allergic disease is greater in athletes, while treatment is often lacking because of the anti-doping regulations that govern elite athletes. So, at the request of the National Olympic Committee, the Global Allergy and Asthma European Network has initiated a study of Olympic athletes. Scientists have designed the study to assess the affect that environmental pollution has on asthma symptoms and lung function, and also to help identify athletes who may develop asthma and allergy symptoms while in Beijing.

Regular exams throughout the Olympics will measure lung function and symptoms in more than 2,000 athletes. Skin prick tests will measure for allergies. It is hoped that the study will lead to a better understanding of allergic disease in top athletes, as well as better care. And that should lead to a better approach for everyday athletes and active kids as well!

Black box warnings about asthma medications such as Xolair and Advair seem to be in the news a lot lately. Should you be concerned about such black box warnings? Are the risks of taking these medications too high?

The answer is that there is no one answer that will be right for everyone in regards to these questions about black box warnings. It mostly comes down to weighing probable benefits against possible risks. But a black box warning doesn't automatically mean the medicine is going to be bad for you. Read more

The first thing many people think of after an asthma diagnosis is, will it go away? Or will my child outgrow asthma eventually? It's a valid question, but you may not like the answer...

Asthma is what is known as a chronic disease, which simply means that it usually doesn't go away once you have it. But the good news is that you or your child can still live a full and active life with asthma. Get the rest of the answer here

Welcome to the Asthma site at About.com. Maybe you're new here & this is your first visit... and maybe not. Maybe you're a regular reader of my blog or my Twitter feed, but you've never really explored the Asthma site as a whole. Did you even know there was a site? If not, don't worry -- you're not alone!

Throughout this site, I try to connect with you and help you understand all there is to know about asthma, though that is, of course, a challenging task, as there is SO much to know. Because I'm both a nurse and an asthma sufferer, I hope I have a unique perspective with which to help you.

So, I invite you to explore the Asthma site. There are many ways to do so:

• If you like moving sequentially, then look to the left if you're on the Home Page of the site, and you'll see the "Must Reads" links. These are probably the most important articles on the site. If you read all 5, you'll have a great handle on asthma and how to manage it effectively.
• Or, if you prefer, you can scroll a bit further down and look for the categories (topics) menu, where you can pick & choose your topics of interest.
• Another option is to use the Search box, which you'll find at the upper right corner of nearly every page on the site.
• One final path through the site is to use the tabs at the top. See them? They're labeled "Asthma" (that's the home page), "Symptoms / Diagnosis", "Treatment", and "Coping". Each tabl contains a number of different links to asthma information.

If you enjoy meeting other people with asthma, you can also become a part of a larger asthma community through the Asthma Forums. We're looking for new, active members. Try it out - discuss what asthma means to you. If you're interested in exchanging ideas on subjects that are important to you with others who are going through similar issues, I highly recommend the Asthma Forum.

You may not be aware that this site is just one of over 770 sites grouped under the umbrella of About.com, which, in turn, is under the umbrella of the New York Times Company. Plus, the Asthma site is one of the 70 sites of the About.com Health Channel. I think you'll find there are many sites that will be of interest, covering topics such as Patient Empowerment, Nutrition, Pediatrics, Alternative Medicine, and a whole lot more. The sites are all staffed by experts too -- Many of the Health Guides are medical professionals -- Some are M.D.'s, others like me are R.N.'s, and yet others are full time therapists, patient advocates, and authors.

Our Health Channel has been awarded an HonCode certification, which means that all the articles written for the sites have been appropriately researched and sourced, and every article is reviewed and approved by a medical professional. It's only on this blog that you'll see me expressing my own opinion, reporting on the news and research studies, asking for reader input, and posting polls and reader questions.

I want to urge readers interested in learning about asthma to go beyond this blog - and to explore the articles on this site on subjects ranging from general information about asthma to articles on asthma treatments, occupational asthma, and much more. Just as importantly, I urge readers to take a look at some of the other guides' sites, both on the Health Channel and beyond.

If you enjoy this particular site, and want updates on what's new - or a quick way to get particular information sent to your mailbox - you can subscribe to the free weekly Asthma Newsletter.

So, once again, welcome to an amazing wealth of resources at About.com. I hope you'll take advantage of some of the ideas and information available here. And please feel free to share your comments on any of the blog posts you see here. I'd be happy to hear from you.

OK, maybe that's not really news. As a nurse and a mom, that's pretty much in sync with my thinking anyway. :)

Of course, thinking that way may seem biased and not quite fair to men, right? But I have to tell you, I read this week of a study that found women doctors provided better asthma care to kids in Turkey than their male counterparts. Here were the reasons cited:

• Female doctors saw less patients, thereby giving them more time to spend with each patient.
• Female doctors were more patient-centered, listening better and attending more to the emotional & social aspects of health.
• Female docs were also more interested in getting patients' input and partnership.

It's important to note that all of the doctors studied, whether male or female, had similar educational/experience backgrounds and were of similar ages. The findings suggested that the female doctors identified chronic cough as an asthma symptom more often than men did, and also prescribed both short-acting bronchodilators and inhaled steroids more.

Researchers concluded that, "Female physicians demonstrated better asthma management than males, the reasons for which are not defined and can only be speculated." They went on to suggest further study to try to determine some of the underlying factors at work here. It's interesting to note that, although the women doctors were clearly not bringing in as many dollars because they were seeing significantly less patients, their patients were enjoying better outcomes, which would reduce overall healthcare expenditures. Hmm... I wonder which one had a more positive impact on the bottom line?

But I have to say that these findings came as no real surprise to me and echo my experiences both inside and outside of health care over the years. Just last year, when my mother was gravely ill, I experienced awful, superficial and uncaring "care" from a male physician and wonderfully thorough, caring, healing care from 3 female physicians. It was quite a contrast in approaches. I'm not silly enough to think there are no good male physicians, but I DO think that the female and male bedside manners are often quite different.

You can use the comments link below to tell us what you think about these findings and your experiences.

When you have asthma, getting the right treatment from a doctor who truly understands the ins and outs of managing asthma effectively is one of the most important factors in staying healthy. But it's also important that you feel comfortable with and trust your doctor. And that's hard to achieve sometimes in today's restrictive healthcare environment or when you feel the need to pick a doctor in an emergency, or at least highly urgent, situation.

Luckily, our Cold & Flu Guide, Kristina Duda, has written a great article on just how to do that! It's called How to Find a Doctor When You Are Sick, and I highly recommend it. If you're worried about being able to communicate effectively with your new doctor, check out my Tips for Talking with Your Doctor article.

Trisha Torrey, our Patient Empowerment Guide, has also written an article on Finding Dr. Right, about finding a doctor who is a good match for your needs and communication style.

It's important for you to recognize that you have both the right and the responsibility to become an active participant in your care. And that starts with picking a doctor who feels the same.

More on Working With Doctors:

• When to See an Asthma Specialist
• Types of Asthma Specialists

Understanding your asthma medicine is key to keeping asthma under control. But that's not as easy as it sounds, with several different classifications of asthma medicines available, along with medicines for related conditions such as nasal allergies and GERD. And that doesn't even take into account general medicine terminology, applicable to medicines for all diseases and conditions. Let's try to demystify the medical speak, shall we?

General Medicine Terminology

I've heard debate over the difference between the terms medicine, medication and drug. One thing is for sure: the 3 terms mean many different things to different people. The bottom line here is that they all basically mean the same thing, a man-made chemical you put into your body to treat a symptom or a disease (or to prevent it). None of them specifically mean prescription and / or illegal. They're just catchall terms.

Some Other General Terms

Here are some more terms used to describe medicine:

• Prescription, which means a drug that only a healthcare professional can authorize for you to take
• Over the counter, a medicine that you can buy off the shelf in a pharmacy without a doctor's prescription
• Generic, meaning a new version of an established brand name drug, that is identical in terms of the active ingredient, dosage, safety, strength & other factors

Asthma Medication Terminology

Then, as mentioned, there are terms that are specific to asthma medicines, such as:

• Quick-relief, or rescue, vs. preventive, or controller
• Long-acting bronchodilator (or beta agonist) vs. short-acting bronchodilator
• Metered dose inhaler vs. nebulizer vs. dry powder inhaler
• Inhaled steroid vs. oral steroid
• Leukotriene modifiers (or agonists) vs. Combination medicines vs. Immunomodulators
• Allergy shots vs. Allergy drops
• CFC vs. HFA inhalers
• Antihistamines

Black box warning is another term you might have heard. Black box warnings for asthma medications have gotten a lot of press over the past year or two, so it's important to understand what they mean. I know all these terms may seem a bit mind-boggling if you or your child have just been diagnosed with asthma, but if you take time to read the different articles linked to above, asthma treatment should begin to make more sense.

Learn More About Medicine:

• Asthma Med Profiles
• Reducing the Risk of Drug Interactions