Add all of the numbers
The Asthma Control Test™ is a quick test for people with asthma 12 years or older. It provides a numerical score to help assess asthma control.
Instructions
1. Select the response to each question.
2. Submit this form to view your results.
3. Print/Discuss your results with your doctor.
Below are some essentials of good sleep habits. Many of these points will seem like common sense. But it is surprising how many of these important points are ignored by many of us.
Many people fall asleep with the television on in their room. Watching television before bed-time is often a bad idea. Television is a very engaging medium that tends to keep people up. We generally recommend that the television not be in the bed- room. At the appropriate bed- time, the TV should be turned off and the patient should go to bed. Some people find that the radio helps them go to sleep. Since radio is a less engaging medium than TV, this is probably a good idea.
Hay fever (Allergic Rhinitis) is the most common of the allergic diseases and refers to seasonal nasal symptoms that are due to pollens. One of the most obvious features of pollen allergy is its seasonal nature; people experience symptoms only when the pollen grains to which they are allergic are in the air. Each plant has a pollinating period that is more or less the same from year to year. Plants produce microscopic pollen grains to reproduce. In some species, the plant uses the pollen from its own flowers to fertilize itself. Other types must be cross-pollinated; that is, in order for fertilization to take place and seeds to form, pollen must be transferred from the flower of one plant to that of another plant of the same species. In-sects do this job for certain flowering plants, while other plants rely on wind transport. The types of pollen that most commonly cause allergic reactions are produced by the plain-looking plants that do not have showy flowers. These plants manufacture small, light, dry pollen grains that are ideal wind transport. Because airborne pollen is carried for long distances, it does little good to rid an area of an offending plant as the pollen can drift in from many miles away. Among North American plants, weeds are the most prolific producers of allergenic pollen. Rag-weed is the major culprit; a single ragweed plant can generate a million grains of pollen a day. Colorful or scented flowers have large, heavy, waxy pollen grains. This type of pollen is not carried by wind but by insects such as butterflies and bees, and is not typically a cause of seasonal allergy. Similarly, the heavy, very visible pine pollen, is usually not a significant cause of symptoms.
A pollen count is a measure of how much pollen is in the air. This count represents the concentration of all the pollen (or of one particular type, like ragweed) in the air in a certain area at a specific time. It is expressed in grains of pollen per square meter of air collected over 24 hours. Pollen counts tend to be highest early in the morning on warm, dry, breezy days and lowest during chilly, wet periods.
Check the pollen count
If you have a respiratory mold allergy, your immune system overreacts when you breathe in mold spores. This reaction triggers a cascade of reactions that lead to allergy symptoms. Like other respiratory allergies, mold allergy can make you cough, make your eyes itch and cause other symptoms that make you miserable. In some people, mold allergy is linked to asthma and exposure causes shortness of breath and other symptoms. Molds are very common both inside and outside. Mold, also known as fungus, is a family of organisms that are found throughout nature. They differ from plants or animals in how they reproduce and grow. The “seeds,” called spores, are spread by the wind outdoors and by air indoors. Some spores are released in dry, windy weather. Others are re-leased with the fog or dew when humidity is high. There are many different types, but only certain kinds of mold cause allergies. Being allergic to one type of mold doesn’t necessarily mean you’ll be allergic to an-other. Allergic symptoms from mold spores are most common from July to late summer. But with molds growing in so many places, allergic reactions can occur year round.
The term “toxic mold” is a misnomer and has no scientific basis. Some molds, called “toxigenic molds” produce byproducts called mycotoxins, which in high enough doses, can be beneficial or detrimental to human health. A common mycotoxin is penicillin – a useful antibiotic. Extreme exposure to very high levels of mycoto-ins may lead to health problems; fortunately such exposures rarely to never occur in normal exposure, even in residences with serious mold problems. Toxic effects may be the result of chronic activation of the immune system, leading to chronic inflammation. Allergy testing does not evaluate patients who feel they suffer from mold toxicity.
In colder climates, molds can be found in the outdoor air starting in the late winter, and peaking in the late summer to early fall months (July to October). In warmer climates, mold spores may be found throughout the year, with the highest levels found in the late summer to early fall months. While indoor molds can occur year round and are dependent on moisture levels in the home, indoor mold levels are higher when out-door mold levels are higher. Therefore, a common source of indoor mold is from the outside environment, although can also be from indoor mold contamination.
Although many people have bad reactions to certain foods, a true food allergy – a reaction triggered by the immune system – isn’t as common as you might think. However, the number of people who have a food allergy is growing. About 2 percent of adults and 6 percent of children have a true food allergy. Far more people have food intolerance, unpleasant symptoms triggered by food. Unlike a true food allergy though, a food intolerance doesn’t involve the immune system. A food allergy reaction occurs when your immune system overreacts to a food or a substance in a food, identifying it as a danger and triggering a protective response. Symptoms of a food allergy can range from mild to severe and typically appear within minutes to 2 hours after ingestion of a food to which he or she is allergic. Just because an initial reaction causes few problems doesn’t mean that all reactions will be similar; a food that triggered only mild symptoms on one occasion may cause more severe symptoms at another time. Symptoms of food allergy may include a tingling sensation in the mouth, swelling of the tongue and throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, low blood pressure, loss of consciousness, and even death. The most severe allergic reaction is called anaphylaxis – a life-threatening whole-body allergic reaction that can be fatal. It must be treated promptly. In some very rare cases, the reaction may be delayed by four to six hours or even longer. Delayed reactions are most typically seen in children who develop eczema as a symptom of food allergy and in people with a rare allergy to red meat caused by the bite of a lone star tick.
While any food can cause an adverse reaction, eight types of food account for about 90% of all reactions: Eggs, Milk and dairy, Peanuts, Tree nuts, Fish, Shellfish, Soy, Sesame. About 50% of children with allergies to milk, egg, soy, and wheat will outgrow their allergy by the age of 6. Those that don’t, and those still allergic by the age of 12 or so, have less than an 8% chance of outgrowing the allergy. Peanut and tree nut allergies are less likely to be outgrown, although evidence now shows that about 20% of those with peanut allergies and 9% of those with tree nut allergies will outgrow their allergies. However, one must never assume they have outgrown an allergy, and this should only be decided with the assistance of an allergy specialist.
Not everyone who experiences symptoms after eating certain foods has a food allergy or needs to avoid that food entirely. Some people with seasonal allergy to pollens experience an itchy mouth and throat after eating a raw or uncooked fruit or vegetables. This may indicate a diagnosis of oral allergy (food-pollen) syndrome – a reaction to pollen, not to the food itself. The immune system recognizes the pollen and similar proteins in the food and directs an allergic response to it. The allergen is destroyed by heating the food, which can then be consumed with no problem. One can experience symptoms, primarily digestive, with a food intolerance. The most common example is lactose intolerance. Because a food intolerance may involve some of the same signs and symptoms as a food allergy does – such as nausea, vomiting, cramping and diarrhea – people often confuse the two. If you have a food in-tolerance, you may be able to eat small amounts of problem foods without a reaction. By contrast, if you have a true food allergy, even a tiny amount of food may trigger a severe allergic reaction.
Once a food allergy is diagnosed the most effective treatment is to avoid the food. People allergic to a specific food may also potentially have a reaction to related foods. For example, a person allergic to one tree nut may be cross-reactive to others. Those allergic to shrimp may react to crab and lobster. Learning about patterns of cross-reactivity and what must be avoided is one of the reasons why people with food allergies should receive care from an allergist. Determining if you are cross-reactive is not straightforward.
The primary way to manage a food allergy is to avoid consuming the food that causes you problems. Carefully check ingredient labels of food products and learn whether what you need to avoid is known by other names. The Food Allergy Labeling and Consumer Protection Act of 2004 (FALCPA) mandates that manufacturers of packaged foods produced in the United States identify, in simple, clear language, the presence of any of the eight most common food allergens in their products. The presence of the allergen must be stated even if it is only an incidental ingredient, as in an additive or flavoring. Be aware that FALCPA labeling requirements do not apply to items regulated by the U.S. Department of Agriculture (meat, poultry and certain egg products) and those regulated by the Alcohol and Tobacco Tax and Trade Bureau (distilled spirits, wine and beer). The law also does not apply to cosmetics, shampoos and other health and beauty aids, some of which may contain tree nut extracts or wheat proteins. Some goods also may be labeled with precautionary statements, such as “may contain,” “might contain,” “made on shared equipment,” “made in a shared facility” or some other indication of potential allergen contamination. There are no laws or regulations requiring those advisory warnings and no standards that define what they mean.
Symptoms caused by a food allergy can range from mild to life-threatening; the severity of each reaction is unpredictable. As noted, people who have previously experienced only mild symptoms may suddenly experience a life-threatening reaction. Therefore, allergists do not like to classify someone as “mildly” or “severely” food allergic – there is just no way to tell what may happen with the next reaction. Epinephrine is the first-line treatment for anaphylaxis. Once you have been diagnosed with a food allergy, your allergist should prescribe an epinephrine auto-injector and teach you how to use it. You should also be given a written treatment plan describing what medications you have been prescribed and when they should be used. Keep an eye on the expiration date of your auto-injector. Anyone with a food allergy should always have the auto-injector close at hand. Having two doses available is important as the severe reaction can recur in about 20% of individuals. Use epinephrine immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, weak pulse, hives, tightness in your throat, trouble breathing or swallowing vomiting, diarrhea or abdominal pain. You should call for an ambulance to be taken to the emergency room. Inform the dispatcher that epinephrine was administered and more may be needed. If you are uncertain whether a reaction warrants epinephrine, use it right away; the benefits of epinephrine far outweigh the risk that a dose may not have been necessary.
Common side effects of epinephrine may include anxiety, restlessness, dizziness and shakiness. In very rare instances, the medication can lead to abnormal heart rate or rhythm, heart attack, an increase in blood pressure and fluid buildup in the lungs. If you have certain pre-existing conditions, such as heart disease or diabetes, you may be at a higher risk for adverse effects from epinephrine. Nevertheless, epinephrine is considered very safe and is the most effective medicine to treat severe allergic reactions. Other medications may be prescribed to treat symptoms of a food allergy, but it is important to note that there is no substitute for epinephrine: It is the only medication that can reverse the life-threatening symptoms of anaphylaxis.
Some fresh fruits and vegetables can trigger a mild allergic reaction that causes the mouth to tingle or itch. This is an example of cross-reactivity — proteins in fruits and vegetables cause the reaction be-cause they’re similar to those allergy-causing proteins found in certain pollens. For example, if you’re allergic to ragweed, you may also react to melons; if you’re allergic to birch pollen, you may also react to apples. Most cooked fruits and vegetables generally do not cause cross-reactive oral allergy symptoms.
Dust mites are the most common cause of allergy from house dust.
There may be as many as 19,000 dust mites in one gram of dust, but usually between 100 to 500 mites live in each gram. (A gram is about the weight of a paper clip.)
COPD, or chronic obstructive pulmonary disease, is a progressive lung disease that causes coughing, sputum production, wheezing, shortness of breath, chest tightness, and other symptoms. COPD is a major cause of disability, and it’s the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. An additional 12 million likely have the disease and don’t even know it. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. The term “COPD” includes two main conditions, emphysema and chronic obstructive bronchitis. In emphysema, the walls between many of the air sacs are damaged, causing them to lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. In chronic obstructive bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic obstructive bronchitis. Thus, the general term “COPD” is more accurate. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of your-self. COPD has no cure yet. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.
Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, along with an examination. The diagnosis is confirmed with lung function tests. These tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs can deliver oxygen to your blood. The primary test for COPD is spirometry. During this painless test, a technician will ask you to take a deep breath in and then blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer. Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of disease and to monitor how well treatment is working.
Asthma is a chronic lung disease that inflames and narrows the airways (the tubes that carry air into and out of your lungs). Asthma causes recurrent wheezing , chest tightness, shortness of breath, and cough. Asthma affects people of all ages, but it most often starts in childhood. In the United States, more than 22 million people are known to have asthma. Inflammation in asthma makes the airways swollen and very sensitive. They tend to react strongly to certain substances that are breathed in. When the airways react, the muscles around them tighten. This causes the airways to narrow, and less air flows to your lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus can further narrow your airways. Sometimes symptoms are mild and go away on their own or after minimal treatment with an asthma medicine. At other times, symptoms continue to get worse. When symptoms get more intense and/or additional symptoms appear, this is an asthma attack. It’s important to treat symptoms when you first notice them. This will help prevent the symptoms from worsening and causing a severe asthma at-tack. Severe asthma attacks may require emergency care, and they can cause death. Asthma cannot be cured. Even when you feel fine, you still have the dis-ease and it can flare up at any time. With proper treatment, most people who have asthma can expect to have few, if any, symptoms either during the day or at night.
Use the asthma control test to determine how well controlled your asthma is.
Household pets are the most common source of allergic reactions to animals. 15-30% of people with allergies have an allergy to dogs, cats, or other animals. Cats are the most common cause for pet allergies and approximately 10 million people in the United States are allergic to cats. Pet allergies are caused by an immune system response to proteins present in the animal. Many people assume that they are allergic to their pet’s fur. Actually, the culprits are proteins in pet dander and dried saliva and urine. Dander occurs naturally as the epidermis, or the outer layer of skin, renews itself. The epidermis is made up of many layers of cells which are constantly pushing upward to re-place the cells above. As this occurs, the outer cells die and flake off into the environment as dander. It has been found, incidentally, that the epidermal turnover is more rapid in breeds that are groomed frequently and especially in breeds that are prone to various forms of dry and oily seborrhea. Saliva and urine are also potential sources of allergens. They are deposited on the fur through licking and urination. More people are allergic to cats than dogs, probably because cats spend more time indoors and bathe them-selves with their saliva. Since dander is very small and light, it can attach itself to your clothes when you are away and ride back into your home undetected. It can also come in on the clothes of your children or guests. Animal dander has been found in many public places, like school classrooms, in quantities high enough to cause an allergic reaction. Many homes without pets have been tested, and similar results have been found. If you have moved into a home where a pet has lived, it will take a year or more for all of the dander to lose its potency. So even if you don’t have a cat in your home you can react as if there is one. Some rodents, such as guinea pigs and gerbils, have become increasingly popular as household pets. They, too, can cause allergic reactions , as can mice and rats. Urine is the major source of allergens from these animals.
Myth: Some breeds of animals are non allergenic.
Reality: Since dander is produced within a cat or dog’s skin and they all have skin, there are no breeds that are non allergenic.
Myth: Only indoor pets cause allergies.
Reality: There are many different animals that can cause allergic reactions, not just your dog, cat or hamster. Outdoor animals such as horses, cows, pigs or chickens also cause a reaction due to their hair or living areas which are mainly enclosed.
Myth: Continuous exposure to animals will desensitize you to them.
Reality: If you are allergic to an animal, continuous exposure will not decrease your allergy. In fact, 1 in 3 people who have other allergies and are exposed to indoor pets will become allergic to them as well over time.
Myth: A shorter hair animal causes less allergic reaction.
Reality: Allergy has little to do with the length of fur (or hair) on the animal. Even though short haired animals shed less, they still produce the same amount of dander, which is the real cause of the pet allergies.
The Truth: Male cats produce more allergen than female cats. Some breeds of dogs produce dog allergen faster than others.
The best avoidance measure for a pet allergy is to remove the animal from the house. However, many people are emotionally attached to the pet and are unwilling to do so. In this case, there are some actions that are recommended to cut down on the amount of allergen in the home:
Remove the pet from the bedroom, and keep the animal off of furniture and outdoors as much as possible.
Have someone else bathe the pet at least once per week, especially if the animal is large.
Consider removal of carpeting from the bedroom and other common areas of the home.
Vacuum the carpet and floors frequently; ensuring the vacuum cleaner should be equipped with a HEPA filter.
Consider purchasing a HEPA filtered air cleaner for the bedroom.
If the pet is removed from the home, it is important to steam clean all carpeting and upholstered furniture, and launder draperies and bedding.
In most cases, people with allergies develop mild to moderate symptoms, such as watery eyes, a runny nose or a rash. But sometimes, exposure to an allergen can cause a life-threatening allergic reaction known as anaphylaxis. Allergies to food, insect stings, medications and latex are most frequently associated with anaphylaxis. The immune system produces antibodies that defend against foreign substances. This is good when a foreign substance is harmful, such as certain bacteria or viruses. But some people’s immune systems overreact to substances that don’t normally cause an allergic reaction. This severe, potentially life-threatening reaction happens when an over-release of natural chemicals such as histamine puts the person into shock. It can occur within seconds or minutes of exposure to something to which you are allergic. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure and in rare cases, anaphylaxis may be delayed for hours. Delayed reactions are most typically seen in children who develop eczema as a symptom of food allergy and in people with a rare allergy to red meat caused by the bite of a lone star tick. If anaphylaxis isn’t treated right away, it can be fatal.
Signs and symptoms
Anaphylaxis symptoms occur suddenly and can progress quickly. The early symptoms may be mild, such as a runny nose, a skin rash or a “strange feeling.” These symptoms can quickly lead to more serious problems, including:
Risk factors
There aren’t many known risk factors for anaphylaxis, but some things that might increase the risk include:
Prevention
Seek emergency medical help
Common side effects of epinephrine may include anxiety, restlessness, dizziness and shakiness. In very rare instances, the medication can lead to abnormal heart rate or rhythm, heart attack, an increase in blood pressure and fluid buildup in the lungs. If you have certain pre-existing conditions, such as heart disease or diabetes, you may be at a higher risk for adverse effects from epinephrine. Nevertheless, epinephrine is considered very safe and is the most effective medicine to treat severe allergic reactions. Other medications may be prescribed to anaphylaxis, but it is important to note that there is no substitute for epinephrine: It is the only medication that can reverse the life-threatening symptoms of anaphylaxis.
The diagnosis and long-term management of anaphylaxis can be complicated, so you will probably need to see a doctor who specializes in allergies and immunology.
If you don’t know what triggers an allergy attack, certain tests (such as skin-prick tests, blood tests and oral food challenges) can help identify the allergen. In some cases, the cause of anaphylaxis is not identified (idiopathic anaphylaxis).
Consider Allergy consultation if:
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