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The following was originally published on March 10, 2015 on healthcentral.com/asthma. What is Adult Onset Asthma?  Adult Onset Asthma (AOA) is the term used to describe cases of asthma that are diagnosed after the age of 20, although they are usually not diagnosed until after the age of 40. Sometimes, when diagnosed after the age of 50, it is called Late-Onset Asthma. Here are some facts to consider. Intrinsic Asthma . It's usually intrinsic, meaning it's caused by something other than allergies. Usually it results from long term or repeated exposure to any of the following: Hormones from menopause Pollution in the air Chemicals in the air at work or home (such as those in common household cleaners) Chemicals in cigarette smoke (tar, arsenic, cadmium, formaldehyde, chromium, etc.) Lung infections (mainly the viral type) Non-steroidal anti-inflammatory (NSAID) medicine (such as Aspirin) Hormones released from fat tissue ( obesity or high fat foods ) Vigorous exercise ( especi...

The following was originally published at healthcentral.com/copd on May 13, 2015 Breaking Down a Pulmonary Function Test (PFT) Pulmonary Function Testing (PFT) is a standard test that can help diagnose chronic obstructive pulmonary disease (COPD). The results may also determine how severe your disease is, and how well treatment is working. A main part of the testing involves placing your mouth over a mouthpiece, blocking your nose with clamps, inhaling as deeply as you can, and forcibly exhaling as long and hard as you can until no more breath comes out. These results are recorded. FVC . Forced Vital Capacity. Total amount of air you can exhale after deep inhalation. TLC . Total Lung Capacity. How much air remains in your lungs after you completely exhale. RV . Residual Volume. Air that remains inside your lungs even after the most forcible exhalation. Some air stays inside to keep your lungs open. FEV1 . Forced Expiratory Volume at the one second mark of FVC. FEV1/ FVC . Express...

The following was originally published at healthcentral.com/asthma on March 4, 2015. What are asthma subtypes and groups? Asthma is now considered a heterogeneous disease, meaning every asthmatic is different and cannot be treated the same. Because of this, researchers found it useful to break asthma into subgroups (also called subtypes or endotypes). Subgroups are nice because they allow researchers to create guidelines tailored to each specific asthmatic. This makes it easier for physicians to help their asthmatic patients gain better control of their disease. Here are some examples of subgroups: 1. Allergic Asthma . These patients develop adverse reactions to common allergens , such as dust mites, cockroach urine, pollen, mold, fungus, and animal dander. Treatment must focus on preventing and controlling both the asthma and allergy component, which can make it complicated to obtain optimal asthma control. 2. Exercise Induced Bronchospasm . Their air passages spasm and narrow aft...

The following was originally published at healthcentral.com/copd on April 17, 2015. CPAP -vs- BiPAP: What You Need To Know Some people with COPD, or COPD plus sleep apnea, may benefit from CPAP or BiPAP. So what are these, and how might they benefit you? Ventilation . Your lungs make sure you are taking in enough oxygen and blowing off carbon dioxide. Oxygen is an essential element in the air that your cells need to make energy. Carbon dioxide (CO2) is a waste product made by cells. An inhalation of an adequate depth is required for adequate ventilation to occur. Diseases like COPD and Sleep Apnea may compromise ventilation, making it so you are not taking in enough oxygen and/ or blowing off enough CO2. COPD . The disease process increases resistance in your airways, forcing you to work hard to take in a breath. This causes shallow breathing, causing areas inside your lungs that do not stay patent, a medical term for open. Less ventilation occurs, causing your oxygen levels ...

The following was written by Roger Canon, LRT There have been accusations, including some by our president, that doctors sometimes order procedures just to make a profit.  For instance, that doctors are more likely to cut out tonsils, or cut off legs, or perform c-sections, because these make more money and are easier than trying to find out why the tonsils are swollen, why a leg is rotting off, or waiting for birth to be natural. The cure for this is supposed to be government run healthcare and not for profit healthcare, as these evils are the result of capitalism. Yes, if you are a doctor and you are cutting out tonsils or cutting off legs just to make a profit than you are a despicable doctor.  Still, government run healthcare will not solve this problem, only make it worse.  I can give you some real life examples to make my point. According to modern healthcare regulations, if you come to the emergency room with generic dyspnea, and the doctor even thinks you should b...

 The following was originally published at healthcentral.com on February 26, 2015 What is the Asthma Syndrome?  To the advantage of every asthmatic, researchers continue to fine tune the definition of asthma . Now, rather than describing it as a disease that affects all victims the same, many asthma experts say it is a syndrome. So what is this, and what does it mean? A syndrome is a group of diseases that present with similar signs and symptoms. There are six very good reasons to refer to asthma as a syndrome. 1. Heterogeneous . Researchers have learned that every case of asthma is unique, and this may be because each asthmatic has a unique combination of asthma genes . 2. Causes . Researchers have determined that there are over 24 things that might cause asthma . This might be because different asthma genes cause asthma only after exposure (or repeated exposure) to certain environmental substances, and this can happen at nearly any stage of life. The substance migh...

The following was originally published on April 15, 2015 at healthcentral.com/copd. Do you need oxygen therapy?  Sometimes people with COPD need to inhale more oxygen than what is provided in the air. The way this is accomplished is by using oxygen therapy. So what is oxygen therapy, and do you need it? Oxygen in room air contains 21 percent oxygen. Usually this is plenty of oxygen. However, certain disease conditions, such as what may occur as COPD progresses , or during COPD flare-ups, may create areas inside your lungs where oxygen is inhaled, but cannot get to your bloodstream. When enough of these areas exist, your blood oxygen levels may decline. To learn more about oxygen and oxygen levels, please read my post “ Understanding Oxygen and Oxygen Levels with COPD .” What is oxygen therapy? It involves inhaling supplemental oxygen, or oxygen percentages that are greater than 21 percent. It allows you to inhale 22-100 percent oxygen, depending on the device used. Nasal C...

So one of my respiratory therapist friends, of whom I will not name here even though he said I could, sent me an email a while back explaining why it is that respiratory therapist driven protocols will never result in a decrease in treatment loads. There will always be the belief that if the patient is short of breath we must do something People sitting in leather chairs in Washington decided that in order to meet criteria for admission a patient must have needed at least 3 treatments in ER.  It eludes them that hospitals would have physicians order them just so the hospital can be reimbursed .  People sitting in leather chairs in Washington decided that in order for a patient's stay to be reimbursed for certain respiratory conditions (pneumonia, CHF, COPD) the patient must have breathing treatments ordered.  This is under the fake belief that if treatments aren't needed why keep the patient.  It eludes them that there may be other reasons for keeping the patient, no...

Some of my asthmatic friends constantly criticize pharmaceuticals as run by a bunch of evil rich people who are greedy and make money at the expense of the sick.  Their evidence is the fact that newer, non-patented, asthma medicine costs so much.  I would like to argue that pharmaceutical companies (or most of them) are run by people who simply want to make enough profit to stay in business. It is true that asthma medicine costs too much. Consider that if your doctor prescribes Advair to control your asthma, it will cost you about $250 a month if you pay out of pocket.  If you have a copay the cost will be about $70 per month.  This copay is high, considering a typical copay for generic medicine is between $20 and $40 a month.  Consider the following facts as reported by medicine.net, " Drugs: Why they cost so much? " The high price of Advair is not the result of greed, but of regulation. In fact, pharmaceuticals are constantly looking to find new medicines to h...

The following was originally published on February 16, 2015, at healthcentral.com/asthma. Asthma Medicine: Home Versus Hospital The goal of asthma treatment is to prevent and control asthma so you can live a normal life with it. Still, from time to time, some asthmatics require a hospital admission to get their lungs back into shape. When this happens, the medicine you normally take at home may change and be administered in a different fashion than you’re used to. Here are some changes to expect if you ever require a hospital admission for your asthma. Controller Medicine . Usually, if you take asthma controller medicine at home (Advair, Dulera, Symbicort, Breo) you will continue to receive the same medicine in the hospital. This is important to note, because it usually takes 2-3 weeks for the medicine to get into your system and start working. Your admitting physician surely won’t want you to start all over once you are discharged. However, it’s important to understand that th...

The following was originally published on April 3, 2015 Understanding Oxygen and Oxygen Levels Oxygen is essential to a normal functioning body. The progression of COPD , and COPD flare-ups , may cause your oxygen levels to become low. So what does this mean to you? Here is all you need to know about oxygen and oxygen levels. What is oxygen? It’s an element with the symbol O. It makes up about 21 percent of air. When you inhale, it travels through your lungs to your bloodstream, and then travels to tissues, such as heart tissue. A cell on this tissue will use it to make energy needed for it to perform its work. Lack of oxygen may cause tissue damage, such as heart damage. How are oxygen levels monitored? There are two tests: Arterial Blood Gas (ABG) . This involves an blood draw from your wrist or arm. Thankfully, this test doesn’t need to be done too often thanks to another, simpler test called... Pulse Oximetry . A probe is placed over your finger or earlobe. Since this...

So, we in the medical profession often refer to some patients as train wrecks.  The official term here is "Medical Train Wreck," although we Americans are good at shortening longer words that take too long to say, which is why some of us refer to them as MTWs. That in mind, We figured we would officially define the term for our Faux Lexicon . Word :  Train Wreck Definition .  A person with greater than ten co-morbidities; treatment of one condition may exacerbate another condition "The patient might be here forever, she is a medical train wreck." Example #1 :  A patient with heart failure, COPD, small bowel obstruction, hypertension,, CVA, myocardial infarction, chest pain, renal failure, sepsis, etc.  Surgery to repair the small bowel obstruction will probably require high doses of fluid; Due to bad lungs the anesthesiologist will refuse to extubate the patient, who will now be moved to intensive care.  The patient will be treated as exacerbation of COPD f...

You'll often hear the phrase: "Medicine is an art based on a science."  A more accurate phrase would be: "Medicine is an art based on some science but mostly consensus."  Lost in the discussion is the fact that science is not a consensus, or if it's a consensus it's not science.  The irony of it all is that most of the theories in medicine are based on consensus, not science. Think of it this way.  Science is an attempt to understand things. Studies are performed, groups of data collected and then interpreted in several ways by observers.  'Consensus' is definitely important in that the more observers you have (i.e. scientists, researchers) that agree with a given interpretation, the more likely said the interpretation is accurate. So, basically, a consensus is a group of scientists who agree with a given interpretation.  In other words, it's the results of a vote.  For instance, back in the 19th century a consensus of physicians believed tha...