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Bill Klaproth (Host): For some people, asthma is a minor nuisance. For others, it can be a major problem. And asthma can't be cured, but its symptoms can be managed. So what are the options for your asthma care? Well, let's learn more with Dr. Navdeep Brar. She is the Medical Director for UPMC Pulmonary and Sleep at UPFC in central PA.

This is Healthier You, a podcast from UPMC. I'm Bill Klaproth. Dr. Brar, thank you so much for your time. So what is asthma and how does someone know if they are suffering from asthma?

Navdeep Brar, MD: Thank you for having me here today. Certainly asthma's a very important topic. Asthma's a long-term condition in which airways in the lungs are swollen and inflamed. The inflammation in turn, narrows your airways and causes cough, mucus production, wheezing and difficulty breathing. Asthma's closely linked to allergies, eczema, sometimes it can run in the families.

Often people get symptoms or diagnosed with asthma when they are young. But it can also appear in elderly people or people who don't have a family history.

Host: So that's really interesting. I always think of asthma as starting young. I didn't know that it could start with an adult. Even people that are, you know, elderly. I didn't know that that could happen.

Navdeep Brar, MD: Yeah. Some people are diagnosed or they develop asthma later in the life. Sometimes they're even like in their forties, seventies. They can develop asthma when they're elderly.

Host: So mucus production, wheezing, difficulty breathing. These are the classic symptoms of asthma?

Navdeep Brar, MD: Yes. And some people can also have like cough and asthma where they just have non-productive cough all the time, along with other symptoms you stated.

Host: Okay. Well that's really interesting. So, at the time of this recording, we're, we're entering spring and we always hear about spring allergies. So now that spring season is just about here, any advice for patients with asthma?

Navdeep Brar, MD: Yeah, so asthma patients often have airways which are very sensitive to triggers like grass, pollen, cat dander, dog dander, smoke, dust mites. It could be even exercising or changes in the weather, viral infections. So all those things can trigger the asthma, especially in the spring when people are more outdoors, they're exposed to the poor air quality.

They're also exposed to grass, pollen, so symptoms, asthma, people can have like flare up of the asthma, so the symptoms could be worse in the spring. So number one advice for asthma patients is to avoid any triggers. Like if their asthma gets triggered with the pollen and grass exposure, they should wear a mask if they're doing yard work. If they're doing the spring cleaning, they should wear a mask if their dust's going to trigger their asthma. We also recommend changing the air filters in the HVAC system. They should also check their medicine cabinet to make sure they have enough supply of their maintenance inhalers, their rescue inhaler. All those things can help manage their asthma.

Host: Yeah. So it sounds like there are tools to help people manage asthma. Is that correct?

Navdeep Brar, MD: Certainly. And you know, patients should have like an asthma action plan if they see that their symptoms are getting worse, they should step up on the treatment.

Host: So know what triggers the asthma and then have an action plan. So let me ask you this. Are there different types of asthma and do they get treated differently?

Navdeep Brar, MD: Yes. So asthma is divided into two large groups. One is the high inflammation and the other one is the low inflammation. Both of them do require, like inhaled steroids, the medication to control the inflammation and that medications, we call them bronchodilators that help relax the airways and open up.

So both types of asthma require those inhalers. But if symptoms are not well controlled and it's number one important thing is to make sure it is asthma, we're not missing, any other underlying conditions. Make sure it's the correct diagnosis. And we do further workup with like blood work. Take pictures of the lung with like chest x-ray or CT scan and breathing test to valid further if what type of asthma it is. And treatment has changed a lot in the past few years. It's more like personalized based on the markers of inflammation in the blood. And there are certain newer medications called biologicals, which can be used for the patients with high markers of inflammation.

Host: Okay, so you just mentioned biologics. Can you tell us what those are?

Navdeep Brar, MD: So biologicals are injectable medications that target certain cells or chemicals in the body that fight against specific kind of inflammation that triggers the asthma. So the most of the biologicals they come in form of autoinjectors, they can be injected under the skin, they can be done in the office, or some patients can also do them at home with simple training.

They are recommended for patients who are getting frequent flareups, patients who are requiring steroids, those are the medications like prednisone for control of the asthma. If they're requiring those medications, which have a lot of side effects, they can be switched to the biologicals.

Host: So we are talking about the different types of asthma. Earlier, you, you said, you know, there are two main groups of this. When it comes to the diagnosing the two types, is the diagnosis process the same and trying to understand if this is asthma for the two different types of asthma?

Navdeep Brar, MD: Yes. The initial thing is to do a breathing test to see if they have asthma, if they actually have an obstruction showing up on the breathing test that the patients cannot exhale properly or let the air out. And then we do further testing to see if, are there any other diseases or chronic lung state that could be causing similar symptoms.

If we know that it is asthma, then we try to classify into like high inflammation or low inflammation, and it's more for people with uncontrolled symptoms that we recommend doing more further testing for their allergies and check other markers of inflammation in the body.

And because if they have high inflammation, then the biologics can definitely decrease the number of flareups per year. They can improve the quality of life, decrease the number of the days people miss from work or school, can also improve the lung function. They still have to keep taking their inhalers along with those medications, but it makes a difference in their quality of life when their symptoms are better controlled.

Host: Absolutely, and it's important to find the right diagnosis as well. So, this has really been, uh, a fascinating interview. I know a lot of people suffer with asthma, Dr. Brar. Anything else you'd like to add?

Navdeep Brar, MD: I think the main treatment for asthma is to avoid any triggers. People should also avoid smoking. Make sure they have, they're vaccinated for COVID and flu as any viral infections can also trigger their asthma. And patients with uncontrolled asthma should definitely talk to their primary care doctors and be referred to pulmonary as there are a lot more treatment options available other than just the inhalers.

Here at UPMC Pulmonary and Sleep in central PA, we have offices in Harrisburg, Mechanicsburg, Carlisle and Will, and we'll be happy to see people who need help with their asthma.

Host: Absolutely. Dr.Brar, thank you so much for your time. This has, uh, really been fascinating. Thank you again.

Navdeep Brar, MD: Thank you, Bill, for having me here today.

Bill Klaproth (Host): And once again, that's Dr. Navdeep Brar. And for more information, please visit upmc.com/centralPAlung. And if you found this podcast helpful, please share it on your social channels. And check out the full podcast library for topics of interest to you. This is Healthier You a podcast from UPMC. I'm Bill Klaproth. Thanks for listening.