Michael Marcus, MD Director Pediatric Allergy & Pulmonary -Maimonides Medical Center . Fellowship:Childrens Hospital of Philadelphia Castle Connolly Top Doctor
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Male: If a proper diagnose of exercise-induced asthma is made, what can you as a pediatrician pulmonologist do to alleviate some of the symptoms? Michael Marcus: There are many things that we can do to improve the symptoms of patients with exercise-induced asthma. The first is to teach patients how to approach their exercise in the optimal fashion. The best way to approach exercise includes several precautions. First, you want to have a good warm up period to condition the muscles and the lungs before going into the more intense exercise period. Second, you want to make sure that the patient is learning to breathe through his nose rather than through an open mouth. Breathing through the nose allows the air to become warm and humidified before it actually hits the lungs, therefore, triggering much less bronchospasm once we breathe that air in. The cold dry air is much greater risk for exercise-induced asthma than warmer moist air. Male: So, it’s more likely to happen to a football player in the winter than a baseball player in the summer? Michael Marcus: Yes and it’s more likely to happen to a football player outdoors in the winter than a basketball player playing indoors in the winter. So part of it’s the dryness, part of it’s the warmth; part of it’s the approach to the condition. Those are all very helpful tools that we can use to help minimize. There are also medications that we can use. If we know a patient has exercise-induced asthma, there are several different types of medications, both inhaled and oral which we could take before an exercise period to minimize the risk and also, to have available, if we have breathing difficulty during the exercise period itself. Male: Are there any medications that can make it worse? Michael Marcus: There are medications that could make it worse, without question medications in the beta-blocker group will make exercise-induced asthma significantly—
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