Asthma affects millions of people in the US and is one of the most common chronic childhood disease. If you or someone you love suffers from asthma, you know that there is no cure - however, with proper care, asthmatics can lead normal, active, and fulfilling lives.

Foreword xxi Introduction 1 About This Book 1 Foolish Assumptions 2 How This Book Is Organized 2 Part I: Asthma Basics 3 Part II: Understanding Asthma Triggers 3 Part III: Treating Your Asthma 3 Part IV: Controlling Asthma with Medications 3 Part V: Special Asthma Conditions 4 Part VI: The Part of Tens 4 Appendix 4 Icons Used in This Book 4 Where to Go from Here 5 Part I: Asthma Basics 7 Chapter 1: Knowing What’s Ailing You 9 Understanding the Relationship between Asthma and Allergies 10 Triggering Asthma and Allergic Reactions 13 Sensitizing your immune system 13 Developing an allergic reaction 13 Previewing Asthma and Related Conditions 15 Asthma: Breathing and wheezing 15 Allergic rhinitis: Running away with your nose 16 Atopic dermatitis: Scratching your itch 17 Food hypersensitivities: Serving up allergens 17 Drug hypersensitivities: Taking the wrong medicine 18 Anaphylaxis: Severe systemic symptoms 19 Managing Asthma Effectively 20 Chapter 2: The Basics of Treating and Managing Your Asthma 23 Understanding Who Gets Asthma and Why 23 Identifying triggers, attacks, episodes, and symptoms 25 Realizing that asthma isn’t in your head 25 Uncovering the Many Facets of Asthma 26 Allergic asthma 27 Non allergic asthma 27 Occupational asthma 28 Exercise-induced asthma (EIA) 28 Aspirin-induced (and food-additive-induced) asthma 28 Asthma and Your Airways 28 The inflammatory response 29 How airway obstruction develops 30 Diagnosing Asthma 32 Taking your medical history 32 Examining your condition 34 Testing your lungs 34 Considering other possible diagnoses 37 Classifying asthma severity 38 Referring to a specialist for diagnosis 38 Managing Your Asthma: Essential Steps 39 Going over the basics 39 Determining your asthma therapy goals 40 Handling emergencies 41 Managing asthma at school 42 Chapter 3: Dealing with Doctor Visits 43 Preparing for Your First Visit 44 Doing your homework 44 Filling out forms ahead of time 46 Telling your story 46 Recording your symptoms and medications 48 Focusing on foods 49 Taking your family history 49 Knowing What Tests Your Doctor May Perform 49 Looking for signs of asthma and allergies 50 Testing for asthma and allergies 50 Following Up: Second and Subsequent Visits 53 Getting a diagnosis: What happens next? 53 Considering allergy shots 54 Paying for Your Care 54 Dealing with insurance issues 55 Gatekeeping and your treatment 55 Getting the care you need and deserve 56 Working Well with Your Doctor 56 Chapter 4: Managing Asthma Long-Term 57 Seeing What a Long-Term Management Plan Includes 57 Focusing on the Four Levels of Asthma Severity 59 Using the Stepwise Approach 60 Stepping down 63 Stepping up 63 Treating severe episodes in stepwise management 64 Assessing Your Lungs 64 What your doctor should do: Spirometry 65 What you can do: Peak-flow monitoring 65 Taking Stock of Your Condition 68 Keeping symptom records 69 Tracking serious symptoms 69 Monitoring your medication use 70 Evaluating your inhaler technique 70 Understanding Self-Management 71 Working with your doctor 71 Evaluating for the long term 72 Becoming an expert about your asthma 72 Improving Your Quality of Life 73 Expecting the Best 73 Part II: Understanding Asthma Triggers 75 Chapter 5: Knowing Your Asthma Triggers 77 Recognizing What Triggers Your Asthma 78 Evaluating triggers 78 Testing for allergic triggers 80 Controlling Inhalant Allergens 81 Clearing the Air at Home 82 Household irritants 83 No smoking, please 83 Filters and air-cleaning devices 83 Working Out Workplace Exposures 84 Targeting workplace triggers 85 Diagnosing and treating workplace triggers 85 Avoiding Drug and Food Triggers 87 Aspirin sensitivities 87 Beta-blockers 88 Sensitivities to sulfites and other additives 88 Food allergies 89 Other Medical Conditions and Asthma 89 Rhinitis and sinusitis 89 Gastroesophageal reflux disease (GERD) 90 Viral infections 91 Chapter 6: Understanding Asthma and the Role of Allergies 93 Protecting Your Health: How Your Immune System Works 94 Classifying Immune System Components and Disorders 95 Protecting and serving in many ways 98 Distinguishing between immune deficiencies and allergic conditions 99 Immunizing and immunology 100 Classifying Abnormal Immune Responses 101 IgE-mediated reactions (Type I) 101 Cytotoxic reactions (Type II) 101 Immune complex reactions (Type III) 102 Cell-mediated reactions (Type IV) 102 Developing an Immediate Hypersensitivity 102 Setting the stage for allergic reactions 102 Reacting to allergen exposures 104 Doing it one more time: The late-phase reaction 106 Becoming hyperresponsive 106 Reacting nonspecifically 107 Reaping the Benefits of Immunology 107 Chapter 7: Hay Fever and Asthma: The United Airway 109 Catching Up with Your Runny Nose 110 Classifying Types of Hay Fever 112 Seasonal allergic rhinitis 113 Perennial allergic rhinitis 113 Occupational allergic rhinitis 114 What Makes Noses Run? 115 Getting a Medical Evaluation 115 Understanding that sneezy, itchy, and runny feeling 115 Seeing red: Allergic conjunctivitis 116 All that drips isn’t allergic 117 Knowing what the doctor’s looking for 119 Doing your part 120 Managing Rhinitis 121 Avoiding allergens 121 Treating with medications 121 Treating the cause of your allergies 122 Considering special cases 122 Chapter 8: Food Allergies and Asthma 125 Types of Adverse Food Reactions 126 Allergic Food Hypersensitivities 127 How allergic food hypersensitivities develop 129 Gastrointestinal tract allergies 129 Hives and other food-related skin reactions 130 Anaphylaxis and allergic food reactions 131 Non allergic (Non-IgE) Food Hypersensitivities 134 Understanding the Differences between Food Allergy and Food Intolerance 135 Lactose intolerance 135 Metabolic food reactions 135 Pharmacologic food reactions 136 Food additive reactions 136 Food poisoning 137 Diagnosing Adverse Food Reactions 137 Keeping a food diary 138 Considering atopic causes 138 Eliminating possible food culprits 138 Testing for food allergens 139 Avoiding Adverse Food Reactions 140 Chapter 9: Asthma and Exercise 141 Understanding EIA 141 Keeping Fit Despite EIA 142 Diagnosing EIA 142 Controlling EIA with medications 143 Athletes and EIA 143 Breathing competitively: Nose versus mouth 143 Warming up and cooling down to prevent EIA 144 Part III: Treating Your Asthma 145 Chapter 10: Avoiding Allergens That Cause Respiratory Symptoms 147 Pollens 148 Pollen particulars 148 Counting your pollens 150 Allergens in the grass 153 Wheezy weeds 153 Can’t sneeze the forest for the trees 154 Molds 155 Spreading spores 155 Moldy matters 156 House Dust 156 Dust mites 157 What else is in my house dust? 158 Dust gets in your eyes or nose, throat, and lungs 158 Avoidance and Allergy-Proofing 159 Why avoidance matters 159 Knowing your limits 161 Crossing the line 161 Table of Contents xv The Great Indoors 162 Indoor air pollution: Every breath you take can hurt you 162 Allergens on the barbie? 163 Allergy-Proofing Begins at Home 163 Controlling the dust in your house 164 Ridding your house of dust mites 165 Controlling dust mites in the bedroom 165 Regulating pet dander 166 Controlling mold in your abode 167 Pollen-proofing 168 Chapter 11: Getting Allergy Tested and Allergy Shots 171 Diagnosing with Skin Tests 172 Pins and needles 172 Skin tests and antihistamines: Not a good mix 173 Starting from scratch: Prick-puncture procedures 174 Getting under your skin: Intracutaneous testing 175 Skin test side effects 176 Blood testing for allergies 176 Reviewing Immunotherapy 177 Seeing how immunotherapy works 177 Deciding whether immunotherapy makes sense for you 178 Getting shots 179 Considering side effects 182 Looking at Future Forms of Immunotherapy 182 Chapter 12: Relieving Your Nasal Allergies 185 Getting Familiar with Pharmacology 186 Blocking Your Histamines: Antihistamines 187 Histamine hints 187 A dose of prevention 188 First-generation OTC antihistamines 188 Newer antihistamines 190 Antihistamines and children 194 Antihistamine nasal sprays 194 Decongesting Your Nose 195 Oral decongestants 195 Nasal decongestants 196 Two for the Nose: Combination Products 197 Analyzing the upside and downside 198 One size fits all may not suit your condition 199 Using Nasal Corticosteroids 199 Cromolyn Sodium 202 Reducing Mucus with Anticholinergic Sprays 203 Treating Rhinitis with Leukotriene Modifiers 204 Keeping an Eye out for Allergic Conjunctivitis 204 Chapter 13: Treating Your Ear, Nose, and Throat Symptoms 207 Complicating Your Allergies and Asthma: Sinusitis 208 Recognizing common causes 208 Sinus science 209 Practical sinus 210 How long has this been goin’ on? 211 Diagnosing sinusitis 212 Determining the best course of treatment 213 An ounce of prevention 215 Otitis Media 216 Revealing common causes 216 Getting an earful 217 Acute otitis media (AOM) 219 Otitis media with effusion (OME) 220 Diagnosing ear infections 221 Taking preventive measures 221 Part IV: Controlling Asthma with Medications 223 Chapter 14: Knowing Asthma Medications 225 Taking Your Medicine: Why It’s Essential 227 Looking at asthma’s changing dynamics 227 Tracking your asthma condition 227 Getting the Long and Short of Asthma Medications 229 Controlling asthma with long-term medications 230 Relieving asthma episodes with quick-relief products 231 Taking asthma medications prior to surgery 232 Delivering Your Dose: Inhalers and Nebulizers 233 Using a metered-dose inhaler 234 Using holding chambers 236 Using a dry-powder inhaler 236 Using a multidose-powder inhaler 239 Using nebulizers 240 Cleaning your medication delivery system 242 Chapter 15: Looking at Asthma Controller Drugs 243 Controlling Airway Inflammation with Corticosteroids 244 Inhaled corticosteroids 244 Oral corticosteroids 248 Preventing Respiratory Symptoms with Mast Cell Stabilizers 250 Cromolyn 251 Nedocromil 251 Prepping for mast cell stabilizers with other drugs 252 Knowing when mast cell stabilizers may not be enough 252 Dilating Your Airways with Long-Acting Bronchodilators 253 Combining two drugs: Advair 254 Understanding timing: Why long-acting products may not always be enough 254 Enhancing anti-inflammatory effectiveness 255 Relieving Nighttime Asthma with Theophylline 255 Watching out for theophylline’s undesirable side effects 256 Bad combinations: Adverse interactions with theophylline 257 Reducing Respiratory Symptoms with Leukotriene Modifiers 257 Understanding the importance of leukotrienes in asthma 259 Watching out for adverse side effects 259 Introducing the Newest Therapy on the Block: IgE Blocker 260 Chapter 16: Treating Asthma Episodes 263 Relieving Symptoms with Short-Acting Bronchodilators 264 Using short-acting bronchodilators effectively 268 Avoiding potential adverse side effects of short-acting bronchodilators 269 Introducing new and improved bronchodilation 270 Reversing Airflow Obstruction with Anticholinergics 272 Looking at Short-Term, Rescue Use of Oral Corticosteroids 273 Chapter 17: Future Trends in Asthma Therapy 275 Getting Better All the Time 276 Improving inhaled corticosteroids 276 Combining for complementary effect 276 Special delivery: More effective devices 277 Under Your Tongue: Swallow Immunotherapy 278 Blocking IgE: A Biotech Breakthrough 279 Exploring the Frontiers of Asthma Therapy 280 Inhibiting interleukins 280 Toll-like receptors (TLRs) 281 Gene therapy 282 Keeping Research Alive: Clinical Trials and You 282 Part V: Special Asthma Conditions 285 Chapter 18: Asthma during Childhood 287 Understanding Your Child’s Asthma 288 Inheriting asthma 289 Identifying children’s asthma triggers 289 Controlling — not outgrowing — asthma 290 Treating early to avoid problems later 290 Identifying Childhood-Onset Asthma 290 Taking your child’s medical history 291 Examining your child for signs of asthma 292 Testing your child’s lungs 292 All That Wheezes Isn’t Asthma 293 Focusing on Special Issues Concerning Childhood Asthma 293 Teaming up for the best treatment 295 Managing asthma in infants (newborns to 2 years old) 295 Treating toddlers (ages 2 to 5 years): Medication challenges 297 Peak-flow meters and school-age children (ages 5 to 12) 298 Using inhalers: Teens and asthma 299 Handling Asthma at School and Daycare 300 Indoor air quality (IAQ) at school and daycare 301 Participating in PE — exercise and asthma 302 Chapter 19: Pregnancy and Asthma 303 Identifying Special Issues with Asthma during Pregnancy 304 Your hormones and your asthma 304 The basics of managing asthma while pregnant 304 Breathing for Two 305 Avoiding asthma triggers, allergens, and irritants during pregnancy 306 Undergoing allergy testing and immunotherapy during pregnancy 306 Managing nasal conditions associated with pregnancy 307 Exercising with asthma during pregnancy 308 Assessing your asthma during pregnancy 309 Monitoring your baby’s condition 309 Taking asthma medications while pregnant 309 Handling asthma emergencies while pregnant 311 Chapter 20: Asthma and the Elderly 313 Recognizing Asthma Later in Life 314 Taking Asthma Medications When Older 315 Using more effective delivery devices 315 Watching out for adverse side effects 316 Part VI: The Part of Tens 317 Chapter 21: Ten Tips for Traveling with Asthma 319 Planning a Safe, Healthy Trip 320 Adjusting Treatment for Travel 321 Taking Medications and Other Essentials 321 Getting Medications and Medical Help Abroad 322 Flying with Allergens and Irritants 322 Considering Allergy Shots and Travel 323 Reducing Trigger Exposures in Hotels and Motels 323 Avoiding Food Allergies during Your Trip 324 Finding Help in Case of Emergencies 324 Traveling with Your Asthmatic Child 325 Chapter 22: Ten Famous Folks with Asthma 327 Augustus Caesar 328 Peter the Great 328 Ludwig van Beethoven 328 Charles Dickens 329 Teddy Roosevelt 330 John F Kennedy 331 Leonard Bernstein 332 Liza Minnelli 333 Kenny G 333 Jackie Joyner-Kersee 334 Appendix: Asthma Resources 335 Organizations 335 Asthma and Allergy Environmental-Control Products 337 Suppliers 337 Manufacturers of asthma and allergy products 338 Other Writings and Media about Asthma and Allergies 338 Books 339 Periodicals 339 Index 341

"Every person with asthma or allergies should own this book!" —Nancy Sander, President, Allergy and Asthma Network/Mothers of Asthmatics Features up-to-date coverage of childhood asthma Identify your triggers and manage your asthma long-term Anxious about asthma? You can breathe easy with this plain-English guide, which clearly explains the diagnosis, symptoms, and treatment of the disease. You’ll find useful information on the relationship between allergies and asthma, exercise’s link to asthma, asthma during pregnancy and in the elderly, and all the latest medications. Praise for Asthma For Dummies "A must read for anyone who suffers or knows someone who suffers from asthma. Asthma doesn't mean you have to sit on the sidelines. You can even become an NFL running back!" —Jerome Bettis, Running Back "You can still achieve your life-long Olympic dreams even with asthma." —Al Joyner, Olympic Champion, first American in 80 years to win the Gold Medal in the Triple Jump "Take it from someone who knows what it’s like to carry a handful of inhalers. . . . This is a book to breathe by!" —Congressman Patrick J. Kennedy Discover how to: Use rescue medicationsAllergy-proof your homeDeal with doctors and insuranceHandle food allergiesAvoid asthma complicationsFind outside support

“…books in this series are well known for their easy-to-read and Asthma For Dummies is no exception.” (The Airways Journal, March 2005) “…you can breathe-easy with this plain-English guide which clearly explains the disease which affects so many people…” (Pride Magazine, July 2004) “…an extremely helpful and comprehensive book – essential reading for anyone with Asthma…” (Irish Examiner, 4th June 2004) “…an invaluable source of information for all sufferers…” (FT Newswire, 18 May 2004) "This really is one of the most informative guides around." (Daily Mail, September 9, 2008)