The Different Stages of Asthma

Asthma, like many diseases, is classified into different levels, or stages. This helps healthcare professionals develop the right plan of care for each person who has asthma.

But what does it mean, exactly, when the doctor tells you that you have “intermittent” asthma versus “moderate persistent” asthma? How does that affect you and what to expect from asthma?

This post will help bring you to a better understanding of the various stages of asthma. These classifications are drawn directly from our national asthma guidelines, developed by a task force of healthcare professionals. The guidelines were written by the National Asthma Education and Prevention Program .

The 4 stages

There are 4 different stages of asthma:

• Intermittent
• Mild persistent
• Moderate persistent
• Severe persistent

And, as a reminder, the hallmark symptoms of asthma include:

• Wheezing
• Cough
• Chest tightness
• Difficulty breathing

Each of these stages, sometimes called steps, is defined by symptom frequency, both during the day and at night. Each stage is also defined by clinical measurements of lung function. It’s possible for people with asthma, especially children, to move up and down these stages over time. Let’s take a closer look at each stage.

First stage: intermittent asthma

At this stage, asthma is likely more of on occasional bothersome occurrence, rather than a disease that interferes significantly with day to day quality of life. I speak from experience — my asthma has been at this stage for some years, although when I was younger and living in a different climate, it was more severe.

Symptoms. With intermittent asthma, daytime symptoms (see above) generally occur less than twice a week. Nighttime symptoms that interfere with sleep occur less than twice a month. Although symptoms might intensify into a flare-up at times, severity varies and the flare is brief. In between flare-ups, there are no active symptoms.

Lung function tests. To aid with diagnosis and treatment, the doctor may order a lung function test that measures your ability to breathe effectively. The test is expressed in terms of FEV, or Forced Expiratory Volume, and the resultant FEV1 will be 80% or more above normal values. If a peak flow meter is used, the readings show less than 20% variability am-to-am or am-to-pm, day-to-day.

Treatment. In terms of treatment for intermittent asthma, a daily controller medicine is usually not needed. However, a quick-relief, or rescue, inhaler will be prescribed to be used when symptoms do arise or flare-up.

Second stage: mild persistent asthma

Although this stage is still relatively mild, asthma is beginning to become more noticeable and starting to interfere with your quality of life.

Symptoms. In mild persistent asthma, daytime symptoms are occurring 3 to 6 times a week. Nighttime symptoms interfere with sleep nearly every week, or 3 to 4 times a month. Flare-ups are more severe and may affect activity levels.

Lung function tests. As with intermittent asthma, the FEV1 is 80% or more above normal values. Peak flow readings show less than 20-30% variability.

Treatment. A low dose inhaled steroid will be used as a controller medication to prevent and control symptoms. Less common alternatives might include cromolyn, a leukotriene receptor antagonist (LTRA), or theophylline. The doctor will also prescribe a quick-relief inhaler for flare-ups.

Third stage: moderate persistent asthma

At this stage, asthma is beginning to significantly affect quality of life on a daily basis, unless treated. It becomes difficult to ignore.

Symptoms. In moderate persistent asthma, daytime symptoms occur every day. Nighttime symptoms are also more common, becoming noticeable 5 or more times a month. Flare-ups are more frequent and likely affect the activity level.

Lung function tests. At this stage, the FEV1 has deteriorated, measuring above 60% but below 80% of normal values. Peak flow readings are showing more than 30% variability.

Treatment. For this level of asthma, the preferred controller medication is a low-dose inhaled corticosteroid, plus a long-acting beta-agonist. These are usually packaged in the form of a combination inhaler. Another option is an inhaled medium-dose steroid. And, of course, a quick-relief inhaler will be prescribed as needed to deal with flare-ups.

Fourth stage: severe persistent asthma

This is the most severe level of asthma, where control is basically non-existent. Quality of life is greatly affected and missed school and work days are frequent.

Symptoms. Daytime symptoms are continual and nighttime symptoms are frequent. Basically, the person in this stage will feel as though they are in a continuous flare-up.

Lung function tests. In this stage of asthma, the FEV 1 is 60% or less of normal values. Peak flow readings have more than 30% variability.

Treatment. The preferred controller medication is an inhaled medium-dose steroid plus a long-acting beta agonist (combination therapy). Alternatives include an inhaled medium-dose steroid, plus either a leukotriene receptor antagonist or theophylline. If neither of those medication regimes result in asthma control, then an inhaled high-dose steroid plus a long-acting beta agonist combination will be tried. And if that does not produce control, then an inhaled high-dose steroid/long-acting beta agonist combination will be prescribed, plus an oral steroid, such as prednisone. Other treatment options for uncontrolled asthma might include:

• tiotropium mist inhaler for patients with a history of exacerbations
• omalizumab for severe allergic asthma
• mepolizumab for severe eosinophilic asthma

In summary

Keep in mind that the main goals in asthma treatment are to prevent asthma attacks and to control the disease. How that is done will depend on your doctor’s assessment of which stage of asthma you are currently at. It will also depend on you. You have a couple of responsibilities:

• Be open with your doctor about how you’re feeling, when your symptoms occur and how often. Also be sure to share how you respond to any prescribed medications. Do they help? How do they make you feel? Are you having any side effects?
• Follow your Asthma Action Plan. Every asthma patient should have a written action plan that spells out the exact plan of care and how to respond when things go awry. Asthma control is dependent on how well you are able or willing to follow the treatment plan and work to avoid contact with any triggers or irritants.

It’s also important to understand that your asthma stage will likely change over time. It might get milder, as mine did. Or, it might become more severe. Whatever happens, if you work closely with your health care team, you will hopefully find the right solution for you.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement

 

Research paves the way to improved treatment for complex blood disorders

Nearly 1.6 billion people worldwide suffer from anemia, and for the first time new research points to how resistance emerges to the drug dexamethasone used to treat the devastating inherited form of anemia known as Diamond Blackfan anemia (DBA). The Feinstein Institutes for Medical Research professor and expert in disorders of the red cell Lionel Blanc, PhD, published his conclusions today in the Journal of Clinical Investigation (JCI).

Research paves the way to improved treatment for complex blood disorders.

These findings are the first to be published that stem from a five-year, $2.5 million National Institutes of Health (NIH) grant Dr. Blanc received in 2019 to research improved treatment for erythropoietic disorders, including DBA. This rare type of anemia that is caused when bone marrow cannot make enough red blood cells and is typically diagnosed when a child is less than a year old.

Dr. Blanc analyzed the effects of dexamethasone, a corticosteroid used to treat inflammation, on red blood cell formation. The results revealed unique insights, including the identification of dexamethasone targets previously unrecognized in humans that show how it influences the cell cycle and red blood cell formation. The research was done in collaboration with investigators from Stanford University and New York Blood Center.

Because many patients who live with anemia are not responsive or cannot continue glucocorticoid treatment due to adverse side effects, the identification of these molecular targets could lead to the development of new drugs and treatment strategies for DBA and perhaps other forms of anemia.

Anemia, and specifically Diamond Blackfan anemia, are debilitating conditions. We are encouraged that the insights resulting from this work may lead to more effective therapies to treat these blood disorders. Through our research, we have also opened up new avenues for investigation of how DBA may also be linked to cancer.”     Dr. Lionel Blanc, Feinstein Institutes for Medical Research professor.

Because other tissues appear to behave in a manner similar to the developing red cell, these may reveal mechanisms relevant to cancer, especially in pediatrics. Thus through the analysis of both normal physiological as well as pathological human blood cell formation, Dr. Blanc hopes to investigate the development of cancer not just in developing blood cells but in broader cell populations.

Dr. Blanc is a recognized leader in hematology research. Before receiving NIH funding, he was awarded a five-year $550,000 career development grant from The St. Baldrick's Foundation, a not-for-profit organization to raise funds to help find cures for children with cancer.

Dr. Blanc was recently named the Les Nelkin Professor of Pediatric Oncology at the Zucker School of Medicine at Hofstra/Northwell.      

    Dr. Blanc’s leadership in discovering basic molecular mechanisms of anemia points the way to new therapies. His translational research lays the basis for finding new cures for complex blood disorders.”    Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     
https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement 

Steroid injections for hip and knee may be harmful

Commonly given hip and knee steroid intra-articular injections may be harmful to some patients with at-risk conditions, according to a new study.

Corticosteroid injections are often given to reduce pain and inflammation  from osteoarthritis.

Researchers  have found accelerated arthritis and joint destruction  can be the unintended result of intra-articular corticosteroid injections.

“We are now seeing that these injections can be very harmful to the joints with serious complications such as osteonecrosis, subchondral insufficiency fracture and rapid progressive osteoarthritis,” said study author .

“Intra-articular corticosteroid injection should be seriously discussed for pros and cons. Critical considerations about the complications should be part of the patient consent which is currently not the case right now,” he added.

Osteoarthritis of the hip and knee is among the most common joint disorders.

A frequently performed treatment for osteoarthritis and other joint related pain syndromes are intra-articular corticosteroid injections, yet there is conflicting evidence on their potential benefit.

For the study, the researchers conducted a search on patients they had injected in the hips and knees during 2018.

They found that eight per cent had complications, with 10 per cent in the hips and four per cent in the knees.

The researchers also suggest that the radiologic community should actively engage in high-quality research on this topic to better understand potential at-risk conditions prior to intervention, and to better understand potential adverse joint events following these procedures to avoid possible complications.

this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   
https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement            

These Groups of People Are More Prone to Vitamin D Deficiency

For those of us who live in North America, there is a very good chance that we don't get all the Vitamin D we need. In fact, about 42% of American adults are deficient in this nutrient. Though other studies suggest that the number is actually closer to 75%. Being deficient in vitamin D is associated with a number of health concerns including risk for Alzheimer's disease, diabetes, osteoporosis and heart disease. 

  It has also been found that if you have been diagnosed with breast or prostate cancer, your chances of survival may be lower than someone with normal levels of vitamin D. This may sound alarming, though it shouldn't come as a surprise. After all, vitamin D isn't found in too many foods - with the exception of salmon and fortified milk and yogurt. The only other way to get the nutrient, is to expose your bear skin to the sun. But if you work indoors all day, this is highly unlikely. 
 
The best way to discover whether you are deficient in vitamin D is to take a blood test. Your levels should be between 45 to 50 µg/mL. This is something you may want to consider if you form part of these groups: 

 

1. You are over 55

Of course, aging does have its perks: you are smarter, more confident and may be enjoying a leisurely life of retirement. Nevertheless, there are some downside. As we age, we tend to become less mobile, making it difficult to spend time outdoors, which would result in getting less vitamin D. In addition, ageing skin cannot synthesize vitamin D as efficiently. According to a 2007  study, about 50% of older American adults with hip fractures were found to have low levels of vitamin D in their blood. So, you're likely falling short on the nutrient  you are taking a daily supplement. 

2. You work in an office

Working a 9 to 5 job would mean that you don't get much sun. According to the doctors, people with occupations that limit sun exposure are unlikely to obtain adequate vitamin D from sunlight. This makes supplementation and a smart diet key to staying healthy. 

3. You have dark skin

Reports continue to show lower levels of vitamin D in those that identify themselves as black in comparison to those who identify themselves as white. This is because darker skin makes it more challenging for the body to produce vitamin D from sunlight, according to experts. If you're darker skinned, you should rely on dietary sources of the nutrient, rather than sunlight to reach your daily vitamin D mark.

4. You suffer from inflammatory bowel disease 

Vitamin D is a fat-soluble vitamin, this means its absorption depends on the gut's ability to take in fat. Fat malabsorption is associated with inflammatory bowel disease (IBD) - this includes conditions like Crohn's disease and ulcerative colitis. In fact, it has been shown that up to 70% of people with IBD have insufficient vitamin D levels, according to a report. If you suffer from IBD, speak to your doctor and check whether you are getting enough vitamin D. 

5. You have a high body fat percentage

If your body mass index (BMI) is over 30 or you have a high body fat percentage, it may be more challenging for vitamin D to circulate throughout your body, the NIH reports. Nevertheless, this doesn't mean that you will always be deficient. Be sure to speak to your doctor and find out just how much vitamin D you will need.

6. You are taking certain medications

We do need certain medications to keep our health on track, however, corticosteroid medications such as prednisone, as well as weight-loss drugs like orlistat, and the cholesterol-lowering drug cholestyramine can impair vitamin D metabolism. If you take any one of these drugs, be sure to check in with your doctor to find out the best way for you to get the right dose. 

7. You suffer from depression

Did you know that people with low levels of vitamin D in their blood are more than twice as likely to be diagnosed with depression, than those with higher levels? Medical experts aren't sure why this is the case, however one hypothesis is that the vitamin may alter hormones and areas of the brain that affect and regulate mood. 

8. You suffer from chronic headaches

If you suffer from regular headaches, low blood levels of vitamin D may be to blame, according to a 2017 study of 2,600 men. Study participants with the lowest vitamin D levels had a twofold risk of chronic headaches compared to study participants with the highest levels. The specific link between headaches and vitamin D remains unclear, researchers believe the nutrient may help combat the inflammation that causes migraines and headaches.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                                                                                                        PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/                                                                                                                                                                             FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-                                                                                                                             https:// kneereplacement-stickclub.blogspot.com/                                                                                       FOR CROCHET DESIGNS                                                                                                                                                                                                                                 https://gscrochetdesigns.blogspot.com

Here are some simple tips to treat Eczema

Suffering from severe eczema? It may best be treated by allergy shots, according to researchers.

A medically-challenging case  found out that allergy shots provided significant benefits to the eczema symptoms suffered by a 48-year-old man.

"The man had suffered with severe eczema since childhood," said the lead author of the paper. 

"He had tried many previous therapies for years including mild and high strength topical corticosteroid cream, as well as other topical anti-inflammatory creams and topical moisturizer creams. Biologic therapy has been available to treat eczema for about a year-and-a-half but was not yet a treatment option at the time we saw this man. We thought allergy shots might be beneficial because he also had multiple allergies."

Atopic dermatitis is an allergic disease, and patients who have it often also have other types of allergies. Symptoms of eczema include severe itching along with excessive dryness or scaling, red or inflamed skin, sleep disturbance and skin pain.

"We conducted skin testing and found the man was allergic to dust mites, weeds, trees, grasses, mold, cats and dogs," said the co-author of the paper. "Because his allergies could all be treated with allergy shots, we thought treating his allergies might also benefit his eczema. After one year, he reported significant benefit to his symptoms, which was great news. And once he reached a maintenance dose of allergy shots, he no longer needed high dose steroid therapy for his eczema."

New and existing treatments for eczema can reduce the severity of symptoms like itching and excessively dry skin. Eczema is a chronic condition, and symptoms can come and go. An allergist can help you find relief from this chronic disease. Allergists are specialists in allergic diseases like eczema and are trained to help you take control of your symptoms, so you can live the life you want. 

Here are some other home remedies:
1. Take bath in Luke-warm (NOT hot) water to prevent dry skin for a maximum of 10-15 minutes.
2. Drying yourself is an important part of Eczema health care routine. Pat dry with a soft-towel and apply a moisturiser to keep the skin supple.
3. Sunflower seed oil: Sunflower oil serves as an anti-inflammatory which significantly reduced the itching. It also enhances skin barrier function and helps heal the skin.
4. Coconut Oil: A popular hair-care ingredient, Coconut oil is also excellent for the skin. According to  a study showed that staph-bacteria reduced by 95 per cent after treated with coconut oil. A mixture of coconut and sunflower oil acts as a moisturiser and reduces itching.
5. Vitamin D: A study showed that eczema worsens during winter months and hence extra care should be taken. Food rich in Vitamin D like Eggs, Salmon, Carrot helps the immune system reduce levels of inflammation and strengthen skin barriers.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                             PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/   

FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-                                                                                                    https:// kneereplacement-stickclub.blogspot.com/                              

FOR CROCHET DESIGNS                                                                                                                                                                                                                                 https://gscrochetdesigns.blogspot.com