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    Jonathan L. Gelfand, MD

    Jonathan L. Gelfand, MD, is a practicing internist and pulmonologist in Pennsylvania.

    Gelfand graduated from the Albert Einstein College of Medicine.  He then completed his residency in internal medicine at Waterbury Hospital Health Center in Connecticut, and his fellowship in pulmonary disease at Georgetown University Hospital in Washington, D.C.

    Gelfand is a member of the American College of Occupational and Environmental Medicine and the American Thoracic Society.  He is also a fellow of the American College of Chest Physicians (FCCP)

    Gelfand is board certified by the American Board of Internal Medicine with the subspecialty certificate in pulmonary disease.

    Gelfand is a physician reviewer for Physicians' Review Network Inc., an independent medical review organization.

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    Quick Answers to Your Asthma Questions

    • What Does Asthma Feel Like?
    • Answer:

      Imagine trying to breathe through a paper straw in your mouth while your nose is pinched closed! That's how millions with asthma describe breathing when they have symptoms of an asthma attack. Now think about living daily, breathing through a paper straw. Can you see how difficult it might be to stay active and alert, engage in exercise, and be productive at work or school? That's why getting an accurate asthma diagnosis and using the prescribed asthma treatments are priorities for living well with this common lung condition. Self-managing asthma by avoiding asthma triggers and using the proper asthma medications allows the vast majority of those with asthma to live active lives without asthma symptoms of coughing, wheezing, or chest tightness.

      For in-depth information, see WebMD's What Is Asthma?

    • When I Laugh, I Start to Cough and Wheeze. Why Would Laughing Trigger an Asthma Attack?
    • Answer:

      Strong emotions, such as laughing and crying, are common asthma triggers. Even sex can cause an asthma episode in some people. When you laugh or cry, you inhale more air and this temporarily dries the airways in your lungs. This causes temporary tightening of the small muscles which surround your airways. This tightening is called bronchospasm, but it can be quickly relieved by using an asthma rescue inhaler. There are many ways to improve asthma control so that minor things no longer trigger coughing spells or wheezing and shortness of breath. Contact your healthcare provider to discuss them.

      For more information, read WebMD's Asthma Attack.

    • My Husband Has Allergies and I Have Asthma. What Are the Chances That our Children Will Have Asthma?
    • Answer:

      If your husband has allergic rhinitis (hay fever) and you have allergic asthma, then each of your children will have about a 50% chance of getting asthma at some time during their life. Allergies are usually inherited from your parents or grandparents. About three out of every five asthma cases are hereditary. Of course, this shouldn't keep you from having children. The vast majority of people with allergic asthma find it rather easy to control it with the many helpful therapies available.

      For more information, see WebMD's Asthma Risk Factors.

    • Can Heartburn Cause my Nighttime Asthma Symptoms?
    • Answer:

      Two out of every three people with asthma also experience frequent heartburn or gastroesophageal reflux disease (GERD). With GERD, the stomach acid regurgitates or backs up into the esophagus to cause heartburn or other symptoms like chest pain, difficulty swallowing, or a chronic cough. You may have a bitter, burning, or sour stomach taste in your throat or mouth.

      GERD may be an asthma trigger or make asthma more difficult to control. If you think you have GERD and it may be worsening your asthma, discuss this with your healthcare provider.

      For in-depth information, see WebMD's Heartburn and Asthma.

    • What Are the Top Warning Signs of an Asthma Attack?
    • Answer:

      The top warning signs of an asthma attack include the following:

      • Wheezing when breathing both in and out
      • Coughing that won't stop
      • Rapid breathing
      • Chest pain or pressure
      • Tightened neck and chest muscles, called retractions
      • Difficulty taking a breath
      • Difficulty talking
      • Feelings of anxiety or panic
      • Pale, sweaty face
      • Blue lips or fingernails
      • Worsening symptoms despite use of your asthma medications

      If you experience any asthma attack symptoms and the symptoms do not improve with your asthma medications, contact your asthma doctor immediately or seek emergency medical treatment.

      For more information, read WebMD's Asthma Attack Symptoms.

    • I've Been Coughing for Weeks. Could it Be Asthma or Something More Serious?
    • Answer:

      Sometimes, coughing is the only symptom of asthma. Cough-variant asthma or "hidden asthma" is vastly underdiagnosed and undertreated. The common triggers of cough-variant asthma are the same as for other types of asthma, including respiratory infections (cold, flu, and sinusitis) and exercise. If you have had allergic rhinitis (hay fever) for many years, then a chronic cough -- a cough which lasts for more than six weeks -- could be due to post-nasal drainage or cough-variant asthma. If you are a smoker, a chronic cough is often due to chronic bronchitis.

      For in-depth information, read WebMD's Cough-Variant Asthma.

    • Are There Different Types of Asthma?
    • Answer:

      Yes, asthma triggers and asthma symptoms vary widely. Some people only experience a chronic cough; some only have chest tightness or shortness of breath; many others have wheezing when their asthma gets out of control. Here are some types of asthma:

      • Allergic asthma -- triggered by allergens such as pollen, mold, and animal dander
      • Exercise-induced asthma -- triggered by exercise
      • Cough-variant asthma -- a dry, non-productive cough, but no wheezing
      • Occupational asthma -- triggered by asthma triggers in the workplace
      • Nocturnal asthma -- with symptoms that occur at night and make sleeping difficult

      For in-depth information, see WebMD's Types of Asthma.

    • Lately, My Asthma Keeps Me Up at Night and I'm Sleepy All Day. What Can I Do?
    • Answer:

      Nocturnal or nighttime asthma, with its chest tightness, shortness of breath, cough, or wheezing at night, causes inadequate restful sleep, which often leads to daytime sleepiness. Asthma symptoms at night are a sure sign that asthma is inadequately controlled, and usually mean that you are not getting enough asthma controller medication during the daytime. However, there are unique nighttime asthma triggers which you may be able to reduce:

      • Nasal congestion, which causes mouth breathing
      • Acid reflux or GERD
      • House dust mite allergy

      If reducing these nighttime asthma triggers is inadequate, your health care provider can modify your asthma controller medications. This will likely resolve your nighttime asthma symptoms and let you sleep well.

      For more information, see WebMD's Nocturnal Asthma (Nighttime Asthma).

    • How Will My Doctor Know I Have Asthma if I Don't Have Symptoms on the Day of My Office Visit?
    • Answer:

      Asthma symptoms come and go for the majority of people with the condition. So it's very common for patients not to have obvious asthma symptoms when they arrive at the doctor's office. You may cough and wheeze all week only to have no asthma symptoms when you see the doctor. This makes diagnosing asthma more difficult -- but you can help.

      Keep a daily asthma diary by jotting down whenever you have respiratory symptoms. Also, write down any factors or exposures that may have caused your respiratory symptoms. Your doctor or health care provider can review the diary, ask questions, do a brief physical examination, and perhaps do a lung function test. Using all of this information, your health care provider can usually make an accurate asthma diagnosis.

      For more information, see WebMD's Keeping an Asthma Diary.

    • What Questions Will My Doctor Ask About My Asthma Symptoms?
    • Answer:

      Your doctor will ask about a family history of allergies, exposures to smoke, your workplace exposures, hay fever, and factors that seem to trigger your asthma symptoms. Questions your doctor may ask include:

      • Can you describe your asthma symptoms?
      • When do you experience these asthma symptoms?
      • Do you have a family history of allergy or asthma?
      • Do you get bronchitis frequently?
      • Have you been diagnosed with or treated for asthma previously?

      It's important to be open about your symptoms of asthma and the suspected causes of asthma to help your doctor make an accurate asthma diagnosis.

      For more information, see WebMD's Diagnosing Asthma.

    • What Do Lung Function Tests Tell My Doctor?
    • Answer:

      Your doctor may use several tests to make an asthma diagnosis, including lung function tests. The most likely lung function test will measure how much air you can exhale. These important asthma tests confirm the presence of airway obstruction that improves with asthma treatment. As an example, your doctor will have you perform spirometry, a lung function test that measures how much air you can blow out of your lungs and how quickly. This asthma test is done before and after using an asthma inhaler with albuterol, a bronchodilator. If your airways expand, allowing air to pass through more freely, then it is highly likely that asthma is the cause of your respiratory symptoms.

      For in-depth information, see WebMD's Lung Function Tests.

    • Are Allergy Skin Tests Only Done Before Allergy Shots?
    • Answer:

      Nine out of every 10 children with asthma have allergies, and more than half of all adults with asthma suffer from allergies. The allergens that affect the nose are usually from outdoor sources, such as grasses, weeds, or trees. The allergens that affect the airways in the lungs, triggering asthma attacks, are usually from indoor sources, such as house dust mites, molds, cockroaches, cats, or dogs.

      Some allergy tests can help your doctor or asthma specialist find the underlying cause of your allergic asthma triggers so he or she can prescribe the most effective asthma treatment to prevent breathing problems. While allergy tests alone are not sufficient to make a diagnosis, when the test results are combined with your personal history of reactivity to the allergen, your doctor will have a much better idea if the suspected allergen is triggering your asthma and allergy symptoms. Ask your doctor about allergy (immunotherapy) shots for allergic asthma to see if this type of treatment may be useful in getting your asthma back in control.

      For more information, see WebMD's Allergy Tests and Asthma.

    • Am I Using My Inhaler Properly?
    • Answer:

      Asthma inhalers (bronchodilators) work by relaxing the bronchial smooth muscle in the lung, opening the airways and allowing more oxygen to move through as you breathe. Your rescue asthma inhaler allows quick relief from asthma symptoms such as coughing, wheezing, and chest tightness.

      Here's how to use it properly:

      1. Slowly exhale most of your air.
      2. Place the inhaler mouthpiece just inside your teeth.
      3. Trigger the inhaler at the beginning of a very slow inhalation.
      4. Keep inhaling very slowly for about five seconds.
      5. Hold your breath for at least five seconds.

      Repeat these five steps for a second dose. You should feel the bronchodilator effect within five minutes.

      For in-depth information, read WebMD's Asthma Inhalers.

    • Are Steroids Dangerous?
    • Answer:

      You're probably thinking of the illegal anabolic steroids that some athletes take to improve performance. The most commonly prescribed asthma controller medication is an inhaled corticosteroid, which reduces airway inflammation. With less inflammation, the airways are less twitchy and sensitive and less likely to react to asthma triggers. This means you'll have more control over your asthma -- and your life.

      For more information, see WebMD's Asthma, Steroids, and Other Anti-Inflammatory Drugs.

    • What Happens if my Child Has an Asthma Attack at School?
    • Answer:

      There are millions of children diagnosed with asthma in the United States, and many of these children have asthma symptoms at school. Sport and other outdoor activities frequently cause exercise-induced bronchospasm. The indoor air of many classrooms contains asthma triggers. Other children bring respiratory viruses to school. That's why asthma symptoms often occur during school hours. That's also why it's important to get the school involved in managing your child's asthma.

      Even if your child has mild asthma, working with the classroom teacher and other school officials is vital for managing your child's asthma and treating mild symptoms early on before they worsen. It's also important to help your child to understand asthma symptoms, asthma triggers, and asthma treatment. Your child should have a rescue inhaler and peak flow meter at school. Make sure that your child's teacher has a copy of his or her written asthma action plan.

      For in-depth information, see WebMD's Managing Your Child's Asthma at School.

    • I Read About a Natural Cure for Asthma. Do These Really Work?
    • Answer:

      Unfortunately, while health food stores and internet sites advertise asthma cures, there is no cure for asthma. Some natural therapies may help to manage asthma. For example, deep abdominal breathing training, progressive muscle relaxation, guided imagery, and biofeedback can help to relieve stress and thus reduce mild asthma symptoms. But these are not asthma cures. At best, they only temporarily relieve asthma symptoms or reduce the need for traditional asthma medications.

      For more information, see WebMD's Natural Asthma Cure.

    • When Should I Use a Peak Flow Meter?
    • Answer:

      Readings from a peak flow meter can help you to recognize early changes that may be signs of worsening asthma. During an asthma attack, the muscles in the airways tighten and cause the airways to narrow. Reduced readings from the peak flow meter may alert you to the airway narrowing often hours or even days before you have worrisome asthma symptoms such as shortness of breath or chest tightness.

      The peak flow meter can also be used to verify that respiratory symptoms are due to bronchospasm. Ask your doctor or allergy specialist for a written asthma action plan that includes the use of a peak flow meter to determine whether you are in the green, yellow, or red zone. You can print an asthma action plan from WebMD and then take it to your health care provider to complete.

      For in-depth information, see WebMD's Using a Peak Flow Meter.

    • Is There a Diet That Will Help My Asthma Symptoms?
    • Answer:

      We aren't aware of an asthma diet that controls asthma by reducing airway inflammation. For example, eliminating dairy products is unlikely to improve asthma control. However, beverages such as strong coffee that contain caffeine provide some relief for an hour or two, because caffeine is a mild bronchodilator. But taking a rescue asthma inhaler is much more effective for the temporary relief of asthma symptoms.

      There is some evidence that people who eat diets higher in vitamins C and E, beta-carotene, flavonoids, magnesium, selenium, and omega-3 fatty acids are less likely to have asthma. Many of these substances are antioxidants, which protect cells from damage. One study showed that children who grew up eating a Mediterranean diet -- high in nuts and fruits like grapes, apples, and tomatoes -- were less likely to have asthma-like symptoms. On the other hand, eating omega-6 fats and trans fats, found in some margarines and processed foods, may worsen asthma.

      For more information, read WebMD's Asthma and Diet: What You Should Know.

    • How Can I Prevent Wheezing After Working Out?
    • Answer:

      Almost everyone with asthma will experience exercise-induced bronchospasm after a bout of strenuous exercise, especially if done outdoors in cold air. However, symptoms can be prevented in almost everyone with asthma except during exacerbations. Talk with your doctor and evaluate your asthma drugs to find the right combination of asthma treatments that allow you to breathe well and exercise.

      Activities that involve short, intermittent periods of exertion, such as volleyball, gymnastics, baseball, and wrestling, are generally well-tolerated by people with asthma, especially when they are faithfully taking an asthma controller medication. Swimming is generally well-tolerated by people with asthma because the swimming pool environment has warm, moist air. Working with your doctor, find the exercise you can perform four to five times a week for at least 30 minutes without asthma symptoms.

      For in-depth information, see WebMD's Exercise and Asthma.

    • I've Noticed That Sudden Stress Makes My Asthma Symptoms Flare. Is This Normal?
    • Answer:

      Yes, stress is a common asthma trigger. When you have stress and asthma, you might feel short of breath, anxious, and even panicked. Add to this more stress from the workplace or home, and your asthma symptoms may worsen and cause you to feel frightened. When stress levels start to creep upward -- whether it's from too many bills, problems at work, or managing your kids' jam-packed calendars -- asthma symptoms can kick into overdrive. As the wheezing and coughing gets worse, your health becomes one more reason to worry. Asthma, stress, and anxiety make for a vicious circle -- one that can spiral downward quickly. Here are some quick and simple tips to help you manage your stress -- and asthma symptoms:

      1. Change your thoughts -- your body only knows what your mind tells it. Try to think more positively.
      2. Reduce your stressors. Identify the major problems and try to resolve them. Talk to a therapist if you need support.
      3. Avoid stressful situations and use time-management skills to avoid feeling rushed each day.
      4. Exercise daily to burn off the accumulated effects of stress.
      5. Get plenty of sleep every night.

      For more information, see WebMD's Stress and Asthma.

    • Can My Smoking Cigarettes Worsen My Daughter's Asthma?
    • Answer:

      Absolutely! Of all the changes you could make in your lifestyle habits, stopping cigarettes should be at the top of the list. Not only is smoking a deadly habit for you, the smoker, but secondhand smoke is a powerful trigger of asthma symptoms in those who live with a smoker -- especially children. When your child inhales tobacco smoke, irritating substances settle in the moist lining of her airways. This airway inflammation is likely to cause an asthma attack in your child that can last for several days to weeks. Secondhand smoke also causes sinus and ear infections in children.

      Inhaling smoke damages tiny hair-like structures in the airways called cilia. Normally, cilia sweep dust and mucus out of the airways. Tobacco smoke damages cilia so they are unable to work, allowing dust and mucus to accumulate in the airways. Some studies show that inhaling secondhand smoke may be even more harmful than actually smoking. That's because the smoke that burns off the end of your cigarette contains more harmful substances (tar, carbon monoxide, nicotine, and others) than the smoke that you inhale. Talk to your health care provider and make a plan to help you stop smoking for yourself and your daughter.

      For in-depth information, see WebMD's Stopping Smoking: Why and How to Quit.

    • Is There an Online Support Group That Gives Asthma Tips?
    • Answer:

      Support groups provide a very useful sharing experience. Asthma support groups for parents offer an environment in which you can learn new ways of dealing with asthma in your family. Many people have years of experience with asthma and asthma medications, and are eager to share the practical knowledge they have gained. You may also wish to share approaches you have discovered while managing your asthma or your children's asthma, too. You will also gain strength in knowing that you are not facing hardships alone.

      WebMD's Asthma Support Group provides 24-hour online support from other individuals just like you.

      Also check out WebMD's Allergies Support Group.

    • When Should I Go to the ER for an Asthma Attack?
    • Answer:

      If your asthma symptoms continue despite use of asthma rescue inhalers and other asthma medications, you should seek emergency care. A severe asthma emergency, or an anaphylactic attack, can occur with little warning and can quickly move to asphyxiation. Symptoms might include breathlessness at rest, high anxiety, wheezing during inhalation and exhalation, severe shortness of breath, chest tightness, and difficulty speaking in complete sentences. When these symptoms and signs occur, don't hesitate to quickly dial 911 for an ambulance. The ambulance crew will immediately provide you with oxygen and nebulized bronchodilators. They will also monitor the level of oxygen in your blood (using a pulse oximeter), and your heart rhythm (using an ECG monitor). And during the trip, they can talk with a doctor in the emergency department for further lifesaving treatment. None of this monitoring or emergency treatment is available if you get a ride to the emergency department or use public transportation.

      For in-depth information, see WebMD's Severe Asthma Attack.

    • Will my Asthma Get Worse During My Pregnancy? What Asthma Drugs Should I Avoid?
    • Answer:

      If you're pregnant and have asthma, it's more important than ever to keep your asthma under control. For some women, asthma during pregnancy worsens. For others, the asthma stays the same. Some women find their asthma improves greatly during pregnancy. The best thing you can do is see your health care providers -- your allergist, internist, and obstetrician -- regularly throughout your pregnancy. It's also important to avoid any asthma triggers, including all sources of smoke, and to follow your written asthma action plan. Have a plan for asthma treatment during labor and while breastfeeding. Most asthma drugs are safe for your baby, but verify this with your health care providers.

      For more information, see WebMD's Pregnancy and Asthma.

    • Why Does My Asthma Always Get Worse at Work?
    • Answer:

      It's possible that you have work-related asthma. This happens when substances at your work (irritants or allergens) cause asthma or worsen asthma. Hundreds of substances found in workplaces have been proven to worsen asthma. Examples of people who are at higher risk for occupational asthma include health care workers, those who work with cleaners or solvents, workers in the chemical industry, construction workers, welders, auto body painters, those using isocyanate foams, and animal care workers.

      Talk to your doctor or asthma specialist about your work-related asthma symptoms. Once the workplace triggers have been determined, your health care provider can help you find ways to reduce your exposures to these substances.

      For more information, see WebMD's Occupational Asthma.

    WebMD Medical Reference

    Reviewed by Carol DerSarkissian on May 13, 2019

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