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THOMAS DEMARINI: Everybody has
either had some problems
with wheezing, coughing,
shortness of breath,
or knows somebody who
has those symptoms
and has watched them struggle
to breathe.
The whole purpose is to prevent
the exacerbation from taking
hold and progressing
on its natural course.
A lot of patients with asthma,
especially if it's in the more
severe category, we have them
use a device called a peak flow
meter.
It's a simple handheld device,
and it can measure how much flow
you're getting in a second
when you're breathing out.
We usually say that if you're
having a 20% drop, that you've
got something going on.
If you're going down
to a 40% or 50%
reduction in your peak flow,
then you're going to have
real trouble.
For some, we work out literally
a written plan.
These plans give you
some suggested ideas about what
you should do.
In general, we work out
those plans.
We customize them.
You may simply step to a higher
dose of inhaled corticosteroid.
It could also be the case
that you would want to go
on an additional medication.
For the more severe asthmatics
that we see, we treat them
with steroids.
There are a lot of what I would
call immunotherapy that are
basically once a month
injections that will
dramatically improve
their airflows
and keep them from having
recurrent attacks.
So there are lots of options
in terms of customizing a plan,
with our goal being,
of course, to keep
the patient feeling well
and to keep them out
of the hospital.