Asthma is a chronic reversible inflammatory airway disease. It is one of the most common diseases of childhood that often occurs well into adulthood and often becomes intermittent throughout life. Symptoms of asthma are cough (especially at night), wheezing, chest tightness and difficulty breathing. There are 4 basic stages of asthma that are based on the frequency, timing and severity of the symptoms of asthma. These steps are used to initiate specific therapies. These stages are arranged in a stepwise fashion to allow clinicians and patients to visualize them better promoting understanding for all and making the treatment of them easier to follow. The stages are labeled as Intermittent, Mild Persistent, Moderate Persistent and Severe Persistent. There are specific criteria that put a person into a particular stage and then certain and exact medications are given at each stage with some overlap. Some patients never move into the more advanced stages, but others are not so fortunate and require more intensive therapy. Patients may move down or up these steps as their asthma is either controlled well or not controlled well at all. During certain times of the year when pollens, dust, mites etc. are worse or more endemic the patient will tend to move up the steps unless preventive treatment is instituted before the season begins.
What to expect during a visit with the clinician?
If the patient or parents are very concerned and the patient is in any distress many of questions desired to be asked will be delayed to make sure there is an adequate amount of oxygen perfusion for the patient and necessary treatments will be started or the patient if need be will be sent to the Emergency Department of the nearest hospital.
Excluding emergencies the first thing patients will experience when visiting a clinic is a detailed history with the clinician that asks questions to find out how the condition has been experienced, to what level and other pertinent information is gleaned to try to find out what triggers are potentially causing the asthma. A family history is taken due to the fact that often there is a familial or genetic component to the problem. Special attention is focused on risk factors that are present and specifically the ones that can be modified or changed are elicited, so that changes can be made such as removing drapes, washing sheets regularly, cleaning stuffed animals, using special filters etc. These modifiable risk factors when addressed help decrease exacerbations. Basically we want to know everything we can about the patient as to what causes it, how bad it is, what we can do to prevent relapses, what medications work the best for that particular patient.
The patient then is examined to determine a baseline if able at that visit. Often the baseline has to be discovered later when the patient is not experiencing symptoms. The baseline is established with a spirometry test that shows the lung function currently. This can then later be used when assessing the patient because we have a before and after comparison so when they come in with problems, we then know where we need go with treatments. Then the patient is given prescriptions for the appropriate drugs and lifestyle changes are instituted in the home and environs are modified to minimize the reoccurrence.
If you or a family member, a neighbor, coworker or other friend needs help with this condition,
call our office at 817-274-2343 and we will get you in immediately for an appointment.