A board certified immunologist will take your history, examine you
and run some blood tests to see if your immune system is working
Treatment of immunodeficiency varies depending on the part of your
immune system that is affected. Your doctor will discuss treatment
options based on your immune system problem.
Signs that your asthma is getting worse include having symptoms at night, a drop in your peak flow and the need to use your rescue medicine more often. Talk to your doctor if you think that your asthma is getting worse.
Some asthma medicines are taken with a metered-dose inhaler. Your doctor will show you how to use an inhaler. Here are the basic steps:
- Remove the cap and hold the inhaler upright.
- Shake the canister.
- Tilt your head back and breathe out.
- Put the inhaler 1 to 2 inches away from your mouth. Or, if you’re using a spacer, put the end of it in your mouth and seal your lips around it. (A spacer is a tube that you attach to your inhaler. It makes using an inhaler easier.)
- Press down on the inhaler to release the medicine as you slowly breathe in for 3 to 5 seconds. (If you use inhaled dry powder capsules, close your mouth tightly around the mouthpiece of the inhaler and inhale rapidly.)
- Hold your breath for 10 seconds so the medicine can get into your lungs.
- Repeat as many times as your doctor suggests. Wait 1 minute between puffs.
Rescue medicines provide quick relief during an asthma attack by helping the muscles around your airways relax, which allows your airways to open.
Inhaled bronchodilators are rescue medicines (some brand names: Brethine, Proventil, Tornalate, etc.). They can be used on a regular basis or only when they are needed to quickly reduce symptoms.
Controller medicines help reduce the swelling in your airways to prevent asthma attacks.
Controller medicines include inhaled corticosteroids (some brand names: Azmacort, AeroBid, Flovent, etc.), cromolyn (one brand name: Intal) and nedocromil (brand name: Tilade).
Newer medicines, called anti-leukotrienes, are also used to prevent asthma attacks. These include montelukast (brand name: Singulair), zafirlukast (brand name: Accolate) and zileuton (brand name: Zyflo).
Controller medicines must be taken on a regular basis–whether or not you’re having symptoms. They take hours or days to start to help and don’t work well unless you take them regularly.
Asthma medicines can generally be divided into two groups: medicines to prevent attacks, (controller medicines), and medicines to treat attacks (sometimes called rescue medicines).
Your doctor will talk to you about these medicines and what to do if you have an asthma attack.
A peak flow meter is a hand-held device that measures your peak expiratory flow rate (PEFR), or how fast you can blow air out of your lungs. Measuring your peak flow regularly can help you tell whether your asthma is getting worse.
To use a peak flow meter, you will first need to find out your “personal best” peak flow. Take a deep breath and blow as hard as you can into the mouthpiece. Your personal best is the highest reading you get on the meter over a 2-week period when your asthma is under good control.
If pollen and mold cause your symptoms, use your air-conditioner and try to keep the windows of your home and car closed. Change the filter on your heating and cooling system frequently.
To keep mold down, clean and air out bathrooms, kitchens and basements often. Keep the level of humidity under 50%. You can do this with an air conditioner or a dehumidifier.
People who are allergic to dust are actually allergic to the droppings of dust mites. To reduce dust mites in your home, wash bedsheets weekly in hot water (above 130°F). Cover mattresses and pillows in airtight covers and remove carpets and drapes. If you must have carpet, you can treat it with chemicals to help reduce dust mites. Try to avoid stuffed animals, dried flowers and other things that catch dust.
Pets can cause problems if you’re allergic to them. If you have a pet, keep it out of your bedroom.
Don’t allow smoking in your house or car. Tobacco smoke can make your asthma worse.
Treatment of your symptoms involves avoiding things that cause asthma attacks, keeping track of your symptoms and taking medicine.
You have an allergy when your body overreacts to things that don’t cause problems for most people. These things are called allergens. Your body’s overreaction to the allergens is what causes symptoms (see the box below for a list of symptoms). For example, sometimes the term “hay fever” is used to describe your body’s allergic reaction to allergens in the air.
Your doctor may want to do an allergy skin test to help determine exactly what is causing your allergy. An allergy skin test puts tiny amounts of allergens onto your skin to see which ones you react to. Once you know which allergens you are allergic to, you and your doctor can decide the best treatment. Your doctor may also decide to do a blood test, such as the radioallergosorbent test (called RAST) or the ELISA test.
Pollens. Shower or bathe before bedtime to wash off pollen and other allergens in your hair and on your skin. Avoid going outside, especially on dry, windy days. Keep windows and doors shut, and use an air conditioner at home and in your car.
Mold. You can reduce the amount of mold in your home by removing house plants and by frequently cleaning shower curtains, bathroom windows, damp walls, areas with dry rot and indoor trash cans. Use a mix of water and chlorine bleach to kill mold. Open doors and windows and use fans to increase air movement and help prevent mold.
Don’t carpet bathrooms or other damp rooms and use mold-proof paint instead of wallpaper. Reducing the humidity in your home to 50% or less can also help. (A dehumidifier can help you do this.)
Pet dander. If your allergies are severe, you may need to give your pets away or at least keep them outside. Cat or dog dander often collects in house dust and takes 4 weeks or more to die down, so a short-term trial of removing your pet from your home may not help.
However, there are ways to reduce the amounts of pet dander in your home. Using allergen-resistant bedding, bathing your pet frequently, and using an air filter can help reduce pet dander. Ask your veterinarian for other ways to reduce pet dander in your home.
Dust and dust mites. To reduce dust mites in your home, remove drapes, feather pillows, upholstered furniture, non washable comforters and soft toys. Replace carpets with linoleum or wood. Polished floors are best. Mop the floor often with a damp mop and wipe surfaces with a damp cloth. Vacuum regularly with a machine that has a high-efficiency particulate air filter. Vacuum soft furniture and curtains as well as floors. Install an air cleaner with a high-efficiency particulate or electrostatic filter. Wash carpets and upholstery with special cleaners, such as benzyl benzoate or tannic acid spray. Wash all bedding in hot water (hotter than 130°F) every 7 to 10 days. Don’t use mattress pads. Cover mattress and pillows with plastic covers. Lower the humidity in your home.
Antihistamines help reduce the sneezing, runny nose and itchiness of allergies. They’re more useful if you use them before you’re exposed to allergens.
Some antihistamines can cause drowsiness and dry mouth. Others are less likely to cause these side effects, but some of these require a prescription. Ask your doctor which kind is best for you.
Decongestants, such as pseudoephedrine and phenylephrine help temporarily relieve the stuffy nose of allergies. Decongestants are found in many medicines and come as pills, nose sprays and nose drops. They are best used only for a short time. Nose sprays and drops shouldn’t be used for more than 3 days because you can become dependent on them. This causes you to feel even more stopped-up when you try to quit using them.
You can buy decongestants without a doctor’s prescription. However, decongestants can raise your blood pressure, so it’s a good idea to talk to your family doctor before using them, especially if you have high blood pressure.
Cromolyn sodium is a nasal spray that helps prevent the body’s reaction to allergens. Cromolyn sodium is more helpful if you use it before you’re exposed to allergens. This medicine may take 2 to 4 weeks to start working. It is available without a prescription.
Nasal steroid sprays reduce the reaction of the nasal tissues to inhaled allergens. This helps relieve the swelling in your nose so that you feel less stopped-up. They come in nasal sprays that your doctor may prescribe. You won’t notice their benefits for up to 2 weeks after starting them.
Your doctor may prescribe steroid pills for a short time or give you a steroid shot if your symptoms are severe or if other medicines aren’t working for you.
Eye drops. If your other medicines are not helping enough with your itchy, watery eyes, your doctor may prescribe eye drops for you.
Allergy shots (also called immunotherapy) contain small amounts of allergens. They’re given on a regular schedule so that your body gets used to the allergens and no longer overreacts to them.
Allergy shots are only used when the allergens you’re sensitive to can be identified and when you can’t avoid them. It takes a few months to years to finish treatment.
Asthma is a disease of the lungs. The airways of people with asthma are extra sensitive to the things they’re allergic to (called allergens) and to other irritating things in the air (called irritants).
Asthma symptoms start when allergens or other irritants cause the lining of the airways to swell (become inflamed) and narrow. The muscles around the airways can then spasm, (contract rapidly), causing the airways to narrow even more. When the lining of the airways is inflamed, it produces more mucus. The mucus clogs the airways and further blocks the flow of air. This is called an “asthma attack.”