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Asthma Consultation: Essential Tips and Advice for Asthma Patients

By Dr. Ajay Lall in Pulmonology

May 23 , 2024 | 2 min read

Many individuals with asthma endure prolonged suffering due to a lack of accurate diagnosis and understanding of their symptoms. Frequently, patients attribute their discomfort to throat irritation, recurrent infections, or pollution-related coughs, leading them to pursue ineffective treatments such as antibiotics or antihistamines. Physicians sometimes hesitate to diagnose asthma, fearing it may dishearten patients or their families, resulting in a reluctance to accept preventive inhaler treatments aimed at controlling symptoms and preventing exacerbations, commonly known as asthma attacks.

Patients must recognize that while the classic asthma symptoms often include coughing, wheezing, and shortness of breath, others may experience only vague sensations of chest tightness, suffocation, or breathlessness upon exertion, possibly accompanied by a dry, irritating cough. Additionally, certain symptoms may exhibit seasonal variations. Despite asthma typically manifesting at a young age, it can also emerge in the elderly.

Thorough evaluation by an experienced physician is essential for dissecting symptoms and considering alternative conditions. Utilizing tools such as stethoscopes and diagnostic tests like spirometry or peak flow meters can aid in confirming an asthma diagnosis. Even if spirometry results appear normal and wheezing is absent, some individuals may still have a form of asthma known as Cough Variant Asthma, which responds to regular use of preventive inhalers. Consulting a pulmonologist can assist in confirming this diagnosis and ruling out other conditions.

Patients sometimes withhold previous prescriptions to gauge a new doctor's unbiased opinion, which can be counterproductive. Patients must retain and present all previous consultation papers, reports, and prescriptions when seeking opinions from new physicians or specialists to prevent unnecessary repetition of tests and provide valuable insights into previous diagnoses and treatment responses.

Most new patients will likely require recent chest X-rays and blood tests for allergy markers. Specialized tests like skin prick testing or comprehensive blood tests may be necessary for difficult-to-treat cases, aiding in the selection and planning of immunotherapy or vaccine treatments for those who do not respond well to conventional inhaled medications.

Proper instruction in inhaler device usage is vital. Most devices combining bronchodilators and steroids in minimal doses are unlikely to cause significant side effects. Occasionally, liquid respules may be prescribed for use with a nebulizer machine during asthma attacks or when patients are unable to use devices due to age-related infirmity or neurological conditions.

During follow-up consultations, physicians can adjust medication doses, provide further education on the disease and trigger factors, and alleviate patient anxiety regarding the need for chronic therapy. Additional spirometry tests may be conducted to document improvements in lung function, reinforcing the importance of regular medication use and empowering patients to self-regulate medication doses effectively.

In rare cases of severe, difficult-to-treat asthma, pulmonologists may explore newer treatment options, such as subcutaneous monthly injections of biological drugs. However, these treatments are expensive and require regular use over many years, necessitating careful consideration by experienced pulmonologists to avoid overprescription.

In conclusion, enhancing understanding and managing asthma is crucial for patients to receive appropriate treatment and improve their quality of life. By educating patients about the diverse symptoms of asthma, ensuring accurate diagnosis through comprehensive evaluation, and implementing personalized treatment plans, healthcare professionals can empower asthma patients to control their condition and lead healthier lives.

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