Asthma: Preparing for the "Big Fall"

So far, 2013 has been a difficult year for those who suffer from sneezing and wheezing. The pollen, mold, poor air quality, and up and down weather patterns have stoked the flames of respiratory inflammation for millions of adults and children across America. Almost every day in my office someone asks, “Is there something about this year that’s making me sicker?”

Currently many regions in the U.S. are experiencing very warm and humid weather. Mold spores thrive in such weather conditions.  Visits to hospitals have been reported to increase in direct proportion to certain mold counts, such as Alternaria.

Air-conditioning keeps humidity levels lower than the surrounding outdoor environment but not low enough to keep dust mites, located in pillows, mattresses, carpets and sofas from thriving. Yes, these tiny creatures that live to eat, poop and multiply escalate in numbers during the warm summer months, despite air conditioning. When it gets cooler (late fall) they bore down deeper into the carpet and cushions where it’s warmer. Their waste particles and dead body parts steadily rise to the surface over winter greatly contributing to indoor allergy triggers.

We usually consider late fall and winter as cough, cold, and flu season. But this year viral upper respiratory infections seemed, at least to me, more of a problem for many patients. Summer colds are often driven by a different family of viral particles. I reported on this earlier in the year.

For many children across the nation school is back in session, which annually signals the eve of cough and cold season. We are only weeks away from “Horrible October” the month which typically stands out, in the Midwest, as the peak period for asthma flare-ups. October most represents the “Big Fall” where we see a fall in: temperatures, leaves, peak flow rates, school and work attendance, and ACT scores.
 
 Are you prepared for the Big Fall? If not, here are 10 Tips to consider:

1. Follow-up with your asthma care provider to see if you have good lung function presently. This means you will likely have a pulmonary function test or peak flow rate as well as physical examination.
2. Update your written asthma action plan (AAP). It should be reviewed and revised, if necessary, on an annual basis.
3. If you are an older child or adult, ask your asthma provider whether a peak flow meter would be useful to have at home. I am able to better assist patients, especially the parents of patients, and college students when they are able to provide peak flow rates at the time of asthma flare ups.
4. Ask your doctor about steps you should take if you have increased nasal drainage, congestion or common cold symptoms. In essence, your action plan should also address your upper airway, which so often influences your lower airway (your lungs).
5. Find out when flu vaccine is available. September and October are usually the months to get vaccinated.
6. While in with your doctor or nurse ask to have your inhaler technique critiqued. Flaws can easily creep into your daily inhaler routine. It’s important to identify them early and make the appropriate adjustments.
7. Don’t forget to review your nasal spray technique if you have a prescribed nasal spray. So many patients aim them down their throat instead of up the nose. My favorite phrase is “look at your toes and squirt up the nose”.
8. Review your indoor trigger factors (for example indoor mold, dust mite or pet dander) and determine whether more should be done to reduce exposure to them.
9. Have your furnace and furnace filters checked in preparation for the eminent cold weather. Air filters should be replaced once a month while in use, unless they have different specifications for frequency of replacement.

10) If you have a home nebulizer unit, check the tubes and mask to see if they need replacement. Also check the expiration dates on the nebulizer medication. They may need to be refilled. You don’t want to be worried about these matters at the time of an asthma flare-up.

James Thompson, MD - Healthcentral