Asthma and Allergy Center

Asthma is a chronic, inflammatory lung disease characterized by recurrent breathing problems.  People with asthma have acute episodes when the air passages in their lungs get narrower, and breathing becomes more difficult. 

The problem is an oversensitivity of the lungs and airways, which overreact to certain "triggers" and become inflamed and clogged.

The cause of the lung abnormality that is asthma is not yet known.  Through research, scientists have established that the disease is a special type of inflammation of the airway that leads to contraction of airway muscle, mucus production and swelling in the airways.  The airways become overly responsive to environmental changes.  The result is wheezing and coughing.

As yet there is no cure for asthma, but asthma can be controlled with proper treatment.  People with asthma can use medicine prescribed by their physician to prevent or relieve their symptoms, and they can learn ways to manage episodes.  They also can learn to identify and avoid the things that trigger an episode.  By educating themselves about medications and other asthma management strategies, most people with asthma can gain control of the disease and live an active life.

No.  Although episodes of asthma can sometimes be brought on by strong emotions, it is important to know that asthma is not the result of emotional factors such as a troubled parent-child relationship.  Years ago, people more commonly believed that asthma was "all in one's head" and therefore not a real illness.  Physicians and other medical scientists today know that is wrong.

Asthma is sometimes hard to diagnose because it can resemble other respiratory problems such as emphysema, bronchitis and lower respiratory infections.  For that reason, asthma is under diagnosed - that is, many people with the disease do not know they have it and therefore are never treated.  Sometimes the only symptom is a chronic cough, especially at night.  Or, coughing or wheezing may occur only with exercise.  Some people mistakenly think they are having recurrent bronchitis, since respiratory infections usually settle in the chest in a person predisposed to asthma.

To diagnose asthma and distinguish it from other lung disorders, your Asthma & Allergy Center physicians rely on a combination of medical history, a thorough physical examination, and certain laboratory tests.  These tests include spirometry (using an instrument that measures the air taken into and out of the lungs), peak flow monitoring (another measure of lung function), chest X-rays and sometimes blood and allergy tests.

An asthma episode feels somewhat like taking deep breaths of very cold air on a winter day.  Breathing becomes harder and may hurt, and there may be coughing.  Breathing may make a wheezing or whistling sound.

These problems occur because the airways of the lungs are getting narrower. The muscles that surround the airways tighten, the inner lining of the airways swells and pushes inward, and the membranes that line the airways secrete extra mucus, which can form plugs that further block the air passages.  The rush of air through the narrowed airways produces the wheezing sounds that are typical of asthma.

There are several asthma support groups.  One national organization is the Allergy and Asthma Network Mothers of Asthmatics.  Another is the Asthma and Allergy Foundation of America.  There also is a Food Allergy and Anaphylaxis Network.

Pollen is the male "seed" of a plant that appears as a dust. It can be transferred by insects or the wind for plant reproduction. 

Only certified counters can read pollen and mold. Each counter must pass a year long certification course provided through the Harvard School of Public Health and must be accredited by the American Academy of Allergy, Asthma and Immunology (AAAAI). The Environmental Health Laboratories has certified counters on staff. Meteorologists, allergy specialists, physicians, and individuals have relied on the Saint Louis County Department of Health for this data since 1960. We report our data to news and weather casters and to health organizations such as the American Lung Association. 

Counters use air sampling equipment to capture airborne pollen and mold. Recently, the Environmental Health Laboratories switched from using a rotorod impaction device to using a Burkard slit-type volumetric spore trap. The rotorod sampled only at specific time intervals while the Burkard is able to continuously sample over a 24 hour period. 

The device is mounted on the roof of a centrally located County building away from any obstructions. It uses suction to pull air through a slit-type opening. Inside the slit is a greased, flat surface (a collection tape) that advances in increments over time. This greased surface collects any particles that are sucked in with the air. 

The collection tape is removed from the sampling device and brought to the laboratory. Here it is stained and prepared for analysis. The sample can then be magnified 400 times to count the pollen grains. For some mold spores, the sample must be magnified 1000 times to be seen and counted. Using the exposure time, the volume of air sampled, and the number of pollen grains or mold spores counted, calculations can be made to determine the number of particles per cubic meter of air sampled. This is the number reported by the laboratory. 

There are many reasons why no count is available at various times. Some possible reasons include technical difficulty with the sampling device, inclement weather, the sample being unreadable, illness or absence of the laboratory's certified counter(s), or the laboratory is closed for the holidays. 

Changes in temperature, wind conditions, humidity, or precipitation can affect the counts greatly.

• Temperature: A sudden temperature drop lowers the pollen count significantly. Certain pollens are seasonal. Trees are dominant in the spring, grasses occur in late spring and early summer, and weeds grow from late summer until the first hard frost.
• Wind: Pollens are small, light, and dry so they are easily spread by wind. The distance the pollen travel can depend on whether the wind is strong or calm that day.
• Humidity: When the air is humid, pollen becomes damp and heavy with moisture keeping it still and on the ground.
•  Precipitation: Rains tend to "cleanse" the air of pollen. When the pollen is wet, it becomes heavy with moisture keeping it on the ground.

Generally tree, grass, and weed seasons are similar every year in the same location. However, the intensity can differ depending on the current weather, the previous year's weather, and other environmental factors. Typically, trees pollinate earliest from February to May, grasses follow in May to mid-July, and weeds peak from late summer to early fall. 

If the climate and geography are similar, the counts should be a good indicator for your area. Keep in mind that samples taken from an urban area, where there is little vegetation, can differ from samples taken from a rural area, where there is more pollen producing vegetation. 

An allergy is an abnormal reaction to an ordinarily harmless substance called an allergen. Common allergens include pollens, molds, dust mites, animal dander, foods, medications, cockroach droppings, and insect stings/bites. You may be allergic to one or more allergens. When an allergen is absorbed into the body of an allergic person, their body fights to rid itself of the allergen. The immune system initiates a defense which causes symptoms such as runny nose, watery eyes, congestion, itching, and sneezing. 

When a person with allergies moves to another location, they will likely be exposed to a new set of allergy triggers. In some cases, the new symptoms may be more tolerable or less intense. Keep in mind that it can take months or years to become allergic to a new allergen. Seasonal allergy sufferers may be able to find temporary relief by vacationing during the peak of pollen season to a different climate or a more pollen-free area such as near large bodies of water. 

During the peak of the pollen or mold season that affects you, try following these guidelines:

• Keep windows closed at night.
• Minimize early morning outdoor activity when most pollen is released (between 5-10 AM).
• Keep your car windows closed when traveling.
• Stay indoors when the pollen count is high and on windy days when dust and pollen are easily scattered.
• Vacation during the peak of pollen season to an area where there is less pollen, like the beach.
• Take any medications your allergist recommends as prescribed.
• Do not rake leaves, mow lawns, or be around freshly cut grass. This stirs up pollen and mold.
• Do not hang laundry outside to dry. Pollen and mold will collect in them.
•  Keep indoor plants to a minimum and never overwater if allergic to mold. Wet soil encourages mold growth.

If you have any of the following conditions, you should see an allergist:

• asthma and frequent cough,
• hay fever,
• sinus infections,
• eye allergies,
• reactions to food, insect stings or drugs,
• skin allergies, including eczema and hives, or
• immune system problems that might cause frequesnt infections.

Allergists treat two of the nation's most common health problems - hay fever and asthma.

It is especially important to talk to an allergist if:

• Your allergies are causing symptoms such as sinus infections, nasal congestion or difficulty breathing.
• You experience hay fever or other allergy syptoms several months out of the year.
• Antihistamines and over-the-counter medications do not control your allergy symptoms or create unacceptable side effects, such as drowsiness.
• Your allergies or asthma are interfering with your ability to carry on day-to-day activities.
• Your allergies or asthma decrease the quality of your life.
• You sometimes have to struggle to catch your breath.
• You often wheeze or cough, especially at night or after exercise.
• You are often short of breath or feel tightness in your chest.
• You previously have been treated for asthma, but you still have frequent episodes even though you are taking asthma medication.
• You have had reactions to foods, medication or stinging insects.

An allergist is trained to find the source of your symptoms, treat it and help you feel healthy.

After earning a medical degree, the physician must complete a three-year residency-training program in either internal medicine or pediatrics.  Then, an allergist completes two or three more years of study in the field of asthma, allergy and immunology. 

If you have allergies or asthma, you may be accustomed to frequent symptoms - perhaps thinking that a stuffy nose or wheezing is normal.  With the help of an allergist, these symptoms can be controlled or cured.

An allergist works with you to determine what causes your problems and to develop a tailored plan that matches your lifestyle and provides the most effective treatments.  The goal is to have you lead a normal, healthy life free of allergy or asthma symptoms.

Evaluation

To find the source of your suffering, the allergist will review your symptoms, how often they occur and what triggers them.  The evaluation will include:

Medical History

You will be asked about your health, your symptoms and whether members of your family have asthma or allergies such as hay fever, hives or skin rashes like eczema.

Physical Examination

Allergy tests and breathing tests.

The allergist usually performs specific allergy skin tests to find out what triggers your symptoms.  The allergist may test for pollens, molds, dust mites, animal dander, insect stings, various foods and drugs.  In some cases, a blood test may be used intestad of a skin test.  The allergist also may perform a test to measure how your lungs are working.  This quick and easy breathing test is called spirometry.  It measures how much air you can blow out of your lungs after taking a deep breath.

Prevention Education

The best way to treat allergies or asthma is to avoid the allergens that trigger your symptoms.  When it is not possible to completely avoid allergens, an allergist can provide you with tips on how to decrease your exposure.

Treatment

Although avoiding the things that trigger your symptoms is one of the most effective strategies, there are a variety of medicines that treat both allergies and asthma.  Allergists have the expertise to select the most effective ones for you.  The allergist also can determine if you should consider allergy shots (immunotherapy).  This treatment involves periodic injections with tiny amounts of an allergen.  Immunotherapy can actually cure your allergy.  Your reactions will become milder or can disappear entirely.  Another treatment for serious allergic asthma, called anti-IgE, stops an allergic reaction before it begins, helping prevent asthma attacks by blocking what causes the reaction.

Just a little.