Health Insurance Plan for the Expectant Mothers

Expectant mothers need to secure themselves with adequate health insurance coverage plan in order to protect themselves from incurring huge expenses in case of any complications during pregnancy or child birth.

Health insurance is not only important for delivery but it would save you of incurring huge expenses for maternity care, prenatal check-ups, routine immunizations and pediatric consultations.

Reports state that about 14% of the uninsured population in America is women who are expecting a baby. Statistics reveal that in many cases, women who give birth to still-born babies or infants with low weight are uninsured.

During pregnancy, the woman needs to undergo a lot of medical check-ups to ensure that her health and also the health of the baby are fine. The check-ups, routine tests and medical procedures are pretty expensive, not to mention the hospitalization charges during delivery which can total up to even $12,000 on an average. This is in case of a non-complicated delivery state. Premature babies and cesarean deliveries cost even higher. The above situations are good enough to explain why insurance is highly mandatory for expecting women.

Women should purchase health insurance plan even before getting pregnant. This is because some of the insurance companies may refuse to grant insurance in case the woman is pregnant at the time applying the policy.

In case you become pregnant and are not insured, you need to browse the internet for companies which offer discounted health insurance plans with pregnancy coverage benefits and buy it on first priority. You may hit upon various insurance providers offering coverage for the same. Request for instant free quotes and compare the benefits and pricing before finalizing on both the insurance provider and the policy.

You may also gather more information on whether your state can be of help during pregnancy as there could be a possibility of chancing upon some federally funded programs that provide assistance based on the income levels.

You may also approach few agencies that work for women and children welfare. These organizations assist women with low income levels or children who are less than 5 years old. Food is provided on a daily basis for such low-income strata of the society.

While choosing a health insurance plan, you need to be careful about the coverage you choose. For example, if the coverage is only for the hospitalization, it may not be very beneficial for you because you may have to visit the doctor or the pediatrician quite a few times after delivery. These expenses would be skyrocketing on an already high budget if you are not covered by a suitable medical insurance plan that reimburses the charges of doctor consultation and prescription drugs.

Every insured should be aware of the terms and conditions stated in the policy especially for pregnancy coverage. For example, some of the plans require you to call shortly after getting admitted in the labor ward. Otherwise, you may have to pay a penalty. Similarly, some medical insurance plans limit the number of days of hospitalization stay that it would cover.

The Purpose of Health Insurance

The Purpose of Health Insurance

Every individual should purchase an affordable health insurance plan to cover the expensive medical costs incurred for various health related expenses like serious health disorders or illnesses, routine check-ups, diagnosis tests, physical examinations, prescription drugs, doctor consultation and various other expenses.

The coverage benefits and costing differ from plan to plan and varies with every insurance provider. Hence, one should perform adequate research on the web and compare the free instant quotes mailed to you within seconds before finalizing on the policy.

Health insurance plans enable you to take extra care of your health. This is because, when you do routine physical examinations, if you need to pay a nominal sum to get check-ups done rather than the actual fee, you would not tend to skip these tests. Otherwise, individuals do not go for check-ups in order to avoid the expenses for medical examinations. It also gives the comfort and psychological relief that in case sudden medical expenses are huge, the insurance plan will take care of most of these expenses.

Individuals pay a specific amount either on a monthly or a quarterly basis. This is referred as premium and the fee is generally paid in advance to the insurance provider for future coverage benefits. Typically, while you purchase a health insurance policy, you are given a health insurance identity card which you present to the clinic, doctor or hospital for verification purposes. The card also has details of your insurance number and the insurance provider. In case you avail direct claims settlement facility, the hospital would send the medical expense bill to the insurance company directly for reimbursement. Hence, you are saved of the tedious procedure of filing claims with numerous proofs for claiming back your expenses.

Every insured person should be aware of the terms and conditions of coverage of the health insurance plan they purchase. For example, pre-existing conditions, which refer to diseases, illnesses or serious health disorders which exist at the time of purchase of the insurance plan would not be covered. Similarly, the exclusions section of the policy document also list those circumstances or conditions under which the insured cannot file for claims. For instance, the insurance company would not pay you for any medical expenses that arise in case of injuries or accidents due to substance abuse or alcohol addiction. Self-inflicted injuries, medical expenses arising due to suicide attempts cannot be claimed from the insurance provider.

Some health insurance plans offer full reimbursement only when any medical expert, clinic or hospital that is tied up to its network is consulted. Otherwise, the individuals may have to bear a certain percentage of the expense out of their pockets. Sometimes, insurance companies insist to inform them before getting admitted for elective surgeries in order to get full reimbursement of the medical expenses.

Every individual should purchase a health insurance plan during their early years of life in order to reap best benefits as an average individual having a fit body at the time of applying for insurance will face lesser restrictions from the insurance provider for offering coverage benefits.

Self Employed Medical Insurance

Self Employed Medical Insurance

Self-employment is highly common in the modern days with baby-boomers and senior citizens starting their own smart ventures, either to get supplemental income or to keep them occupied during their retirement period or to establish their own careers and do what they always wanted to pursue during their younger days. There are many middle-aged people and young adults who opt for this kind of employment to have a career change.

Reports reveal that these self-employed individuals opt out of buying a suitable affordable health insurance plan in order to cut down the expenses on health care. They sometimes think that investing on a health insurance policy is a waste of money and this can be used for other useful purposes in the business. This is a huge mistake as these individuals do not sometimes realize what kind of expenses they would incur in case they are not covered by a suitable health insurance plan.

Hospitalization charges could sky rocket to thousands of dollars and it is even worse in case you end up in sudden surgeries or you are in need of emergency medical attention. Typically, a heart surgery could cost you about $100,000. It is not easy for an average person to bear this kind of an expense from their personal pocket.

These are good enough reasons for self-employed individuals to purchase a suitable self-employed health insurance. This would help these motivated individuals to secure their future peacefully and stop worrying about incurring huge unexpected sudden medical expenses in case serious illnesses crop up.

The number of self-employed individuals is not less in number. About 63% of the working population fall into this category or work in small businesses where the employers do not offer health insurance coverage. About 25% of the self-employed population is over 50 years which also means that they are highly prone to health disorders due to their old age. Hence, health insurance plan coverage is highly required for this population.

Every self-employed individual can protect himself or herself by medical insurance benefits through affordable individual health insurance plans or get insured through their own business corpus funds or get covered by their spouse’s insurance policy by getting registered as a dependant, or register in a federally run insurance program.

For example, senior citizens above 65 years are eligible for coverage under Medicare plans even if they choose to work further. However, they also need to have supplemental health insurance coverage for higher expenses as Medicare would not cover for many other health care expenses which are huge.

If you have just resigned from a corporate job, continue with the same health insurance scheme provided by your employer for a while through the COBRA (Consolidated Omnibus Budget Reconciliation Act) scheme. This may not be feasible for a long time as you have to bear the premium costs on your own and the corporate premiums may be slightly on the higher side for you. But do not discontinue the health insurance coverage until you have found another suitable medical insurance plan.

Achondroplasia

Achondroplasia is a disorder of bone growth. Achondroplasia literally means "without cartilage formation". The problem in this condition is converting the cartilage into bones, particularly the long bones. Achondroplasia is a genetic (inherited) condition that results in abnormally short stature. All persons with achondroplasia are little people. The average height of an adult with achondroplasia is 131 cm (52 inches, or 4 foot 4) in males and 124 cm (49 inches, or 4 foot 1) in females.

Emphysema - The Facts

Emphysema - The Facts

Emphysema is a particularly acute lung disease in which the damage is permanent so it is important to take all steps possible to avoid these conditions in the first place.

Anyone suffering from a disease of the lungs knows how distressing the shortness of breath can be. Emphysema is a particularly acute lung disease in which the damage is permanent so it is important to take all steps possible to avoid these conditions in the first place.

Inside the respiratory system, there are very small sacs of air called alveoli and the passages that lead to these sacs of air are called bronchioles. In pulmonary emphysema, the bronchioles become permanently distended with air. This condition reduces the number of blood vessels because of the loss of elasticity in the lung tissues. Consequently, the ability of the lungs to provide oxygen continues to decrease and the person becomes breathless very easily.

The condition is more common in men and usually appears after the age of forty. It is thought that women may be protected by a hormonal factor but this has not actually been proven. This condition can cause disability and eventually death. The main cause of emphysema is cigarette smoking. However, exposure to pollution and dust on an ongoing basis can also bring on the disease. This becomes a risk factor in some industries where there are large amounts of dust. Also, people who suffer from chronic bronchitis may also suffer from emphysema. If these people are also smokers, it makes the condition even worse.

Not all smokers contract emphysema and it also occurs in non smokers. Some feel that the white cells in the lungs produce a substance called elastase. Smoke or dust interferes with the cells causing them to release this elastase. If this happens, it may attack the lung tissue.

When a person suffers from chronic bronchitis, the airways become blocked with mucous because of irritation by smoke, dust and other pollutants. This makes it difficult to breathe as the person must overcome the resistance of the mucous. Inspiration of air then results in distension of the alveoli. The elasticity of the lung tissue may also be weakened by bacterial infections which are common in chronic bronchitis.

Subcutaneous emphysema can also result from a broken rib that punctures the lung or from whooping cough.

The most recognized symptom of emphysema is breathlessness. This can be accompanied by a cough that can be brought on by the smallest amount of action. Simply laughing or talking can make the person breathless. There may also be discomfort after a meal because the lungs have expanded. Sometimes this can result in loss of appetite and resultant weight loss.

Some patients become cyanosed due to a lack of oxygen in the blood. This bluish discolouration is most noticeable on the lips and under the fingernails.

Emphysema can also affect the heart. The lungs become resistant to the flow of blood as the alveolar walls thicken. This means the heart has to work harder to force blood through the lungs, putting extra strain on the heart.

The progress of pulmonary emphysema may be slowed with treatment but it cannot be cured. Some bronchodilator drugs give relief, particularly if the patient also has chronic bronchitis. Breathing pure oxygen from a cylinder allows enough gas to enter the blood stream.

Surgery to reduce lung volume is a new, experimental treatment in which parts of both lungs are removed, decreasing the hyperinflation of the chest and improving breathing.

Emphysema can sometimes be slowed but lung damage cannot be repaired, so it is better not to begin smoking.

Achondroplasia

Which doctor can i consult if my baby has achondroplasia?
You can consult a pediatrician, orthopedic surgeon, dental surgeon and a neuro surgeon.

What can be done for patients with achondroplasia?
Children and adults with achondroplasia can lead normal lives provided they receive attentive, informed care by their physicians and parents.

My spouse and I both have achondroplasia. What is the probability that we will have a child of average stature?
The chances are 25 percent, or 1 in 4 .

Gangrene

Gangrene is the death and subsequent decay of body tissues caused by infection, also known as tissue necrosis. It is most commonly the result of critically insufficient blood supply sometimes caused by an injury and subsequent contamination of the wound with bacteria. This condition is most common in the extremities.

One specific example of gangrene is so called diabetic foot that can be seen in long-standing complicated diabetes. It is caused by a combination of arterial ischemia, injury and poor healing that is rather common in diabetics.

The most common medical treatment for irreversible gangrene is amputation.

Brain tumors

A brain tumor is a mass created by abnormal and uncontrolled growth of cells either found in the brain (neurons, glial cells, epithelial cells, myelin producing cells etc.) (primary brain tumors) or originating in another part of the body and spreading to the brain (secondary brain tumors or metastatic brain tumors). Brain tumors are usually located in the posterior third of the brain in childhood and in the anterior two-thirds of the brain in adulthood.

Primary brain tumors

Primary brain tumors are named due to the cell types, from which they are originated. Frequently encountered histologic brain tumor types are glioma, glioblastoma, astrocytoma, oligodendroglioma, medulloblastoma, meningioma and neuroglioma. Tumors can be benign and are usually, but not necessarily, localized to a small area. They can also be malignant and invasive (i.e., spreading to neighboring areas). Brain cells can be damaged by tumor cells by (i) directly being compressed from growth of the tumor, (ii) indirectly being affected from inflammation ongoing in and around the tumor mass, (iii) brain edema (swelling) or (iv) increased pressure in the skull (due to brain edema or to the blockage of the circulation of the cerebrospinal fluid).

Metastatic brain tumors

Secondary or metastatic brain tumors take their origins from tumor cells which spread to the brain from another location in the body. They are more frequent than primary brain tumors. Approximately, one quarter of metastatic cancers spread to brain. Lungs and breasts are most common locations from which secondary brain tumors originate. Tumor cells travel to brain by blood vessels. Since brain has no lymphatic drainage system like other organs (cerebrospinal fluid system acts like lymphatic system in the brain), spreading of tumor cells by lymphatic route (which is very typical for cancers of other organs) is impossible for brain. Different from primary brain tumors, metastatic tumor masses may occur in various remote locations in the brain. Highly aggressive brain tumors like glioblastoma may also be observed in more than one location but usually in the advanced stages of the disease.

Symptoms and complications of brain tumors

Local tissue damage (either by direct or indirect mechanisms) causes focal neurologic symptoms, which vary due to the location of the brain tumor. Hemiparesis, aphasia, difficulty speaking, ataxia, hemihypoesthesia (numbness and decreased sensation of touch on one side of the body) and localized headache are some of the symptoms occurring due to the local effects of the brain tumor. Increased pressure in the skull or brain edema cause more generalized symptoms like generalized headache, nausea and vomiting, loss of consciousness (stupor or coma) and intellectual decline. Seizures due to the local irritating effect of the brain tumor or metabolic changes caused by the cancer are also frequently observed. Since the development of the skull is incomplete during infancy, infants with brain tumor may have increased head perimeter, bulging fontanelles or separated sutures.

Neurologic examination reveals local (specific to the location of the tumor) or generalized neurologic changes. Slowly progressive nature of the neurologic symptoms is suggestive of a possible brain tumor and the diagnosis is confirmed by CT scan or MRI of the head. Angiography, EEG examination or brain biopsy may aid in diagnosis in difficult cases. Although slow progression is an important hallmark of the disease, some brain tumors may enlarge very quickly and thus may cause sudden neurologic changes. Treatment includes the surgical removal of the tumor mass or the destruction of the tumor cells by radiation (radiotherapy) and/or drugs (chemotherapy) in cases with contraindications for a surgical operation.

Primary or secondary, brain tumors may cause herniation of the brain (displacement of one part of the brain tissue due to mass effect of a lesion, usually causing the compression of the neurons controlling the respiratory system in the brainstem and eventually death) and permanent neurologic changes including intellectual decline.

Anal cancer

Anal cancer

Introduction

Incidence

Anal cancer is an uncommon malignancy, accounting for only a small percentage (4%) of all cancers of the lower alimentary tract.

Estimated new cases and deaths from anal cancer in the United States in 2005:

• New cases: 3,990.
• Deaths: 620.

Gender

Slightly higher in females than in males, male to female ratio: 1:2. The incidence in men younger than 35 has increased and the sex ratio is reversed in this group.

Age

Anal cancer most commonly develops in patients 50 to 60 years old. The incidence in men younger than 35 has increased and the sex ratio is reversed in this group.

Race and ethnicity

Recently an increase in the incidence of anal cancer in black men in the United States has been noticed.

Geography

Anal cancer more frequently afflicts urban than rural population.

Acute myeloid leukemia

Acute myeloid leukemia

Introduction

Updated: October 27, 2005

Acute myeloid leukemia, or AML is the most commonly diagnosed type of adult leukemia, and accounts for about half the cases of childhood leukemia. It is specifically a malignancy of the myeloid line of white blood cells.

Incidence

The incidence of acute myelogenous leukemia (AML) is 2.7 per 100,000 population.

Estimated new cases and deaths from acute myeloid leukemia (AML) in the United States in 2005.

• New cases: 11,960.
• Deaths: 9,000.

Gender

Slightly higher in males than in females. There are two theories to explain slightly higher incidence in males: Occupational exposure to chemical carcinogens and the higher incidence of myelodysplastic syndrome in males (see causes).

Age

AML affects all age groups. Age-specific incidences of AML are similar to those of other solid tumors in adults, with an exponential rise after age 40 years. The median age of onset is 65.

Race and ethnicity

The incidence of acute leukemia is slightly higher in populations of European descent (whites). Also, a report from the University of Southern California indicates that acute promyelocytic leukemia (APL) is more common in Hispanic populations than in other ethnic groups.

Geography

AML is more commonly diagnosed in developed countries

Adrenal cancer

Introduction

Updated: October 1, 2005

Incidence

• Adrenocortical carcinoma is a rare tumor that affects only up to 2 persons per one million population.
• Adrenocortical carcinoma accounts for 0.2% of all cancer-related deaths.

Gender

• The male-to-female ratio is approximately 1:3.
• Female patients are more likely than male patients to have an associated endocrine syndrome.
• Nonfunctional Adrenocortical carcinomas are distributed equally between the sexes.
• Male patients tend to be older and have a worse overall prognosis than female patients.

Age

• It occurs in 2 major peaks: in the first decade of life and again in the fourth to fifth decades.
• The median age is 44 years at diagnosis but the tumor occurs at all ages. The median age at presentation for children is 4 years.

Race and ethnicity

Adrenocortical cancer has no racial or ethnic predilection.

Geography

Some reports suggest an inordinately high frequency of cases among children in southern Brazil, for unknown reasons.

Magnetic system could be key to surgery without scars

Magnetic system could be key to surgery without scars

DALLAS � March 26, 2007 � Physicians at UT Southwestern Medical Center and engineers at UT Arlington have collaborated to invent a groundbreaking system that could be key to delivering on the promise of surgery without scars.

The new technique, which is still in the developmental stage, allows for magnetically maneuvering laparoscopic surgical tools inserted into the abdominal cavity through the bellybutton or throat. The challenge remains, however, to design the new instruments and determine just how to move them once they�re inside the human body.

�A fixed hole has a limited working envelope that is conical in shape,� said Dr. Jeffrey Cadeddu, associate professor of urology and radiology and director of the Clinical Center for Minimally Invasive Treatment of Urologic Cancer. He and his colleagues describe the new surgical concept, called the Magnetic Anchoring and Guidance System, in the March edition of Annals of Surgery.

The idea of using magnets to manipulate the instruments in the abdominal cavity was formulated after Dr. Cadeddu watched a television show featuring teens who used magnets to hold studs on their lips to avoid getting their lips pierced.

�Once you think about, it�s an obvious thing,� said Dr. Cadeddu, whose team of urologists and surgeons worked with engineers from UTA�s Automation and Robotics Research Institute and the Texas Manufacturing Assistance Center to build the prototype.

The system uses a stack of magnets outside the abdomen to attract other magnets attached to laparoscopic instruments inside the abdomen. Surgeons can then move the outside magnets to position an internal camera at the best spot for seeing or to move a retractor or other surgical instrument. Once optimally positioned, the instruments can be locked in place. That allows a much greater range of maneuverability and the surgical team can more easily reposition the camera or instrument, said Dr. Cadeddu.

In animal studies, surgeons have been able to successfully remove a kidney using the Magnetic Anchoring and Guidance System.

While working on the system, Dr. Daniel Scott, assistant professor of surgery, joined UT Southwestern as director of the Southwestern Center for Minimally Invasive Surgery. He said the technology may solve the fundamental problem of guiding instruments through the abdomen for natural orifice surgery, which now inserts the instruments through the throat, colon or vagina.

�The current state of the art for laparoscopic surgery requires four or five holes. The question behind this is, can we do the surgery through only one hole and can we hide the hole in a cosmetically advantageous or less painful location,� Dr. Cadeddu said.

Study researchers concluded that �the ability to reduce the number of trocars (holes) necessary for laparoscopic surgery has the potential to revolutionize surgical practice,� but noted that there will be a learning curve for the new system and that because of the expanded maneuverability, surgeons will likely need to develop new techniques.

Also, until the system is fully tested in humans, surgeons won�t know whether fewer entry points will result in fewer complications or faster healing, advantages usually seen in moving from conventional surgery to laparoscopic surgery.

Needle-stick injuries are common but unreported by surgeons in training

Needle-stick injuries are common but unreported by surgeons in training

A survey of nearly 700 surgical residents in 17 U.S. medical centers finds that more than half failed to report needle-stick injuries involving patients whose blood could be a source of HIV, hepatitis and other infections.

Authors of the report � appearing in the June 28 issue of The New England Journal of Medicine � say most residents in the survey falsely believe that reporting and getting timely medical attention won�t prevent infection. Residents also say reporting takes �too much time� and interrupts their work.

�The fact that we have so many residents who fail to understand the importance of timely reporting of needle-stick exposures in order to protect themselves from serious medical consequences clearly illustrates the breadth of this problem and the need for hospitals to develop systems to address it,� says contributing author Mark S. Sulkowski, M.D., of the Division of Infectious Diseases at Johns Hopkins.

Lead author Martin Makary, M.D., M.P.H., a surgeon at The Johns Hopkins Hospital, says that while residents must take more responsibility, it�s also up to hospitals to take �immediate steps to improve safety and care for health care workers to reduce the spread of HIV and hepatitis infection.�

Makary says injuries could be greatly reduced by hospitals� increasing the use of nurse practitioners and physicians assistants to reduce surgical workloads and adopting sharpless surgical techniques such as electric scalpels, clips and glues.

�Twenty percent of all general surgery operations could be done without using any sharp instruments,� he says. Furthermore, Makary says, residents would more likely report exposures if hospitals used timely reporting mechanisms (e.g., internal hotlines and response teams), routine prompts (e.g., postoperative checklists that monitor exposures), and peer-to-peer education to create a local culture that encourages speaking up.

�We know also that many residents resist reporting because the training culture suggests that needle sticks �go with the territory� and reporting them may lower peer esteem,� Makary notes.

The survey, which took place in 2003, revealed that 99 percent of surgeons-in-training suffered an average of eight needle-stick injuries in their first five years. Of these surgeons, only 49 percent reported injuries to an employee health service. Of those who reported, 53 percent had experienced an injury involving a patient with a history of intravenous drug use and/or infected with HIV, hepatitis B (HBV) or hepatitis C (HCV).

�We did not realize the extent to which health care workers are at risk � a risk that is preventable,� says Makary, a surgeon who studies medical errors and health care quality. Makary says improved techniques that reduce the number of needle sticks and timely treatment for those who are injured could all but eliminate the risk of getting infected with disease.

Makary says 57 percent of surgical residents reported a feeling of being �rushed� as the primary cause of the injury. He adds that 42 percent said they did not report the injury because it took �too much time� and 28 percent said there was �no utility in reporting.�

In fact, says Sulkowski, early reporting and treatment with antivirals can prevent the establishment of infection in people exposed to HIV and HBV and can eradicate evidence of virus in more than 90 percent of people with acute HCV infection.

Previous studies suggest that an estimated 600,000 to 800,000 needle-stick injuries are reported each year by U.S. health care workers. Furthermore, a recent study of a general surgical service in an urban academic hospital revealed that 20 percent to 38 percent of all procedures involved patients with bloodborne pathogens.

Asthma History - Through The Ages

Ancient Egypt

We know that asthma existed in ancient Egyptian times, and there is some evidence that asthma has been around even before that. The Georg Ebers Papyrus - found in Egypt in the 1870s - contains prescriptions written in hieroglyphics for over 700 remedies. One of the ancient Egyptian remedies was to heat a mixture of herbs on bricks and inhale their fumes.

China

A few hundred years ago it was common in China to give a person with asthma herbs containing ephedrine from which they could inhale beta-agonists.

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Term Asthma Comes From Greek Aazein

The term Asthma comes from the Greek verb aazein, meaning to pant, to exhale with the open mouth, sharp breath. In The Iliad, a Greek epic poem (attributed to Homer) describing the siege of Troy, the expression asthma appeared for the first time.

The Corpus Hippocraticum, by Hippocrates, is the earliest text where the word asthma is found as a medical term. We are not sure whether Hippocrates (460-360 BC) meant asthma as a clinical entity or as merely a symptom. Hippocrates said spasm linked to asthma were more likely to occur among anglers, tailors and metalworkers.

Aretaeus of Cappadocia (100 AD), an ancient Greek master clinician, wrote a clinical description of asthma. Galen (130-200 AD), an ancient Greek physician, wrote several mentions of asthma which generally agreed with the Hippocratic texts and to some extent those of Aretaeus of Cappadocia. He described asthma as bronchial obstructions and treated it with owl's blood in wine.

Moses Maimonides (1135-1204 AD), the rabbi and philosopher who lived in Andalucia (Spain), Morocco and Egypt, was also a physician who practiced medicine in the court of Sultan Saladin of Egypt and Syri. Among many medical texts, Maimonides wrote Treatise of Asthma for Prince Al-Afdal, a patient of his. Maimonides revealed that his patient's symptoms often started as a common cold during the wet months. Eventually the patient gasped for air and coughed until phlegm was expelled. He noted that the dry months of Egypt helped asthma sufferers. Maimonides also suggested avoidance of strong medication, plenty of sleep, fluids, moderation of sexual activity, and chicken soup.

Jean Baptiste Van Helmont (1579-1644 AD), a physician, chemist and physiologist from Belgium, said that asthma originates in the pipes of the lungs.

Bernardino Ramazzini (1633-1714 AD), known to some as the father of sports medicine, detected a link between asthma and organic dust. He also recognized exercise-induced asthma.

At the beginning of the 20th century asthma was seen as a psychosomatic disease - an approach that probably undermined any medical breakthroughs at the time. During the 1930s to 1950s, asthma was known as one of the holy seven psychosomatic illnesses.

Asthma was described as psychological, with treatment often involving, as its primary component, psychoanalysis and other 'talking cures'. A child's wheeze was seen as a suppressed cry for his or her mother. Psychoanalysts thought that patients with asthma should be treated for depression. This psychiatric theory was eventually refuted and asthma became known as a physical condition.

Asthma, as an inflammatory disease, was not really recognized until the 1960s when anti-inflammatory medications started being used.

Types of Asthma

Child-Onset Asthma

Asthma that begins during childhood is called child-onset asthma. This type of asthma happens because a child becomes sensitized to common allergens in the environment - most likely due to genetic reasons. The child is atopic - a genetically determined state of hypersensitivity to environmental allergens.

Allergens are any substances that the body will treat as a foreign body, triggering an immune response. These vary widely between individuals and often include animal proteins, fungi, pollen, house-dust mites and some kind of dust. The airway cells are sensitive to particular materials making an asthmatic response more likely if the child is exposed to a certain amount of an allergen.

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Adult-Onset Asthma

This term is used when a person develops asthma after reaching 20 years of age. Adult-onset asthma affects women more than men, and it is also much less common than child-onset asthma.

It can also be triggered by some allergic material or an allergy. It is estimated that up to perhaps 50% of adult-onset asthmas are linked to allergies. However, a substantial proportion of adult-onset asthma does not seem to be triggered by exposure to allergen(s); this is called non-allergic adult-onset asthma. This non-allergic type of adult onset asthma is also known as intrinsic asthma. Exposure to a particle or chemical in certain plastics, metals, medications, or wood dust can also be a cause of adult-onset asthma.

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Exercise-Induced Asthma

If you cough, wheeze or feel out of breath during or after exercise, you could be suffering from exercise-induced asthma. Obviously, your level of fitness is also a factor - a person who is unfit and runs fast for ten minutes is going to be out of breath. However, if your coughing, wheezing or panting does not make sense, this could be an indication of exercise-induced asthma.

As with other types of asthma, a person with exercise-induced asthma will experience difficulty in getting air in and out of the lungs because of inflammation of the bronchial tubes (airways) and extra mucus.

Some people only experience asthma symptoms during physical exertion. The good news is that with proper treatment, a person who suffers from exercise-induced asthma does not have to limit his/her athletic goals. With proper asthma management, one can exercise as much as desired. Mark Spitz won nine swimming gold medals during the 1972 Olympics and he suffered from exercise-induced asthma.

Eighty percent of people with other types of asthma may have symptoms during exercise, but many people with exercise-induced asthma never have symptoms while they are not physically exerting themselves.

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Cough-Induced Asthma

Cough-induced asthma is one of the most difficult asthmas to diagnose. The doctor has to eliminate other possibilities, such as chronic bronchitis, post nasal drip due to hay fever, or sinus disease. In this case the coughing can occur alone, without other asthma-type symptoms being present. The coughing can happen at any time of day or night. If it happens at night it can disrupt sleep.

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Occupational Asthma

This type of asthma is triggered by something in the patient's place of work. Factors such as chemicals, vapors, gases, smoke, dust, fumes, or other particles can trigger asthma. It can also be caused by a virus (flu), molds, animal products, pollen, humidity and temperature. Another trigger may be stress. Occupational asthma tends to occur soon after the patients starts a new job and disappears not long after leaving that job.

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Nocturnal Asthma

Nocturnal asthma occurs between midnight and 8 AM. It is triggered by allergens in the home such as dust and pet dander or is caused by sinus conditions. Nocturnal or nighttime asthma may occur without any daytime symptoms recognized by the patient. The patient may have wheezing or short breath when lying down and may not notice these symptoms until awoken by them in the middle of the night - usually between 2 and 4 AM.

Nocturnal asthma may occur only once in a while or frequently during the week. Nighttime symptoms may also be a common problem in those with daytime asthma as well. However, when there are no daytime symptoms to suggest asthma is an underlying cause of the nighttime cough, this type of asthma will be more difficult to recognize - usually delaying proper therapy. The causes of this phenomenon are unknown, although many possibilities are under investigation.

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Steroid-Resistant Asthma (Severe Asthma)

While the majority of patients respond to regular inhaled glucocorticoid (steroid) therapy, some are steroid resistant. Airway inflammation and immune activation play an important role in chronic asthma. Current guidelines of asthma therapy have therefore focused on the use of anti-inflammatory therapy, particularly inhaled glucocorticoids (GCs). By reducing airway inflammation and immune activation, glucocorticoids are used to treat asthma. However, patients with steroid resistant asthma have higher levels of immune activation in their airways than do patients with steroid sensitive (SS) asthma.

Furthermore, glucocorticoids do not reduce the eosinophilia (high concentration of eosinophil granulocytes in the blood) or T cell activation found in steroid resistant asthmatics. This persistent immune activation is associated with high levels of the immune system molecules IL-2 (interleukin 2), IL-4 and IL-5 in the airways of these patients.

Medicines and Devices

Asthma medications are generally considered to fall into two classes: bronchodilators, which stop asthma attacks after they've started and help prevent attacks, and anti-inflammatories, which control the airway inflammation and prevent asthma attacks from starting.

Although these medicines come in several brand names and various forms such as sprays, pills, powders, liquids and shots, your physician will determine the one which is best for you.

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Bronchodilators

Bronchodilators provide relief during an asthma attack. They relax muscles in your air tubes, forcing them to open up and allowing you to breathe. Bronchodilators also may help clear mucus from the lungs, allowing it to move more freely and be more easily coughed out.

Some examples of bronchodilators include short-acting beta-agonists (usually used to prevent exercise-induced asthma), anticholinergics (usually used in addition to or as an alternative to short-acting beta-agonists, and theophylline (a long-acting drug used to treat difficult-to-control or severe asthma).

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Anti-Inflammatories

Anti-inflammatories prevent asthma attacks by keeping air tubes open all of the time. They are designed to reduce swelling in the air tubes and decrease the amount of mucus. Cromolyn and nedocromil are two examples of anti-inflammatory medicines.

Corticosteroids are the most popular class of anti-inflammatories and are the drug of choice for persistent asthma. Other anti-inflammatories include mast cell stabilizers.

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Side Effects

There is always a risk of side effects associated with taking medicine. These may include sore throat, nervousness, nausea, rapid heartbeat, loss of appetite, or staying awake. A doctor may need to modify your treatment plan if side effects become severe.

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Allergy-related

Asthma sufferers with allergies may receive hyposensitization therapy or allergy shots. The shots may help prevent asthma attacks, but experts do not agree about their usefulness.

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Over-The-Counter

Over-the-counter asthma drugs such as "Primatene Mist" and "Bronkaid" are widely available bronchodilators that provide short term relief. These medicines, however, do not control long-term asthma and should not be used every day to relieve asthma symptoms. Check with a physician before using over-the-counter medicines.

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Metered-Dose Inhalers

The most common device used to deliver medicine to the lungs of asthmatics is the metered-dose inhaler. Inhalers have two parts: 1) a canister consisting of a propellant, the medicine, and stabilizers, and 2) an actuator or mouthpiece consisting of a discharge nozzle and a dust cap. Inhalers are easily used by pressing down the top of the canister and inhaling the gas that is released. Usually the medicine administered by metered-dose inhalers is a bronchodilator, corticosteroid, or a mast cell stabilizer.

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Dry Powder Inhalers

As an alternative to the aerosol-based metered-dose inhalers, dry powder inhalers deliver medicine from a capsule in powder form. These devices require the patient to inhale forcefully to pull the powder from the device into the lungs and can be more complicated to use than metered-dose inhalers.

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Nebulizer

Medication may also be administered using a nebulizer, providing a larger, continuous dose. Nebulizers vaporize a dose of medication in a saline solution into a steady stream of foggy vapor that is inhaled by the patient. Nebulizers are more common in hospital settings for patients who have difficulty using a metered-dose inhaler.

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Asthma Spacer

Asthma spacers are attachments that can be added to metered-dose inhalers. The spacer goes between the patient's mouth and the mouthpiece of the inhaler, and it acts as a reservoir that briefly holds the medication. Spacers allow a patient to inhale the medicine without having to coordinate the breathing and mechanical actions needed to use an inhaler. Spacers also help patients deliver the medication directly to the lungs, avoiding medicine on the side of the mouth and the condition known as "thrush".

Living with Asthma

Asthma should not stop anyone from leading an active, healthy life. The chronic condition requires proper long-term care, active management, and adherence to an asthma action plan. Asthma can be a stressful condition to manage, and stress can even trigger asthma attacks. Asthmatics should strive to reduce stress as much as possible and learn to cope with the challenges and frustrations of living with asthma in a positive way.

Day-to-day living may be more manageable if you can find support from other people who are also living with asthma. Online forums also exist for people to share experiences, opinions, and frustrations. Support is equally important for children and teens with asthma.

An important part of managing asthma is adopting a healthy lifestyle. Eat a healthy diet rich in fruits and vegetables and low in fats and sugars, get plenty of rest, exercise regularly, work on managing stress, and, of course, do not smoke.

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The Asthma Action Plan

You and your doctor should design your personal asthma action plan. The plan should consist of instructions for medication, a list of asthma triggers, responses to worsening symptoms, and benchmarks to indicate the level of your asthma control. Typical plans also include instructions for dealing with emergencies such as asthma attacks. A plan is only useful if it is followed, and successful asthma management is no exception.

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Education

Learning as much as possible about asthma will help you to properly manage the condition. You should know what causes your symptoms, how to prevent them, and how to use your medicines correctly. Educate yourself about controlling symptoms and reducing asthma attacks, and be aware of barriers that may prevent you from doing so. Never hesitate to ask your physician for assistance with any issues that may arise.

Collect data about yourself on a regular basis. Record asthma symptoms and their triggers, and use a peak flow meter to measure and record how well your lungs are working. Information gathered over time can be used to track changes and progress. You will become more informed about how your body responds to the environment, and you will be quicker to spot problems and prevent attacks.

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Avoid Triggers

Identifying and avoiding asthma triggers will help you to maintain an active and healthy lifestyle with asthma. The following list discusses common triggers and suggests ways to handle them:

Tobacco smoke - avoid inside and outside of the home
Air pollution - try antihistamine medications and staying indoors
Pollen - try antihistamine medications and staying indoors
Animal dander - keep pets outside, wash them often, find them a new home
Viral infections - see a physician
Heavy exercise - lower the impact of your exercise routine and consult a doctor
Stress - many methods of stress reduction exist, including breathing, meditation, progressive relaxation, and exercise.
Dry or cold air - wear a scarf over your mouth and nose during winter months
Dust mites - keep sheets, blankets, pillows, and stuffed toys clean
Sulfites in dried food and wine - avoid foods with allergens
Combustion particles - minimize exposure to combustion particles and gases, change furnace filters, and do not use a gas stove to heat the home
Deodorants, perfumes, air fresheners, paint, and cleaners - avoid if possible

Video: Asthma Triggers

You should start to feel much better if your home is a trigger-free place. Sometimes, relocation is advised since some areas of the country are more likely to have asthma triggers than other areas.

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Preventive Care

Schedule regular visits with the physician that helps you manage asthma so that you can assess your level of asthma control. Checkups are usually recommended every 6 to 12 months for mild intermittent or mild persistent asthma that has been well-controlled for at least 3 months. Those with moderate persistent asthma should be checked up every 3 to 6 months, and those with uncontrolled or severe persistent asthma should be checked every 1 to 2 months.

You may have to make adjustments to your asthma action plan if it is not working right for you. Your physician will consult with you to find the best plan that meets your needs.

Additionally, get regular treatment for any conditions that may interfere with your asthma management. Keeping all aspects of asthma under control is the key to living with it successfully.

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Indications of Worsening Asthma

Your asthma may be getting worse if:

• Your symptoms start to occur more often and are more intense
• Your symptoms bother you at night, causing you to lose sleep or wake during the night
• Your symptoms require you to limit normal activities and miss school or work
• Your peak flow number is low relative to your personal best or it is wildly inconsistent
• Asthma medicines do not work well
• You are using your quick-relief inhaler more often (i.e., every day is too often)
• You have an attack that requires an emergency room visit

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Children and Teens

Children aged 10 or older should be involved in developing and following their asthma action plan. However, you will need to be sure that the plan is followed in order for it to work. It is imperative to bring your child to doctor's appointments or visits with allergy and lung specialists. A physician will be the key to making sure you and your child understand the asthma action plan

You should talk to your child about asthma and how to control it. Protect your child from secondhand smoke in your home and in public places, and prevent your child from coming into contact with common asthma triggers such as pollen, dust mites, cockroaches, or pet dander.

Make sure your child receives his or her asthma medication, and teach your child how to use medical devices properly such as peak flow meters by actively participating in asthma management.

Teens may require some extra attention, as they will see the disease as a barrier to their independence. Support and encouragement will help teens follow their asthma action plans. It is important to help teens remember that asthma will not ruin their lives. Consider allowing them to visit physicians alone to encourage them to manage care independently.

It is important for your child or teen to be active, participating in everyday kid activities and play.

A plan that allows teens to participate in sports and exercise is ideal. Additional support may be found by introducing your child to other teens or children who have asthma.

Video: Kids and Asthma

Famous People with Asthma

Sports

Jerome Bettis - professional football player
Bruce Davidson - Olympic equestrian
Tom Dolan - Olympic medalist, swimming
Kurt Grote - Olympic medalist, swimming
Nancy Hogshead - Olympic medalist, swimming
Jim "Catfish" Hunter - professional baseball player
Miguel Indurain - Tour de France winner (5 times) and Olympic champion
Jackie Joyner-Kersee - Olympic medalist, track
Bill Koch - Olympic medalist, cross-country skiing
Greg Louganis - Olympic medalist, diving
Tom Malchow - Olympic medalist, swimming
Debbie Meyer - Olympic medalist, swimming
Art Monk - professional football player
George Murray - wheelchair athlete & Boston Marathon winner
Robert Muzzio - decathlete
Paula Radcliffe - world record holder marathon
Dennis Rodman - professional basketball player
Jim Ryun - Olympic medalist, track
Alberto Salazar - marathon runner
Mark Spitz - Olympics medalist, swimming
Alison Streeter - crossed the English channel a record 43 times
Isaiah Thomas - professional basketball player
Jan Ullrich - Tour de France winner
Amy VanDyken - Olympic medalist, swimming
Dominique Wilkins - professional basketball player
Kristi Yamaguchi - Olympic medalist, figure skating

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Entertainment

Steve Allen - comedian, actor
Loni Anderson - actress
Jason Alexander - actor, director
Ludwig von Beethoven - composer
Leonard Bernstein - conductor, composer
Judy Collins - folk singer
Alice Cooper - rock singer
DMX - rapper
Morgan Fairchild - actress
Kenneth Gorelick (Kenny G) - musician
Bob Hope - comedian, actor
Billy Joel - singer
Robert Joffrey - dancer, choreographer
Diane Keaton - actress
Liza Minelli - actress, singer
Arnold Schoenburg - composer
Martin Scorsese - film director
Paul Sorvino - actor
Sharon Stone - actress
Elizabeth Taylor - actress
Apex Twin - techno DJ
Antonio Vivaldi - composer, conductor
Orson Welles - actor, director

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Literature

Ambrose Bierce - journalist and author
Elizabeth Bishop - poet and author
Charles Dickens - author
Oliver Wendell Holmes - poet, physician, inventor
Samuel Johnson - 18th century poet, critic, essayist
Joseph Pulitzer - publisher, philanthropist
Dylan Thomas - poet, playwright
John Updike - author
Edith Wharton - author

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Politics

Calvin Coolidge - 30th President of the U.S.
Bill Clinton - 42nd President of the U.S.
Benjamin Disraeli - British statesman, author
Che Guevara - South American revolutionary leader
Rev. Jesse Jackson - political leader
John F. Kennedy - 35th President of the U.S.
John Locke - 17th century politician, philosopher
Walter Mondale - 42nd Vice President of the U.S.
Peter the Great - Russian Czar
Theodore Roosevelt - 26th President of the U.S.
Seneca - Roman philosopher and politician
William T. Sherman - hero of the American civil war
Daniel Webster - lawyer, statesman
William III of England (1650-1702) - Prince of Orange, King of England, Scotland and Ireland
Woodrow Wilson - 28th President of the U.S.

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Science

Baruj Benacerraf - Nobel Prize Winner in medicine
E.J. Corey - Nobel Prize Winner in chemistry
Beruj Benacerraf - Immunologist, Nobel Prize winner
Jan Baptista van Helmont - Belgian pioneer in medicine and chemistry

Treatment for Asthma

Asthma is not so much "treated" as it is "controlled". As a chronic, long-term disease, there is no cure. However, there are tools and medicines to help you control asthma as well as benchmarks to gauge your progress.

The Peak Flow Meter

A peak flow meter is a simple, small, hand-held tool that can help you maintain control of asthma by providing a measurement of how well air moves out of the lungs.

After blowing into the device, the meter reveals your peak flow number. A physician will indicate how often to test as well as how to interpret the result to determine the amount of medication to take. Some people record scores every morning while others use the peak flow meter intermittently.

Often, each test with the peak flow meter will be judged against your "personal best" peak flow number (found during 2 to 3 weeks of good asthma control). If peak flow tests begin to decline - even before other symptoms are present - it may indicate a looming asthma attack. After taking asthma medication, the peak flow meter can be used to test the effectiveness of drug therapy.

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Good Control

Asthma is considered "well-controlled" if:

• Chronic and troublesome symptoms (coughing and shortness of breath) are prevented and occur no more than 2 days per week.
• There is little need for quick-relief medicines or they are needed less than 2 days per week.
• You maintain good lung function.
• Your activity level remains normal.
• Your sleep level remains normal and symptoms do not wake you from sleep more than 1 to 2 nights per month.
• You do not need emergency medical treatment.
• You have no more than one asthma attack each year that requires inhalation of corticosteroids.
• Your peak flow stays above 80% of your personal best number.

These benchmarks can be obtained by working with a doctor and avoiding factors that can make your asthma flare up. Also be sure to treat other conditions that may interfere with asthma management.

Good control also means avoiding things that trigger asthma or asthma symptoms such as allergens. This may mean limiting time spent outdoors when pollen levels or air pollution levels are highest and limiting contact with animals. Asthma linked to allergies can also be suppressed by getting the necessary allergy shots.

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Preventive Checkups

Part of good asthma control is seeing a doctor every 2 to 6 weeks for regular checkups until it is under control. Then checkups may be reduced to once a month or twice a year.

It is a good habit to keep track of asthma symptoms and attacks and diagnostic numbers such as the peak flow measurement. Doctors and nurses will ask about these and about daily activities in order to gauge the status of your asthma control.

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Medicine

Medication for asthma is broadly categorized as either quick-relief medicine or long-term control medicine. Reducing airway inflammation and preventing asthma symptoms is the goal of long-term control medicines, where as immediate relief of asthma symptoms is the goal of quick-relief or "rescue" medicines.

Medications can be ingested in pill form, but most are powders or mists taken orally using a device known as an inhaler. Inhalers permit medicines to travel efficiently through the airways to the lungs.

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Inhaler

Medication may also be administered using a nebulizer, providing a larger, continuous dose. Nebulizers vaporize a dose of medication in a saline solution into a steady stream of foggy vapor that is inhaled by the patient.

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Long-Term Control

Long-term control medicines are taken every day and are designed to prevent asthma symptom such as airway inflammation. Inhaled corticosteroids are the most effective long-term control medicine - the best at relieving airway inflammation and swelling. They are usually taken daily to greatly reduce the inflammation that initiates the chain reaction of the asthma attack.

Even if taken every day, inhaled corticosteroids are not habit-forming. However, the medicines do have side effects such as the mouth infection known as "thrush". Thrush occurs when the corticosteroids land in your throat or mouth. Spacers or holding chambers have been developed to help avoid this. Thrush can also be avoided by rinsing the mouth out after inhalation.

Inhaled corticosteroids also increase the risk of cataracts (clouding of the eye's lens) and osteoporosis (weakening of the bones) if taken for long periods of time.

There are other long-term control medicines available that doctors may prescribe. Most of them are taken by mouth and are designed to open the airways and prevent airway inflammation. Examples include inhaled long-acting B2-agonists (used with low-dose inhaled corticosteroids), leukotriene modifiers, cromolyn and nedocromil, and theophylline.

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Quick-Relief Medicines

Quick-relief medicines relieve asthma symptoms when they occur. The most common of these are inhaled short-acting B2-agonists - bronchodilators that quickly relax tight muscles around the airways, allowing air to flow through them.

The quick-relief inhaler should be used when asthma symptoms are first noticed, but should not be used more than 2 days a week. Most people carry the quick-relief inhaler with them at all times. Quick-relief medicines usually do not reduce inflammation and therefore should not be used as a replacement for long-term control medicines.

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Emergency Care

If your medicines do not relieve an asthma attack or your peak flow is less than half of what it normally is, emergency medicine may be necessary. Call 911 or have someone take you to the emergency room if you cannot walk because you are out of breath or if you have blue lips or fingernails.

Lifesaving treatments at the hospital will consist of direct oxygen (to alleviate hypoxia) and higher doses of medicines. Emergency personnel will likely administer a cocktail of short-acting B-2 agonists, systemic oral or intravenous steroids, other bronchodilators, nonspecific injected or inhaled B-2 agonists, anticholinergics, inhalation anesthetics, the dissociative anesthetic ketamine, and intravenous magnesium sulfate.

Intubation (a breathing tube down one's throat) and mechanical ventilation may also be used in patients undergoing respiratory arrest.

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Children

Although quick-relief medicines can relieve wheezing in young children, long-term control medicines will be used to treat infants and young children if symptoms are likely to persist after 6 years of age.

Like adults, children are treated with inhaled corticosteroids, montelukast, or cromolyn. Often, treatments will be tried for 4 to 6 weeks and stopped if the desired outcome is not seen. Inhaled corticosteroids carry the side-effect of slowed growth, but the effect is generally small and is only apparent for the first few months of treatment.

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Elderly

Elderly asthma care may require adjustments to prevent interactions between medicines. Beta blockers, aspirin, pain relievers, and anti-inflammatory medicines can prevent asthma medicines from working correctly and may worsen symptoms. In addition, it may be difficult for older persons to hold their breath for 10 seconds after inhalation of medicines, but spacers have been developed to help this issue.

The increased osteoporosis risk brought on by inhaled corticosteroids may be magnified in older adults with weak bones. It is common to take calcium and vitamin D pills, among other therapies, to keep bones healthy.

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Pregnant Women

Proper asthma control is necessary for pregnant women in order to ensure a good supply of oxygen to the fetus. Babies born of asthmatic mothers have a higher chance of premature birth and lower birth weight. For pregnant women, the risks associated with having an asthma attack outweigh any risks associated with asthma medicines.

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Non-medical Treatments

Some people treat asthma using unconventional alternative therapies, but there is little formal data to support the effectiveness of these methods. There is research, however, that has found acupuncture, air ionizers, and dust mite control measures, to have little or no effect on asthma symptoms or lung function. Evidence is inconclusive to support or reject osteopathic, chiropractic, physiotherapeutic, and respiratory therapeutic techniques. Homeopathy may mildly reduce the intensity of symptoms, but this finding is not robust.

Diagnosing Asthma

Asthma diagnoses are based on three core components: a medical history, a physical exam, and results from breathing tests. A primary care physician will administer tests and, if you have asthma, determine your level of asthma severity as intermittent, mild, moderate, or severe.

Medical History

A detailed family history of asthma and allergies can help your doctor make an accurate asthma diagnosis. Your own personal history of allergies is also important as many are closely linked to asthma.

Information about asthma symptoms is also useful. Be prepared to divulge when and how often they occur and what factors seem to exacerbate or worsen symptoms. Common symptoms and signs include:

Wheezing
Coughing
Breathing difficulty
Tightness in the chest
Worsening symptoms at night
Worsening symptoms due to cold air
Symptoms while exercising
Symptoms after exposure to allergens

It is also wise to make note of health conditions that can interfere with asthma management such as runny nose, sinus infections, acid reflux disease, psychological stress, and sleep apnea.

It is often somewhat harder to diagnose young children who may develop their first asthma symptoms before age 5. Symptoms are likely to be confused with those of other childhood conditions, but young children with wheezing episodes during colds or respiratory infections are likely to develop asthma after 6 years of age.

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Physical Exam

A physical examination will generally focus on the upper respiratory tract, chest, and skin. A doctor will use a stethoscope to listen for signs of asthma in your lungs as you breathe. The high-pitched whistling sound while you exhale - or wheezing - is a key sign of both an obstructed airway and asthma.

Physicians will also check for a runny nose, swollen nasal passages, and nasal polyps. Skin will be examined for conditions such as eczema and hives, which have been linked to asthma.

Physical symptoms are not always present in asthma sufferers, and it is possible to have asthma without presenting any physical maladies during an examination.

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Asthma Tests

Lung function tests, or pulmonary function tests, are the third component of an asthma diagnosis. To measure how much air you breathe in and out and how fast you can blow air out, physicians administer a spirometry test.

Spirometry is a noninvasive test that requires you to take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer. The spirometer then displays two key measurements:

Forced vital capacity (FVC) - the maximum amount of air one can inhale and exhale
Forced expiratory volume (FEV-1) - the maximum amount of air exhaled in one second

The measurements are compared against standards developed for a person's age, and measurements below normal may indicate obstructed airways.

It is common for a doctor to administer a bronchodilator drug to open air passages before retesting with the spirometer. If results improve after the drug, there is a higher likelihood of receiving an asthma diagnosis.

Children younger than 5 years of age are difficult to test using spirometry, so asthma diagnoses will rely mostly on symptoms, medical histories, and other parts of the physical examination. It is common for doctors to prescribe asthma medicines for 4 to 6 weeks to see how a young child responds.

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Other Tests

A "Challenge Test" (or bronchoprovocation test) is when a physician administers an airway-constricting substance (or something as simple as cold air) to deliberately trigger airway obstruction and asthma symptoms. Similarly, a challenge test for exercise-induced asthma would consist of vigorous exercise to trigger symptoms. A spirometry test is then administered, and if measurements are still normal, an asthma diagnosis is unlikely.

Physicians use allergy tests to identify substances that may be causing or worsening asthma. These tests cannot be used to diagnose asthma, but they can be used to understand the nature of asthma symptoms.

Doctors may also test for another disease with similar symptoms as asthma, such as reflux disease, heartburn, hay fever, sinusitis, sleep apnea, chronic obstructive pulmonary disease (COPD), airway tumors, airway obstruction, bronchitis, lung infection (pneumonia), blood clot in the lung (pulmonary embolism), congestive heart failure, vocal cord dysfunction, and viral lower respiratory tract infection.

Tests may be administered for these ailments such as chest x-rays, EKGs (electrocardiograms), complete blood counts, CT (computerized tomography) scans of the lungs, gastroesophageal reflux assessment, and sputum induction and examination.

A new test using exhaled nitric oxide is being evaluated since physicians are looking for a test that is more accurate than spirometry. Higher levels of nitric oxide are linked to higher degrees of asthma severity. The current drawback lies in the high cost of the test and the specialized equipment required to measure this chemical marker.

An asthma specialist can usually be avoided as most primary care physicians are capable of diagnosing asthma. An asthma specialist may be necessary, however, if you need special asthma tests or have had a life-threatening asthma attack in the past. In addition, specialists can be of use if you need more than one kind of medicine or higher doses of medicine in order to control your asthma, if you have overall difficulty controlling asthma, or if you will be receiving allergy treatments.