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Health
Asthma and angioplasty
Dear Dr. De La Flor,
What’s the difference between asthma that is due to allergies and asthma that is not? Is it possible to overuse the inhaler that I use (Ventolin)? Thank you, Vivian.


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10.04.2012 - Dear Vivian, Allergic asthma is an over-reactive immunologic response that occurs because your body makes too much of an immune system component called immunoglobulin E (IgE). In general, patients with allergic asthma are bothered by common allergens like animal dander, dust mites, pollen, mold, or cockroaches, and they are often allergic to more than one of these things. When a person has asthma that isn’t related to allergies, but is instead triggered by factors that act directly on the lungs, such as infections, exercise, cold air, pollution, and stress, they have non-allergic asthma. Many people with asthma have a combination of non-allergic and allergic asthma. The inhaler you use (ventolin) is a bronchodilator, a drug that helps open up the airways. They are only for ‘rescue use’, when you truly need help breathing. Anything more than twice a week, unless the inhaler is being used for exercise-related symptom prevention, is too much. Patients who need to use it more than twice a week need to reassess their asthma control therapy. Using bronchodilator inhalers several times a day, actually increases mortality risk. Bronchodilators open the airways by relaxing the muscles around them, and overly frequent use can make it more difficult for these muscles to relax on their own. The lungs basically lock up. My advice is to have a conversation with your GP – a thorough examination of your daily activities as well as ‘triggers’ and re-assess your treatment if necessary. Best wishes. Dear Dr. De La Flor, My doctor told me that I may need an angioplasty in my neck. Is it dangerous? What is it exactly? Regards, Donna Dear Donna, Unfortunately what your doctor means is that your carotid arteries (located in your neck) are clogged. This is called Carotid Artery Disease. It occurs when fatty, waxy deposits called plaques clog your carotid arteries. Your carotid arteries are a pair of blood vessels that deliver blood to your brain and head. The buildup of plaques in these arteries blocks the blood supply to your brain and increases your risk of stroke. Because it develops slowly and often goes unnoticed, the first outward clue that you have the condition may be a stroke or transient ischemic attack (TIA), sometimes referred to as a mini-stroke.
Treatment usually involves a combination of lifestyle changes, medications and, in some cases, surgery or a stenting procedure.
Carotid angioplasty is a procedure that will open up the clogged arteries to prevent a stroke. The procedure involves temporarily inserting and inflating a tiny balloon where your carotid artery is clogged to widen the artery. Carotid angioplasty is often combined with the placement of a small metal coil called a stent in the clogged artery. The stent helps prop the artery open and decreases the chance of it narrowing again. Carotid angioplasty and stenting may be used when traditional carotid surgery isn’t feasible or is too risky.
Whether you need to or not undergo an angioplasty, my advice is to sit down with your GP and set some goals regarding life-style changes – you can do much more than you think to prevent cerebrovascular episodes and hopefully keep surgeries and surgeons away! Best wishes!

 

COACHING CORNER by Dr. De La Flor
Everyone has their story, a fair or perhaps unfair blend of personal suffering and victories. Every morning however, what matters is not so much what our history has been, but our interpretation of our current circumstances and the desire to do our best under those circumstances.
It is the nature of the inner conversation that limits us or on the contrary serves as a springboard to bring out the very best in us.
ReSOLUTION
For the next two weeks, we should try to do a courageous ‘check up’ of our inner conversation. Is the conversation we are having one that invests in greater possibilities, or greater limitations? Are we allowing ourselves to be side-tracked by the unexpected, and even annoying, challenges that have presented themselves in our lives, or are we reminding ourselves that without suffering and pain nothing substantial can be obtained? Are you willing to use your circumstances and conditions as a launch-pad from which to shine? Like a rose, sometimes we grow from unappealing compost. Our contribution is not in spite of our history, but comes through it.
Best wishes for those enduring any illness or pain. Wish you all a meaningful, compassion-filled year. Talk to you in a couple of weeks.    
By the way, feel free to add me as friend on facebook (Manuel De La Flor). Talk to you in a couple of weeks.       
Dr. De La Flor, licensed G.P./Family Doctor. Holds certificates in coaching, nutrition and medical exercise from Berkeley University and the American Council on Exercise. His medical approach is highly influenced by Positive Psychology; an empowering, encompassing way of approaching patients through the study of their strengths and virtues to enable them to thrive and lead fulfilling lives, accept the past, find happiness in the present, and hope for the future. You can reach the doctor at 00-34-697.888.666 to schedule a consultation in his surgery or in your home/business.

 



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