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Breathing Easier: Battling Seasonal Asthma

Posted 2/10/2016 by UHBlog

If you have a wheezing cough or shortness of breath, it could be asthma. We can help.

Breathing Easier: Battling Seasonal Asthma

Did you know that asthma can start at any age, even in people over age 65? Yet many seniors may not even know they have the disease, says pulmonary/critical care specialist Andre Fabien, MD.

“Everyone thinks of asthma as a young person’s disease. And in fact, it is estimated that 75 percent of asthmatics are diagnosed at age 7 and under,” he says. “But there’s an increasing recognition of asthma in seniors.”

According to Dr. Fabien, among patients 65 years and older, 4 to 8 percent have asthma, versus around 7 percent of the overall U.S. population. The number of seniors diagnosed with asthma is expected to grow, too, as the population ages and awareness builds.

In seniors, it can be tricky to diagnose and control asthma, he says. Often, it’s difficult to differentiate it from underlying chronic illnesses, such as chronic obstructive pulmonary disease (COPD) or heart failure. Other times, seniors underestimate their symptoms because they’ve adapted to it over time.

“Many people don’t realize coughing is a common symptom of asthma,” Dr. Fabien says. Other symptoms include:

  • Wheezing
  • Shortness of breath
  • Fatigue

When he diagnoses asthma in an older adult, Dr. Fabien says he believes it’s often long-standing, meaning you developed asthma symptoms as a child or in early adulthood that persisted later in life – whether you knew it or not.

“Everyone loses lung function as they age,” he says. “When people feel chronically breathless, that’s when they come to our attention. They may not have perceived it, but I believe they’ve always had some element of asthma throughout their adulthood.”

Cognitive or memory problems that affect older adults can make implementing a complex treatment plan difficult.

“Many of the senior patients I see also have a history of strokes and difficulties with using their inhaler medications correctly to provide maximal benefit,” he says.

Winter and early spring are particularly challenging for seniors with asthma.

“Factors that can trigger underlying asthma include irritants, such as smoking, and indoor or outdoor pollution – from dust mites to smoke from wood-burning stoves,” he says. “Other triggers include exercise and weather changes, especially cold weather.”

Exposure to frigid temperatures may constrict the smooth muscles of the airway, he says, or perhaps cause loss of water in the airways, leading to inflammation and narrowing. If you can’t avoid going outdoors in extreme cold, he suggests covering your nose and mouth with a scarf or mask to help contain heat and moisture when breathing.

No matter what your age, controlling your asthma involves:

  • Developing a Plan – “For everyone I see, I develop an asthma action plan, instructing the patient what to look for and do if their symptoms worsen,” he says.
    If you’re taking medications for another chronic condition, some asthma therapies may interact with these medicines or exacerbate underlying asthma symptoms. For example, eye drops used to treat glaucoma may cause airway constriction.
  • Monitoring – Tools such as peak flow expiratory meters can help track your lung function at home – whether you’re symptomatic or not – and help you decide when you need medical care. In-office breathing tests can tell your doctor whether your action plan is working.
  • Avoiding Triggers – Keeping a symptom diary can help track whether your asthma flares indoors or outdoors, or during a particular time of year. For instance, early spring allergies often stem from tree pollens, Dr. Fabien says, while grass pollens cause flare-ups in late spring.
    To treat these problems, “ask your doctor about anti-allergy medication,” he says. “Or if you're already on it, step up your dosage.”
  • Using Drug Therapies – Short-acting inhalers can assist with acute shortness of breath. Long-acting inhaler medications, including a steroid and long-acting albuterol, help to maintain control year-round.

Andre Fabien, MD is a pulmonary/critical care and internal medicine specialist at University Hospitals Cleveland Medical Center, University Hospitals Bedford Campus and University Hospitals Richmond Campus. You can request an appointment with Dr. Fabien or any other University Hospitals doctor online.

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