Dr. Leah L. Ishmael, DO

Treatment for most asthma patients involves three steps. Patients learn what their asthma triggers are and avoid them. They take a daily control medication, usually an inhaled corticosteroid, to reduce inflammation in the lungs. Also, they have rescue medication with them at all times to take in case of a severe attack. These quick-acting inhaled medications relax the muscles around the airways and allow the lungs to open up for air.

There is no cure for asthma, but with treatment it should not interfere with daily life and activities.

Nasal endoscopy is the use of a thin, flexible tube (called a 'scope') that is inserted into the nostril to examine the structures of the nose. The scope contains a fiber optic light and a camera that allow a physician to see much more of the nasal passages, airways, and sinuses than is possible with a standard nasal exam.

A nasal endoscopy is typically performed by an otolaryngologist (or ENT) in their office. It may be performed for a variety of reasons, but some common ones include:

• Sinus infections
• Nasal polyps
• Frequent nosebleeds
• Persistent stuffiness
• Obstruction in the nose
• Suspected tumor in the nasal passages

In most cases, a medication containing a decongestant and anesthetic is sprayed into the nose before the scope is inserted. The doctor uses the scope to examine any problem areas. If necessary, most scopes allow for tiny tools to be inserted and used to removed tissue or take samples. Nasal endoscopy is a very safe and relatively easy procedure.

Before treatment is begun, patients and their doctors first have to identify different factors that trigger their symptoms. Then, skin tests are done to confirm which substances cause allergic reactions. Blood tests may be performed as well, but they are typically not necessary.

There are two phases to subcutaneous allergen immunotherapy: a build-up phase and a maintenance phase. The build-up phase lasts three to six months, during which patients receive shots with increasing amounts of the allergens once or twice a week. When the effective dose is reached, the maintenance phase begins and may continue for up to five years.

Although allergy shots are the longest-lasting and most effective allergy treatment available, they are not for everyone. If patients have heart problems, high blood pressure, or severe asthma, they should not be given allergy shots. The injections are generally safe, but they may have a little swelling at the injection site, which is normal. Rarely, severe shock-like reactions, called anaphylaxis, can also occur. Patients will likely be required by their doctor to stay for half an hour after their shot, so in the event of an anaphylactic reaction, it can be treated immediately.