Latasha Phelan Wright’s journey to her diagnosis and control of her severe asthma was long and stressful, beginning with treatment for allergies and breathing difficulties. She ended up in the hospital several times before being a referred to Njira Lugogo, M.D.,, a pulmonologist and director of the asthma program at U-M Health.

In a recent livestream, Wright shares her story and provides advice for patients living with asthma symptoms. Anna Kovalszki, M.D., of the Division of Allergy and Immunology and Lugogo answer common questions about allergies and asthma, including how to recognize symptoms, common therapies, and insights for patients with severe allergy and asthma on ways to improve their quality of life. Here are some highlights (edited for clarity):

What are the signs and symptoms of severe asthma?

Lugogo: Asthma symptoms can range from mild to severe, but I’m even a little hesitant to refer to asthma as mild. Even patients with so-called mild asthma can suffer fatal events, and a lot of the time when a patient is told they have mild, they feel comforted and don’t take it very seriously. We need to think of asthma as a condition that is either active or not very active at different times.

On the severe end of the spectrum, patients have daily symptoms, waking up at night short of breath, coughing, wheezing, requiring a lot of medication that can keep asthma under control or even uncontrolled despite the medication. I want everyone to understand that once you have asthma, you should be serious about it regardless of where you fall on that spectrum because it is a serious condition that requires attention.

People talk about the “trifecta” of asthma, allergies & eczema – why are these things connected?

Kovalszki: The underlying process is a person has a propensity for developing allergies, often driven by genetics and family history but also driven by what they’re exposed to. So, if they are exposed to things that can potentially increase the rate of allergic inflammation, such as car exhaust fumes or factory pollution, for example, [these have] been shown to increase [reactions]. For example, patients with pets in their home might notice if their dog licks their hand, they develop hives. That is a skin manifestation of the same allergy that will drive their asthma to develop and get worse. The manifestation of the allergy can come out in the nose, lungs, skin, GI tract (in the case of food allergy), but the underlying mechanism is all the same.

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