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Monday, November 1, 2010

Fall hard on asthmatics

I've noticed that there have been a ton of asthmatics in the emergency room recently. I've also had many of my asthmatic friends, including myself, report an increased use of rescue medicine lately.

I've talked with some doctors, and they report similar findings. Dr. James Thompson is one such doctor, as he recently reported to me in an email:
"This has been a bad year for many allergy patients right from the start. I'm always busier in October when the weather transitions. This year may be accentuated by the high mold counts which preceded the cooler shifts. Guess it gives us more to do and talk about. The rewards are that I still have some patients doing well as they tap into their action plans and follow tips presented to them in prior months/years."
He mentions a neat point, that the rewards are that this also provides an opportunity to see asthma action plans in action. It's a time when we learn what we teach is working.

Plus it's a time when we learn that modern wisdom and modern medicine benefits asthmatics, such as while I do report many asthmatics in the emergency room, most of them were treated and sent home.

In the past two weeks we have only admitted one asthmatic, and he was a kid who was not on any asthma controller medicines. I bet that changes now, after he spent four days in the hospital. I hope anyway.

Yes, as I wrote about a few weeks ago, "Fall Allergies are upon us."

As I look back on my medical records, I can see many of my hospital visits were in the fall. In fact, three years in a row I ended up in the ER on Halloween night, which is probably because the mask I wore was pulled out of a box, and covered with dust. I wrote about this in more detal in my post, "10 tips to help asthmatics avoid the halloween fright."

Dr. Thompson wrote an excellent article this week about why the fall is such an active time for asthmatics, "Avoid the Seasonal 'Fall' in Asthma Control." He provided some theories why asthma might be worse this time of year:

  1. The temperature change from warm to cold
  2. Forced air heat being turned on for the first time may escalate dust and mold particles residing in and around ducts and vents.
  3. Cough cold and flu season ushers in a wave upper respiratory tract infections which commonly cause asthma attacks.
  4. Cats, dogs and other furred creatures spend more time in the home exposing allergic inhabitants to higher levels of dander.
  5. Winter clothing and bedding is brought up from the basement or hauled down from the attic contributing to more household dust exposure.
  6. Fireplace wood or gas burning further increases indoor air pollution.
  7. Leaf burning, especially in many suburban locales expose neighbors blocks and miles away, to tremendous irritant smoke particles.
  8. Poor compliance with controller medications (especially inhaled steroids) becomes more evident this time of the year when the above triggers set in. This explanation does not apply to those who rarely miss doses of their controller medication.
He provides some tips to help you prevent your asthma from acting up in the fall. Yet I think his best advice is simply to make sure that if you have asthma that you take your asthma controller medicines every day. This is the best way to prevent an asthma attack.

There's a lot of asthmatics coming to doctor's offices and coming to the ER. This should serve as a reminder to all asthmatics: be compliant with your asthma medicines, and take control of your asthma before your asthma controls you.

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