RANDOLPH AIR FORCE BASE, Texas –
Living in the San Antonio area is challenging nearly year round for people who suffer from allergies.
The Asthma and Allergy Foundation of America places San Antonio 42nd in this year's list of the "most challenging places to live with spring allergies," and that standing is even higher in the fall and winter, when cold fronts blow mountain cedar pollen this way, bringing misery to many.
Those allergens that are seemingly ever present make living even more difficult for those who suffer from asthma, a chronic lung condition characterized by airway constriction and inflammation.
Taking care of children who suffer from asthma - and who are especially vulnerable to its complications - is a daily concern at the Randolph Pediatric Clinic.
"We have 5,000 to 6,000 children enrolled at the clinic, and between 5 and 10 percent of that population has asthma," said Capt. Catherine Giordano, 359th Medical Operations Squadron pediatric nurse practitioner and clinic asthma specialist. "It's one of the most common chronic diagnoses for the children here."
Those percentages also mirror the population at large, which has an 8- to 10-percent incidence of asthma, she said.
Captain Giordano said coughing is the main symptom of asthma. Other symptoms include wheezing, a feeling of tightness in the chest and getting tired or out of breath easily.
Allergies are a big trigger of asthma, she said.
"From December to January, mountain cedar is bad here," Captain Giordano said. "During the fall, it's trees and ragweed. Oak and mold are higher this time of year, when trees are blooming and grass is growing."
Other allergens include dust, dust mites and pet dander.
For children, colds or upper respiratory infections often trigger asthma attacks, she said. Other asthma triggers are exercise, changes in the weather and strong smells such as smoke, perfume and cleaning products.
Captain Giordano said a variety of medicines are used to treat asthma.
"Inhalers or nebulizers with medicines such as albuterol help to reduce the airway constriction," she said. "They are fast acting and can make a person feel better quickly. Preventative medicines may help with airway inflammation and allergies."
In addition to medication, annual flu shots and allergy shots, which are effective but time-consuming, avoidance of triggers is another way to help alleviate the effects of allergens that aggravate asthma, Captain Giordano said.
Changing air-conditioning filters regularly, replacing carpet with tile or wood floors, getting rid of knickknacks that attract dust, using blinds rather than curtains and using pillow and mattress dust covers are helpful measures, she said.
The Randolph Pediatric Clinic takes a proactive approach to the treatment of asthma, Captain Giordano said.
"We want to see every child who has asthma twice a year for an asthma checkup," she said. "We perform a lung function test for children who are more than 7 years old, adjust each child's medication, counsel the child's family on triggers and provide an asthma action plan detailing treatment based on symptoms. A copy of the action plan is provided for their home and their school."
Captain Giordano advises parents to determine what their child's triggers are and recognize symptoms.
"As soon as their child starts coughing, they should use a rescue inhaler," she said. "That will open up the airways so their child can breathe more easily."
For persistent asthma, daily medication is recommended.
Captain Giordano said children are "more likely to have problems because their airways are smaller."
"Small children are more at risk for serious reaction," she said. "Asthma is an overreaction of the body to something - a cold, allergy or exercise."
Because the Randolph Medical Clinic is not an emergency treatment facility, Captain Giordano said anybody with symptoms of respiratory distress should call 911 or seek treatment at the closest emergency room.
She said those symptoms include trouble breathing or talking, or being unable to breathe or talk; breathing very fast or hard; retractions, or chest heaving in and out; and lips turning blue.
Captain Giordano said the clinic conducts a quarterly asthma education class at the Health and Wellness Center. The next one is planned for June.
For the most up-to-date information at the Randolph clinic, visit https://kx.afms.mil/randolph or search for the 359th Medical Group on Facebook.