Asthma

By German Iosif, MD
Board Certified Pulmonologist

What is asthma?
Asthma is characterized by the chronic inflammation of the airways within the lungs. Most cases of asthma, especially in younger individuals, have an allergic basis. The allergic trigger or triggers are usually found in the outdoors, home environment or frequently both. Non-allergic triggers such as viral colds, fumes, smoke and other irritants as well as environmental conditions of extreme cold or humidity can also frequently precipitate asthma symptoms.

How is asthma diagnosed?
People who suffer from undiagnosed asthma usually exhibit a number of symptoms. These can include coughing, wheezing, tightness in the chest, and bouts of bronchitis. Patients usually complain that these symptoms are severe enough to impact their daily activities. Physicians who suspect that a patient may have asthma can establish the diagnosis with readily available testing devices.

What are the triggers for asthma?
Once a patient is diagnosed with asthma, the physician will generally assess the triggers that seem to stimulate an asthma flare. In many cases, patients will be treated with a controller inhaler that is used daily to decrease the likelihood of on-going illness and avoid the long term effects of the disease. A variety of inhaled medications are also available for relief of acute symptoms.

How is asthma treated?
Treating asthma involves multiple methods. Proper diagnosis is the first step. The second step is for the patient to eliminate as many triggers from their environment as possible. For example, allergy testing may reveal that a patient is sensitive to a specific element. Eliminating or reducing exposure to these in daily life is often a key for good health.

A pulmonologist or other physician may then prescribe maintenance or controller medications that are generally inhaled, and perhaps inhalers to treat more acute episodes. Patients are also encouraged to monitor their own lung function through the use of a peak flow meter. Recording these results provides a roadmap for each individual, and can help alert patients as to potential problems before they get out of control. Treatment of asthma should be a true partnership between patient and physician.

If you are experiencing symptoms of asthma, talk with your doctor. With proper diagnosis and treatment, people with asthma can enjoy full and productive lives.

German Iosif, MD
Board Certified Pulmonologist

What is COPD?
COPD is characterized by the obstruction of airflow in and out of the lungs.

COPD includes two major breathing disorders: chronic bronchitis and emphysema. Many people with COPD suffer from both chronic bronchitis and emphysema and both frequently share the same symptoms.

What are the differences between chronic bronchitis and emphysema?
Chronic Bronchitis is an inflammation of the airways in the lungs that leads to the overproduction of mucus with plugging and obstruction of these airways resulting in symptoms of cough, phlegm production and wheezing.

Emphysema is characterized by the destruction of healthy lung tissue resulting in the formation of blebs and air pockets within the lungs. These in turn cause compression of the airways with impaired flow of air during breathing and steady over-inflation of the lungs and chest with trapped air. Shortness of breath is the main manifestation of emphysema.

What causes COPD?
Current and former cigarette smoking accounts for more the 90% of COPD patients; occupational exposure to dust, and possibly outdoor air pollution are less frequently identified.

What are the symptoms of COPD?
As many as 50% of COPD cases remain undiagnosed, and many people do not even realize that they have modified their daily lives to accommodate their decreasing lung capacity.

A persistent morning cough mistaken for a normal occurrence in a smoker, frequent bouts of so-called bronchitis that clear slowly after a cold, and increasing breathlessness during ordinary activities blamed on being part of the normal aging process can be early manifestations of the disease.

If you are experiencing these symptoms, talk to your physician. The diagnosis can be easily established through simple lung function testing available at many doctors’ offices and your local hospital. Early detection of COPD and prompt, aggressive treatment can greatly improve long-term prognosis.

A consultation with a pulmonologist may be recommended for a complete diagnosis and a treatment plan.

By German Iosif, MD
Board Certified Pulmonologist

What is obstructive sleep apnea?
Modern medicine has identified more than 80 different sleep disorders. The most serious among them is a syndrome called obstructive sleep apnea, or OSA. About 30 million Americans suffer from the disorder.

Productivity lost to sleep disorders costs our national economy millions of dollars each year. Sleepiness also causes more than 100,000 car accidents and 1500 highway fatalities in the
United States each year.

While they sleep, people suffering from OSA actually stop breathing for periods that can last 90 seconds and longer. People with severe OSA may stop breathing a hundred times or more during a single night. Each episode of the breathlessness ends with a person’s partial awakening. Although the person is unaware of these repeated partial awakenings, he or she is still deprived of the continuous, deep sleep the body needs to function normally. This leads, over time, to the development of chronic sleep deprivation.

What causes OSA?
Collapse of the throat causes the OSA sufferer to stop breathing during sleep. This throat closure occurs when the neck muscles that normally hold the throat open relax during sleep and allow the throat to narrow. When the throat narrows too much, airflow into the lungs stops and the sleeper has an apneic, or non-breathing episode. The episode ends only when the sleeper wakes, or partially wakes, to restore his or her own breathing.

What are the symptoms of OSA?
People suffering from severe OSA tend to feel extremely tired and sleepy during the day. This fatigue and sleepiness can lead to problems at work or school, and problems with relationships. It can also lead to car accidents and other potentially dangerous situations. Those suffering from severe OSA are also prone to having heart attacks or strokes during sleep. This is why doctors consider OSA the most serious of all sleep disorders.

OSA’s chief symptoms are daytime fatigue and sleepiness, and loud snoring. The snoring is often punctuated by periods of silence or by choking sounds. Obesity, high blood pressure, restless sleep, depression and impotence are other features that commonly occur with OSA.

How do doctors treat OSA?
Doctors have treated OSA with a wide variety of methods. For some people, a change in sleeping position can prevent sleep apnea. For others, weight loss can help as well as reducing the consumption of nicotine or alcohol, and avoiding sleeping pills and tranquilizers.

Continuous positive airflow pressure, or CPAP, has proved an effective treatment for many people. CPAP involves sleeping with a mask over one’s nose. The mask supplies the sleeper with a stream of pressurized air that keeps the nasal passages open and prevents sleep apnea.

Some patients can prevent sleep apnea by wearing certain dental appliances that hold the lower jaw forward during sleep, which helps to keep the throat open. Finally, there are various surgical procedures that have helped prevent sleep apnea.

If you’re exhibiting symptoms of obstructive sleep apnea, talk with your primary care doctor.