Meet the Expert

Jurairat J. Molina, MD, is a board-certified allergist who has been practicing in field of allergy and clinical immunology for the past two decades. She owns Corpus Christi Allergy Associates in Corpus Christi, Texas.

Tens of millions people in America live with asthma, which can impact their participation in daily life. What’s more, a person’s daily living situation can impact their risk of developing asthma, or developing severe consequences from their asthma later in life.

As a result, people who face more barriers in their work or home life situations may struggle to control their asthma on a daily basis, or be more at risk for poor outcomes. And now, as the COVID-19 pandemic has impacted routine standards of living, these risks may be on the rise.

According to the American Lung Association (ALA), asthma is responsible for millions of school and work absences each year, and is the third leading cause of hospitalization for children. More than 26 million Americans have asthma, 6.1 million of whom are children, according to ALA.

Jurairat J. Molina, MD, allergist and medical board expert for Verywell Health, discusses the viscous loop of how asthma diagnosis and daily living activities can impact each other–and how new normals introduced by the COVID-19 pandemic have affected them both. 

Verywell Health: How can asthma impact daily activities?

Dr. Molina: When someone has increased asthma symptoms or an asthma exacerbation, they might not be able to go to work or even do the daily activities like working around the house, or socializing, or exercising, or going out in general.

When children are sick or have asthma exacerbations, they could miss school, and their parents may have to miss work to take care of them.

Verywell Health: How can daily living situations impact asthma risk?

Dr. Molina: If someone with asthma lives in an environment with pollution, secondhand smoke, mold, dust, or is an unclean environment in general, that could be a trigger of their asthma. We already know things like bacteria, viruses, pollution, smoke, and mold are common triggers of asthma symptoms.

Kids who inhale secondhand smoke from parents who are smokers can also be at increased risk for developing asthma. Smokes would increase the risk of children to have a respiratory tract infection and recurrent respiratory tract infection would increase the risk of asthma later on in life.

Verywell Health: How can asthma treatment impact daily life?

Dr. Molina: Treatment of asthma needs a high level of engagement and self management. If you don't have that clear understanding of how to take medication or health information in front of you, it could lead to poor control or a serious outcome down the road.

Your allergy triggers are probably the best way to prevent you from having asthma exacerbation, or put you in better control of your asthma if you know your triggers. So talk to your providers, go to see an allergy doctor, try to identify the trigger of your asset. It could be allergy related like dust, mold, pollen, it could be non allergy related, like pollution, sacred smoke, infection. Once you identify those triggers, then your providers can advise you how to avoid or minimize those triggers.

You can also make changes in your daily life to reduce risk. For parents with children who have asthma, consider your child’s daycare setting. If it seems unclean, then maybe it's a good idea to transition from five days of daycare a week down to one or two days a week. Or if a parent smokes and that smoke triggers their child's asthma, then maybe do something about it. 

Verywell Health: How can a person's finances impact access to asthma treatment?

Dr. Molina: Asthma medications are expensive–each inhaler could cost you a couple of hundred dollars. And if you don't have insurance and a job, then you will not be able to afford that medication.

As providers, sometimes we have a patient that we think ‘this’ is the best medicine for you. It's new, it's just FDA approved, it's the best asthma medication -- and we forget that this could cost you, and the insurance that you have, Medicaid, Medicare, might not cover it. 

If you have that concern that you may not be able to afford medication, share that concern with your healthcare providers. 

On the provider side, you have to be sensitive of–and listen to–patients' concerns as well. What is their priority? Is the cost the priority? Is it the frequency they have to use?

Verywell Health: How has COVID-19 impacted the cost of asthma treatment?

Dr. Molina: During the COVID-19 pandemic, a lot of people lost their jobs and lost their insurance. And for that reason, they were not able to afford regular, preventative asthma medication. So once they lost that insurance or loss of income, then they were not able to refill their medications, and the asthma symptoms became worse.

Another thing is that a lot of offices actually closed out during that time – mostly just for a few weeks, and after that we were trying to do virtual visits and things like that. But, there was a period of time that people were not able to come in and get their medication, or follow-up routine care for their asthma.

Now, there are people I have not seen for two years, and they just showed up! It's like, "What happened? Where were you?” And it was because they ran out of asthma medication.

Some elderly patients said that their kids wouldn’t allow them to leave the house. Some people lost their job, and then lost the insurance with it, and were not able to afford the asthma medication.

Verywell Health: Can COVID-19 Impact Asthma Risk?

Dr. Molina: Viral or bacterial infections can increase asthma symptoms, or trigger asthma exacerbation. COVID-19 is a respiratory tract virus. So if you get COVID, then your asthma gets worse or triggered.

You also have a higher risk of developing severe consequences from COVID-19 when you have underlying asthma, or a chronic lung condition in general – and it takes you longer to recover. You could end up with pneumonia or respiratory failure if admitted to the hospital ICU.

Verywell Health: For people looking for help managing their asthma–or who face barriers to treatment–where is a good place to start?

Dr. Molina: Seeking out asthma treatment can be overwhelming. It's hard. You don't know where to start. But I think the first thing you can do is just talk to your healthcare provider, your PCP, your family, doctor, just just tell them how you feel and where you're at in terms of your health conditions. Start from there, and try to ask questions and share your concerns. Sometimes just doing that can be enough to get you started. 

Source link