A lung disease that inflames and narrows the airways, asthma has no cure.
It affects more than 25 million of Americans on a daily basis and nearly 25% of all asthma sufferers are children.
Board-certified Summit Medical Group allergist and immunologist, Alan J. Goodman, will discuss different types of asthma, asthma triggers, symptoms, and the treatment and management of this chronic condition.
Selected Podcast
Asthma
Featured Speaker:
Before joining Summit Medical Group, Dr. Goodman practiced privately with Allergy, Asthma, and Immunology, PA, in Livingston and Union, New Jersey. Dr. Goodman is Former Section Chief in the Division of Allergy at Union Hospital Medical Center in Union, New Jersey. He has been an allergy consultant for the Veterans Administration Medical Center Ambulatory Care Department in East Orange, New Jersey, Attending Allergist with Louis Lasky Medical Center in New York City, and an emergency department physician at Flushing Hospital Medical Center in Flushing, New York. While in Washington, DC, he was Director of House Officers and Employee Health at Sibley Memorial Hospital and an emergency department physician at Capitol Hill Hospital.
Dr. Goodman is Past President of the New Jersey Allergy and Immunology Society. He remains active on the New Jersey Allergy and Immunology Society Board of Directors. In addition, Dr. Goodman is a member of American Academy of Allergy, Asthma, and Immunology, New York Allergy Society, Medical Society of the State of New Jersey, and Essex County Medical Society.
Alan Goodman, MD
Alan J. Goodman, MD, JD, FAAAAI, specializes in allergies, asthma, rhinitis, bee sting allergy, and sinus disorders.Before joining Summit Medical Group, Dr. Goodman practiced privately with Allergy, Asthma, and Immunology, PA, in Livingston and Union, New Jersey. Dr. Goodman is Former Section Chief in the Division of Allergy at Union Hospital Medical Center in Union, New Jersey. He has been an allergy consultant for the Veterans Administration Medical Center Ambulatory Care Department in East Orange, New Jersey, Attending Allergist with Louis Lasky Medical Center in New York City, and an emergency department physician at Flushing Hospital Medical Center in Flushing, New York. While in Washington, DC, he was Director of House Officers and Employee Health at Sibley Memorial Hospital and an emergency department physician at Capitol Hill Hospital.
Dr. Goodman is Past President of the New Jersey Allergy and Immunology Society. He remains active on the New Jersey Allergy and Immunology Society Board of Directors. In addition, Dr. Goodman is a member of American Academy of Allergy, Asthma, and Immunology, New York Allergy Society, Medical Society of the State of New Jersey, and Essex County Medical Society.
Transcription:
Asthma
Melanie Cole (Host): A lung disease that inflames and narrows the airway, asthma has no cure. It can affect more than 25 million Americans on a daily basis and nearly 25% of all asthma suffers are children. Here with us today is board-certified Summit Medical Group allergist and immunologist, Dr. Allan Goodman. Welcome to the show, Dr. Goodman. Tell us about the different types of asthma and what are the most common triggers for them?
Dr. Allan Goodman (Guest): Arbitrarily, asthma is divided into two different categories: allergic and non-allergic asthma. But it’s a very blurred category. For the most part, a patient doesn’t care what’s causing their problems.
With a little child, a lot of times and not really having an allergic cause, they get sick. They get a cold, they get the flu; they get a respiratory volume. That’s considered to be the non-allergic asthma, while as they get a little older some of these problems may be more related to allergic causes. The pollens come out in the spring; they go visit their friends or their relative or grandma with a cat or a dog, they go horse-back riding. These people end up very sick because they’re not prepared or they never knew there was a problem.
Melanie: It can be quite scary to watch someone have an actual asthma attack. Back in the day, Dr. Goodman, if you were an asthmatic, you didn’t have gym, you didn’t go to recess, you pretty much stayed in, but that’s different today. Tell us about how people with asthma go about their daily life now.
Dr. Goodman: The ultimate goal is to give someone a normal lifestyle. Normal means being able to do whatever you want whenever you want. But the patient has to be aware that medications are very helpful and they should be taken on a regular basis, especially if they have known triggers or that it is a long-time problem. A common problem these days is exercise-induced asthma. With that, I mean that upon activity, whether it’s a gym class, whether someone’s going out dancing, whether they’re playing the softball game, whether they’re running, you can be Olympic athletic and still have asthma, but be able to quality because you know when to take your medicines and what medicines to take.
Melanie: What would we notice, as a parent or the school, if a child is having an asthma attack and what do we do about it these days? Give us some symptoms and then some emergent treatments and long-term treatments.
Dr. Goodman: The first symptom is ‘I can’t breathe’. The patient or child will say, “I feel heaviness in my chest.” It can come on suddenly or it can come on over a long period of time. “I’m sitting there and all of sudden, my chest feels heavy, I feel tight; I’m making wheezing sounds.” That’s the classical case of asthma.
When it’s a little bit hard to sort of sort out is when people have what’s known as cough variant asthma. They’re never really wheezing. They don’t have the specific shortness of breath, but they just start coughing. The primary treatment for these symptoms that may come up every now and then is to have an emergency inhaler, something in the family of Albuterol. Albuterol is a fast-acting medication that you inhale it, probably through a metered dose inhaler, or maybe with a small child or someone who is not coordinated, through a nebulizer. Within 10 to 15 minutes, this patient should feel a lot better.
Melanie: These are rescue medications in case of an attack. What about on a daily basis? Are there medications you recommend, Dr. Goodman, for asthma suffers that they take every day? And what about some of the over-the-counter ones? Gosh, there’s a million today that you can read about and hear about. Speak about those too, please.
Dr. Goodman: In terms of prevention, for those everyday symptoms, the best medication is the inhaled steroid. It’s gotten a lot of bad press. People say, “Steroids. I don’t want my child to be on steroids.” But if the patient is having symptoms, especially daily symptoms, they’re at more risk from not taking the medication than from taking the medication. Having to take a very low dose of inhaled steroid would be a very good preventive medication, allowing the patient, the child, the adult, to have a normal lifestyle as opposed as having these acute episodes where all of sudden they’re just sitting there and get short of breath and they can’t do their activities. Those are prescription medications.
Over-the-counter, there really, really aren’t very good medications for the treatment of asthma. Yes, if someone has allergies that will cause asthma, such as going to visit the animal, you can take an antihistamine beforehand to help prevent this problem, but that won’t treat the asthma symptoms per se.
Melanie: You’ve said you’ve liked the inhaled corticosteroids. What about some things that we see on TV like Singulair and the oral medications for a regular basis?
Dr. Goodman: Singulair is a reasonable medication, but unfortunately, it’s not as effective as the inhaled steroids, the inhaled corticosteroids. Singulair will work in a particular class of patients, but unfortunately there’s nothing we can tell when someone walks into the office if Singulair will be the good drug for them. While the inhaled corticosteroids, the inhaled steroids, work in the majority of patients across the board no matter what is causing their problem.
That, from an allergist’s point of view, is probably the primary medication. As I said before, it meets a lot of resistance from parents especially. I will start many times with the Singulair if I feel that the child has a mild case of asthma, and then we will assess to see how well they’re progressing, how much their activities are being impaired or allowed. That will let me tell the therapy that would be best for all parties concerned.
Melanie: Dr. Goodman, is it possible to avoid your triggers? Give us some lifestyle and home remedies, things that parents and asthma sufferers can do at home, whether it’s getting those allergen-reducing pillows or air filters. What can they actually do and do any of those really work?
Dr. Goodman: Oh, yes, they work a lot. That’s where the allergist comes in [handy], as a team member in helping provide the best care for the patient. By having a good allergic evaluation, we can help define some of these triggers, whether or not these mechanisms are necessary, these environmental control measures.
As it is known, a lot of patients will react to animals. They may be unsure or maybe reluctant to deal with that fact but to have that knowledge will help maintain the best environment. If someone is allergic to dust mites, to use those environmental covers that will wrap the pillow and the mattress, to get some of the stuffed animals off the bed, to remove the carpeting. Nothing in itself will be 100% but this will help maintain a better lifestyle and have less symptoms and less medication use.
Similarly, if we know that we have patients who have problems with animals, there’s a lot that can be done. Get the animal out of the bedroom, at a minimum, or maybe the animal out of the house. Air cleaners are not very good for dust mites but they are pretty good for animal allergies. Having an air cleaner in the room may help minimize, maybe not eliminate but minimize some of these symptoms.
Melanie: What about keeping a clean house? Does that have any affect?
Dr. Goodman: Yes, especially if you have problems with the environmental allergens: the dust, the cat, the dog. By eliminating a lot these problems or these allergens, there’ll be less triggers, so, yes, keeping a clean house, having less clutter, is very important.
Melanie: Dr. Goodman, you mentioned exercise-induced asthma. What about for people that don’t suffer from exercise-induced asthma? Can they exercise? Can they do those kinds of things outside or go to gym class, all of those kinds of things? Is that good or bad for their asthma?
Dr. Goodman: It’s not going to make their asthma any worse, so we try and keep them on the best and the most active lifestyle because for overall health, that’s pretty good. The more someone does, the more someone’s capacity will be. But exercising itself will not make the asthma go away, so you need to be prepared if there may be a potential problem.
I may make some environmental changes such as during the spring when the pollen season is very high in the northeast, to limit some the activities outdoors. But indoor activities in an environmentally controlled atmosphere, such as a gym or any sort of training area, will be totally allowed. But outdoor activities may bring about things if someone is not on medications or is not adequately controlled.
Melanie: In just the last minute or a half left, Dr. Goodman, give us your best advice for people listening that suffer with asthma or have a child or a loved one that suffers with asthma, your best advice for their lifestyle management of this chronic disease.
Dr. Goodman: First thing is to have a good action plan. You should know what’s going on, what’s causing the problems, and how are you going to treat this if it comes up? In the best case scenario, they will be stable and nothing will happen. If something were to happen, to have a plan, what do I take and when? That’s where the doctor, as a team manager, can help a lot to have the environmental survey, to go over the medications, what medications can be used where and when and why. A lot of patients have medications but they just don’t know what is its use. That’s where the doctor comes in handy, especially the allergist.
Melanie: Certainly great information. Thank you so much, Dr. Allan Goodman. You’re listing to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks for listening.
Asthma
Melanie Cole (Host): A lung disease that inflames and narrows the airway, asthma has no cure. It can affect more than 25 million Americans on a daily basis and nearly 25% of all asthma suffers are children. Here with us today is board-certified Summit Medical Group allergist and immunologist, Dr. Allan Goodman. Welcome to the show, Dr. Goodman. Tell us about the different types of asthma and what are the most common triggers for them?
Dr. Allan Goodman (Guest): Arbitrarily, asthma is divided into two different categories: allergic and non-allergic asthma. But it’s a very blurred category. For the most part, a patient doesn’t care what’s causing their problems.
With a little child, a lot of times and not really having an allergic cause, they get sick. They get a cold, they get the flu; they get a respiratory volume. That’s considered to be the non-allergic asthma, while as they get a little older some of these problems may be more related to allergic causes. The pollens come out in the spring; they go visit their friends or their relative or grandma with a cat or a dog, they go horse-back riding. These people end up very sick because they’re not prepared or they never knew there was a problem.
Melanie: It can be quite scary to watch someone have an actual asthma attack. Back in the day, Dr. Goodman, if you were an asthmatic, you didn’t have gym, you didn’t go to recess, you pretty much stayed in, but that’s different today. Tell us about how people with asthma go about their daily life now.
Dr. Goodman: The ultimate goal is to give someone a normal lifestyle. Normal means being able to do whatever you want whenever you want. But the patient has to be aware that medications are very helpful and they should be taken on a regular basis, especially if they have known triggers or that it is a long-time problem. A common problem these days is exercise-induced asthma. With that, I mean that upon activity, whether it’s a gym class, whether someone’s going out dancing, whether they’re playing the softball game, whether they’re running, you can be Olympic athletic and still have asthma, but be able to quality because you know when to take your medicines and what medicines to take.
Melanie: What would we notice, as a parent or the school, if a child is having an asthma attack and what do we do about it these days? Give us some symptoms and then some emergent treatments and long-term treatments.
Dr. Goodman: The first symptom is ‘I can’t breathe’. The patient or child will say, “I feel heaviness in my chest.” It can come on suddenly or it can come on over a long period of time. “I’m sitting there and all of sudden, my chest feels heavy, I feel tight; I’m making wheezing sounds.” That’s the classical case of asthma.
When it’s a little bit hard to sort of sort out is when people have what’s known as cough variant asthma. They’re never really wheezing. They don’t have the specific shortness of breath, but they just start coughing. The primary treatment for these symptoms that may come up every now and then is to have an emergency inhaler, something in the family of Albuterol. Albuterol is a fast-acting medication that you inhale it, probably through a metered dose inhaler, or maybe with a small child or someone who is not coordinated, through a nebulizer. Within 10 to 15 minutes, this patient should feel a lot better.
Melanie: These are rescue medications in case of an attack. What about on a daily basis? Are there medications you recommend, Dr. Goodman, for asthma suffers that they take every day? And what about some of the over-the-counter ones? Gosh, there’s a million today that you can read about and hear about. Speak about those too, please.
Dr. Goodman: In terms of prevention, for those everyday symptoms, the best medication is the inhaled steroid. It’s gotten a lot of bad press. People say, “Steroids. I don’t want my child to be on steroids.” But if the patient is having symptoms, especially daily symptoms, they’re at more risk from not taking the medication than from taking the medication. Having to take a very low dose of inhaled steroid would be a very good preventive medication, allowing the patient, the child, the adult, to have a normal lifestyle as opposed as having these acute episodes where all of sudden they’re just sitting there and get short of breath and they can’t do their activities. Those are prescription medications.
Over-the-counter, there really, really aren’t very good medications for the treatment of asthma. Yes, if someone has allergies that will cause asthma, such as going to visit the animal, you can take an antihistamine beforehand to help prevent this problem, but that won’t treat the asthma symptoms per se.
Melanie: You’ve said you’ve liked the inhaled corticosteroids. What about some things that we see on TV like Singulair and the oral medications for a regular basis?
Dr. Goodman: Singulair is a reasonable medication, but unfortunately, it’s not as effective as the inhaled steroids, the inhaled corticosteroids. Singulair will work in a particular class of patients, but unfortunately there’s nothing we can tell when someone walks into the office if Singulair will be the good drug for them. While the inhaled corticosteroids, the inhaled steroids, work in the majority of patients across the board no matter what is causing their problem.
That, from an allergist’s point of view, is probably the primary medication. As I said before, it meets a lot of resistance from parents especially. I will start many times with the Singulair if I feel that the child has a mild case of asthma, and then we will assess to see how well they’re progressing, how much their activities are being impaired or allowed. That will let me tell the therapy that would be best for all parties concerned.
Melanie: Dr. Goodman, is it possible to avoid your triggers? Give us some lifestyle and home remedies, things that parents and asthma sufferers can do at home, whether it’s getting those allergen-reducing pillows or air filters. What can they actually do and do any of those really work?
Dr. Goodman: Oh, yes, they work a lot. That’s where the allergist comes in [handy], as a team member in helping provide the best care for the patient. By having a good allergic evaluation, we can help define some of these triggers, whether or not these mechanisms are necessary, these environmental control measures.
As it is known, a lot of patients will react to animals. They may be unsure or maybe reluctant to deal with that fact but to have that knowledge will help maintain the best environment. If someone is allergic to dust mites, to use those environmental covers that will wrap the pillow and the mattress, to get some of the stuffed animals off the bed, to remove the carpeting. Nothing in itself will be 100% but this will help maintain a better lifestyle and have less symptoms and less medication use.
Similarly, if we know that we have patients who have problems with animals, there’s a lot that can be done. Get the animal out of the bedroom, at a minimum, or maybe the animal out of the house. Air cleaners are not very good for dust mites but they are pretty good for animal allergies. Having an air cleaner in the room may help minimize, maybe not eliminate but minimize some of these symptoms.
Melanie: What about keeping a clean house? Does that have any affect?
Dr. Goodman: Yes, especially if you have problems with the environmental allergens: the dust, the cat, the dog. By eliminating a lot these problems or these allergens, there’ll be less triggers, so, yes, keeping a clean house, having less clutter, is very important.
Melanie: Dr. Goodman, you mentioned exercise-induced asthma. What about for people that don’t suffer from exercise-induced asthma? Can they exercise? Can they do those kinds of things outside or go to gym class, all of those kinds of things? Is that good or bad for their asthma?
Dr. Goodman: It’s not going to make their asthma any worse, so we try and keep them on the best and the most active lifestyle because for overall health, that’s pretty good. The more someone does, the more someone’s capacity will be. But exercising itself will not make the asthma go away, so you need to be prepared if there may be a potential problem.
I may make some environmental changes such as during the spring when the pollen season is very high in the northeast, to limit some the activities outdoors. But indoor activities in an environmentally controlled atmosphere, such as a gym or any sort of training area, will be totally allowed. But outdoor activities may bring about things if someone is not on medications or is not adequately controlled.
Melanie: In just the last minute or a half left, Dr. Goodman, give us your best advice for people listening that suffer with asthma or have a child or a loved one that suffers with asthma, your best advice for their lifestyle management of this chronic disease.
Dr. Goodman: First thing is to have a good action plan. You should know what’s going on, what’s causing the problems, and how are you going to treat this if it comes up? In the best case scenario, they will be stable and nothing will happen. If something were to happen, to have a plan, what do I take and when? That’s where the doctor, as a team manager, can help a lot to have the environmental survey, to go over the medications, what medications can be used where and when and why. A lot of patients have medications but they just don’t know what is its use. That’s where the doctor comes in handy, especially the allergist.
Melanie: Certainly great information. Thank you so much, Dr. Allan Goodman. You’re listing to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks for listening.