Month: May 2014

Asthma Symptoms and Goals for Treatment

Asthma is one of the most common chronic diseases afflicting both adults and children. Over 20 million Americans suffer from this condition and more than 6 million of them are children.

There are three main features of asthma.  Chronic inflammation of the airways in the lung causes swelling of the tissues around these airways and is the most important abnormality in asthma.  In addition to this chronic inflammation, the muscles around the walls of the airways will spasm which results in the narrowing of the lumen (inside of the airway or breathing tubes) which restricts the amount of air that flows in and out of the lungs during breathing.  As this is not bad enough, the third factor that occurs in patients with asthma is that there is excess mucous production.  This increase in mucous will cause a further blockage of the airways as it sits inside the lumens of the breathing tubes.  So not only does an asthmatic feel like he or she is breathing from a straw, but now the straw is partially clogged with mucous.  These three factors together, lead to the feeling of chest tightness/heaviness, cough, shortness of breath and/or wheezing (a high pitched whistling noise caused
by passage of air through narrowed tubes).

These bothersome symptoms impact the quality of life of an asthmatic.  Many experience lost work and/or school days.  Sudden flare-ups of asthma can be triggered by exposure to allergens (dust mites, molds, pollens, pets, etc.), strong scents (perfumes, colognes, cleaning fluids, etc.), upper respiratory infections, exercise, cold air, increased humidity, cigarette smoke, medications (certain blood pressure medications, etc.), as well as other factors.  Asthma can be life-threatening.  However, there are effective treatments available which can control the inflammation, preserve the lung function, and prevent the symptoms and exacerbations of asthma.

The goals of treatment of asthma are to use the least amount of medications that can achieve the above objectives, taking precautions to minimize the side effects.  This calls for identification of the specific triggers (which can vary from person to person) and their avoidance, choosing the correct medication (whether is be inhaled, taken by mouth, or injected such as allergy shots) at an appropriate dosage, and close monitoring of symptoms and lung capacity to enable either stepping-up or stepping-down the treatments at regular intervals.

The board certified allergists at Black & Kletz Allergy practice have received advanced training in the management of asthma and constantly keep themselves abreast of the latest developments in evidence based medicine.  They are committed to utilize their expertise and years of experience in treating asthma in children and adults to thoroughly educate their patients and offer individualized treatment plans following national guidelines and practice parameters.

Insect Sting Reactions

As we enter into warmer months, insect sting reactions are one of the major concerns in our greater Washington, DC metro area. Most people who are stung by insects experience swelling, redness, and pain at the site of the sting. These symptoms usually resolve within a few days. However, some of us are “allergic” to the insect venoms and the stings can lead to severe life-threatening reactions. In fact, about one-half a million people seek emergency room care every year in United States for insect sting reactions and about 50 deaths are reported every year from these reactions. If we are predisposed to develop allergic reactions, our immune systems make IgE antibodies to the venom after an initial sting. steam cloud . If we are stung by the same insect again, the antibodies interact with the venom and cause the release of certain chemicals into the bloodstream which causes the serious reactions.

Though many insects cause local reactions, almost all the severe generalized reactions commonly found in northern Virginia, Washington DC, Maryland, and the surrounding areas are caused only by four types of insects. These four types include Honey bees (live in colonies or “honeycombs” in hollow trees or cavities of buildings), Yellow Jackets (usually nest underground and rarely in woodpiles or cracks in masonry), Hornets (grey or brown football shaped nests above ground in the branches of trees or in shrubbery) and Wasps (nests are made up of paper-like material under eaves, behind shutters, or in shrubs).

In order to reduce your chance of being stung, it is advisable that you take a few precautions like avoidance of walking outdoors with exposed skin. It is also recommended to avoid wearing dark colored clothing and to also avoid wearing strong perfumes and deodorants. If one has a systemic reaction following an insect sting, he or she has a 60% chance of a similar or more severe reaction in the case of a subsequent sting by the same insect. Another important tidbit of information to know is that if a honey bee stings you, it will leave it’s stinger in your skin at the site of the sting. You should never pull out the stinger, instead, you should scrape off the stinger with your fingernail or credit card. Pulling out the stinger actually causes the bee’s venom sac to pump more venom into you which can make your reaction to its venom more severe. Luckily, there is a highly efficacious treatment option called Venom Immunotherapy, (also known as Venom shots or Venom injections), which has proved to be 97% effective in preventing life-threatening reactions in people who are sensitized to the insect venoms. Allergy shots for indoor and outdoor allergies are different, but also highly effective.

Over the past five decades, the board certified allergists at Black and Kletz Allergy practice have helped hundreds of patients sensitized to insect venoms in Virginia, Washington, DC, and Maryland to lead a normal life. Through education, training in self-injectable epinephrine, and most importantly, by desensitization, our patients have been able to live without the fear of a having a serious reaction from insect stings and are able to enjoy being outside in the warm months.