HEALTH MATTERS: Allergies
31
August

By Adem Lewis / in , , , , , /


>>Announcer: ON “HEALTH MATTERS,” SPRING IS IN THE AIR BUT ALONG WITH GREENING GRASS AND BUDDING FLOWERS COMES ALL THAT STUFF THAT MAKES ALLERGIES BLOOM, TOO. FROM PETS TO PEANUTS, THE AIR WE BREATHE OR THE FOOD WE EAT CAN MAKE US SICK. ARE ALLERGIES BECOMING MORE COMMON OR DOES IT JUST SEEM THAT WAY. ARE THERE NEW MEDICINES AND TREATMENTS ON THE HORIZON? WE ASK THOSE QUESTIONS AND MORE WHEN “HEALTH MATTERS” TALKS ALLERGIES. NEXT! “HEALTH MATTERS” IS MADE POSSIBLE BY VIEWERS LIKE YOU. THE FRIENDS OF KSPS AND BY THE FOLLOWING…>>I REALLY LIKED THE IDEA OF BEING PART OF PROVIDENCE WHERE IF I HAVE A QUESTION, IF THERE’S SOMETHING THAT I’M CONCERNED ABOUT, I CAN ALWAYS CALL A SPECIALIST. I’M DR. ANABARBER AND I CHOSE PROVIDENCE BECAUSE HERE I CATCH HELP CHILDREN THRIVE AND REACH THEIR HIGHEST POTENTIAL.>>IF YOU READ PROVIDENCE’S MISSION STATEMENT, IT IS ABOUT DELIVERING QUALITY CARE TO THE PATIENT AT ALL TIMES. I’M DR. PETER RINALDI, I CHOSE PROVIDENCE BECAUSE THEY PUT THE DOCTOR/PATIENT RELATIONSHIP FIRST.>>”HEALTH MATTERS” IS ALSO BROUGHT TO YOU BY HOLLISTER STIER ALLERGY. IMPROVING QUALITY OF LIFE FOR ALLERGY SUFFERERS SINCE 1921. WASHINGTON STATE UNIVERSITY SPOKANE, STUDYING THE FEASIBILITY OF A MEDICAL SCHOOL ON THE WSU SPOKANE HEALTH SCIENCES CAMPUS TO HELP SOLVE THE PRIMARY CARE PHYSICIAN’S CRISIS IN WASHINGTON. MORE AT MEDICINE.WSU.EDU.>>Teresa: GOOD EVENING. I’M YOUR HOST, TERESA LUKENS. WHOEVER CAME UP WITH THE SAYING “SPRING IS IN THE AIR” MIGHT HAVE BEEN REFERRING TO THE FACT THAT ALLERGY AND ASTHMA SUFFERERS GET HIT HARD THIS TIME OF YEAR. AT LEAST TWO OUT OF EVERY TEN AMERICANS SUFFER FROM ALLERGIES. SO TONIGHT, WE’RE GOING TO TALK ABOUT THE COMMON CAUSES OF SEASONAL ALLERGIES PLUS HOW EVERYTHING FROM PETS TO PEANUTS CAN POTENTIALLY CAUSE AN ALLERGIC REACTION. AS ALWAYS, WE HAVE ASSEMBLED A PANEL OF LOCAL EXPERTS TO ANSWER YOUR QUESTIONS VIA PHONE CALL AND E-MAIL TONIGHT. LET’S MEET THEM. DR. STEVEN KERNERMAN WORKS WITH ADULTS AND CHILDREN AT SPOKANE ALLERGY AND ASTHMA CLINIC. DR. RICHARD GOWER IS A PRACTICING ALLERGIST AND IMMUNOLOGIST AT MARYCLIFF ALLERGY SPECIALISTS IN SPOKANE. DR. JITEN PATE IS WITH THE PULMONARY CRITICAL CARE CENTER AT ROCKWOOD CLINIC. SUZANNE LEVITCH IS AN ADVANCED PRACTICE REGISTERED NURSE WITH MARYCLIFF ALLERGY SPECIALISTS. THANK YOU FOR BEING HERE TONIGHT. THIS IS CERTAINLY A VERY HOT TOPIC, ESPECIALLY THIS TIME OF YEAR. DR. KERNERMAN, LET’S BEGIN WITH YOU. TALK ABOUT WHAT HAPPENS ESPECIALLY IN THE SPRING WHEN WE’RE TALKING ABOUT POLLEN AND SEASONAL ALLERGIES. WHAT’S GOING ON?>>SO YOU MIGHT HAVE NOTICED TREES ARE BLOOMING AND THAT IS THE POLLEN THAT WE’RE SEEING RIGHT NOW. SO ALDER, BIRCH, SYCAMORE, THESE POSSIBLES ARE COMING OUT. PEOPLE WHO ARE SENSITIZED WILL HAVE ALLERGIC REACTIONS. PEOPLE ARE HAVING ITCHY EYES, RUNNY NOSES, THEY’RE HAVING NASAL CONGESTION. THEY THINK THEY HAVE A COLD. IT IS PROBABLY ALLERGIES.>>Teresa: HOW DO WE KNOW THE DIFFERENCE BETWEEN HAVING THE COMMON COLD OR HAVING AN ALLERGY AND SEEKING TREATMENT FOR THAT ALLERGY, DR. GOWER?>>THE COMMON COLD — IT IS NOT ASSOCIATED WITH A FEVER. SO USUALLY IT IS HOW YOU FEEL OTHER THAN JUST BEING TIRED OR STUFFY, ITCHY EYES. USUALLY YOU CAN TELL. MOST PEOPLE BLAME IT — ESPECIALLY IF THEY HAVE NOT BEEN DIAGNOSED PROPERLY.>>Teresa: THESE CAN BE DEBILITATING FOR SOME PEOPLE. IT CAN GO FROM FEELING A LITTLE CRUMBY THAT DAY WITH A ITCH IN THE BACK OF THE THROAT TO REALLY PUTTING YOU DOWN FOR A NUMBER OF DAYS. SO DR. PATEL, SHOULD I SEEK TREATMENT AT THAT POINT? BECAUSE I CAN GET RELIEF?>>AS YOU DEVELOP A SENSE OF WHAT ALLERGIES YOU’VE HAD TO — YOU’VE HAD GROWING UP, SOME OF THE ALLERGIES START WHEN YOU’RE YOUNGER AND YOU DEVELOP AN ACUMEN, YOU FIND YOUR DRIP IS WORSENING OR ITCHY EYES OR YOU START DEVELOPING A RUNNY NOSE THAT’S UNCONTROLLABLE WITH A WORSENING COUGH THAT PERHAPS YOUR PRIMARY CARE SHOULD BE AVAILABLE.>>Teresa: WHAT KIND OF TREATMENTS ARE WE TALKING ABOUT NOW? WHAT IS AVAILABLE?>>WE’RE VERY FORTUNATE TODAY BECAUSE THERE ARE VERY EFFECTIVE TREATMENTS THAT ARE AVAILABLE IN STORES. IT IS HELPFUL TO HAVE SOMEONE GUIDE ONE THROUGH THE SYSTEM BUT MOST OF THE ANTIHISTAMINES THAT USED TO BE PRESCRIPTION –>>Teresa: THE CLARITINS –>>ZYRTEC, ALLEGRA, THESE ALL USED TO BE PRESCRIPTION ITEMS. FOR MOST PEOPLE, THEY CAN GO IN THE STORE — IF SOMEONE HAS MILD ALLERGIES, THAT MIGHT BE ALL THEY NEED. AN ALLERGY SPECIALIST WILL START TO SEE PEOPLE WHO — THEY’RE MISSING WORK. THEY’RE REALLY SUFFERING. IT IS NOT JUST OH, MY — I’M SNEEZING. IT’S I FEEL FATIGUED, WRUNG OUT. I SNEEZE 20 TIMES IN A ROW. JUST FEELING MISERABLE.>>Teresa: THIS CAN ALSO — KIDS CAN HAVE PROBLEMS WITH THIS, TOO, SUZANNE. HOW IS IT DIFFERENT FROM — IN CHILDREN AND ADULTS OR DOES IT PRESENT PRETTY MUCH THE SAME?>>CHILDREN ARE PRETTY RESILIENT CREATURES AND REALLY YOU CAN’T TELL AS EASILY WITH A CHILD ESPECIALLY A TODDLER. ALLERGIES CAN PRESENT AS EARLY AS A YEAR OR SO BUT A LOT OF TIMES YOU’LL SEE THE RUNNY NOSE, THE DRIPPY NOSE OR THEY’LL HAVE ATOPIC DERMATITIS. SOME CHILDREN GO ON TO HAVE ASTHMA. AND MOST CHILDREN THAT HAVE ASTHMA HAVE SOME ALLERGIES.>>Teresa: SO THERE IS A RELATIONSHIP BETWEEN THE TWO. WE WANT TO TALK TONIGHT ABOUT THAT CONNECTION WITH ASTHMA. WE’RE ACTUALLY GOING TO MEET A WOMAN IN AWHILE WHO’S DEALT WITH THAT ALL OF HER LIFE. WHAT IS THE CONNECTION THEN, DR. GOWER, BETWEEN THE TWO?>>THE FACT THAT ALLERGIES CAUSE ASTHMA IN A LARGE MAJORITY. IF YOU HAVE A CHILD WHO HAS ASTHMA, PROBABLY 85% OF THE TIME, THEY HAVE ALLERGIES, ALSO. AS A TRIGGER FACTOR, AS A CAUSING FACTOR OF THE ASTHMA. IF YOU HAVE AN ADULT WITH ADULT ONSET ASTHMA WITH NO HISTORY OF ALLERGIES AS A CHILD AND THEY’RE 30 YEARS OLD, THAT HAS A LESSER FREQUENCY OF HAVING ALLERGIES, MAYBE 60%, 65% OF THE TIME. BUT STILL, THAT’S A LARGE ASSOCIATION BECAUSE THE ALLERGY ANTI BODY IS PROUD BY THE BODY AGAINST ANTIGENS CAUSING A LOT OF REACTIONS CAUSING THE ITCHY EYES, DRIPPY NOSE AND STUFFINESS AND CONGESTION AND PHLEGM IN THE CHEST. IF THIS EXACERBATES, IT TENDS TO MAKE THIS WORSE AS WELL. WHENEVER YOU SEE ANYBODY WITH ASTHMA, ONE HAS TO CONSIDER THE POSSIBILITY OF ALLERGIES AS A TRIGGER FACTOR.>>Teresa: WE ASK THE QUESTION IN THE OPENING OF THE PROGRAM, ARE WE SEEING MORE SEASONAL ALLERGIES OR ALLERGIES OVERALL OR ARE THEY BEING DIAGNOSED EARLIER? CAN WE ANSWER THAT QUESTION EVEN, DR. KERNERMAN?>>ALL OF THE ABOVE. I THINK WE’RE MUCH BETTER AT RECOGNIZING SYMPTOMS AND CALLING THEM WHAT THEY ARE. DIAGNOSING ASTHMA AND TREATING IT. DIAGNOSING ALLERGIES AND TREATING THEM. THERE PROBABLY ARE MORE ALLERGIES. THERE’S PROBABLY MORE RECOGNITION OF THE ALLERGIES THEMSELVES.>>Teresa: I ACTUALLY HAD A COWORKER, MANY OF THEM COME UP TO ME AND WHEN THEY FOUND OUT THIS WAS OUR TOPIC TONIGHT AND WANTED TO PRESENT QUESTIONS TO ME. ONE OF THEM SAID THAT SHE HAS DRY EYES, AS A RULE. THEN GETS THE SEASONAL ALLERGIES BUT WHEN SHE TRIES TO TREAT THE DRY EYES WITH DROPS, IT SEEMS TO MAKE THE CONDITION WORSE. AGAIN, IS THAT SOMETHING THAT SHE, YOU KNOW, SHE SHOULD SEEK HELP FROM HER DOCTOR TO TRY TO TREAT THE TWO PRESENTING PROBLEMS THERE THAT ARE KIND OF COLLIDING, I GUESS, THIS TIME OF YEAR?>>THERE’S MULTIPLE SYMPTOMS WHEN YOU TALK ABOUT ALLERGIES WITH ITCHY EYES, DRY SKIN, POST-NASAL DRIP, COUGH, CHEST CONGESTION. THERE IS NEVER ONE SYMPTOM THAT PRESENTS. MOST PATIENTS COMPLAIN OF MULTIPLE SYMPTOMS. WHEN THEY START IMPACTING YOUR QUALITY OF LIFE, WE SUGGEST THEY SHOULD GET SOME HELP.>>TERESA, LET ME PUT ONE THING ON THE TABLE I WANT TO MAKE SURE WE COVER TONIGHT AND THAT IS IT A MULTITUDE OF SYMPTOMS BUT THEY HAVE TO RECOGNIZE AND SOMETIMES PUT THAT PACKAGE TOGETHER. THE PATIENTS DON’T ALWAYS DO THAT. THAT IS THE ONLY REAL RISK I SEE OF HAVING VERY GOOD OVER-THE-COUNTER MEDICINES BECAUSE SOMETIMES PEOPLE, ESPECIALLY IN ALLERGIES, MOST PEOPLE HAVE ALLERGIES, HAD IT AS A KID, AS DR. PATEL SAID. SO THEY GET USED TO IT. WHEN THEY GET USED TO A HEADACHE OR MOUTH BREATHING OR NOT SLEEPING WELL AND THEY’RE COUGHING OR WHEEZING, THEY’RE 20 OR 30 YEARS OF AGE, THAT’S HOW THEY’VE BEEN ALL THEIR LIFE. THEY DON’T SORT IT OUT UNTIL THEY GO TO THE EMERGENCY ROOM OR SOMEBODY ELSE TELLS THEM THAT. SELF-DIAGNOSIS CAN BE A TWO-EDGED SWORD WHEN IT COMES TO THAT. THEY’RE CHEATING THEMSELVES BY NOT REALLY GETTING OPTIMAL CARE. I AGREE WITH DR. KERNERMAN, IT THEY’RE MILD OR MILD-MODERATE AND THEY DIAGNOSE PROPERLY, THEY TAKE THE PROPER MEDICINES AND THEY WORK WELL FROM OVER THE COUNTER SOURCES, I HAVE NO PROBLEM WITH THAT BECAUSE IT ALLOWS PEOPLE TO FALL IN THE AREA OF MILD OR MODERATE TO SEVERE THAT AREN’T DOING AS WELL AS THEY SHOULD BECAUSE THE PATIENTS AREN’T RECOGNIZING THE SIGNIFICANCE OF THE SYMPTOMS.>>Teresa: BECAUSE MAYBE MOM AND DAD DIDN’T RECOGNIZE IT WHEN THEY WERE CHILDREN? IT WAS SOMETHING THAT HAPPENED EVERY YEAR IN THE SPRING?>>THEY HAD SUMMER COLDS, THEY HAD SPRING COLDS. AS WAS MENTIONED, IT IS PROBABLY AN ALLERGY. IF YOU START LOOKING AT — WE’VE ALL SEEN PATIENTS AND YOU BRING IT — EVERY SPRING I HAVE A COLD WHENEVER I’M AROUND CATS, I HAVE A COLD.>>WITH THAT YEARLY SINUS INFECTION, THAT’S A KEY, TOO.>>Teresa: IT CAN GET INTO THE SINUSES IN THAT REGARD, TOO. DR. PATEL?>>I WAS GOING TO SAY THERE’S SUCH A THING AS A HISTORIC ETOPIC MARCH WHERE CHILDREN AS A CHILD DEVELOP ATOPIC DERMATITIS AND THEN AS THEY WENT INTO EARLY CHILDHOOD ADOLESCENCE, THEY DEVELOPED ALLERGIC RHINO SITUS. YOU’LL HAVE THE LEARNED PATIENT WHO KNOWS WHEN THEY’RE COUGHING MORE OR WHEEZING MORE OR SHORT OF BREATH THAT THEY SHOULD GET HELP. THERE’S A LARGE NUMBER OF PATIENTS WHO DON’T REALIZE THAT’S NOT NORMAL.>>Teresa: I’VE HAD PEOPLE TELL ME I DIDN’T HAVE HAY FEVER, SEASONAL ALLERGIES WHEN I WAS A KID BUT AS I GOT OLDER, I STARTED DEVELOPING THOSE ALLERGIES. CAN THAT ALSO BE THE CASE, DR. KERNERMAN?>>I SEE BOTH CHILDREN AND ADULTS. ONE OF MY FAVORITE SCENARIOS — NOT MY FAVORITE SCENARIO BUT ONE OF MY FAVORITE SCENARIOS IS I’LL SEE KIDS AND THEY’RE 5 TO 12 YEARS OF AGE AND 50% OF ALLERGY OR SO SHOWS UP THEN. THEN I’LL SEE PEOPLE IN THEIR 30s AND THEY’RE LIKE GOSH, YOU KNOW, WHY AM I HAVING ALLERGIES? THEY’LL BE A LITTLE BIT SURPRISE, A LITTLE AMUSED BUT OKAY, I CAN DEAL WITH THAT. I’LL SEE PEOPLE IN THEIR 50s AND THEY’RE PISSED. LIKE I’M NOT SUPPOSED TO GET ALLERGIES. HOW CAN THIS BE? ISN’T THAT SOMETHING KIDS GET? [ LAUGHTER ] I LIKE TO SAY, I SAW A GENTLEMAN WHO IS 99 YEARS OLD. HE DIDN’T HAVE ALLERGIES BEFORE. I WAS SEEING HIM FOR AN ALLERGIC PROBLEM.>>Teresa: THAT IS CRAZY.>>THERE IS NO CUTOFF.>>Teresa: THAT’S WHY IT IS HARD FOR PEOPLE TO RECOGNIZE THEY HAVE ALLERGIES BECAUSE THEY DIDN’T HAVE THEM BEFORE.>>ON THE OTHER HAND, SOMETIMES THEY HAD IT AS A CHILD AND IT GOT WORSE WITH THE MARCH THAT DR. PATEL WAS TALKING ABOUT. THEY HAD PROGRESSIVE SYMPTOMS. THEY’RE TEENAGERS. AND THEY GET BUSY. OTHER THINGS TAKE PRECEDENCE. THEY GET MARRIED, GO TO THE WORKFORCE AND THEY START HAVING SNEEZING OR COUGHING OR WIPING THEIR NOSE AND THEIR COWORKERS START BRINGING THIS TO THEIR ATTENTION AND THEY HAVE HEALTH INSURANCE AND THEY RECOGNIZING THEY’RE DIFFERENT THAN THE OTHER PEOPLE. THEY HAVE SYMPTOMS SO IT IS RECOGNIZING AND PAID ATTENTION TO WHEN THEY’RE 20, 30, OR 40 BUT THEY MAY HAVE HAD IT ALL THEIR LIVES. DID YOU HAVE ASTHMA? YEAH, I ALMOST DIED 15 TIMES AS A KID BUT I DON’T HAVE ASTHMA ANYMORE. IF THEY HAD ASTHMA BEFORE, THEY STILL HAVE THE GENETIC TENDENCY TO HAVE ASTHMA. THEY CAN GROW OUT OF THE SYMPTOMS OR THE SYMPTOMS CAN GROW WORSE. AS GOOD DETECTIVES AS WE ARE, WE HAVE TO SORT THAT OUT. PATIENTS WILL NOT NECESSARILY VOLUNTEER ALL OF THAT INFORMATION BECAUSE IT DIDN’T SEEM IMPORTANT TO THEM BEFORE.>>Teresa: SPEAKING OF THAT, IT BRINGS UP AN EXCELLENT POINT ABOUT DIAGNOSING AND WEEDING THAT OUT. WHAT IS THE PROCESS WHEN YOU HAVE A PATIENT COME TO YOU BECAUSE OBVIOUSLY IN THE NORTHWEST, ESPECIALLY, WE HAVE MANY THINGS THAT CAN BLOOM FROM YOU KNOW, THE PINE POLLENS AND ANY SORTS OF TREES AND GRASSES AND AS YOU MENTION, THE MOLDS COMING INTO PLAY. WHAT IS THE PROGRESS FOR DIAGNOSING AND REALLY NAILING THAT DOWN, SO TO SPEAK?>>IN OUR OFFICE, TOMORROW IS A BIG DAY. WE’RE GOING TO BE STARTING TO DO POLLEN COUNTS.>>Teresa: AND WE SEE THOSE ON THE EVENING NEWSCASTS NOW SO PEOPLE CAN PAY ATTENTION.>>SO WE ACTUALLY KNOW EXACTLY WHAT POLLENS ARE OUT THERE. OVER TIME, AN ALLERGIST KIND OF LEARNS WHAT THE TOPOGRAPHY IS AS FAR AS POLLENS IN THE AIR. YOU KIND OF FINE TUNE WHAT YOU’RE TESTING FOR DEPENDING ON WHAT YOU KNOW IS GOING TO BE OUT THERE. IN ANY ALLERGY OFFICE, THERE ARE CERTAIN THINGS, YOU KNOW THEY’RE GOING TO HIT AT CERTAIN TIMES, GIVE OR TAKE A WEEK AND THAT’S WHAT YOU TEST FOR. BECAUSE, FOR EXAMPLE, THERE ARE CERTAIN THINGS THAT WE DON’T HAVE HERE. TO ANY BIG DEGREE LIKE OLIVE TREES. WE JUST DON’T HAVE THEM. SOMEONE COULD BE SENSITIZED FOR THAT BUT OLIVE TREES DON’T DO WELL HERE. WE DON’T NECESSARILY TEST PEOPLE FOR THAT. WE DO HAVE ALL VARIETY OF GRASSES. THAT’S A HUGE ALLERGEN HERE. WE ABSOLUTELY TEST FOR THAT. WE HAVE RUSSIAN THISTLE HERE. WE TEST FOR THAT. WE HAVE BIRCH AND ALDER HERE SO WE DEFINITELY TEST FOR THAT.>>Teresa: HOW DO YOU TEST FOR THAT?>>THE MOST COMMON WAY THAT AN ALLERGIST WOULD TEST FOR AN ALLERGY IS TO DO AN ALLERGY SKIN TEST.>>Teresa: THE SCRATCH TEST WE USED TO CALL IT, I THINK? IT USED TO BE?>>IT SEEMS TYRRANICAL. WE’RE GOING TO SCRATCH YOU UP! IT IS A SKIN TEST.>>LIKE THE PRICK TEST.>>WE’RE GOING TO GENTLY APPLY TO YOUR SKIN AND REALLY FOR MOST PEOPLE NOWADAYS, AS OPPOSED TO WHEN WE SPOKE TO OUR PARENTS’ PARENTS, ALLERGY TESTS MIGHT HAVE BEEN TAR MORE DIFFICULT. NOW, I THINK MOST WOULD SAY THAT YEAH, IT IS UNCOMFORTABLE BUT IT’S NOT TERRIBLE. BUT A SKIN TEST WOULD BE APPLIED USUALLY TO THE ARM OF AN ADULT. ON A CHILD IT MIGHT BE ON THE THIGHS. SOMETIMES ONE MIGHT USE THE BACK DEPENDING ON HOW THE SKIN IS.>>Teresa: WILL YOU SEE A REACTION IMMEDIATELY THEN?>>15 MINUTES. TRADITIONALLY ABOUT 15 MINUTES IS — YOU HAVE YOUR ANSWER. AND FROM THERE, YOU HAVE YOUR PLAN.>>IT SOUNDS A LOT WORSE THAN IT IS. IT IS LIKE TAKING A LITTLE NEEDLE AND PRICKING THE SKIN. YOU’RE BREAKING THE SURFACE OF THE SKIN AND INSERTING THE ANTIGEN. IF THE BODY HAS — AGAINST THE ANTIGEN, IT IS A REACTION LIKE A MOSQUITO BITE.>>Teresa: I MENTIONED TODAY BEING A RAINY DAY. I SAID THE POLLEN SHOULDN’T BE AS BAD TODAY BUT WHEN I MENTIONED THAT TO YOU, SUZANNE, YOU SAID THAT’S WHEN THE MOLDS COME INTO PLAY. TALK ABOUT THAT.>>MOLDS, MOST OF THEM LIVE IN THE SOIL ALTHOUGH WE DO HAVE SOME HOUSEHOLD MOLDS, TOO. WHEN THE RAIN COMES DOWN, IT FLUSHES THE TREE POLLEN DOWN TO THE GROUND AND JUST LETS IT LIE ON THE GROUND. BUT THE RAINDROPS THEN, WHEN THEY HIT THE GROUND, THE SPORES FROM THE MOLD ARE AEROSOLIZED.>>Teresa: PEOPLE CAN HAVE DIFFICULTY ON A RAINY DAY. THERE’S NO ESCAPING IT.>>THERE’S NO ESCAPING.>>ALLERGIES WILL BE TRICKY, TOO. BECAUSE, FOR EXAMPLE, TREE POLLEN WAS OUT YESTERDAY AND THE DAY BEFORE. NOT SO MUCH TODAY. WELL, THERE’S PEOPLE WHO WERE SENSITIZED THROUGH YESTERDAY WHO ARE ACTUALLY HAVING SYMPTOMS TODAY.>>Teresa: I WAS NOTICING SYMPTOMS TODAY. I’M ONE OF THOSE PEOPLE WHO SAYS I DON’T HAVE ALLERGIES.>>THE IM– THE PUMP NEEDS TO BE TREATED. IF YOU KNOW WHEN YOUR SYMPTOMS WILL BE, IN THE SPRING, SUMMER OR FALL, START YOUR TREATMENT A WEEK OR TWO BEFORE THAT. THE PLANTS ARE SMARTER THAN WE DO. THEY POLLINATE PRETTY MUCH ON SCHEDULE. ALTHOUGH WITH GLOBAL WARMING, THE SEASONS ARE EXPANDING A LITTLE BIT. ONCE IT STARTED, IT TAKES — AS THE SEASON PROGRESSES, IT TAKES LESS AND LESS AND LESS TO CAUSE MORE AND MORE SYMPTOMS. THERE CAN BE A DELAY.>>Teresa: GET A JUMP ON IT. LET’S BRING OUR FIRST PHONE CALLER. WE HAVE REG CALLING FROM MONTANA. GOOD EVENING, REG. GOOD EVENING.>>Caller: WHEN I WAS IN MY 20s, 30s, 40s, I HAD LOTS OF ALLERGIES. I WOULD JUST DRIP AND I WOULD GET FIXED UP WITH THE DOCTORS AND INJECTIONS AND SO ON AND TRY TO CONTROL THIS. I ALSO HAVE A SEVERE ALLERGY TO SUNFLOWER SEEDS. I DON’T HAVE NEAR THE SYMPTOMS ANYMORE AS I USED TO AND I’M IN MY 70s.>>Teresa: DR. PATEL?>>I THINK MY ALLERGIST WOULD BE BETTER.>>THAT’S ONE OF THE GOOD THINGS ABOUT GETTING OLDER, YOU TEND TO GET LESS ALLERGIC BUT NOT ALWAYS. HOWEVER YOU GET CANCER, KIDNEY STONES AND HEART ATTACKS AND SO ON AS YOU GET OLDER SO IT IS AWASH. BUT THE IMMUNE SYSTEM DOES CHANGE. AND THAT’S ONE OF THE GOOD THINGS TO LOOK FORWARD TO. I CONGRATULATE IN MAKING IT TO YOUR 70s. I’M NOT THERE YET BUT CLOSE.>>Teresa: IT IS THAT PROCESS. YOU MAY HAVE HAD AS A KID, YOU MAY NOT HAVE WHEN YOU’RE IN YOUR 70s.>>IT HAPPENS WITH ASTHMA AS WELL AS THE ALLERGIES. SOME PEOPLE WILL GO 50 YEARS AND NEVER HAVE A PROBLEM. THEY CAN DEVELOP. THAT’S UNUSUAL BUT IT CAN HAPPEN. FOOD ALLERGIES IN CHILDREN ARE A LOT MORE COMMON THEN THEY TEND TO OUTGROW THEM. PEANUT AND TREE NUTS AND SHRIMP, THEY TEND NOT TO BUT THEY CAN. YOU HAVE TO LISTEN TO THE BODY AND FIGURE OUT IF YOU CAN, BY YOURSELF, YOUR FAMILY DOCTOR, YOUR ALLERGIST AS TO WHAT THE CAUSE IS. IF YOU’RE GETTING BETTER, CELEBRATE IT. I CONGRATULATE YOU.>>Teresa: LET’S BRING SHARI IN FROM SPOKANE.>>Caller: HELLO.>>Teresa: YOU HAVE A QUESTION FOR THE PANEL?>>Caller: YES, I DO. I WENT TO AN ALLERGIST HERE IN SPOKANE AND GOT TESTED. I’M ALLERGIC TO EVERY BLADE OF GRASS AND TREE IN THE WHOLE AREA. I TRIED TO GO FOR ALLERGY SHOTS. I ALSO HAVE REALLY SEVERE ARTHRITIS. EVERY TIME I GOT AN ALLERGY SHOT, IT WENT RIGHT INTO MY JOINTS. I’VE TRIED ALL OF THE ANTIHISTAMINES AND I CAN ONLY TAKE ZYRTEC AND BENADRYL, THAT’S ABOUT IT. THEY’RE GETTING WORSE YEAR AFTER YEAR AND I’M GETTING SINUS INFECTIONS. WHAT’S NEW? WHAT’S ON THE HORIZON? THE ALLERGY SHOTS ARE NOT FOR ME. IT RUNS IN MY FAMILY. ALL OF MY KIDS ARE JUST BOMBED.>>Teresa: ALL RIGHT, STHARRY. EXCELLENT QUESTION. WHO WOULD LIKE TO ANSWER SHARI’S QUESTION? ANY RELIEF FOR HER?>>THAT’S A DRAG WITH THE RHEUMATOID ARTHRITIS BEING MADE WORSE WITH THE ALLERGY SHOTS.>>Teresa: DO YOU KNOW OF ANYTHING NEW SHE SHOULD TRY? SHE SHOULD TALK TO HER DOCTOR ABOUT?>>I WOULD ASSUME THAT THERE WERE SOME ATTEMPTS AT OTHER NONANTIHISTAMINE MEDICINES, MAYBE TRY AN ANTAGONIST. MAYBE INTRANASAL CORTICOSTEROID SPRAYS. I DON’T KNOW IF WE WANT TO TALK ABOUT ANTI-IEG THROWNS — ANTI BODIES BUT IT MIGHT BE WORTH HER GOING BACK TO HER ALLERGIST AND DELAYING ON THE TABLE AND SAYING WHAT ELSE? THERE’S GOT TO BE SOMETHING.>>THERE’S ALSO A NEW FORM OF TREATMENT CALLED SUBLINGUAL THERAPY, TABLETS. TWO WERE JUST APPROVED SPECIFICALLY FOR GRASS WITHIN THIS MONTH.>>Teresa: WHICH SHE MENTIONED.>>APRIL 1 AND APRIL 10 SO THAT MIGHT WORK. IT IS A DAILY THERAPY RATHER THAN A WEEKLY OR MONTHLY. SIMILAR MECHANISMS BUT DIFFERENT AREA. USING THE GASTROINTESTINAL SYSTEM, THE IMMUNE SYSTEM TO INVOKE THE RESPONSE INSTEAD OF THROUGH THE SKIN AND THE SUBCUTANEOUS TISSUE. THAT’S A CONSIDERATION. IN THE OLD DAYS, THAT WAS A RELATIVE CONTRAINDICATION, IT WAS — IF THEY HAD LUPUS OR SOME AUTO IMMUNE DISEASE, THE STUDIES I’M AWARE OF HAVE DISPROVEN THAT BUT SOMETIMES WHEN THERE’S SMOKE, THERE’S FIRE AND IF IT IS NOT STATISTICALLY IMPORTANT DOESN’T MEAN IT IS NOT FOR ANY ONE INDIVIDUAL. I THINK DR. KERNERMAN’S SUGGESTION, TRYING AGAIN. IF THE SYMPTOMS ARE BAD ENOUGH, KEEP TRYING AGAIN. THERE ARE NEWER MEDICINES, ALTERNATIVE MEDICINES. IT WOULD BE WORTH A TRIAL.>>RHEUMATOID ARTHRITIS COMPLICATES OR CONFOUNDS WHAT’S GOING ON HERE. IT IS AN AUTOIMMUNE PROCESS. SO THERE ARE CERTAINLY NUMEROUS PULMONARY MANIFESTATIONS OF RHEUMATOID FROM POLYPS TO WHEEZING AND REACTIVE AIRWAYS THAT YOU CAN GET. SO ALTHOUGH SHE’S POSITIVE FOR MULTIPLE ALLERGIES, OF SOME HER SYMPTOMS MAY AFFECT HER WINDOW TO HER LUNGS, HER SINUSES AND HER LUNGS. SO I THINK PERHAPS A DISCUSSION WITH THE RHEUMATOLOGIST AS WELL.>>Teresa: LET’S BRING CARRIE IN FROM CHATTAROY.>>Caller: GOOD EVENING. I THINK I HAVE A QUESTION PROBABLY FOR DR. KERNERMAN. I HAVE A FAMILY MEMBER WHO HAS PROBLEMS WITH ASPIRIN. WHEN THEY TAKE AN ASPIRIN PRODUCT, THEY HAVE PROBLEMS WITH THEIR ASTHMA. IS THERE ANY TREATMENTS AVAILABLE THAT WOULD BE HELPFUL IN THAT SITUATION? BECAUSE THEY’RE KIND OF GETTING TO AN AGE WHERE THEY NEED SOME SORT OF A NONSTEROIDAL OR SOME SORT OF AN ANTI-INFLAMMATORY AND ALL OF THOSE MEDICINES SEEM TO CAUSE MORE ISSUES WITH THEIR BREATHING.>>Teresa: VERY GOOD, KERRY. DR. KERNERMAN?>>SO THERE’S SOME PEOPLE THAT HAVE ASTHMA THAT IS TRIGGERED BY ALLERGIES. SOME PEOPLE, IT IS BY VIRUSES. SOME PEOPLE DO A FUNNY THING WHERE IF THEY TAKE ASPIRIN OR ANTI-INFLAMMATORY DRUG, IT TRIGGERS THEIR ASTHMA AND PROMOTES SINUS TROUBLE AND POLYPS AND THINGS LIKE THAT. THERE IS SOMETHING WHERE YOU CAN BE DESENSITIZED FOR THE ASPIRIN AND THAT’S CALLED ASPIRIN EXACERBATED RESPIRATORY DISEASE. THAT IS SOMETHING THAT WE DO HERE IN SPOKANE. SO IT IS SOMETHING THAT, IN THE LITERATURE, THEY REPORTED A LOT. I DON’T THINK IT IS AS COMMON AS THAT BUT THERE IS TREATMENT. SO THAT WOULD BE WORTH DISCUSSING WITH THE DOCTOR.>>Teresa: OKAY. WE’VE BROUGHT UP THE TOPIC OF ASTHMA A FEW TIMES THIS EVENING ALREADY. SO I WANT TO TALK MORE ABOUT ASTHMA NOW. IN SOME CASES, IF NOT TREATED PROPERLY, ASTHMA CAN BE LIFE-THREATENING. BUT WE MET A WOMAN WHO SHOWED US THAT IT DOESN’T HAVE TO BE LIFE ALTERING. JOGGING THROUGH HER COEUR D’ ALENE NEIGHBORHOOD, TERESA FEELS HER LUNGS FILL WITH AIR AND LISTENS TO HER BREATHING. SHE DOESN’T TAKE ANY OF IT FOR GRANTED. THE 50-YEAR-OLD FLIGHT ATTENDANT LEADS AN ACTIVE, ATHLETIC LIFE THAT MUST HAVE SEEMED IMPOSSIBLE WHEN SHE WAS GROWING UP WITH ASTHMA.>>IT WAS REALLY LIMITING. I WAS A KID WHO ALWAYS LIKED TO GO OUT AND PLAY. I WASN’T THE KID WHO STAYED INSIDE. I HAD A MILLION SCARS FROM PLAYING OUTSIDE. AND I COULDN’T ALL THE TIME BECAUSE I HAD TO COME IN AND SIT ON THE COUCH WHEN I COULDN’T BREATHE. WHEN I GOT INTO MY TEENS, MY ASTHMA REALLY SPIKED. I WAS IN AND OUT OF THE EMERGENCY ROOM ALL THE TIME.>>Teresa: WHAT SETS HER OFF?>>MOLDS AND MILDEWS AND ANIMALS AND THEN I JUST HAVE A BASELINE UNHAPPY LUNG.>>Teresa: WHEN SHE WAS A TEENAGER, TERESA’S FREQUENT HOSPITAL VISITS WERE REPLACED BY HOME THERAPIES WITH THE INTRODUCTION OF THE DRUG ALBUTEROL. IT IS A BRONCHODILATOR THAT RELAXES MUSCLES IN THE AIRWAYS AND INCREASES AIR FLOW TO THE LUNGS.>>IF I KNOW I’M GOING TO EXERCISE, I’LL ALWAYS TAKE MY ALBUTEROL INHALER, JUST A PUFF BEFORE I GO AND THEN I’M FINE. I CAN GO RUN A HALF MARATHON. SOMETIMES I’LL KEEP THAT INHALER WITH ME JUST IN CASE.>>Teresa: TERESA CONTROLLED HER ASTHMA WITH A DAILY DOSE OF CORTICOSTEROID, A MEDICINE THAT PREVENTS LUNG INFLAMMATION. SHE ADVISES OTHER ASTHMATICS TO KEEP A STRICT ROUTINE.>>TAKE YOUR MAINTENANCE MEDS. WHO WANTS TO TAKE A MEDICINE WHEN YOU’RE NOT FEELING SICK. THAT’S THE POINT IS IT KEEPS YOU FROM FEELING SICK AND WORKING WITH YOUR DOCTOR TO FIND THE LOWEST DOSE YOU CAN USE TO MAINTAIN AN EVEN BALANCE IN YOUR LIFE.>>Teresa: THIS IS ADVICE SHE SHARES WITH HER FAMILY.>>I HAVE THREE CHILDREN. MY OLDEST SON DOESN’T HAVE ANY ASTHMA. MY TWO DAUGHTERS, HOWEVER, DO. SIMILAR TO MINE WHERE THEY’RE ALLERGIC TO PETS. THEY ALSO HAVE EXERCISE-INDUCED ASTHMA.>>Teresa: WITH A MOM WHO RUNS A HALF MARATHON AND TRAVELS INTERNATIONALLY AND PLAYS THE FLUTE, TERESA’S GIRLS KNOW THEIR ASTHMA DOESN’T HAVE TO BE AN OBSTACLE.>>THERE ARE THINGS YOU CAN DO TO HAVE A WONDERFUL, VIBRANT LIFE AND STILL HAVE ASTHMA. I DON’T CONSIDER MYSELF, I’M AN ASTHMATIC. I DON’T WEAR IT LIKE A LABEL. IT IS SOMETHING I HAVE BUT IT ISN’T SOMETHING THAT KEEPS ME FROM ANYTHING.>>Teresa: I SAW YOU NODDING QUITE A BIT. SHE HAS A GREAT ATTITUDE.>>I WASN’T SLEEPING.>>Teresa: NODDING IN AGREEMENT WITH TERESA. SHE HAS A GREAT ATTITUDE. SHE KNOWS HOW TO MANAGE HER ASTHMA. SO MANY THINGS COMING INTO PLAY THERE. SHE MENTIONED SOME ALLERGIC TRIGGERS, ALSO.>>WELL, ASTHMA HAS BEEN MY FAVORITE DISEASE TO TREAT. I DON’T HAVE ASTHMA. FOR ALL OF MY CAREER IN MEDICINE. ONE OF THE REASONS IS IT IS A POTENTIALLY FATAL DISEASE BUT IT IS AN EXTREMELY TREATABLE DISEASE. I CAN’T MAKE THE POINTS AS WELL AS SHE DID. TAKE YOUR CONTROLLERS, IF YOU HAVE A DISEASE THAT’S DOES DOEST LIKE HYPERTENSION, YOU NEED A MEDICINE TO CONTROL THE DISEASE. SHE SPOKE WELL OF THAT ISSUE. IF YOU DON’T DO THAT, YOU CAN GET INVOLVED AND IT TRIGGERS FROM ALLERGIES OR ASPIRIN OR INFECTIONS AND I’VE SEEN PEOPLE DIE FROM THAT. AND I’VE SEEN MANY MORE LIVES IMPAIRED BY THAT. THE QUALITY OF LIFE IMPAIRED. AND SO IT’S SO NICE FOR US TO SEE PATIENTS LIKE MISS DeWIT. THAT’S WHAT THEY LIVE FOR TO HELP PATIENTS LIKE THAT. THERE ARE A LOT OF DISEASES WE CAN DIAGNOSE BUT NOT TREAT BUT ASTHMA IS A VERY CONTROLLABLE DISEASE. EVEN THE MORE SEVERE ASTHMATICS CAN LEAD A REALLY VERY GOOD LIFE IF THEY’RE DIAGNOSED PROPERLY. THEY DO ALL OF THE RIGHT THINGS, THEY DON’T SLEEP WITH THEIR CATS IT THEY’RE ALLERGIC TO CATS. THEY DON’T SMOKE AND TAKE THEIR MEDICATION. IT WAS HEARTENING TO ME. THAT’S WHY I WAS NODDING. IT IS A VERY GOOD TESTIMONY.>>Teresa: SHE STAYS EXTREMELY PHYSICAL FIT. SHE’S A RUNNER. HOW IMPORTANT IS THAT IN ALLERGIES OR ASTHMA TO MAKE SURE THAT YOU’RE EATING PROPERLY AND STAYING PHYSICALLY FIT?>>WELL, ONE OF THE THINGS THAT I LIKE THAT SHE SAID AND I TRY TO BE VERY CAREFUL WITH MY VERBAL HYGIENE WHEN I TALK TO SOMEONE WHO HAS ASTHMA, I SAY YOU’RE SOMEONE WHO HAS ASTHMA. YOU’RE NOT ASTHMATIC. IN OTHER WORDS, THE ASTHMA DOESN’T DEFINE WHO I AM. I HAPPEN TO BE SOMEONE WHO HAS ASTHMA. I HAVE TO DEAL WITH THIS. THIS IS SOMETHING THAT’S ON MY PLATE. SO ONE OF THE THINGS THAT YOU CAN DO IS TAKE YOUR MEDICINES. ANOTHER THING YOU CAN DO IS TAKE CARE OF YOUR BODY. EXERCISING THE LUNGS, JUST SEEMS OBVIOUS BUT YEAH, I MEAN BEING AS ABSOLUTELY INTO LIFE AS ONE CAN BE.>>Teresa: BECAUSE THERE WAS A TIME, MANY YEARS AGO, WHERE PEOPLE WITH ASTHMA WERE TOLD TO THE — NOT TO BE PHYSICALLY FIT OR OVEREXERT. THAT WASN’T WHAT YOU WERE SUPPOSED TO DO. COMPLETELY CONTRARY TO WHAT SHE DOES.>>I AGREE WITH DR. GOWER. IN OUR PRACTICE LIFETIME, ONE OF THE THINGS THAT’S BEEN HUGELY GRATIFYING IS THE TREATMENT OF ASTHMA. ASTHMA USED TO BE SOMETHING WHERE YOU WOULD BE HOSPITALIZED. YOU WOULD BE IN THE EMERGENCY ROOM. YOU WOULD BE CONSTANTLY USING QUICK-ACTING MEDICINES. YOU WOULD BE SICK. YOU WOULD BE MISSING OUT. YOU WOULD BE SIDELINED. WHEREAS TODAY, MOST PEOPLE WITH INTERMITTENT OR MILD OR MODERATE ASTHMA OR EVEN SEVERE ASTHMA ARE FULLY FUNCTIONAL. AND THAT’S BECAUSE OF ALL OF THESE ADVANCES IN JUST UNDERSTANDING HOW TO TREAT IT.>>I ALSO THINK THE PATIENT’S UNDERSTANDING THE DISEASE, I KNOW ALL FOUR OF US AROUND THE TABLE BELIEVE IN PATIENT EDUCATION. IN ADDITION TO TAKING THE MEDICINES, WEIGHING THE TRIGGER FACTORS AND TAKING CARE OF THE BODY, THEY HAVE TO UNDERSTAND THE DISEASE. WE HAVE WEBSITES, WE GIVE THEM LITERATURE AND ARTICLES AND EDUCATE THEM ON WHAT THE DISEASE PROCESS IS, HOW TO HANDLE IT AND LIVE WITH IT AND THE TIME TO NOT RUN A MARATHON IS AFTER YOU’VE HAD A BAD INFECTION. IT HAS GONE INTO YOUR CHEST AND SOME INFECTIONS GO INTO THE CHEST AND TRIGGER THE ASTHMA MORE THAN OTHERS. IT MAY BE TIME TO FOLD IT AND NOT RUN THAT TIME. SO KNOWING THEIR BODY, KNOWING WHAT THEIR LIMITS ARE. KNOWING WHAT THEY’RE CAPABLE OF IS VERY IMPORTANT, I THINK, AS WELL. SO THE EDUCATION ASPECT IS EXTREMELY IMPORTANT, I THINK.>>Teresa: WITH THAT SAID ALSO, THERE ARE SPORTS ASTHMATICS, PEOPLE WHO — WHEN THEY DO EXERT THEMSELVES, WILL HAVE ASTHMA. WHAT IS THE DIFFERENCE BETWEEN THE TWO?>>I THINK THERE’S DIFFERENT DEFINITIONS OF ASTHMA. IT IS WHERE YOUR AIRWAYS CLOSE DOWN AND THERE ARE PRECIPITATING FACTORS. WHAT’S WONDERFUL ABOUT HER, I WANT TO STEP BACK BUT MOST PEOPLE INNATELY WILL STOP WORKING OR DOING ANYTHING WHEN THEY’RE SHORT OF BREATH. THE FACT THIS LADY IS ACTIVE, USES PREVENTIVELY A PUFFER FOR EXERCISE-INDUCED CONSTRICTION IS A WONDERFUL OBSTACLE SHE’S OVERCOME. SO WHEN DOES — DO YOU DECIDE NOT TO, IF YOUR SYMPTOMS ARE WORSENING. IT IS A LEARNED BEHAVIOR. IF HER DAUGHTERS DEVELOP ASTHMA LATER IN AGE, THEY’LL MAKE SURE THEY’LL AVOID THEIR ALLERGIES AND CERTAIN PRECIPITATING FACTORS, AVOIDING PEOPLE WITH PERFUMES OR CATS OR DOGS. CHANCES ARE THEY WON’T GROW UP IN A HOUSEHOLD WITH A CAT OR DOG BECAUSE THEY HAVE A HISTORY OF REACTIVE AIRWAYS OR ASTHMA. I THINK IT IS IMPORTANT THAT PATIENTS BECOME COGNIZANT OF WHAT TRIGGERS THEIR ASTHMA. THEN UNDERSTANDING WHAT, YOU KNOW, THEIR MAINTENANCE THERAPY IS. THERE’S LOTS OF MEDICATIONS ON THE MARKET IN ORAL FORM, INHALED FORM. IN THE ARM METARIUM, THE KEYWORD SHE USED, MAINTENANCE. THAT’S VERY IMPORTANT. ONE MEDICINE MIGHT NOT WORK WELL FOR HER, MIGHT WORK WELL FOR ANOTHER PATIENT. BUT TRIAL AND ERROR IN PART PLAYS A BIG ROLE.>>Teresa: ABSOLUTELY.>>WITH RESPECT TO THE EXERCISE AS DR. PATEL SAID, TO EXTEND THAT A LITTLE BIT, NOT EVERYBODY RESPONDS TO THE SAME TRIGGER FACTORS THE SAME WAY. EXERCISE IS THE SOLE TRIGGER FACTOR FOR SOME PEOPLE WHO DON’T HAVE CHRONIC ASTHMA. THEY JUST HAVE EXERCISE-INDUCED –>>Teresa: WE SEE THAT IN CHILDREN. THEY’LL HIT THE SOCCER FIELD AND HAVE AN EPISODE.>>COUGHING IS USUALLY THE FIRST MANIFESTATION. JOHNNY IS RUNNING AND EVERY TIME HE RUNS OR PLAYS, HE COUGHS. THAT’S SOMETIMES THE FIRST MANIFESTATION OF ASTHMA SYMPTOMATOLOGY. THE EXERCISE CAN BE A TRIGGER FACTOR FOR SOME PEOPLE MORE THAN OTHERS. WHEN I ASK THEM, DO YOU HAVE ASTHMA? NO, I DON’T HAVE ASTHMA, I JUST HAVE EXERCISE-INDUCED ASTHMA. THE REALITY IS — THAT MAY BE TRUE BUT PEOPLE DON’T WANT TO HAVE ASTHMA. I DON’T BLAME THEM BUT THEY MAY HAVE JUST BRONC COSPASMS INDECEMBERRED BY EXERCISE BUT MOST OF THEM, 80%, 90% IS CHRONIC ASTHMA MADE WORSE BY EXERCISING. IT LEADS TO WHAT MISS DeWIT WAS SAYING, AVOID THE TRIGGERS, TAKE YOUR MEDICINES AND LIVE LIFE.>>Teresa: WE HAVE A NUMBER OF PHONE CALLS WE WANT TO TRY TO GET TO. VIVIAN FROM SPOKANE. GOOD EVENING, VIVIAN.>>Caller: GOOD EVENING. HOW IS EVERYONE TONIGHT?>>Teresa: WE ARE WONDERFUL.>>Caller: I HAVE AN ODD QUESTION. I’M 75. FOR 57 YEARS, I WAS A VERY, VERY HEAVY SMOKER. BUT I HAVE NOT SMOKED FOR A YEAR AND A HALF NOW. AND MY ALLERGIES ARE WORSE THAN THEY HAVE EVER BEEN. WOULD THE FACT THAT I’M NOT SMOKING MAKE THEM SEEM MORE IMPORTANT THAN THEY WERE WHEN I WAS SMOKING?>>Teresa: FIRST OF ALL, CONGRATULATIONS ON STOPPING SMOKING. OBVIOUSLY SHE’S GONE THROUGH A BIG CHANGE AFTER SMOKING FOR SO MANY YEARS. SO WHAT MAY BE GOING ON WITH VIVIAN AND THE ALLERGIES PRESENTING NOW THAT SHE’S STOPPED SMOKING?>>I THINK THE RESIDUAL EFFECTS OF TOBACCO ARE PROFOUND. TOBACCO ITSELF AND SMOKE INHALANTS AND THE OTHER 2200 CONSTITUENTS LEAD TO AIRWAY PHENOMENAL. THE CHRONIC INFLAMMATORY RESPONSE FROM TOBACCO AND THE NUMBER OF YEARS SHE SMOKED HAS AN EFFECT ON HER DAILY SYMPTOMS STILL. PERHAPS SHE NEEDS BETTER CONTROL OF HER CHRONIC INFLAMMATION AND IN HER AIRWAYS. PERHAPS IF SHE’S HAVING SYMPTOMS, AN INHALER, STEROID OR DIFFERENT AGENTS THAT ARE VENT VENTOLIN FORMS WILL MANAGE HER COUGH OR WHEEZE SHE’S DESCRIBING.>>ONE THING SUZANNE AND I HAVE NOTICED IN OUR EXPERIENCE IS WHEN PEOPLE HAVE STOPPED SMOKING, THEY BECOME MORE ALIVE. IT GOES TO THE POINTS THAT DR. PATEL WAS MAKING AND SOME SYMPTOMS THAT THEY MIGHT HAVE HAD, THEY DIDN’T KNOW THEY HAD BECAUSE OF THE SMOKE. AND WHEN THEY QUIT SMOKING, THEY TASTE BETTER, THEY SMELL BETTER, THEY’RE ALIVE MORE. ACTUALLY, THE CHEST SOMETIMES PRODUCES MORE PHLEGM. PEOPLE SAY I’M WORSE NOW IN MY CHEST. BUT THE SAME THING APPLIES IN THE NOSE AND SINUSES. THINGS START DISCHARGING, CLEANING THE LUNGS OUT, IF YOU WILL.>>Teresa: SHE COULD BE RECOGNIZING THE SYMPTOMS MORE.>>AT LEAST FROM THE LUNGS, THAT’S A GOOD THING TO GET THAT STUFF OUT OF THERE.>>AFTER TOBACCO SMOKE, THE HAIR FOLLICLES THAT PROPEL AND ELEVATE UP AND THEY STUNT — THEY’RE STUNNED WHEN YOU’RE AN ACTIVE SMOKER. AS THEY START TO RECHARGE AND REGENERATE, YOU START TO SLOUGH THE OLD MATERIAL AND YOU HAVE HAIR FOLLICLES THAT CAUSE MUCOUS TO MIGRATE UP.>>Teresa: OKAY. LET’S BRING IN BETTY FROM COEUR d’ALENE. GOOD EVENING. YOU HAVE A QUESTION FOR THE PANEL TONIGHT?>>Caller: HI. I DO. I HAVE ANGIOEDEMA. THAT’S AN ALLERGY AND I’M VERY ALLERGIC TO FRESH FRUITS AND SOME MEDICATIONS. AND I ATE FRESH FRUITS, MY MOUTH SWELLS. I HAVE TO DO AN EPIPEN. BENADRYL SOMETIMES HELPS. NOW, IS THERE AN — AND ALSO I’M ALLERGIC TO SOME PRESCRIPTION MEDICATIONS. IS THERE ANY PREVENTION OR TREATMENT THAT CAN BE DONE TO HELP THESE ALLERGIES?>>Teresa: ARE YOU CURRENTLY ON ANY TREATMENT, BETTY?>>JUST WHEN IT HAPPENS AND YOU NEVER KNOW.>>Teresa: OKAY. YOU’RE LOOKING FOR SOMETHING PREVENTIVE.>>YES.>>I CAN ADDRESS THAT. IS THERE ANY FAMILY HISTORY OF ANGIOEDEMA. BROTHERS, SISTERS, PARENTS?>>Caller: MY TWO DAUGHTERS.>>OKAY. THERE IS A SYNDROME, VERY RARE, 6,000, 7,000, 8,000 PEOPLE IN THIS COUNTRY WHO HAVE HEREDITARY ANGIOEDEMA. ONCE IT OCCURS, IT IS AUTO DOMINANT. IT DOESN’T NECESSARILY HAVE TO BE YOUR PARENTS. IT CAN BE YOU AND THEN YOUR SIBLINGS. THAT’S A POSSIBILITY. FOR THAT, WE HAVE LOTS OF NEW TREATMENTS. FOR MOST ANGIOEDEMA OR SWELLING WHICH IS LIKE BIG HIVES, IF YOU WILL, DEEPER VESSEL INVOLVEMENT, LEAKY VESSELS, THAT’S WHAT WE CALL ANGIOEDEMA OF THE GARDEN VARIETY TYPE FROM FOODS AND DRUGS AND OTHER THINGS. THE ONLY REAL TREATMENT FOR THAT THAT I KNOW OF IS AVOIDANCE, AVOIDANCE AND KNOWING CROSS REACTIVITIES OF FOODS AND MEDICATIONS AND TAKING ANTIHISTAMINES AND OTHER MEDICINES TO DEPRESS THE INFLAMMATORY RESPONSE.>>Teresa: IN SOME CASES, SHE DOESN’T KNOW SHE’S GOING TO HAPPEN — IT’S GOING TO HAPPEN –>>BUT IT MAY BE CROSS REACTIVE WITH THINGS SHE KNOWS SHE’S SENSITIVE TO.>>Teresa: DR. KERNERMAN?>>I THINK SHE SHOULD BE VISITING WITH SOMEONE. I WAS THINKING FRESH FRUITS AND VEGETABLES, THERE IS AN ODD VARIATION ON FOOD ALLERGY CALLED ORAL ALLERGY SYNDROME WHERE YOU HAVE PEOPLE THAT REACT TO FRESH FRUITS AND VEGETABLES TO CERTAIN POLLENS THAT THEY BOT ANICALLY CROSS REACT TO WHICH IS A WAY DIFFERENT THING THAN ANGIOEDEMA. IT CAN CAUSE ANGIOEDEMA BUT IT IS A DIFFERENT BEAST ENTIRELY. SO IF NOT HAVING VISITED AN ALLERGIST BEFORE, THEN PLEASE DO SO NOW.>>Teresa: OKAY. VERY GOOD. JERRY FROM OTIS ORCHARDS. GOOD EVENING.>>Caller: GOOD EVENING. ALLOW ARE YOU?>>Teresa: VERY WELL.>>Caller: I’M ENJOYING YOUR PROGRAM. JUST WANTED TO MENTION YOU HAD SPOKEN OF A WORKER THERE AT THE STATION THAT HAS HAD DRY EYES. AND WHEN SHE TOOK DROPS, APPARENTLY IT DIDN’T HELP. I’VE HAD DRY EYES FOR A NUMBER OF YEARS AND I HAD A DOCTOR ACTUALLY HELP ME WITH THAT, AN M.D. WHO SAID IF I WOULD INCREASE THE EYEIO DINE PRODUCTION — THE IODINE INTAKE IN MY DIET, THAT IT WOULD HELP THE DRY EYES AND HE PUT ME ON A LITTLE PROGRAM WHERE I PUT IT IN FRUIT JUICE AND TOOK IT EACH DAY. AND I CAN HONESTLY SAY IT CERTAINLY DID INCREASE THE TEAR PRODUCTION AND I WAS JUST WONDERING IF THE DOCTORS MIGHT HAVE SOME THOUGHTS ON THAT. IF IT IS A METHOD THEY USE OR JUST THIS PARTICULAR PHYSICIAN.>>Teresa: DO YOU HAVE THE DRY EYES THIS TIME OF YEAR OR YEAR AROUND?>>Caller: YEAR AROUND. IT IS NOT NECESSARILY, YOU KNOW –>>Teresa: ALLERGY-RELATED.>>Caller: BUT IT CERTAINLY DOES INCREASE THE TEAR PRODUCTION. HE PUT ME ON IT PRETTY HEAVY DOSAGE FOR A PERIOD OF TIME. AND THEN TAPERED IT OFF. IT DID WORK.>>Teresa: OKAY. SUSAN, IS THAT SOMETHING YOU’VE EVER HEARD OF?>>I THINK THAT’S A BETTER QUESTION FOR OUR ALLERGIST FRIENDS BECAUSE I’M NOT FAMILIAR WITH THAT AT ALL.>>I’M GLAD HE’S BETTER. AS WE ALL AGE, WE TEND TO GET DRY SKIN, DRY EYES, DRY MOUTH AND SO ON. THERE’S AUTOIMMUNE DISEASES THAT ARE ASSOCIATED WITH THAT, TOO, HEARING NONE FROM JERRY, I DON’T ASSOCIATE THAT. BUT I DON’T KNOW HOW THE MECHANISM OF IODINE IN THE JUICES WOULD HELP. GLAD IT DID. IT COULD HAVE BEEN CIRCUMSTANTIAL. RELATIVELY SAFE. WITHOUT HARMS THAT I UNDERSTAND. I DON’T UNDERSTAND THE MECHANISM THERE.>>Teresa: INTERESTING THOUGH. IT SEEMED TO WORK FOR HIM. THAT’S GOOD TO HEAR. I’LL PASS THAT ALONG TO MY COWORKER ALSO. SOMETHING WE’VE JUST BARELY TOUCHED ON AND WE’VE GOTTEN INTO THE FOOD ALLERGIES BUT CERTAINLY PEANUT ALLERGIES HAVE BECOME SO PREVALENT IN THE LAST FEW YEARS, ESPECIALLY AMONG CHILDREN. DEADLY IN SOME CASES. AND IN SOME CASES, CHILDREN CAN’T EVEN BE NEAR A PEANUT OR A PRODUCT THAT HAS PEANUTS IN IT. WHAT ARE WE SEEING WITH PEANUT ALLERGIES THAT WE DIDN’T SEE WHEN I WAS A CHILD? DR. GOWER?>>IT IS RECOGNIZED MORE. IT IS MORE COMMON AS WELL, I THINK. IN THIS COUNTRY, WE BASICALLY ROAST THE PEANUTS AND THE NUTS SAY MORE THAN IN CHINA AND THAILAND. THEY BROIL THEIRS, I THINK. THERE IS A DIFFERENCE IN THE ANTIGENICITY OF THE PRODUCT. SO WE’RE SEEING THAT MORE AND MORE. IT IS A PROBLEM, ESPECIALLY ON AIRPLANES AND SCHOOLS AND SO ON. AGAIN, HALLMARK TREATMENT OF ANY ALLERGY IS TO AVOID — IDENTIFY AND AVOID, AVOID, AVOID. THE NICE THING ABOUT PEANUT ALLERGY, IF THERE IS ANYTHING, THERE ARE ORAL DESENSITIZATION PROGRAMS THAT HAVE BEEN DEVELOPING WITH SUCCESS. IT IS STILL NOT STANDARD OF PRACTICE. THERE IS NO LICENSE FOR THAT IN THIS COUNTRY BECAUSE OF THE RISKS OF THAT BUT IT WORKS. AND WE WILL SEE THAT HOPEFULLY IN MY LIFETIME AND I THINK THAT WHAT YOU DO IS FOR THOSE PEOPLE WHO CANNOT AVOID, YOU PUT THEM ON THE THERAPY TO DESENSITIZE THEM TO HELP PROTECT THEM AND GIVE THEM QUALITY OF LIFE AND MOBILITY OF MOVEMENT.>>Teresa: SO IT IS A PROCESS OF SLOWLY INTRODUCING –>>SAME THING WITH THE DESENSITIZATION. WHAT WE’RE DOING WITH DESENSITIZATION OF ANY SORT AND LIKE THE ASPIRIN DESENSITIZATION FOR DR. KERNERMAN IS FOOLING THE BODY INTO ACCEPTING IT AS NOT FOREIGN. AND IT WORKS. ALLERGY SHOTS HAVE BEEN USED FOR A HUNDRED YEARS. THE ORAL TABLETS HAVE BEEN USED IN EUROPE NOW LICENSED IN THIS COUNTRY. ASPIRIN DESENSITIZATION HAS BEEN USED FOR 20 YEARS, 30 YEARS IN THIS COUNTRY. THE PEANUT DESENSITIZATION HAS BEEN EVOLVING FOR 20 YEARS, AT LEAST. I THINK THAT WE’LL SEE THAT HAPPEN IN THE NEAR FUTURE AS IT IS PERFECTED WHICH WILL BE LIFE SAVING FOR SOME PEOPLE BECAUSE SOME PEOPLE CANNOT AVOID AND THEY’RE SO SUPER SENSITIVE THAT LITTLE BITS WILL SET THEM OFF. THAT’S THE REMARKABLE THING ABOUT THIS FIELD. NOT JUST THE STUFFY NOSE. IT IS ANAPHYLAXIS AND IT IS DEATH NOT JUST FROM ASTHMA BUT FROM FOODS.>>Teresa: IT CAN BECOME DEADLY.>>YES. BEE STINGS, AS WELL. THAT’S CALLED ANAPHYLAXIS. THAT’S WHAT PEANUTS DO.>>Teresa: THOSE PATIENTS WILL CARRY AN EPIPEN WITH THEM? UNLESS THEY DON’T KNOW THEY HAVE IT.>>CORRECT.>>Teresa: THEN IT CAN BECOME QUITE DANGEROUS. LET’S TAKE ANOTHER PHONE CALL. MILLIE FROM THE AIR FORCE BASE.>>Caller: GOOD EVENING. I’M SORRY FOR MY VOICE BUT I HAVE FALLEN VICTIM TO THIS CONTAGIOUS GAMBU I CALL IT THAT’S BEEN GOING AROUND. I WOULD LIKE TO ASK WHAT I SHOULD DO — I DON’T WANT TO GO TO AN EMERGENCY ROOM BECAUSE IT HANGS ON FOR A WEEK. MY THROAT IS ON FIRE. MY CHEST IS ON FIRE. AND I’M EXHAUSTED. SO WHAT SHOULD I DO?>>Teresa: IT JUST STARTED?>>Caller: I’VE HAD IT FOR THREE DAYS AND I STILL HAVE TO WORK AND IN FACT, I GET IT — I GOT IT FROM MY CLIENT. I’M A CAREGIVER.>>Teresa: OKAY. SO IT IS NOT AN ALLERGY?>>Caller: NO. IT IS NOT.>>Teresa: DO YOU KNOW IF IS THERE A TRIGGER, SOMETHING THAT CAUSES YOU TO GET IT EVERY YEAR?>>Caller: DIE GET IT EVERY YEAR. I’VE GOTTEN IT FROM MY CLIENT AND I’VE HAD ANOTHER FRIEND WHO HAD IT. THEY’VE BEEN DOWN FOR A WEEK. I JUST DON’T KNOW IF I SHOULD GO TO MY ALLERGIST OR SHOULD I GO TO THE DOCTOR?>>Teresa: OKAY.>>GO TO YOUR DOCTOR.>>A VISIT TO THE PRIMARY CARE IS WARRANTED, DEFINITELY.>>Teresa: SHE SOUNDS MISERABLE.>>YES, SHE DOES. SOUNDS LIKE SHE CAUGHT A VIRUS. PROBABLY NOT A SEASONAL ALLERGY.>>Teresa: THERE IS SOME CRUD GOING AROUND. IT IS MIXED IN, TOO, WITH THE SEASONAL ALLERGIES RIGHT NOW.>>VIRUSES CAN TRIGGER ALLERGIES AND THE POST-NASAL DRIP.>>Teresa: THERE THEY GO COLLIDING AGAIN. SO MUCH FUN! YOU MENTIONED ALSO BEES. A NUMBER OF YEARS AGO, MY OWN FATHER WHO HAD A NUMBER OF BEE STINGS WAS STUNG BY A BEE. THE THROAT STARTED TO CLOSE. I WAS HOME WITH HIM. HAD NO IDEA WHAT WAS GOING ON. HE DIDN’T EVEN RECOGNIZE WHAT WAS GOING ON. AGAIN, HEN STUNG A NUMBER OF TIMES AND THIS ONE PARTICULAR TIME, HAD A BAD REACTION. HOW COMMON IS THAT SORT OF OUT OF THE BLUE OR IS A DIFFERENT VARIETY OF SPECIES OF A BEE THAT YOU’RE GETTING STUNG BY? BECAUSE I DON’T THINK IT HAS HAPPENED TO HIM SINCE.>>THIS IS ANOTHER AREA WHERE AN ALLERGIST CAN BE EXTREMELY HELPFUL. SOMEONE WHO’S HAD A SYSTEMIC REACTION, DEFINED BY LOSING THEIR BLOOD PRESSURE, HAVING ANAPHYLAXIS, HAVING SWELLING IN THE THROAT –>>Teresa: AND IT HAPPENED SO FAST.>>SOMETHING THAT HAPPENS THAT FAST, THERE’S TREATMENT. PEOPLE THAT ARE SPECIFICALLY ALLERGIC TO SPECIFIC BEES FOR EXAMPLE A YELLOW JACKET, THEY CAN BE TESTED FOR IT AND BE DESENSETIZED FOR THAT. IN OUR WORLD OF ALLERGY, THAT’S A VERY SATISFYING TREATMENT BECAUSE IT IS EFFECTIVE AND IT CAN PREVENT PEOPLE FROM GOING INTO A SYSTEMIC-TYPE REACTION IN THE FUTURE. SO IF SOMEONE HAS THAT, IT IS REALLY WORTHWHILE, EXPLORING, NOT JUST ACCEPTING OKAY, I’M GOING TO SIT INSIDE IN THE SUMMER AND I’M NOT GOING TO GO TO PICNICS AND I’LL HAVE MY EPIPEN WITH ME ALL OF THE TIME. THERE ARE THINGS YOU CAN DO.>>Teresa: THAT’S GOOD TO KNOW.>>WE’VE ALL SEEN THAT AND THE GRANDMOTHER WHO SITS BEHIND THE DINING ROOM DOOR FOR 20, 30 YEARS WATCHING HER KIDS OR GRANDKIDS HAVING PARTIES BECAUSE IF SHE GETS STUNG, SHE HAS A 50%, 60%, 70% CHANCE OF DYING. THE IMMUNOTHERAPY TO VENOMS THAT THE DOCTOR BRINGS UP IS ABOUT 97% EFFECTIVE. THAT’S ABOUT AS GOOD AS PENICILLIN FOR STREP THROAT IF YOU TAKE THE SHOTS. ONCE YOU GET ON IT, IT GIVES VERSATILITY AND COMFORT AND QUALITY OF LIVE. AGAIN, YOU HAVE TO RECOGNIZE ARE YOU BAD ENOUGH TO GO SEE SOMEBODY ABOUT IT AND THIS IS WHERE THE DISCIPLINE OF ASSESSING THE SEVERITY OF THE PROBLEM LIKE YOUR FATHER HAD BECAUSE THEY NEVER HAD IT BEFORE. IF THEY SURVIVE, THEY FEEL FINE.>>Teresa: HE’S NEVER SOUGHT TREATMENT.>>I DIDN’T KNOW THAT BUT I ASSUMED THAT. BUT A LOT OF PEOPLE DON’T. WHEN WE TAKE THE HISTORIES, AT LEAST THE — WE ASK VENOM SENSITIVITY. NOT ANYMORE. I ALMOST DIED. I WENT UNCONSCIOUS, LOST MY BLOOD PRESSURE BUT I’M OKAY NOW. HAVE YOU BEEN STUNG SINCE? NO. BUT THE NUMBERS SHOW IF THEY GET STUNG AGAIN BY THE SAME OR SIMILAR CRITTER, THEY HAVE A 40% TO 70% CHANCE OF HAVING THE SAME, WORSE OR DEAD AND THEY DON’T ALL CARRY THEIR EPIPEN OR EPINEPHRINE. THERE ARE THREE OR FOUR PRODUCTS THAT HAVE EPINEPHRINE ON THE MARKET AT THIS POINT. IT IS TOUGH TO CARRY THAT STUFF WITH YOU ALL THE TIME. SO THE SHOTS GIVE THE VERSATILITY WITH CREATIVE EFFICACY.>>SOMETHING THAT I FIND FASCINATING IS I’LL SEE SOMEONE WHO TRULY IS ALLERGIC TO BEES. AND WE DO TESTING AND WE GO THROUGH THE EXPLANATION OF GOING ON DESENSITIZATION. I DIDN’T KNOW THIS WAS AVAILABLE. LIKE IT IS SOMETHING THAT’S A UNIQUE TREATMENT WHEREAS THIS HAS BEEN AVAILABLE FOR A HUNDRED YEARS. PERFECTED MAYBE 40 YEARS AGO WHEN WE WENT TO SPECIFIC VENOMS AND BETTER TECHNIQUES OF DIAGNOSING AND TREATING BUT STILL, THIS IS SOMETHING WHERE IF EVER YOU COULD GET THE WORD OUT TO SOMEONE, YOU WOULD REALLY HOPE SOMEONE WHO IS ANNA FILL ACTICALLY ALLERGIC TO BEE STINGS TALKS TO SOMEONE ABOUT IT BECAUSE THERE ARE THINGS THAT CAN BE DONE.>>Teresa: THIS IS AN EXCELLENT PLATFORM FOR THAT. A LOT OF PEOPLE LISTENING ARE HAVING LIGHT BULB MOMENTS. LET’S BRING IN JIM FROM EAST WENATCHEE WITH A PHONE CALL THIS EVENING. GOOD EVENING, JIM.>>Caller: THANK YOU SO MUCH FOR TAKING MY CALL AND THANK YOU FOR YOUR WONDERFUL PROGRAM AND ALL OF YOUR PARTICIPANTS THERE. VERY INTERESTING. I KNOW YOU STARTED OUT THERE WITH ASTHMA. AND IT TRIGGERS A QUESTION. I WAS WONDERING CAN DOCTORS TELL IF A PERSON HAS ASTHMA AS WELL AS FIBROSIS. I’VE BEEN DIAGNOSED WITH PULMONARY FIBROSIS BUT I WONDER IF I HAVE ASTHMA, TOO. MY MOTHER HAD IT. SHE DIED BECAUSE OF IT. SHE WENT INTO A COMA. A FRIEND OF MINE HAS ASTHMA AND HE TELLS ME DIFFERENT THINGS HE DOES LIKE HOT COFFEE TO CALM DOWN HIS ASTHMA. I’VE TRIED THAT AND IT HELPED. I THINK A HOMEOPATHIC MEDICATION FOR ASTHMA SOMETIMES AND THAT SEEMS TO HELP, TOO. SO CAN YOU DISTINGUISH BETWEEN THE TWO OR ARE THEY ALL LUMPED TOGETHER OR CAN DOCTORS TELL IF I HAVE ASTHMA, TOO?>>Teresa: DR. PATEL?>>COMPLICATED ISSUE. BUT WHEN HE DESCRIBES PULMONARY FIBROSIS, A DISEASE OF THE INFRASTRUCTURE OF YOUR LUNG. IF YOU IMAGINE A WALL WITH PAINT, BEHIND ARE FOUR BY FOURS. PULMONARY FIBROSIS IS A DISEASE OF THE FRAMEWORK, THE FOUR BY FOURS. ASTHMA IS SOMEWHAT IN THE BRONCHIAL AIR WAY ISSUE. YOU CAN CERTAINLY HAVE ASTHMA GROWING UP AND IT BE CONTROLLED AND UNFOLD. PULMONARY FIBROSIS IS A DISEASE THAT’S AN UMBRELLA. UNDER THE UMBRELLA IS AN AUTOIMMUNE DISORDER. THERE COULD BE IDEOPATHIC — IT COULD BE RELATED TO SMOKING. YOU CAN GET FIBROSIS. RELATE TO SOME MEDICATION OR DRUG. SO YOU CERTAINLY CAN DIFFERENTIATE BETWEEN PULMONARY FIBROSIS AND ASTHMA. PULMONARY FIBROSIS TYPICALLY PRESENTS WITH COUGH AND THEN THE SHORTNESS OF BREATH TYPICALLY ISN’T RELIEVED BY AN INHALER.>>Teresa: THE TWO NEED TO BE TREATED INDEPENDENTLY.>>OR MONITORED INDEPENDENTLY. PATIENTS VARY. YOU DON’T HAVE JUST ONE THING. PULMONARY FIBROSIS, DEPENDING ON THE TYPE, IF HE HAS TOBACCO RELATED CALLED RESPIRATORY LUNG PROBLEMS, IT IS PART OF THE TREATMENT FOR THE FIBROSIS THAT OCCURS FROM THAT IS STOP SMOKING AS WELL AS INHALERS. SO THERE’S SOME OVERLAP AND CERTAIN TYPE OF PULMONARY FIBROSIS.>>Teresa: CERTAINLY A DISCUSSION HE NEEDS TO HAVE WITH HIS DOCTOR.>>IN ADDITION TO THAT, I THINK THE WAY WE MAKE THAT ASSESSMENT IS THE LITTLE GRAY CELLS LIKE IS SAID, USE THE LITTLE GRAY CELLS. YOU HAVE TO KNOW THE HISTORY. THINK ABOUT IT. BUT THEN YOU HAVE TO TEST. I DON’T THINK WE’VE DISCUSSED IT TONIGHT. THE TEST IS THE WAY YOU MAKE THE DIAGNOSIS OF ASTHMA. I SEE SO MANY PATIENTS WHO ARE ON BRONCHODILATORS OR ASTHMA MEDICINES, CONTROLLERS, THEY’VE NEVER HAD A PULMONARY FUNCTION TEST. THE EXAMPLE I GIVE TO THEM IS IF YOU HAVE HIGH BLOOD PRESSURE, WOULD YOU START BLOOD PRESSURE MEDICINE, IF YOU HAVE DIABETES, HOW DO I KNOW WHAT YOUR BLOOD SUGAR IS UNLESS WE MEASURE IT.>>Teresa: THOSE ARE PRESCRIBED MEDICATIONS. SO ARE DOCTORS PRESCRIBING THE MEDICATION –>>THE DIAGNOSIS OF ASTHMA ON THE HISTORY AND THE PHYSICAL BUT THEY DON’T DO THE PULMONARY FUNCTION TEST MANY TIMES. THAT’S NOT WHAT THEY SHOULD DO. YOU CAN’T MAKE THE DIAGNOSIS ADEQUATELY WITH PULMONARY FIBROSIS UNLESS YOU DO A LISTEN, A CHEST X-RAY AND A CT AND SO ON OR BIOPSY. THERE ARE DIFFERENT WAYS TO ASSESS IT. YOU GO DOWN THE LINE BUT A PULMONARY FUNCTION CHEST AND A CHEST X-RAY IF THE PERSON HAS SYMPTOMS THAT ARE REQUIRING MEDICATIONS. NOT AT ALL UNWARRANTED.>>ABSOLUTELY. TO DIFFERENTIATE THE OBVIOUS, ASTHMA IS AN OBSTRUCTIVE FUNCTION. PULMONARY IS A RESTRICTIVE PROBLEM. WHEN YOU BREATHE, YOU BREATHE IN. THAT’S AN ACTIVE PROCESS. BREATHING OUT IS A PASSIVE PROCESS. PULMONARY CAUSES LIMITATION OF BREATHING IN. ASTHMA IS AN ISSUE WITH BREATHING OUT. SO THERE ARE SEVERAL CAVEATS.>>JUST ONE ADDITIONAL POINT, THE ASTHMA CAN BE SO DRAMATICALLY BAD AND FATAL, USUALLY IT’S NOT BUT CAN BE. PULMONARY FIBROSIS TENDS TO BE MORE INSIDIOUS, GRADUAL, PROGRESSIVE. I’VE SEEN PEOPLE WAY ADVANCED IN PULMONARY FIBROSIS WHEN THEY WOULD HAVE BEEN DIAGNOSED 10, 20 YEARS AGO. NO CHEST X-RAY WAS DONE. I’VE SEEN PATIENTS WITH PULMONARY FIBROSIS WHO HAVE HAD A CHEST X-RAY EVERY YEAR. READ AS NORMAL AND THEY WEREN’T NORMAL. SO IT TAKES MULTIPLE EVALUATIONS AND SEVERAL PEOPLE SOMETIMES LOOKING AT THE SAME PICTURE TO COME UP WITH THE RIGHT ANSWER.>>Teresa: CERTAINLY JIM HAS A LOT TO DISCUSS WITH HIS DOCTOR OR DOCTORS. WE’RE COME TOWARD THE END OF THE PROGRAM. AND SO I WANT TO GET SOME FINAL THOUGHTS FROM EACH OF YOU. I CAN’T BELIEVE AN HOUR HAS ALREADY PASSED. CERTAINLY, I THINK ONE OF THE THINGS I’M TAKING AWAY FROM TONIGHT’S SHOW IS YOU DON’T HAVE TO SUFFER IF YOU HAVE ALLERGIES OR ASTHMA. AND DR. PATEL, SOME FINAL THOUGHTS.>>ASTHMA IS A CONTROLLABLE DISEASE. YOU HAVE TO BE COGNIZANT OF YOUR SYMPTOMS AS YOU’RE GROWING UP WITH IT, YOU CERTAINLY NEED TO ADDRESS AND AVOID THE PRECIPITATING FACTORS. I THINK MAINTENANCE THERAPY IS AN IMPORTANT PART. AVOID SANS A BIG PART. AND THEN MOVING FORWARD, AVOID THOSE INDIVIDUALS WHO SMOKE AND DON’T SMOKE. ONE OF THE MORE COMMON REASONS FOR WHY ASTHMA EXACERBATES.>>Teresa: DR. GOWER.>>YOU SUMMARIZED IT, PATIENTS SHOULD NOT SUFFER UNNECESSARILY. DR. KERNERMAN ADDRESSED THIS EARLIER. IF YOU HAVE MILD ALLERGIES, YOU TREAT IT WITH AVOIDANCE AND MILD SAFE, OVER-THE-COUNTER MEDICINES. I HAVE NO PROBLEM. I DON’T NEED TO SEE YOU IN THE OFFICE. THE MAJORITY OF PATIENTS, THERE’S 25, 40 MILLION PEOPLE WITH ALLERGIES, 25 MILLION WITH ASTHMA, MANY OF THEM ARE NOT WELL ENOUGH CONTROLLED BECAUSE THEY DON’T ASK ENOUGH OF THEMSELVES AND THEY CHEAT THEMSELVES, I THINK OF QUALITY OF LIFE. THEY SHOULDN’T DO THAT.>>Teresa: DEMAND MORE. DR. KERNERMAN?>>WITH REGARD TO ALLERGIES, I THINK THAT IN A WAY, I DON’T THINK WE’VE BEEN BETTER AT DIAGNOSING OR BETTER AT TREATING THAN WE ARE NOW. THERE ARE SO MANY THINGS THAT CAN BE DONE. SO MANY THINGS PEOPLE CAN DO TO AVAIL THEMSELVES TO AND IT IS ONLY GOING TO GET BETTER. I TELL PEOPLE JUST TALKING ABOUT PEANUT AGAIN, WHO HAVE BAD PEANUT ALLERGY, OKAY, YOU MIGHT NOT OUTGROW IT BUT HOW DO I KNOW IN FIVE OR TEN YEARS WE MIGHT NOT HAVE IMMUNOTHERAPY FOR THAT. THERE ARE AMAZING THINGS. 50 YEARS AGO, IF YOU HAD TOLD SOMEONE YOU USE THIS INHALER EVERY DAY AND YOU’LL GO RUNNING HALF MARATHONS, THEY WOULD HAVE BEEN LIKE YEAH, WHATEVER.>>Teresa: ABSOLUTELY. SUSAN?>>IF YOU HAVE ALLERGIES AND THEY’RE NOT BEING WELL-TAKEN CARE OF BY THE OVER-THE-COUNTER OR BY AVOIDANCE, COME IN, SEE US, WE CAN HELP YOU DIAGNOSE, HELP YOU AVOID AND HELP YOU TREAT.>>Teresa: AND HELP YOU LIVE A BETTER LIFE.>>CORRECT.>>Teresa: I WANT TO THANK THE PANEL SO MUCH THIS EVENING. A GREAT DISCUSSION. UNFORTUNATELY, THAT WILL DO IT FOR THIS SHOW. BUT BEFORE WE GO, WE WOULD LIKE TO THANK THE SPONSORS OF TONIGHT ‘S SPONSORS OF “HEALTH MATTERS.” PROVIDENCE HEALTHCARE. WE’RE BACK ON MAY 15th WHEN OUR TOPIC WILL BE BRAIN DEVELOPMENT. UNTIL THEN, THANKS FOR WATCHING. I’M TERESA LUKENS. GOOD NIGHT.>>Announcer: “HEALTH MATTERS” IS MADE POSSIBLE BY VIEWERS LIKE YOU, THE FRIENDS OF KSPS AND BY THE FOLLOWING.>>I REALLY LIKED THE IDEA OF BEING PART OF PROVIDENCE WHERE IF I HAVE A QUESTION, IF THERE’S SOMETHING I’M CONCERNED ABOUT, I CAN ALWAYS CALL A SPECIALIST.>>I’M DR. ANABARBER AND I CHOSE PROVIDENCE BECAUSE HERE I CAN HELP CHILDREN THRIVE AND REACH THEIR HIGHEST POTENTIAL.>>IF YOU READ PROVIDENCE’S MISSION STATEMENT, IT IS ALL ABOUT DELIVERING QUALITY CARE TO THE PATIENT AT ALL TIMES. I’M DR. PETER RINALDI AND I CHOSE PROVIDENCE BECAUSE THEY PUT THE DOCTOR/PATIENT RELATIONSHIP FIRST.>>FIND YOUR DOCTOR ONLINE AT PHC.ORG.>>”HEALTH MATTERS” IS ALSO BROUGHT TO YOU BY HOLLISTER STIER ALLERGY, IMPROVING QUALITY OF LIFE FOR ALLERGY SUFFERERS SINCE 1921.>>WASHINGTON STATE UNIVERSITY SPOKANE, STUDYING THE FEASIBILITY OF A MEDICAL SCHOOL ON THE WSU SPOKANE HEALTH SCIENCES CAMPUS TO HELP SOLVE THE PRIMARY CARE PHYSICIAN’S CRISIS IN WASHINGTON. MORE AT MEDICINE.WSU.EDU.


Leave a Reply

Your email address will not be published. Required fields are marked *