Q: I was recently stung on the arm by a yellow jacket, and my arm became extreme

A: In general, a large local reaction like the one you experienced does not increase your risk for having an anaphylactic (“life-threatening”) reaction to a future sting. The treatments for large localized reactions include cold compress-es, antihis-tamines and occasion-ally pain relievers (Tylenol or Motrin). Insect stings are also a common cause of severe allergic reactions. Symptoms of a severe reaction might include hives, swelling of the skin away from the area that was stung, nausea, vomiting, diarrhea, shortness of breath or throat discomfort. If you ever experience any of these symptoms, you should call 911 and seek immediate medical attention. Additionally, you should make an appointment to see an allergy specialist for testing and possibly venom immunotherapy (allergy shots), which can decrease the risk of anaphylaxis by 97 percent.

— Dr. Lee Perry, Chattanooga Allergy Clinic; member, Chattanooga-Hamilton County Medical Society

Number of asthma sufferers increases

Over the last two decades, the number of people diagnosed with asthma has increased significantly, resulting in approximately 34 million sufferers. Asthma causes nearly 500,000 hospitalizations and nearly 4,000 deaths each year. It is a serious problem that, if left untreated, not only lowers your quality of life, but also causes a staggering 23 million missed school and workdays annually. Dr. Todd Levin, a boardcertified allergist at Chattanooga Allergy Clinic, remembers asthma affecting him as a young boy.

“Growing up, I had asthma and didn’t really understand what is was and why it caused so much trouble for me, especially when it came to participating in sports,” said Levin. Asthma is caused by inflammation in the airways deep in the lungs. The inflammation can be caused by a number of factors including allergies, infections, and environmental irritants. Up to 80 percent of asthmatics have allergies that can set off symptoms such as wheezing, coughing, and difficulty exercising. “Just as allergies can cause runny nose and congestion, they can produce inflammation of the airways when they attack the lungs, triggering asthma attacks,” said Levin. Infections and irritants, such as smoke and pollution, can also lead to airway inflammation. This inflammation causes thickening in the lining of the lungs, mucus production, and twitching of the small airways that leads to wheezing.

“The key to treating asthma is controlling inflammation,” said Levin. “There are a variety of medications and other treatment that can do this.” These include controller medications such as inhaled steroids like Flovent and QVAR, combined steroids and long acting bronchodilators like Advair and Dulera, and Leukotriene Receptor Blockers like Singulair. Albuterol is often prescribed in addition to controller medications as it temporarily relieves the symptoms of asthma without affecting inflammation. “Patients may worry about long term use of steroids, until I explain to them that these inhaled steroids are generally very safe in the doses used to treat asthma,” said Levin.

Widespread use of inhaled steroids has helped to decrease rates of asthma problems. Still, if you have to take a few of these medicines together, it can be overwhelming. Levin says that many long time asthma sufferers initially come to his office looking for a way to decrease their reliance on multiple medications.

“One way to decrease your need for medications is to avoid allergic triggers,” he said.

“The first step is to find out what you are allergic to with a simple, 15 minute skin test performed by your boardcertified allergist. After you discover your allergies, you can start avoiding them.” For instance, dust mite exposure can be decreased with dust mite covers and special cleaning techniques. Mold can be reduced with dehumidifiers.

After avoidance, the best way to decrease reliance on medication is to use allergy immunotherapy, commonly known as allergy shots. “Immunotherapy harnesses the power of your own immune system to decrease sensitivity to the mold, pets, mites, or pollens that are causing all the problems,” said Levin. A recent study showed that people receiving dust mite immunotherapy were able to cut their inhaled steroid dose in half compared to similarly allergic patients not on shots. Immunotherapy patients typically have fewer asthma attacks and use less rescue medications, resulting in reduced time spent in the emergency room. “Better asthma control is cheaper in the long run,” said Levin.

“And many studies have shown that immunotherapy saves money over time.” Successfully controlling a patient’s asthma can dramatically increase their quality of life, but there is one important question asked by many of Levin’s asthma patients: What can they do to possibly prevent their children from developing asthma?

“Asthma can be inherited and research shows that having allergies, particularly to mold, pets, and mites, can increase the risk of developing asthma,” said Levin. “In fact, 40 percent of all allergic patients can go on to develop asthma.” Parents shouldn’t feel helpless in this case. “Starting allergy shots early cuts a patients’ risk of developing asthma by 50 percent,” said Levin.