Issue 4

New School Year New Allergy & Asthma Season

[By: John Dice, MD]
It’s back to school season and along with the normal things that parents and their children have to be concerned about, it’s also a big trouble season for patients with asthma and allergies.  In fact, there are three main concerns during this time of the year that patients should be aware of.

First of all, when kids go back to school, there is usually a tendency for asthma symptoms to increase.  With school comes the return of physical education classes.  After a summer of relaxed activities where kids can adjust their exertion as they see fit, now they will be put back into structured classes with longer distance runs and competitive sports.  Frequently this will lead to an increase in shortness of breath with activity.  Sometimes this may be perceived as just being “out of shape”, but if the child in question is notably behind his or her classmates it often represents increasing asthma symptoms.

Second of all, when kids go back to school, mingling with hundreds of other kids in confined spaces, there is a high likelihood of spreading respiratory infections.  For patients with asthma and allergies this can lead to asthma attacks, sinusitis, bronchitis and sometimes even pneumonia.  Teaching children to wash their hands on a regular basis and covering up their sneezes and coughs can help prevent the spread of infections, but let’s be honest, children frequently forget these lessons!  Most of these respiratory infections are viral in nature and do not need antibiotics or additional medications other than simple over the counter cough & cold remedies plus age-appropriate Tylenol or Motrin.  However, if the patient’s asthma increases significantly and is not relieved with their quick-acting rescue inhaler or if symptoms do not improve after 7-10 days they should see their doctor for evaluation and appropriate treatment.

As if these factors weren’t enough this time of year also brings with it the start of the fall weed pollen season.  The most infamous of the weeds is, of course, ragweed. This pollen can cause a dramatic increase in both allergy and asthma problems.  If the patient’s allergies and asthma are well-controlled with current therapies, there may not be a significant worsening of symptoms.  But if asthma worsens and is associated with the classic allergy symptoms of sneezing, clear & watery nasal drainage, congestion, itchy watery eyes, then ragweed and its cousins are likely the cause.

There is certainly enough to worry about at this time of year without having to think about medical issues as well.  But keeping an eye on children going back to school and addressing problems early can help avoid a severe attack later.  Make sure you take ALL of the medications your doctor prescribes and see a Board-certified specialist in Allergy & Immunology if basic measures still do not provide adequate control.

What is Asthma?

[By: Joseph Diaz, MD]
Asthma is a condition of the lungs in which there is inflammation of the airways resulting in mucus production, tightening of the muscle in the lungs and subsequent obstruction.  This results in narrowing of the airway and symptoms most often consisting of coughing, wheezing, shortness of breath and chest tightness.  These asthma symptoms, when present, are often worse at night mainly due to coughing and can worsen with exercise. 

Asthma affects approximately 8% to 10% of the population.  In Bexar County, there are approximately 135,000 patients with asthma, of which approximately 35,000 are pediatric patients.  There are approximately 4,000 deaths from asthma each year in the United States, accounting for approximately 11 patients dying per day because of asthma in the United States.  Asthma is the number one reason children go to the emergency room and the number one reason children miss school. 

The most common asthma symptom in children is cough.  Sometimes cough can be the only symptom of asthma.  Other common symptoms include shortness of breath, wheezing, chest tightness, awakening at night because of cough and worsening of symptoms during exercise. 

The underlying cause of asthma is unknown.  There are genetic predispositions, and children born to parents who have asthma are much more likely to develop asthma in their lifetime.  Asthma is a complex disease, not only caused by genetic factors, but also environmental exposures.  It has been shown that children with the genetic predisposition to asthma, when exposed to various allergens (dust, indoor pets, smoke) have a higher chance of developing asthma. 

There are two main types of medications used to treat asthma.  The “relievers” are used to treat the symptoms of asthma when present.  These medications are also called bronchodilators and work by relaxing the smooth muscle in the lungs.  This relaxation opens up the bronchioles and results in improved air flow and decreased symptoms.  Because asthma is characterized by inflammation of the airways, the other types of medications are referred to as “controllers.”  These medications treat and prevent asthma by decreasing the inflammation that is present.  The most common controller medications are the inhaled steroids.  There are many types of inhaled steroids that are available, and they have been shown to be very safe and effective. 

Many experts believe that if you have asthma, you will always have the tendency to have asthma.  There are many patients, however, who have had asthma in their childhood, who have “outgrown” their symptoms in adulthood.  Experts believe that although you still have asthma, your symptoms have become quiescent.  On many occasions in patients such as this, the asthma does return later in life.  At this time, experts believe that, in general, patients do not “outgrow” their asthma.

We Our Proud to Welcome Mirie Hosler, MD to Allergy Asthma & Immunology Associates of South Texas!

Her husband is a geriatrician at the University of Texas Health Science Center at San Antonio. In her free time, Dr. Hosler enjoys spinning, knitting, movies and reading.  She looks forward to exploring San Antonio with her family.

Allergy, Asthma & Immunology Associates of South Texas is Moving West!

[By: Brandon Kreager]
Allergy, Asthma & Immunology Associates of South Texas (AAIASTX) has come a long way from a single doctor medical practice. Founded by Dr. Joseph Diaz in 1988, the practice has distinguished itself by making impressive business choices over the years. San Antonio’s rapid growth pattern has helped AAIASTX position itself in the city’s expanding areas, thereby reaching a new range of patients in search of medical care and services.

Opening its second office on Stone Oak Parkway in 1997 and successfully opening its third office on Barlite Boulevard in 2007, AAIASTX is already in the process of opening its fourth site. The new clinic, which officially broke ground on July 2, 2010, is located in the fast-growing community of Westover Hills at the Westover Hills Medical Park.
The new 3,500-square-foot facility is equipped with state-of-the-art medical equipment and offers the same quality care found at the other three locations. Two full-time allergists/immunologists manage patient care at the new facility. Once the office is operating at maximum capacity, they will be able to treat an average of eight patients every hour, giving each patient the time, service and care that have become a trademark of AAIASTX.

The carefully engineered community of Westover Hills is already a haven for corporate giants in the business world, with the trend beginning to look the same for the medical industry. The medical market already includes Methodist Healthcare, Vanguard/Baptist Health System and CHRISTUS Santa Rosa.

Westover Hills has a wide spectrum of medical specialties, such as family medicine, pediatrics, internal medicine, otolaryngology (ENT) and soon allergy/immunology. AAIASTX’s new medical office will further diversify the existing medical community and close the gap for a much-needed allergy and asthma specialty practice.     

According to Kimberly Gatley, senior vice president and director of research for NAI REOC San Antonio, the 78251 zip code is projected to have a population of 56,081 by 2014. That is a 21-percent increase compared to the estimated 46,352 residents currently living in Westover Hills. The North Independent School District (NISD) has been working vigorously to better serve the community and meet the demand for “less students per classroom.”

“NISD continues to draw thousands of families to Bexar County and its communities,” said Pascual Gonzalez, director of communications for NISD. “NISD is opening five new schools this summer and plans to continue building new schools over the next four to five years to meet the ever-growing demand.”   

For both adults and children, asthma continues to be one of the most common chronic illnesses in our country. An estimated 22 million Americans have asthma, and 6.5 million of them are under the age of 18. Asthma results in 497,000 hospitalizations and 1.8 million emergency room visits each year. Asthma is a controllable condition. With the proper medications and under the supervision of a trained specialist, the majority of asthma patients live an asthma-free lifestyle. 

More than 50 million Americans have some type of allergy. Allergic diseases are the fifth most prevalent chronic diseases in all ages, and the third most common in children. In 2009, San Antonio was ranked No. 12 out of 100 cities by the Asthma and Allergy Foundation of America on its list of the “Most Challenging Place to Live with Fall Allergies.”

Pete Tassos of Sullivan Commercial Realty represented AAIASTX in the acquisition of the land and building. Drewry Martin Architect & Interior Design developed the exterior and interior design for the project. Eaton Commercial was contracted to complete the construction for AAIAST’s new office location.

Construction Photos

• Advair
• Symbicort
• Singular
• Xyzal
• ProAir
• Zyrtec
• Clarinex
• Omnaris
• Veramyst
• Astepro
• Proventil HFA
• Nasonex
• Asmanex
• Patanase
• Pataday
• Allergra Syrup/ODT