Asthma can be an embarrassing condition for many. You might find yourself struggling to walk alongside friends or coworkers. Or you might have trouble holding a conversation without constantly coughing. Especially for young patients with asthma, having to slow down can be discouraging.
Some asthma patients have dealt with symptoms for so long, they just accept them as normal. Or they simply dismiss symptoms as a cold. However, if you’re having long-term issues with breathing or coughing, it’s important to see a doctor for an evaluation.
Renee Burcham, a 43-year-old from Concord, North Carolina, is glad she got the care she needed for her asthma. Renee had been coping with asthma for at least 10 years before seeking treatment at Atrium Health. Her condition was mostly triggered by allergies and exercise.
As a financial crimes associate manager and an avid gardener, asthma was interfering with her work and everyday activities. She struggled to lead conference calls without coughing or using her rescue inhaler. She couldn’t even walk around her home without feeling tightness in her chest or having trouble breathing. Once triggered, her asthma symptoms lasted for about a month. She would get bronchitis almost every year.
“Everything was just harder,” says Renee. “I really couldn’t do my gardening or anything outside. Walking from my car to the office was a struggle. I couldn’t even walk up steps without looking foolish. Even just playing with my dog was hard.”
In early 2022, Renee moved from Charlotte to Concord and was looking for a new primary care doctor. She scheduled an appointment with Dr. Alyssa Kuprenas, internal medicine physician with Atrium Health Primary Care Concord Internal Medicine, hoping she could treat her asthma.
“My niece was with me while I was searching on the Atrium Health website, since she was also looking for a new doctor,” Renee explains. “We both found Dr. Kuprenas at the same time. We liked the kindness in her face, so we both chose her for our primary care.”
Asthma Symptoms and Testing
The most common symptoms of asthma include:
- Shortness of breath
- Wheezing, especially while lying flat in bed
- A sensation of tightness or pressure around the chest when taking a deep breath
- Allergy symptoms, including runny nose and throat drainage
When several of these symptoms happen at once, it can make an accurate diagnosis challenging.
According to Kuprenas, the gold standard for asthma testing is a pulmonary function test. This painless assessment measures the patient’s lung volume to see if the airway is sensitive to the medication used to treat asthma. If the patient’s airway responds to the medication, it suggests that the patient has asthma.
Environmental triggers and allergies are known to make asthma symptoms worse.
“One of first things Dr. Kuprenas did was send me for allergy skin testing,” Renee explains. “I found out I was allergic to almost everything they tested me for. I’m currently going through a series of allergy shots. It’s giving me hope that they will help me be able to enjoy the outdoors again.”
Renee was diagnosed with allergic asthma, which means that the same allergens that trigger her allergies also trigger her asthma symptoms.
Comprehensive, Stepwise Treatment
Most asthma patients start by seeing their primary care doctor. If the patient still has trouble controlling their symptoms with an inhaler regimen, the doctor can request a referral to pulmonology. Luckily, Kuprenas was able to control Renee’s asthma with medication, so she didn’t need to see a pulmonologist.
Patients like Renee benefit from Atrium Health’s multidisciplinary approach to asthma care.
“As part of a robust health system, our doctors have access to resources that allow us to provide comprehensive care,” says Kuprenas. “In the primary care setting, we can easily communicate with other specialists in pulmonology, allergy and immunology, ensuring a comprehensive approach to symptom management.”
Continuity of care is also important for asthma patients.
“It’s vital that you have a provider who can keep listening to your lungs and monitoring your breathing. They should be doing the same exam every time you visit,” notes Kuprenas.
Renee’s diagnosis and treatment took about four months. She is now on a good regimen that includes inhalers and allergy shots.
“We treat asthma in a stepwise fashion over a period of time,” Kuprenas explains. “We start with one type of inhaler, but then may need to add mediations or change the inhaler. We may need to increase the dose of an inhaler or add an inhaler to maintain good control of the symptoms.”
It’s important to remember that asthma is a chronic condition that won’t go away on its own.
“Untreated asthma can lead to worsening symptoms over time, specifically in the airways themselves,” warns Kuprenas. “If you don’t treat it in a timely fashion, it can cause chronic inflammation and scarring in the lungs. In severe cases, this can lead to death. So it’s really important that you get evaluated as soon as possible.”
Throughout her experience, Renee appreciated Kuprenas’ listening skills and her ability to ask the right questions. She also followed up with Renee right away when her test results came in.
At one point, Kuprenas wanted to change Renee’s medication to see if it would improve her symptoms. But first, she ordered an X-ray to get a better look at her lungs. The imaging showed possible scar tissue, which was very concerning to Renee since her mom passed away from pulmonary fibrosis (scar tissue in the lungs).
“Dr. Kuprenas was great about picking up on my anxiety,” explains Renee. “She was very good at easing my mind. She ordered a CT scan to get some better images. She let me know as soon as she could that my scar tissue was caused by past cases of bronchitis and pneumonia.”
Renee says she was constantly impressed with Kuprenas’ bedside manner.
“The last time I saw Dr. Kuprenas, she said, ‘If you need anything, I’m here for you, and I care about you as a person.’ She’s very genuine and respectful. She tries to educate you on the best way to live your life.”
Along with her caring nature, Kuprenas has been diligent about making sure Renee takes her medication as prescribed.
“She doesn’t let me get away with anything,” Renee says.
Improved Quality of Life
“For me, this year is going to be a lot different,” says Renee.
After more than 10 months of allergy shots, she’s looking forward to enjoying the warmer months outdoors. She is excited to attend her godson’s soccer games and play with her great-niece and great-nephew outside.
Renee says her work meetings are much easier now. She’s able to have long conversations and participate in conference calls without coughing.
As an asthma patient, Renee stresses the importance of knowing your limitations but also seeking the right treatment.
“If you get the treatment you need, you can expand your life and do more things,” she explains. “I think a lot of people end up feeling a little depressed when they’re limited by asthma. It’s easier to just not think about it. When you get the help you need, it opens up a world of opportunity to live your life the best way you can.”
To enjoy results like Renee, Kuprenas encourages patients to make an appointment with their primary care doctor.
“You might not even realize how bad you’re feeling until you see a doctor,” Kuprenas notes. “Don’t dismiss bothersome symptoms. It’s important to develop a relationship with a doctor who will openly listen to your symptoms and establish an effective diagnosis and treatment plan.”