LVHN’s clinicians are champions for adults and children with asthma
While we have gorgeous parks and a dynamite baseball team, our region does not score well when it comes to the air we breathe. In fact, the Asthma and Allergy Foundation of America has ranked the Lehigh Valley the country’s third-top asthma capital, and the American Lung Association gave our area an “F” for air quality.
Because poor air quality contributes to respiratory conditions, the pulmonology team at Lehigh Valley Health Network (LVHN), part of Jefferson Health, is always on alert. It helps patients distinguish between allergies, which are the body’s immune system response to harmless substances, and asthma, which is chronic inflammation of the airways that causes coughing, wheezing, chest tightness and shortness of breath.
Our region is packed with all three kinds of respiratory challenges. One is particulate matter, such as pollution and vehicle exhaust. Another is allergens from plants – like pollen – and animals. And there’s ozone, a gas that forms in the air especially during the hot, humid months of summer. The impact of these elements is made worse by our geography.
“We essentially live in a bowl,” says pulmonologist Joseph Schellenberg, MD, with LVPG Pulmonary and Critical Care Medicine. “We’re surrounded by mountains and there aren’t many air currents that reach us. So, we’re prone to everything settling at a breathable level.”
Given the situation, LVHN’s pulmonology teams are experts in diagnosing and treating asthma in both adults and children.
“There can be a genetic tendency toward asthma, but it’s usually allergy driven,” Dr. Schellenberg says. “Sometimes we see an allergic response at an early age, but some people never have that. Other people develop a sensitivity over time that can potentially worsen.”
There’s nothing that cures asthma. So, the goal is to help patients become symptom-free first, then reduce the stimulus.
“The cornerstone treatment is a combination of an inhaled steroid and a long-acting airway opener,” Dr. Schellenberg says. “We gauge the need for additional medications based on how well the symptoms are controlled.” If needed, he says, the team uses biologic agents that target allergic inflammation at its source, blocking or decreasing the production of antibodies.
The same kind of treatments are used for children, according to pediatric pulmonologist Courtney Quinlan, DO, with LVPG Pediatric Pulmonology. They’re based on the “stepwise approach outlined in the Global Initiative for Asthma (GINA) guidelines,” she says. “For children, we use plastic tube-shaped devices, called spacers, that help deliver the medication to the lower airways.”
For “reducing the stimulus,” Dr. Schellenberg recommends completing an allergen profile, then limiting exposure to those things. He says you can also install filters at home that remove particulate matter from the air.
LVHN clinicians urge patients to be proactive about asthma to live comfortably in a “hard-to-breathe” region. Managing this “chronic yet common condition that is treatable and controllable” starts with not ignoring symptoms and knowing what to do.
“Communicate with your clinicians to create an asthma action plan – what you’ll do to optimize control and avoid an acute asthma attack,” Dr. Schellenberg says. “And use airnow.gov or a weather app to track and be aware of asthma action days.”
For parents, Dr. Quinlan recommends working closely with their clinicians to understand what to do when their child is both well and sick. That includes learning to identify asthma triggers such as weather changes, viral illness or temperature extremes.
“Ensure rescue medications are always accessible, understand how to use medications correctly and take responsibility for adhering to the medication regimen,” she says. “Manage the home environment to be smoke- and dust-free, and partner with schools to keep children safe. With preparation, education and regular follow-up, most children – and adults – with asthma or allergies can live healthy, active lives.”
