Asthma Care Starts with Getting to Know Our Patients
Our asthma care patients usually come to us because they are experiencing symptoms like coughing, shortness of breath, or wheezing. Before we jump into testing, we start by listening to our patients first. This approach allows us to build a better relationship with our patients, because we can get to know their personalities, sensitivities, and needs. Once we understand the person and the troubles they are having, we can then cater our testing and treatment recommendations to them. This results in better experiences and outcomes for our patients.
The first step in our asthma testing is to identify triggers such as allergies, sinus trouble, or gastroesophageal reflux (GERD). Then we proceed with the appropriate testing for the suspected triggers. This may include allergy testing, CT scan and rhinoscopy if there are sinus issues, and sometimes we check for mold in the lungs as well. Other triggers like GERD, cold air, perfumes, and cigarettes can be identified by looking at history and with additional tests.
We use breathing tests like a spirometry pulmonary function test to determine the openness of the airway. We also have a highly specialized nitric oxide test which indicates inflammation of the airway; this can be a very helpful tool when diagnosing mild asthma.
Mild asthma is often overlooked. It can be very difficult to diagnose, especially in cases of chronic cough, which can be "off and on." We are the only outpatient practice in Washington, DC that offers methacholine challenge testing on an outpatient basis. It is essentially a lung stress test. Following a normal breathing test, methacholine is inhaled, and if the patient is bothered by it (numbers in the normal breathing test worsen), we can conclusively diagnose mild asthma.
If an asthmatic is healthy and is relatively symptom-free, regular breathing / lung function tests are recommended (usually annual) to monitor the condition, and no other treatment may be necessary. In symptomatic cases, treating asthma is very similar to treating allergies. The therapies include avoiding triggers, using proper medication, desensitization in the case of allergic asthma, and biologicals, which are injections used to reduce inflammation.
For an asthmatic, avoidance means staying away from triggers like cold air and cigarette smoke.
Emergency inhalers, like bronchodilators, may be used as needed or before exercise. An anti-inflammatory medicine like the pill montelukast or a steroid inhaler may be used for more chronic asthma. If those don't work well individually, we may combine treatments to use an airway opener and an anti-inflammatory at the same time.
Our goal is to minimize the amount of medication that needs to be taken. Addressing the triggers completely - for example, identifying and treating the allergies that trigger asthma - will yield the best outcome for asthma patients.
NOTE: About 80% of asthma sufferers also have allergies.
Should I Schedule an Appointment with an Asthma Specialist?
If you experience any of the following symptoms because of any of the following triggers, you should definitely schedule an appointment with an asthma specialist:
- Shortness of breath
- Wheezing / whistle when you breathe
- Cold air
- Cigarette smoke
- Upper respiratory infection
- Household fumes / cleaning products
If you've had a non-productive, dry cough off and on over the years, but haven't been able to identify the cause, you may have mild asthma. You should schedule an appointment with an asthma specialist / allergist.
NOTE: Anyone with asthma should be seen by an allergist at least once, even young children. Statistics show that asthma patients who have been treated by an allergist experience better outcomes.
Fishman Allergy / Asthma / ENT provides asthma care, testing, and treatment for all ages: infants, children, teenagers, adults (including pregnant women), and seniors.
Our Asthma Specialists Serve Washington DC, Northern Virginia, Maryland, and Beyond!
Fishman Allergy / Asthma / ENT has treated patients from Washington DC, Northern Virginia, Maryland, and beyond since 1989. Our motto is "Concern, Care, and Comfort". We love our patients, and our specialists treat them with geniune care and concern. In addition to treating patients who find us directly, our outpatient practice is also a referral center.
Allergy, asthma, and ENT / ear nose throat issues often overlap with each other, and we are able to diagnosis and treat for all three in a single location. We have state-of-the-art technology, some of which is only available in a referral center like ours. We have our own sinus CT scan and rhinoscopy equipment, which results in same-day diagnosis and treatment. We can provide advanced therapy medications in office like anti-inflammatories for asthma and desensitization / immunotherapy.