You’ll be surprised by some of the lesser known triggers…

Whether it’s the wintertime pleasure of sitting next to a crackling log in the fireplace…or the summertime thrill of cooling off in a swimming pool, many of our most treasured seasonal pastimes can mean big trouble for some people.

Hidden threat: If you or a family member is among the 24 million Americans coping with asthma, such seemingly harmless activities could be a mistake.

Asthma, which inflames and narrows the airways, is serious business. Half of all adults with asthma have poorly controlled or even uncontrolled asthma, meaning they are at increased risk for sudden worsening of symptoms, which can lead to complications—such as persistent breathing difficulties and even death.

That’s why it is imperative for asthma sufferers to avoid common missteps that may prevent them from properly controlling their condition. Among the biggest mistakes…

MISTAKE #1: Not seeing the right doctor. Too many asthma patients—and even some doctors—fail to recognize the crossover component between asthma and allergies. For about one-third of adult asthma patients, acute episodes and poor control can be triggered by allergies to common substances such as mold, dust, pollen and animal dander. When the immune system of an asthma patient mistakes these substances for a foreign intruder, allergy antibodies (known as IgE) are produced and make their way to the lungs, often leading to an asthma attack.

An internist or a family doctor can manage asthma cases that flare up only occasionally. But for people with severe and persistent asthma (marked by repeated episodes of coughing, wheezing and/or difficulty breathing that take multiple medications to control), the best doctor is often an allergist, who can perform testing to determine whether a patient’s asthma triggers are allergy-based.

My advice: Consider seeing an allergist if you have persistent asthma symptoms (described above) that limit everyday activities or you’ve ever had a life-threatening asthma attack. If an allergist is not available in your area, ask your doctor for a referral to a pulmonologist (a lung function specialist).

MISTAKE #2: Not getting treated for allergies. To pinpoint allergies that may be contributing to their asthma, patients should undergo allergy testing as soon as possible after an asthma diagnosis.

Unfortunately, some asthma patients who learn they indeed have allergies don’t get allergy shots, a form of immunotherapy that can reduce sensitivity to these triggers. Until this step is taken, repeated bouts of severe asthma symptoms are likely.

A relatively new treatment, sublingual immunotherapy (in which an allergen in tablet form is taken under the tongue) may be an option for certain allergy sufferers. If you’re interested, talk to your doctor.

MISTAKE #3: Missing less obvious triggers. Asthma triggers include anything—whether a true allergen or other irritant—that can aggravate symptoms. While most people already know about many of their own asthma triggers, such as strenuous exercise, rapidly breathing in cold air, certain medications, including nonsteroidal anti-inflammatory drugs like aspirin, ibuprofen or naproxen, or even strong emotions, many other triggers fly under the radar. What are some of these less obvious irritants?

Household plants. Asthma attacks can be precipitated by mold spores that are often found in the soil of many household plants.

My advice: Mold-sensitive patients should minimize indoor plants and keep them out of rooms in which they spend a lot of time, such as the bedroom. If you want to have some plants in your home, you may want to try English ivy, a peace lily or a rubber plant. These plants have been found in research to reduce airborne toxins, including mold spores. Note: Keep English ivy, peace lily and the Indian rubber plant out of the reach of pets and children—these plants can be toxic if consumed.

Wood smoke. Most people realize that cigarette and cigar smoke are irritants, but wood smoke is often overlooked, even though it too can trigger an asthma flare-up.

My advice: If you have asthma, avoid exposure to wood smoke from fireplaces, grills and open fires to avoid worsening symptoms.

Chlorine. A dip in the pool can be invigorating and even help build lung function, but it can also take your breath away if the water is highly chlorinated. While not a true allergy, chlorine sensitivities can trigger chest tightness, coughing and wheezing.

My advice: If you have asthma, limit your exposure to freshly chlorinated pools—especially hyper–chlorinated public pools—and shower thoroughly afterward. If possible, swim in a saltwater pool.

Also, if chlorinated pools make your symptoms worse, be careful about using household cleaning products that contain bleach—only use these products in areas that are well-ventilated.

Candles and air fresheners. Pleasant aromas from scented candles and air fresheners can irritate nasal passages and contribute to an asthma attack.

My advice: To prevent a possible allergic reaction, it’s best to avoid scented candles and air fresheners.

MISTAKE #4: Not getting a flu shot. Getting an annual flu shot is especially important for asthmatics, who are at increased risk for dangerous flu complications, such as pneumonia. It’s best to get the flu shot in October, but it’s still helpful to get it up until March. Pneumonia vaccines, which can be given anytime during the year, are also recommended for people with asthma.

MISTAKE #5: Not recognizing flare-up symptoms. It’s crucial that people with asthma watch for subtle warning signs—such as increasing shortness of breath while exercising or restless sleep—that indicate their asthma may be veering out of control.

Rule of thumb: Asthma is considered poorly controlled if wheezing or other symptoms occur more than twice a week or if you awaken more than twice a month with asthma symptoms. Other red flags include needing to use “rescue” inhalers, such as albuterol more than twice a week…requiring oral corticosteroids to treat severe attacks…and/or changing activity patterns (such as avoiding stairs, etc.).

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