Exercise-induced asthma

October 29th, 2010

Many athletes questions whether breathlessness during cardiovascular workouts is related to deconditioning, asthma, appropriate response, or another medical condition. Although the answer is not always immediately apparent, physical examination and basic tests are helpful to rule in or out some of the possible explanations for sub-optimal performance on the field or track. Lung function testing (spirometry) at baseline and (for some athletes) during exercise may revealed exercise-induced bronchospasm (EIB). When other conditions such as cardiac abnormalities, anxiety, reflux, and vocal chord dysfunction are excluded, EIB is usually manageable with a combination of behavioral modification and sometimes medications. Often, athletes find success when exercising in cold weather if they implement a slow warm-up AND slow cool-down to prevent bronchospasm. When additional treatment is necessary, it is best to measure lung function to exclude persistent asthma as the cause of EIB. As with most chronic diseases, physical activity (including vigorous cardiovascular workouts) is beneficial in chronic asthma.
Kevin Parks MD

Humoral Immunodeficiency

October 29th, 2010

This week at the allergy and asthma center we have seen 3 new diagnoses of humoral immunodeficiency–2 selective IgA deficient patients and 1 common variable immunodeficiency patient. These patients had experienced frequent respiratory infections and presented for evaluation of allergies and/or immunodeficiency as the underlying problem. A great website to learn about immunodeficiency is www.primaryimmune.org, hosted by the Immune Deficiency Foundation. Links for education centers are available as well as blogs, support services, and other interesting bits of information for patients and caregivers.
Kevin Parks MD

aspirin allergy or “aspirin-exacerbated respiratory disease”

October 1st, 2010

Lately we’ve seen several new patient with severe asthma, nasal polyposis, and aspirin (and other non-steroidal anti-inflammatory) intolerance. This diagnosis, “AERD” or aspirin-exacerbated respiratory disease, is typically made in adults during the 3rd – 6th decade of life.
Although some AERD patients are effectively managed with conservative medications alone, aspirin desensitization is a treatment option for select individuals, and provides a disease-modifying effect with fewer subsequent asthma exacerbations, reduction of nasal polyps, fewer sinus surgeries, improvement in lung function, less reliance on asthma medications, and improved taste/smell. Although aspirin desensitization was formerly performed only in the hospital setting, this can now be safely done in the outpatient setting for appropriate individuals. We’ve had success with individuals at AAC using the 2-day Scripps protocol.
If you think you have AERD, please discuss this option with your doctor!
Kevin Parks MD