30/Jan/2015

Who’s at Risk for Asthma

In this NBC4 video, Dr. Jackie Eghrari-Sabet, of Family ENT, Allergy & Asthma Center in Gaithersburg, Maryland, tells us who’s at higher risk of asthma and how budget cuts in Maryland affect those who suffer from it.

Are the Maryland budget cut short sighted? Does your zip code matter? Dr. Jackie refers to a Johns Hopkins asthma study, showing that race, ethnicity and income are the biggest risk factors for asthma.

Asthma in inner city linked to demographics, not urban factors

Who's at Risk for Asthma: Demographics plays role in asthma prevalence in the United States
Who’s at Risk for Asthma: Demographics plays role in asthma prevalence in the United States

High asthma incidence in inner-city areas may be due to demographic factors rather than living in urban neighborhoods, according to study findings in the Journal of Allergy and Clinical Immunology.

Researchers analyzed data from the 2009-2011 National Health Interview Survey, the US Census and the National Center for Health Statistics for 23,065 children aged 6 to 17 years.

“Current asthma prevalence was significantly higher among blacks (17.1%) and Puerto Ricans (19.8%), compared with whites (9.6%), Hispanics (8.8%) and Asians (8.1%).”

“Black race and Puerto Rican ethnicity remained strong independent predictors of current asthma, even when neighborhood-level poverty, urban/rural status, region, sex, age and birth in the United States were included in the model.”


02/Oct/2014

Dr. Jackie On How Concerned Should We Be About Ebola and Enterovirus?

With the first confirmed case of Ebola now showing up here in the U.S. and with the Enterovirus spreading across the country, how concerned should we be about these viruses?

Dr. Jackie Eghrari-Sabet, of Family ENT, Allergy & Asthma Center in Gaithersburg, Maryland, discusses how concerned we should be about Ebola and enterovirus.

Dr. Jackie: How Concerned Should We Be About Ebola and Enterovirus - Family ENT, Allergy & Asthma Center
Dr. Jackie Talks About How Concerned Should We Be About Ebola and Enterovirus, Image source PontiacTribune.com

This NBC4 video addresses a range of relevant questions.

  • Let’s start with Ebola. We’ve been told patients are only contagious when symptomatic and only if you have contact with their body fluids.  But just how easy is it to catch?
  • The CDC says we can stop Ebola in its tracks. But many people still wonder just how well-prepared we  are to do that?
  • Let’s review the symptoms which show up from 2-21 days after infection.
  • Enterovirus paralysis and asthma. There’s been one confirmed child death in Rhode Island. Does this virus lead to asthma or pose the biggest threat to children who have asthma?
  • What about the link to paralysis in children? What kinds of precautions should parents take?
  • The flu virus is coming. Are more of your patients getting the vaccine this year?

04/Sep/2013

Even with insurance, you can still benefit from these ways to save money with asthma.

By Vanessa Caceres for Everyday Health
Medically reviewed by Farrokh Sohrabi, MD

Lower Asthma Medication Costs

Asthma management isn’t cheap. You’re shelling out for maintenance inhalers, rescue inhalers, and often allergy medications — both prescription meds and over-the-counter antihistamines, decongestants, and eye drops — to help control your asthma triggers. That doesn’t even include what you’re spending on physician’s visits, emergency room visits, and asthma-related equipment, like nebulizers.

Although insurance helps cut the cost of medications and provider visits, you still usually have some patient responsibility to shoulder. Plus, asthma costs add up over time because you have to take the medications regularly. “It’s not an antibiotic you take for 10 days,” says Jacqueline Eghrari-Sabet, MD, founder of Family ENT, Allergy & Asthma Center in Gaithersburg, Md.

Recent U.S. statistics show the average per-person cost of asthma is $3,300 a year, a figure that combines medical expenses with missed days at work and school. Unfortunately, these costs aren’t expected to dwindle anytime soon thanks to the growing number of people managing the disease — up from 7 percent in 2001 to 8 percent in 2009, or one in 12 people.

But even with the rising numbers, there are ways to lower your asthma medication costs. Here are some suggestions from asthma treatment experts for how to reduce the cost of asthma medication.

Dr. Jackie offers 8 Ways to Lower Asthma Medication Costs

1. Be up front about cost concerns. “Patients should be honest about what they can afford so we don’t have them walking out of the office with five brand-name medications,” says Marilyn Li, MD, director of the Breathmobile of Los Angeles County and the University of Southern California Medical Center in Los Angeles. If cost is a concern — and it may be an issue even if you have insurance, particularly if you have a high-deductible plan — your physician can work with you on some of the suggestions below.

2. Ask for generic alternatives if available. Generic drugs will cost less than brand-name.

3. Ask for samples to lower asthma medication costs. If your doctor’s office has samples, you can use those for a short period of time. When cash is a concern for you, your doctor may be able to offer an extended use of samples to sustain you until your next visit.

4. Look out for coupons. Your physician’s office may have coupons, vouchers, or rebates from the manufacturers of some of the most common asthma and allergy medications, says Dr. Li. You can also search online for coupons from some of the larger asthma medication makers, including GlaxoSmithKline and Merck.

5. Apply for patient assistance programs. The biggest asthma drug makers also have patient assistance programs, says Li. If your application to the program is accepted, it will cover or help cover your medication costs. There are usually income restrictions, and the programs are often geared toward people who do not already have insurance.

6. Consider allergy shots. For many people, asthma is triggered by allergies. With allergy shots, you visit your allergy doctor according to a schedule — one that often goes from weekly to monthly over a couple of years. “You ‘vaccinate’ against your allergy,” explains Dr. Eghrari-Sabet. “You get some long-term control, and some people even get permanent relief over allergies.” Allergy shots, also called immunotherapy, are more cost-effective than asthma and allergy medication taken over a lifetime, she adds.

7. Follow the treatment regimen your physician recommends. Your treatment for asthma may leave you reaching for your pocketbook a little more than you’d like, says Li. However, it will beat the alternative of missed school and workdays because of illness as well as the medical bills and copays associated with ER visits.

8. Make sure a member of your medical team explains how to use your asthma medication. On the surface, this may not seem relevant to saving money, and most providers are usually good about explaining how to use asthma medications. However, Li shares the example of a pediatric patient who was constantly in the ER even though his mom gave him asthma medication. After staff worked with her a little more on how to give the medication and how to use an Aero Spacer (a device that helps control the delivery of asthma medication), the boy’s asthma appeared well under control by the next follow-up visit.

Better education on using your meds can help save time and money, not to mention get you better control over your symptoms.


07/Aug/2013

Study analyzed medical records of more than 600,000 children

By Dennis Thompson, HealthDay ReporterStill Carry Higher Health Risks Kids Worldwide Getting Less Heart Fit, Research Shows Could Weight-Loss Surgery Help Slow Aging for Some? Women With Asthma May Take Longer to Get Pregnant: Study Cat Allergies Double Among Asthma Sufferers, Study Reveals Share on facebook Share on twitter Share on email Share on print More Sharing Services 43 Obese Kids More Likely to Have Asthma, With Worse Symptoms

WEDNESDAY, Aug. 7, 2013 (HealthDay News) — Overweight and obese kids are more likely to struggle with asthma than kids of normal weight, according to a new review of more than 623,000 children.

Researchers found that children carrying extra weight are between 1.16 to 1.37 times more likely to develop asthma than normal-weight kids, with the risk growing as their body-mass index — a measure of body fat encompassing height and weight — increases.

Obese children also experience more frequent and severe episodes of asthma, requiring more medical attention and drug therapy, found the study in the Aug. 7 issue of theAmerican Journal of Epidemiology.

For example, heavier kids required more visits to the doctor to treat their asthma, and needed to use inhalers more often to help restore normal breathing.

Inflammation caused by body fat is suspected to be one factor in the kids’ increased risk of asthma, said study lead author Mary Helen Black, of the department of research and evaluation at Kaiser Permanente Southern California.

The extra pounds also might affect the severity of asthma by placing additional weight on a child’s chest, Black said.

“Overweight and obese youths have greater perceived symptoms of asthma,” she said. “When they have difficulty breathing, it seems more extreme to them than to kids with normal weight.” This could be due to the added weight constricting their breathing.

Asthma is the most common chronic childhood illness in the United States, affecting one of every 10 kids, according to study background information.

For the study, the researchers examined electronic health records maintained by Kaiser Permanente for 623,358 children and classified them from normal weight to extremely obese based on their height and weight.

The link between asthma and obesity was particularly pronounced among moderately and extremely obese girls between 6 and 10 years old, who had between 1.36 and 1.56 times higher risk of asthma than normal-weight girls their age.

Moderately and extremely obese Asian-Pacific Islander children also were inordinately affected, running between 1.41 and 1.67 times higher risk of asthma, the investigators found.

Obese Kids More Likely to Have Asthma, With Worse Symptoms

The new study confirms a common-sense link between the effects of obesity and the causes of asthma, said Dr. Jacqueline Eghrari-Sabetan allergy and asthma specialist in Gaithersburg, Md., and a fellow of the American Academy of Allergy, Asthma & Immunology. She was not involved with the study.

“Really you could have figured this out if you lined up all of the boxes neatly on your table,” Eghrari-Sabet said. “Fat is a huge reservoir of toxins. Toxins can of course cause inflammation. This is kind of like, what do you expect?”

Eghrari-Sabet noted that the inflammatory response caused by obesity already has been linked to other chronic conditions such as heart disease.

“If we explored this idea a little further: Is that the same cardiac disease you see in the adult? It would make you take the asthma in the young person so much more seriously because the problem is, so many people do not take asthma seriously,” she said. “If you said your asthma is linked to heart disease, you would get that kid treated so much faster for asthma.”

Study author Black said physicians and families should monitor overweight and obese children closely for signs of asthma.

“If they already have asthma, parents should think about their medication regimen and do everything they can to prevent some of these symptom exacerbations [flare-ups] from happening, knowing that kids who are obese are more likely to have these exacerbations,” Black said.

More information

Visit the American Academy of Allergy, Asthma & Immunology to learn more about childhood asthma.

SOURCES: Mary Helen Black, Ph.D., department of research and evaluation, Kaiser Permanente Southern California; Jacqueline Eghrari-Sabet, M.D., allergy and asthma specialist, Gaithersburg, Md., and fellow, American Academy of Allergy, Asthma & Immunology; Aug. 7, 2013, American Journal of Epidemiology

Last Updated: Aug. 07, 2013

Copyright © 2013 HealthDay. All rights reserved.


07/Aug/2013

Obese Kids More Likely to Have Asthma, With Worse Symptoms

Study analyzed medical records of more than 600,000 children

WEDNESDAY, Aug. 7, 2013 (HealthDay News) — Overweight and obese kids are more likely to struggle with asthma than kids of normal weight, according to a new review of more than 623,000 children.

Researchers found that children carrying extra weight are between 1.16 to 1.37 times more likely to develop asthma than normal-weight kids, with the risk growing as their body-mass index — a measure of body fat encompassing height and weight — increases.

Obese children also experience more frequent and severe episodes of asthma, requiring more medical attention and drug therapy, found the study in the Aug. 7 issue of the American Journal of Epidemiology.

For example, heavier kids required more visits to the doctor to treat their asthma, and needed to use inhalers more often to help restore normal breathing.

Inflammation caused by body fat is suspected to be one factor in the kids’ increased risk of asthma, said study lead author Mary Helen Black, of the department of research and evaluation at Kaiser Permanente Southern California.

The extra pounds also might affect the severity of asthma by placing additional weight on a child’s chest, Black said.

“Overweight and obese youths have greater perceived symptoms of asthma,” she said. “When they have difficulty breathing, it seems more extreme to them than to kids with normal weight.” This could be due to the added weight constricting their breathing.

Asthma is the most common chronic childhood illness in the United States, affecting one of every 10 kids, according to study background information.

For the study, the researchers examined electronic health records maintained by Kaiser Permanente for 623,358 children and classified them from normal weight to extremely obese based on their height and weight.

The link between asthma and obesity was particularly pronounced among moderately and extremely obese girls between 6 and 10 years old, who had between 1.36 and 1.56 times higher risk of asthma than normal-weight girls their age.

Moderately and extremely obese Asian-Pacific Islander children also were inordinately affected, running between 1.41 and 1.67 times higher risk of asthma, the investigators found.

The new study confirms a common-sense link between the effects of obesity and the causes of asthma, said Dr. Jacqueline Eghrari-Sabet, an allergy and asthma specialist in Gaithersburg, Md., and a fellow of the American Academy of Allergy, Asthma & Immunology. She was not involved with the study.

“Really you could have figured this out if you lined up all of the boxes neatly on your table,” Eghrari-Sabet said. “Fat is a huge reservoir of toxins. Toxins can of course cause inflammation. This is kind of like, what do you expect?”

Eghrari-Sabet noted that the inflammatory response caused by obesity already has been linked to other chronic conditions such as heart disease.

“If we explored this idea a little further: Is that the same cardiac disease you see in the adult? It would make you take the asthma in the young person so much more seriously because the problem is, so many people do not take asthma seriously,” she said. “If you said your asthma is linked to heart disease, you would get that kid treated so much faster for asthma.”

Study author Black said physicians and families should monitor overweight and obese children closely for signs of asthma.

“If they already have asthma, parents should think about their medication regimen and do everything they can to prevent some of these symptom exacerbations [flare-ups] from happening, knowing that kids who are obese are more likely to have these exacerbations,” Black said.

More information

Visit the American Academy of Allergy, Asthma & Immunology to learn more about childhood asthma.

SOURCES: Mary Helen Black, Ph.D., department of research and evaluation, Kaiser Permanente Southern California; Jacqueline Eghrari-Sabet, M.D., allergy and asthma specialist, Gaithersburg, Md., and fellow, American Academy of Allergy, Asthma & Immunology; Aug. 7, 2013, American Journal of Epidemiology


14/Nov/2012

How Do Your Children Grow?

Did you notice on election night how much first daughters Sasha and Malia Obama have grown over the past four years? They’re obviously eating well from the White House garden!

Most children grow fast at that age, but these days it seems kids are growing faster than ever.  So what’s the new normal?

Meds and other factors can impact growth

Pediatricians say on average, expect a child to add 10 inches in length and triple their weight between birth and the first birthday. After that, the growing slows down.  Kids add about 5 inches and 6 pounds between 12 and 24 months, and average 2½ inches and 6 pounds each year from ages 2 to 10. During puberty, there’s a growth explosion. Girls can sprout up to 9 inches, gaining 15 to 55 pounds. Boys add an average 11 inches and up to 65 pounds.

Dr. Jackie Eghrari-Sabet, of Family ENT, Allergy & Asthma Center in Gaithersburg, Md., sees a lot of these children in her practice.  She says new research shows asthma meds can affect a child’s growth.

“This has been studied a very long time,” she said.  “The latest research published in the September edition of the New England Journal of Medicine found that in the first two years of treatment, children who take relatively high doses of inhaled corticosteroids, the most prominent, maintenance medication, will lose about  ½  an inch of their overall adult height,” she said.

But don’t worry.

“Even if your child is on that medication for a decade, the research shows the child is still only going to lose that ½ inch, but at least the child will be healthy, in school and doing well. So there’s a risk benefit,” Dr. Jackie said.

Many moms may assume that the size of their baby at birth is an indicator of how tall the child will grow.  Not so.

“Just because you have a baby bigger than your Butterball turkey this Thanksgiving doesn’t mean you’ll end up with a tall child,” according to Dr. Jackie. “There are a lot of factors and basically growth is genetic, but generally, firstborns and multiples will be smaller because there’s not a lot of room in the uterus. Obese and diabetic mothers may have bigger babies.  An asthmatic mother will have a smaller bab.”

A few other interesting growth facts! Girls grow earlier but stop growing about three years after their first period. In boys, growth spurts tend to happen later and longer, through their teen years. Also, we know kids grow when they sleep.

“That’s because sleep releases their growth hormones,” Dr. Jackie said.

And although experts don’t know just why, believe it or not, kids grow faster in warmer weather — just like we’re sure those veggies must grow in the White House garden.


02/Dec/2011

Figuring out where to go may be the key in preventing triggers of your asthma or allergies and may keep them from ruining your vacation.

Best and Worst Spots for Pollen Allergies

Dr. Jackie Eghrari-Sabet on iVIllageBest: If high pollen counts make your head hurt, head to the coast. According to Jacqueline Eghrari-Sabet, M.D., founder of Family ENT, Allergy and Asthma Center in Gaithersburg, Md., beaches are the best bet for people with hay fever. Sea breezes tend to tame pollen counts. But stay close to shore: Going even a half-mile inland can make allergies soar. Top spots to sun yourself without sniffling: Miami and San Diego. If the beach isn’t your thing, seek (much) higher ground. There’s less vegetation in the mountains and pollen from evergreens doesn’t usually pose a problem. Consider Denver or Salt Lake City.

Worst: Don’t even think about whistling Dixie. Pollen likes a warm, humid environment. Since southern states have plenty of rain and a longer growing season, you can expect to sneeze and sniffle from February to May if allergic to trees, and nearly year-round if grass sets off your symptoms. According to the Asthma and Allergy Foundation of America (AAFA), many of the worst places for spring allergies fall inside the eastern part of the Sun Belt, with southern states like Tennessee, Alabama, Kentucky and Georgia claiming top spots.

Dust Allergies? Make a Clean Break

Allergic to housecleaning? Aren’t we all! For people allergic to dust, household chores really can be irritating. Of course, you probably won’t be doing much cleaning on your vacation; but dust mites, the little critters that make grime so irritating, can bother you even while you’re on holiday. “Dust mites are the bane of the asthmatic traveler,” says Dr. Eghrari-Sabet. While it may feel like dust is inescapable, dust mites actually thrive in warm, humid places. Their ideal climate is 70 degrees or warmer, with humidity above 70 percent. Rather than drinking water, dust mites absorb moisture from the air, so they depend on a damp environment to stay hydrated. When humidity falls below 40 to 50 percent, dust mites begin to die off. However, because they’re so hardy, that process can take months.

Read the full article on iVillage here.


31/Jan/2011

Many With Asthma Don’t Know It or Won’t Admit It

In this NBC4 videoDr. Jackie Eghrari-Sabet, an allergy doctor at Family ENT, Allergy & Asthma Center with offices in Gaithersburg, Olney and Frederick, MD, with advice on identifying and treating asthma.

It may be the most misunderstood disease in America, and as quiet as it’s kept, it’s almost become a bad word for many sufferers.

Asthma is the second most commonly-occurring disease in the U.S. Heart disease is No. 1, but asthma strikes twice as often as cancer and diabetes.

In Denial About Asthma

“It wrecks our daily lives and kills an estimated one person every two hours,” said Dr. Jackie Eghrari-Sabet of Family Allergy & Asthma Care in Gaithersburg.

“No one wants to own up to having it. They think they can’t get insurance coverage or will be kicked off the track team, so they just ignore their symptoms,” Eghrari-Sabet said.

And she said it isn’t just patients who are sticking their heads into the sand. Doctors are also loathe to use the “A” word and tend, instead, to classify their patients’ symptoms as “wheezy bronchitis, reactive airways disease, or exercise-induced bronchoconstriction,” according to Dr. Eghrari-Sabet.

Meanwhile, with sufferers in denial, the disease rages on and patients aren’t getting the treatment they need to get it under control. In fact, more than half the people with asthma are considered “out-of-control,” according to Eghrari-Sabet. Yet, she said, if you ask them how they’re doing, they’re likely to say “just fine.”

Eghrari-Sabet’s advice is simple: Just look at your DNA, your daytime symptoms, your nighttime symptoms and your use of albuterol. Are you coughing, wheezing and short of breath with even mild exertion more than twice a week? Do asthma symptoms wake you up at night more than twice a month? Do you use your albuterol inhaler more than twice a week? Are you inhaling more than one canister per year? If your answers are “yes,” you are out of control and need to get to your doctor.

“You cannot rely on the rescue medication. If you do, it will stop working, and you could die,” Eghrari-Sabet said.

Here are more asthma facts from the Allergy & Asthma Foundation of America:

  • It’s the most common chronic condition in children
  • It’s more common in boys than girls, but more common in adult women than men
  • It’s more prevalent among African Americans
  • It accounts for one-quarter of all yearly ER visits
  • Each day, it kills 11 Americans

Article by Pat Lawson Muse.


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