How to Consult a Doctor About Asthma

Patients with asthma may experience symptoms occasionally, frequently, or continually. Furthermore, the severity of an individual’s asthma can vary considerably, from being a mild nuisance to life-threatening. In addition, the symptoms of asthma may be severe on one occasion or well-controlled on the other not interfering with normal life. It is not uncommon to see patients having severe asthma for 2-3 years and then remain symptom-free without drugs for years together. Often the person with asthma is intolerant of exercise, experiences chronic fatigue from extra efforts of breathing, or may even experience weight loss when the illness is severe. In children, asthma is a major cause of school absenteeism.

Usual Symptoms of Asthma

Wheeze

During asthmatic problems, a whistling sound is heard with breathing called wheeze. Wheeze is a musical sound that is audible even to a person sitting next to the patient. After running or climbing stairs many asthmatic patients feel a wheeze which is probably indicating the presence of active disease.

Wheeze test:

  1. Take a deep breath.
  2. Close your ears with fingers.
  3. Through the mouth exhale fully to empty your lungs. During exhalation especially during the latter part of expiration, you may feel a musical sound. This is a wheeze.

Cough

Cough is an important symptom of asthma. After exposure to the trigger factor, it is the first symptom of the onset of asthmatic attack in many patients. There is a special group of asthmatic patients who have only the sole symptom of cough. They do not have other asthmatic symptoms. Therefore if a cough persists for a period of more than 10 days without any disease, then one should get checked up for asthma.

Click here to hear the cough sound of an asthmatic patient.

Shortness of breath

At the time of attack shortness of breath is the most distressing symptom for asthmatic patients. In such a situation even trivial exertion may aggravate shortness of breath further. The patient takes a breath with great effort. The Neck muscles of the patient become tight and spaces between ribs become deep and prominent.

Chest tightness

In addition to wheeze, cough, and shortness of breath, asthmatic patients also experience chest tightness. This symptom can be intermittent, as the following exposure to a trigger, or continuous. It is also not uncommon to see patients having asthma without shortness of breath. Such patients may present with just cough or chest tightness. 

Thick spiral type expectoration

Expectoration is not a major problem in asthmatic patients, however, the majority of patients cough out typical sputum which is very viscous. It comes out like a grain of wheat or gram and when pulled it stretches in the form of a thread. During symptom-free periods also such sputum comes out with a huff or cough, though infrequently. It may indicate the presence of asthma in the asymptomatic stage.

Differentiation from other diseases

These symptoms of asthma can be found in association with other lung diseases such as bronchitis or emphysema. Therefore the mere presence of these symptoms is not diagnostic of bronchial asthma. However, the pattern of these symptoms is characteristic of asthma. These symptoms are usually intermittent and improve with therapy in asthma while in other forms of lung diseases, the symptoms are usually present all the time and respond poorly to treatment.  

An important characteristic of asthma symptoms is a nighttime flare-up. The nighttime flare of asthma is very common and can pose diagnostic problems. Usually, people with nighttime symptoms are totally normal during the day. Hence there is no, or little, evidence of asthma at the routine time of examination. The situation can perplex both the patient and physician. In the morning, these patients get up early due to asthmatic distress. After taking a cup of morning tea the distress subsides gradually.

Notice in Doctor’s waiting-room… To avoid delay, please have your symptoms ready.

Important Therapeutic Rules

It has been observed that with proper caution asthma may be controlled just short of a cure. However, many times ignorance on the part of patients may cost heavily in form of the fatal attacks, hospitalization, or sometimes death. The following set of rules are a bare minimum requirement to lead an asthma-free life.

Know your Doctor

The patient should know the name and telephone number of his regular doctor and where he can be contacted in the emergency. Remember any asthmatic patient can have a severe attack of asthma. They should also know an asthma specialist & discuss all the problems and action plans for potential problems such as what to do for sore throat, nocturnal dips, exertion-induced asthma, etc.

Know your drugs

It is extremely helpful for patients to know the names and doses of all the drugs that they are taking. It is important to know how often the drug should be taken and whether or not it is permitted to increase the number of doses take in a day. Theophylline has many interactions and hence check other drugs if you are taking theophylline.

Maintain your stock

If you need drugs to treat your asthma, it is important that an adequate supply is kept at home, even if they are only needed very occasionally. Running out of drugs is not only just inconvenient but could be very dangerous in some situations. Attacks of asthma can occur at any time and it may be difficult to purchase medicines during the night. If you are on regular daily treatment with drugs, don’t wait until you have run out before purchasing new medicines.

Give details of treatment to any strange doctor consulted

If you need medical attention from a doctor who is not familiar with your case, it is vital that you should tell this doctor as much as possible about treatment. This is especially important if you develop something unrelated to asthma, for example at the time of an accident or if you need to have an operation. If you are taking steroid drugs or has taken them regularly in the previous year, it is essential to let any new doctor know about it, particularly if you are going to need an anesthetic. This also applies to a dental operation.

Don’t stop treatment suddenly

Unless you are told by your doctor, it is unwise to stop any drug suddenly. This is particularly important for preventive drug Cromolyn and for steroid drugs because asthma attacks may return rapidly. It is quite safe to stop these drugs over a period of few days on a doctor’s advice and it may also be safe to stop steroids suddenly if they are taken only for a short time. This is a medical decision, however, and you should rely on expert advice.

Know what to do for an attack

Even if your asthma is well under control you should ask your doctor what to do if you get worse or develop a severe attack. Usually, this will mean increasing the dose and you should be sure how to do this safely and effectively. In some cases, it will mean adding standby drugs to your usual treatment for a few days.

Know when to consult a doctor

There is no doubt that some of the most difficult attacks occur in the most capable patients because they tend to continue to tolerate for too long before calling the doctor. If you are not improving over a few hours despite the recommended treatment, it is usually worth speaking to the doctor about it. This is more important in the evening or before the weekend when it may be difficult to contact him if things are really bad.

Don’t take advice from amateurs

There are great many grand ma’s tales about asthma which are best useless and at times dangerous. It is very unwise for patients to seek or take advice from anyone other than a medically qualified individual. This applies particularly to anyone offering to “cure” by means of patent medicines, faith healing, or hypnotism. There is no “cure” for asthma, only treatment to relieve it until the patient grows out of it.

How to consult a doctor or how to take maximum benefit of consultation with a doctor?

Asthma is a chronic disease and every patient has mainly two aims. Control of the disease and control of the recurrence. A doctor prescribing medicines can control your disease but its recurrence depends on you. If you take adequate care and precaution you will be able to control the recurrence. However, carelessness will cause the recurrence of the disease. These are essential aspects of treatment, you should learn from your doctor. During the consultation, however, busy doctors and forgetfulness on your part are important barriers in consultation. By proper planning, you can take the maximal benefit of consultation from your doctor. In order to take maximum benefit from a specialist doctor, please have the following information ready.

  • What are your symptoms and when these began?
  • What makes the symptoms better or worse?
  • Have you ever had eczema, urticaria, allergic cold, eye allergy, or asthma?
  • Repeated bouts of ear infection.
  • Sinus infection.
  • Loss of smell or taste.
  • How old were you when asthma started?
  • Did the disease start first with episodes of wheezing and breathlessness (asthma), daily productive cough (Bronchitis), or breathlessness on effort (emphysema)?
  • Has it improved or deteriorated since then?
  • Are you ever completely free of asthma symptoms?
  • When is asthma more severe: around Diwali/ Holi/ Winter/ Summer?
  • How many times per month,
    • Do you wake up due to asthma?
    • Have you stayed in bed?
    • Called the doctor?
  • During asthma is there any difference between,
    • Indoor/ outdoor?
    • At home/school?
  • Effect of exercise, cold air, exposure to pollution.
  • Are you in contact with animals?
  • Do you have any feathers in the bedroom?
  • Can you tolerate aspirin?
  • Smoking habit?
  • Do you or any member of the family smoke?
  • Have you ever been admitted to the hospital for asthma?
  • Do any of the parents, siblings, or children have eczema, urticaria, allergic cold, eye allergy, or asthma?
  • Medications are taken for relieving the symptoms.
  • How many weeks does an asthma spray last?
  • Reports of previous treatment or tests.

Learn from your doctor

  • When to use reliever medicine?
  • When to discontinue preventive medicine?
  • How to face the challenge of trigger exposure?
  • What to do when already exposed to trigger factors?
  • How to make adjustment of therapy with the onset of warning signals?
  • Which hospital to go to in an emergency?

You can supplement the treatment options provided to you by your doctor with regular acupuncture treatments from AB Acupuncture. The practice has been used in China and Western countries to relieve some of the symptoms associated with asthma.

Overview of Headaches

Primary and Secondary Types Plus Warning Signs

Most people have headaches now and then, which can range from migraine, tension, and cluster headaches to the most serious types. What kinds of headaches are there?

Headache is one of the most common complaints seen in the clinic. It is also a condition that most people try to manage on their own without a visit to the doctor. While most headaches are benign, one must not forget that there are different causes for headaches, including the occasional serious type that is life-threatening without prompt evaluation. The following is an overview of the causes of headaches.

Primary Headaches

A migraine headache tends to be bothersome for those who experience it. It starts as a mild steady headache and peaks as an intense throbbing headache usually felt on one side of the head. It can be accompanied by nausea and vomiting as well as sensitivity to light and noise. In fact, being in a dark and quiet room may provide relief. About one-fifth of people with migraine headaches have auras, which are neurological phenomena preceding the headache. They may involve, for example, seeing flashing lights and experiencing facial numbness.

You can ease the frequency and intensity of migraine headaches with regular acupuncture treatment. Book an appointment and free consultation at AB Acupuncture for migraine treatment done by experienced acupuncture professional.

Tension headache is generally associated with stress. Unlike migraine, the pain of a tension headache tends to be a steady non-throbbing pain involving both sides of the head without accompanying symptoms that characterize a migraine headache. This type of headache can be episodic or constantly present.

Cluster headaches get their name from their characteristic timing. They occur about several times a day for weeks to months, which is followed by a period of no headaches as if the headaches are clustered together in a single time period. A headache is a severe deep pain occurring on one side of the head, usually in the eye or temple. Accompanying symptoms may include tear formation, eye redness, sweating, and nasal congestion on the same side as the headache.

Secondary Headaches and Warning Signs

Besides primary headache, there is also headache from secondary causes, including sinus infections, head trauma, glaucoma, and caffeine withdrawal. Types of headaches that are uncommon but serious include brain tumors, intracranial bleeding, and giant cell arteritis (a.k.a. temporal arteritis), which is inflammation of the arteries and associated with a risk for blindness if left untreated.

While there is no need to see the doctor for every single headache, it is still a good idea to know the types of headaches that warrant immediate attention. If the headache is getting worse despite treatment or is suddenly severe from the start, one should immediately call the doctor or go to the nearest emergency department. In addition, headaches associated with symptoms such as numbness, fainting, fever, and stiff neck should also be evaluated as soon as possible. One should not assume such a headache to be an innocent one or else serious consequences may occur.

Final Words

The causes of headaches summarized above should provide a better understanding of what appears benign and what might not be. Nevertheless, it is advisable to talk to a doctor if there is doubt about headaches that occur.

Causes & Treatments of Dizziness According to Chinese Medicine

The term referring to the condition dizziness in Chinese Medicine, Xuan Yun, has two major components. The first refers to visual acuities where the vision may become fuzzy, blurry, or completely black altogether; the second can be best summarized as a feeling that objects around the person or a person’s body may be spinning, commonly referred to as vertigo. These two conditions often present in unison, which is why the Chinese have chosen to use these terms collectively to define the condition of dizziness.

As we well know, our sense of balance is regulated by an interdependent network of sensory organs within the body. These include the sensory nerves, the eyes, and the inner ear. Any deviation in the normal function of these organs can have negative repercussions and lead to a loss of balance or dizziness. From a western medical perspective, dizziness can have many different causes: Meniere’s disease, irregular blood pressure, heart disease or heart arrhythmias, hardening of the cerebral arteries, tumors, stroke, migraines, insufficient volume of blood within the arteries, hypoxia, low blood sugar, dehydration, anemia, fatigue, stress, or neuropathy. In mild cases, simply closing the eyes and slowing down the respiratory rate can relieve these symptoms. In more severe cases, the symptoms can not be self-controlled, and the person may not be able to regain their balance or stand up. The condition may be further complicated in some cases by headaches, stiffness of the neck, nausea, vomiting, uncontrolled eye movements, tinnitus or hearing loss, profuse sweating, or in the worse cases, fainting. Due to the myriad of different factors that can attribute to dizziness, diagnosis and treatment of the condition can be a daunting task. Using medications or other therapies that are only directed at one organ system or one cause of dizziness often leads to unsatisfactory results, and a cure can remain elusive for many suffers.

Thankfully, practitioners of Chinese medicine are more inclined to take a holistic approach to treat their patients and have over 3,000 years of clinical observations at their disposal. Chinese clinicians first typified the condition in one of the earliest remaining Chinese Medical Text “The Yellow Emperor’s Internal Canon” (Huang Di Nei Jing). It is referred to multiple times within the text and is attributed to many different causes: irregular liver function, lack of marrow, blood deficiency, and obstruction of the blood vessels and circulatory system. By the Han dynasty, one physician Zhang Zhong Jing, promoted the theory that the major underlying cause of dizziness was actually phlegm or highly viscous fluids in the body that may inhibit or retard fluid or food metabolism. This later gave rise to the maxim attributed to Zhu Dan Xi from his text, “if there is no phlegm then there is no dizziness”. From henceforth, herbal formulas to treat the condition would focus on strengthing the spleen to improve fluid transportation and metabolism as well as resolving phlegm. By the time of the Jin and Yuan dynasties, there was a major revolution in how the condition was viewed. There was a shift in believes as to the causes of the disease, the pathology of the disease, and the herbal formulas that should be used to treat the disease. It was postulated that the internal stirring of both the body’s wind and fire elements was occurring simultaneously to produce the apparent dizzying effect. In response to this change in ideology herbal formulas used to treat dizziness at that time were altered to incorporate herbs that were more bitter, sour, and astringent in nature to combat the simultaneous attacks from both the internal wind and fire within the body. Nevertheless, the idea that phlegm was still the major cause was still upheld within the writings of certain physicians during this time period, and never completely lost popularity. In later years, during the Ming and Qing dynasties, after further investigation of the condition, a pattern of constitutional deficiencies was noted within patients suffering from dizziness. The old maxim was altered slightly by a physician named Zhang Jie Bin in his text, “if there is no deficiency then there is no dizziness”. It wasn’t until this time period that a complete synthesis of all these various theories took place, and that physicians would begin to recognize the need to treat all of the factors involved in producing dizziness. This meant that in treating the condition it was necessary to differentiate the underlying causes based on the patient’s body type. A good example of this comes from the text, “for those that are pale and obese and suffer from dizziness, the main principle in treating the disease is to resolve the phlegm and descend the fire while using herbs that will supplement the qi; for those with a dark complexion and thin that suffer from dizziness, the treatment principle is to use herbal formulas that increase the body’s fluids and descent the fire, while also inhibiting the liver”. It was also during this time period that Chinese physicians first noted the connection between dizziness and cerebral vascular disease, and that those who suffer from dizziness are more likely to incur a stroke. The numerous changes in the theories of the causes and pathology of dizziness may dishearten some and have led others to say that Chinese medicine is unscientific. While that may be one possible conclusion, I prefer to look at it as a 3,000-year process of development and refinement based on clinical findings and a better understanding of the condition.

There are some notable factors and precursors to the development of dizziness according to Chinese medicine. Often there is an element of emotional imbalance. Specifically, long-standing depression or being prone to bouts of over anger. These conditions if left unchecked, over time affect the liver’s normal physiological function. This in turn gives rise to the overactivity of both the body’s internal wind and fire, which as we mentioned above is the main pathology of dizziness. Age also plays a role in the development of dizziness. As we age our cognitive function slowly declines, due to the hardening of the cerebral arteries and a restriction of blood flow to the brain. In Chinese medicine, this is referred to as a loss of marrow. Normal brain function is dependent on a rich supply of marrow. The production of marrow is supported by the kidneys. The kidneys store essence, which comes in two different forms. One form is that which was supplied to us by our parents at birth, the original essence (xian tian Zhi jing). This is combined with nutrients that are filtered from the blood, commonly known as acquired essence (hou tian zhi jing). These are then put back into the circulatory system and transported throughout the body to support normal bone health, where marrow is produced. Excess marrow is transported to the brain where it is stored and used in cognitive function. When we can no longer provide enough marrow to support the brain, due to a decline in kidney function and the degradation of our bones, we become more susceptible to dizziness or other cerebral vascular diseases. A healthy immune and circulatory system is also critical in maintaining good brain health and staving off dizziness. If we suffer a serious prolonged disease or the immune system becomes compromised we can acquire a condition known in Chinese medicine as qi deficiency. If our circulatory and cardiovascular systems do not supply an ample volume of blood to the body a separate but complementary condition can insure known as blood deficiency. Over time the body weakens and normal metabolic processes can no longer be carried out which provides the platform for the development of dizziness. Poor nutrition and unhealthy habits such as smoking and drinking to excess can also stress the body and in time cause enough harm where dizziness can develop. Lastly, severe trauma to the head can cause bruising and swelling which may disrupt our sensory system and cause a loss of balance and dizziness. As mentioned previously in our discussion, it is often a combination of these factors which leads to dizziness. If all factors involved are not treated in a holistic and systematic fashion the dizziness may not abate. This is why Chinese medicine often produces good results when other modalities fail.

In addition to the normal battery of western medical tests that are used to diagnose the causes of dizziness practitioners of Chinese medicine also look for certain signs and symptoms the patient may be suffering from or suffered previously to guide their treatment principles. The first step is to recognize which organ systems are involved. Overactivity of the liver is suspected in patients with headaches accompanied by a feeling of distension within the temporal regions of the head, reddening of the face, easily irritated or angry, insomnia, and excess dreaming, with a bitter taste in the mouth and a wiry pulse. If the spleen, stomach, and digestive system are involved and the patient suffers from blood and qi deficiencies the patient will present with poor appetite, lassitude, fatigue, palpitations, and insomnia, and will have a pale complexion. If the metabolic transportation is insufficient, also a function of the spleen, due to internal dampness the patient will report a feeling of heaviness in the limbs with difficulty moving them, nausea, a headache which feels like the head is encapsulated by something with excessive pressure, chest tightness, overtired with excessive sleeping, and a greasy yellow tongue coating with a rolling or intermittent pulse. If there is a deficiency of kidney essence the patient will complain of weakness and pain in the knees and legs, forgetfulness, and tinnitus that sounds like crickets. In addition to knowing which organs are involved the practitioner should be able to determine if there is an underlying excess or deficiency in the patient’s constitution, or both occurring simultaneously. This can be determined by the use of several simple deductions based on the patient’s body type and symptoms. The quote mentioned above is still as true today as it was then and should always be considered when treating a dizzy patient. Furthermore, it is important to remember that for those suffering with dizziness there are normally multiple organ systems involved and deficiencies that have led to excess conditions and that all of these must be considered if a cure is to be effected.  

Given the complicated nature of the condition and the number of causal factors involved it is of great importance that treatment is specialized to the individual and based on their constitutional deficiencies and imbalances. This is the greatest strength of Chinese medicine in treating dizziness. Treatment will most likely involve a combination of using herbal medicine and acupuncture. Commonly used herbal formulas in treating this condition include Tian Ma Gou Teng Yin, Gui Pi Tang, Zuo Gui Wan, and Ban Xia Bai Zhu Tian Ma Tang. Normally, one formula is chosen based on the organ system most adversely affected and then altered to include other essential herbs to match the individual needs of the patient For suffers from external trauma one very useful formula is Tong Qiao Huo Xue Tang, which helps to open the orifices and move stagnant blood and fluids which may cause swelling and can impair the function of the sensory organs. Herbs are taken two to three times a day for five to seven days. The patient is then reevaluated and any modifications in the prescription are then made and another course is begun. Acupuncture treatment is very much custom-tailored to deal with current symptoms and to treat the underlying conditions which led to the dizziness occurring. Most symptoms such as headaches, stiffness of the neck, nausea, vomiting, tinnitus, and profuse sweating will be alleviated within the first five to ten treatments. The normal course of treatment for acupuncture is two to three times a week, with 10-15 treatments being one course. Most patients will see significant improvement within the first course but may need up to three or more before a complete cure can be brought about. Treatment should be coupled with exercises that can help improve balance. In a typical treatment, the first step involves using scalp acupuncture and having the patient go through these exercises with the needles inserted to help recruit blood flow to these areas of the brain and improve neural function. In addition, emphasis should be placed on the patient trying to keep a calm demeanor, avoiding stimulants, any excess physical labor, and getting ample rest while undergoing treatment. Certain breathing and Tai Ji exercises can be immensely helpful in improving the patient’s sense of balance. Eating habits should also be changed to avoid certain foods and overeating and drinking at meals to help improve the immune system. Early treatment of these conditions is also important.

For those suffering from dizziness, even the simplest tasks can be incredibly arduous or uncomfortable. Many feel that there is no cure for their dizziness and it has become for many a fact of life.