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OTHER HEALTH CONDITIONS CAN AGGRAVATE ASTHMA SYMPTOMS

DEAR MAYO CLINIC: I was diagnosed with bronchial asthma when I was 11. I had the attacks weekly through most of my teen years. As I got older, the attacks diminished until I was almost asthma-free from age 28 to 59. Then I began to develop a steady chronic condition again. Now I’m 83 and on several medications for asthma, including Advair, Lotensin, Levoxyl and hydrochlorothiazide. Are medications the only treatment options? — Vashon, Wash.

ANSWER: Your situation isn’t surprising. Asthma can worsen or improve throughout a person’s lifetime. While it’s often thought of as a disease starting in childhood, it can develop at any age. About 20 million Americans have asthma; an estimated 6.2 million of them are children.

For an older adult, managing asthma is increasingly complicated if you have other health problems, too. Hypertension, heart disease, gastroesophageal reflux disease and other conditions can cause chest symptoms that are similar to those of asthma. These health conditions can make asthma symptoms worsen. Medications for other health problems can interplay with asthma medications. For both physician and patient, determining what is causing the symptoms and which treatments are effective can be difficult.

From what you’ve shared, it appears you do have other health problems. Of the medications you mentioned, only Advair (fluticasone/salmeterol combination inhaler), which contains an inhaled corticosteroid, is an asthma medication. The others are used for various conditions, including thyroid disorders (levothyroxine/Levoxyl), high blood pressure (hydrochlorothiazide, benazepril/Lotensin) and heart disease (benazepril/Lotensin).

At your age and with multiple health concerns, your best bet for managing your asthma is to work with a doctor who can care for the whole person — that is, manage treatment for all your health conditions and ensure that medications work effectively together. A primary-care physician or internal medicine specialist could fill this role and regularly review all aspects of your care.

Medications likely will remain part of your asthma treatment program to control chronic symptoms and prevent asthma attacks.

There are other steps you can take to improve your asthma if you haven’t already. If you smoke, stop. Smoking worsens asthma symptoms. If your asthma is related to allergies, find ways to minimize your exposure to allergy triggers.

— James Li, M.D., Ph.D., Allergic Diseases, Mayo Clinic, Rochester, Minn.

Additional Resources:
Asthma
Appointment Information
More Information on Asthma

READERS: First, a cancer diagnosis. Then, worries about possible side effects from the treatment — the nausea and vomiting you’ve heard about from others who have been treated for cancer.

In just the last decade, anti-nausea (antiemetic) drugs have improved, making a positive difference for people taking chemotherapy treatments, according to Mayo Clinic Health Letter.

Chemotherapy drugs are rated for how likely they are to cause nausea. Based on those ratings, anti-nausea medications are commonly given as a preventive measure before chemotherapy begins.

In addition to medication choices, there’s evidence that acupuncture can help provide relief from nausea and vomiting that’s related to chemotherapy.

Along with anti-nausea medications, self-help strategies such as relaxation techniques may make a difference in how you feel during chemotherapy. Some other steps you can take to manage nausea include:

— Not delaying: Use medications at the first sign of nausea.

— Talking to your doctor: Be sure your doctor has a clear understanding of the severity of any nausea you experience. Usually, changes can be made to help in subsequent chemotherapy cycles if needed.

— Eating lightly and frequently: Avoid having three large meals. Try a light snack a few hours before treatment.

— Eating and drinking slowly: Pace yourself and stop eating when you are satisfied. Don’t overeat.

— Eating what appeals to you: Go for variety, but choose foods you find easiest to eat and digest. Even old standbys, such as soda crackers, may help.

— Drinking plenty of fluids: Try sipping on cool beverages such as cola, flat ginger ale or lemon-flavored water to reduce nausea. But avoid filling up on liquids when you are eating.

— Resting after eating: Don’t lie flat, but take it easy after a meal with quiet activity that keeps your mind occupied.

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.