- Asthma in adults – what to ask the doctor
- How Is Asthma Diagnosed?
- Health History
- Testing for Asthma
- Breathing Problems During Exercise
- Diagnosing Asthma in Children
- Discussing an Asthma Treatment Plan
- Asthma Diagnosis
- Asthma: Testing & Diagnosis: Test Details
Asthma in adults – what to ask the doctor
Am I taking my asthma medicines the right way?
- What medicines should I be taking every day (called controller drugs)? What should I do if I miss a day or a dose?
- How should I adjust my medicines if I feel better or worse?
- Which medicines should I take when I am short of breath (called rescue or quick-relief drugs)? Is it OK to use these rescue drugs every day?
- What are the side effects of my medicines? For what side effects should I call the doctor?
- Am I using my inhaler the right way? Should I be using a spacer? How will I know when my inhalers are getting empty?
- When should I use my nebulizer instead of my inhaler?
What are some signs that my asthma is getting worse and that I need to call the doctor? What should I do when I feel short of breath?
What shots or vaccinations do I need?
What will make my asthma worse?
- How can I prevent things that can make my asthma worse?
- How can I prevent getting a lung infection?
- How can I get help quitting smoking?
- How do I find out when smog or pollution is worse?
What sort of changes should I make around my home?
- Can I have a pet? In the house or outside? How about in the bedroom?
- Is it OK for me to clean and vacuum in the house?
- Is it OK to have carpets in the house?
- What type of furniture is best to have?
- How do I get rid of dust and mold in the house? Do I need to cover my bed or pillows?
- How do I know if I have cockroaches in my home? How do I get rid of them?
- Can I have a fire in my fireplace or wood-burning stove?
What sort of changes do I need to make at work?
What exercises are better for me to do?
- Are there times when I should avoid being outside and exercising?
- Are there things that I can do before I start exercising?
- Would I benefit from pulmonary rehabilitation?
Do I need tests or treatments for allergies? What should I do when I know I am going to be around something that triggers my asthma?
What type of planning do I need to do before I travel?
- What medicines should I bring?
- Whom should I call if my asthma gets worse?
- Should I have extra medicines in case something happens?
Mayapada Hospital Immunology & Pulmonology and Internal Medicine Center specializes in allergy, immunology, pulmonology and internal medicine treatments.
Patients with allergies and respiratory diseases will experience a full range of clinical services, including pulmonary, critical care, allergy, asthma and immunology. At the core of the Center’s expertise isit’s the extensive clinical knowledge of our team which has been gained through active research into asthma and chronic obstructive pulmonary disease, lung injury, evaluation and through the treatment of obstructive airway disease, lung cancer and critical care. Other areas in which the Center excels include evaluation and treatment for sleep disorders, treatment of occupational pulmonary disease such as mesothelioma and asbestosis and the active investigation of genetic susceptibility in respiratory diseases.
Mayapada Hospital Immunology & Pulmonology and Internal Medicine Center evaluates and treats a full range of allergic conditions including :
- Asthma and allergic rhinitis
- Allergies testing
- Urticaria (hives)
- Chronic cough
- Lat ex allergy
- Allergy to stinging insects
- Adverse drug reaction
- Immunotherapy (allergy vaccines)
- Primary immunodeficiency evaluation and treatment
- Patient instruction in correct inhalation technique for asthma inhalers
- Adult immunization
Thoracentesis Facilities in Immunology & Pulmonology and Internal Medicine :
- 5 private consultation rooms
- Treatment & assessment room
- Bronchoscopy room (2 recovery beds and 1 operating bed)
- ECG or electrocardiography
- Allergy and immunology education room
- Specimen collection room
- Pneumatic Tube
- Prick Test
- Patch Test
How Is Asthma Diagnosed?
If you or your child experience symptoms such as wheezing, frequent cough, shortness of breath or chest tightness, it is important to see a healthcare provider to determine if the symptoms point to asthma.
To diagnose asthma, a doctor will evaluate these symptoms, ask for complete health history, conduct a physical exam and look at test results.
Today, asthma is no longer thought of as a single disease. Asthma is often categorized into different types based on the triggers identified by the doctor and the patient that cause breathing problems and make asthma symptoms worse. They include:
- Allergic asthma
- Aspirin-induced asthma
- Cough-variant asthma
- Exercise-induced asthma
- Nighttime asthma
- Steroid-resistant asthma
- Occupational asthma
Some people have asthma that is very difficult to treat that does not respond well to inhaled corticosteroids.
Depending on the type of asthma, there are different management steps and treatment options that can help.
Researchers have started to look deeper at the role that inflammation plays in asthma. They believe that all people with asthma have some degree of inflammation of the airways. They have categorized these into four biological pathways of inflammation, or endotypes:
- Mixed eosinophilic and neutrophilic
- Non-inflammatory (Paucigranulocytic)
You will be asked for some medical history, which should include family members with asthma, allergies, smoking and exposure to secondhand smoke, and exposure to pollutants in your workplace.
Testing for Asthma
There are also several breathing tests your healthcare provider may perform. The most common lung function test is called spirometry. This lung function test uses a device called, a spirometer, to measure the amount and speed of the air you blow out. This helps your healthcare provider see how well your lungs are working.
Other tests could include allergy testing (blood or skin), a blood test to check for cells responsible for inflammation, exhaled nitric oxide or FeNo test, and challenge tests, such as methacholine. Other lung diseases may cause some of the same symptoms as asthma. If your doctor thinks you might have something else, he or she may order additional tests.
Breathing Problems During Exercise
If you have chest tightness, cough, wheeze or shortness of breath during exercise, your doctor may perform extra tests to see if you have a type of asthma called, exercise-induced asthma or exercise-induced bronchospasm. For some people, they will only have asthma symptoms during exercise. There are many benefits to exercise, so work with your doctor to find the best management steps and treatment options for you.
Diagnosing Asthma in Children
A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:
- a parent has asthma
- the child has signs of allergies, including the allergic skin condition eczema
- the child wheezes even when he or she doesn’t have a cold or other infection
To help your child’s healthcare provider make a correct diagnosis, be prepared to provide information about family history of asthma or allergies, the child’s overall behavior, breathing patterns and responses to foods or possible allergy triggers. Lung function tests are often used to make an asthma diagnosis, but they are very hard to do with young children. The doctor may use a 4- to 6-week trial of asthma medicines to see if they make a difference in your child’s symptoms. Get more information for parents of children with asthma.
Discussing an Asthma Treatment Plan
If you are diagnosed with asthma, you and your doctor will discuss a treatment plan just for you, including the use of medicines. Make sure you know how and when to use these medications—ask your doctor, asthma educator or pharmacist.
To diagnose asthma, your doctor will discuss your medical history with you and perform a physical exam. You may need a lung function test and maybe other tests, such as a chest or sinus X-ray. If you or your child are having problems breathing on a regular basis, don’t wait! Visit a doctor immediately. Knowing what to expect during the diagnostic process may help.
What Are Common Ways to Diagnose Asthma?
Personal and medical history. Your doctor will ask you questions to understand your symptoms and their causes. Bring notes to help jog your memory. Be ready to answer questions about your family history, the medicines you take and your lifestyle. This includes any current physical problems. Shortness of breath, wheezing, coughing and tightness in your chest may show asthma. This also includes all previous medical conditions. A history of allergies or eczema increases your chance of asthma. A family history of asthma, allergies or eczema increases your chance of having asthma, too. Tell your doctor about any home or work exposure to environmental factors that can worsen asthma. For example, these might include pet dander, pollen, dust mites and tobacco smoke. The doctor may also ask if you get chest symptoms when you get a head cold.
Physical exam. If your doctor thinks you have asthma, they will do a physical exam. They will look at your ears, eyes, nose, throat, skin, chest and lungs. This exam may include a lung function test to detect how well you exhale air from your lungs. You may also need an X-ray of your lungs or sinuses. A physical exam then allows your doctor to review your health.
Lung function tests. To confirm asthma, your doctor may have you take one or more breathing tests known as lung function tests. These tests measure your breathing. Lung function tests are often done before and after inhaling a medicine known as a bronchodilator (brahn-ko-DIE-ah-lay-tor), which opens your airways. If your lung function improves a lot with use of a bronchodilator, you probably have asthma. Your doctor may also prescribe a trial with asthma medicine to see if it helps. Common lung function tests used to diagnose asthma include:
- Peak airflow
- FeNO tests (exhaled nitric oxide)
- Provocation tests
Will They Test for Other Conditions?
If your doctor thinks you have something other than asthma or besides asthma, they may run other tests. These might include a chest X-ray, acid reflux test, sinus X-rays or other specialized tests. Your doctor may also perform allergy tests. Allergy tests aren’t used to determine if you have asthma. But, if you have allergies, they may be causing your asthma.
What Are the Different Types of Asthma?
There are four levels of asthma, based on how severe it is. How often you have symptoms and your lung function determines how bad your asthma is. Your doctor will ask you questions about how often you have symptoms and wake up at night from coughing or trouble breathing. They might also ask how often you have trouble doing normal activities or use a rescue inhaler.
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Intermittent Asthma — You have symptoms less than twice a week and wake up less than two nights a month.
Mild Persistent Asthma — You have symptoms two or more days a week and wake up three to four nights a month.
Moderate Persistent Asthma — You have symptoms at least every day and wake up one or more nights a week.
Severe Persistent Asthma — You have symptoms during the day and wake up every night due to asthma.
How Is Asthma Diagnosed in Children?
Diagnosing asthma in children under 5 is a little different. Children this age usually are not given a breathing test. Instead, the doctor asks about certain signs and symptoms and prescribes a bronchodilator if they think it might be asthma. If the bronchodilator helps reduce your child’s symptoms, that is a sign that your child may have asthma.
Medical Review September 2015.
Asthma: Testing & Diagnosis: Test Details
What are pulmonary function tests?
Pulmonary function tests (or lung function tests) include numerous procedures to diagnose lung problems. The two most common lung function tests used to diagnose asthma are spirometry, exhaled nitric oxide and challenge tests.
Spirometry — This is a simple breathing test that measures how much and how fast you can blow air out of your lungs. It is often used to determine the amount of airway obstruction you have. Spirometry can be done before and after you inhale a short-acting medication called a bronchodilator, such as albuterol. The bronchodilator causes your airways to expand, allowing for air to pass through freely. This test might also be done at future doctor visits to monitor your progress and help your doctor determine if and how to adjust your treatment plan.
Exhaled nitric oxide – Nitric oxide is a gas that is produced in the lungs and has been found to be an indicator of inflammation. Because asthma is an inflammatory process, this test has become helpful in the diagnosis and management of asthma. The test is performed by having you breathe into a small, handheld machine for about 10 seconds at a steady pace. It then calculates the amount of nitric oxide in the air you breathe out.
Challenge tests — These tests might be performed if your symptoms and screening spirometry do not clearly or convincingly establish a diagnosis of asthma. There are 2 types of challenge tests: methacholine and mannitol. These agents when inhaled, can cause the airways to spasm and narrow if asthma is present. During these tests, you will inhale increasing amounts of either methacholine aerosol mist or mannitol dry powder inhaler before and after lung function tests. The test is positive when your lung function drops during the challenge. A bronchodilator is always administered at the end of the test to reverse the effects of these agents.
How do I prepare for pulmonary function tests?
Ask your doctor if there is anything you need to do to prepare for spirometry.
Before taking a challenge test, be sure to tell your doctor if you have recently had a viral infection, like a cold, or any shots or immunizations, since these might affect the test’s results.
Other general preparations to follow before the test include:
- No smoking on the day of the test
- No coffee, tea, cola, or chocolate on the day of test
- Avoid exercise and cold air exposure on the day of test
- Medicines taken to treat asthma can affect the test results. Different medicines must be stopped at different intervals. You will be told how long before testing to discontinue any medicines you are taking.
What is a chest X-ray?
An X-ray is an image of the body that is created by using low doses of radiation reflected on special film or a fluorescent screen. X-rays can be used to diagnose a wide range of conditions, from bronchitis to a broken bone. Your doctor might perform an X-ray exam on you in order to see the structures inside your chest, including the heart, lungs, and bones.
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