Ask Dr. John

Respiratory & Allergies

Paula writes: "Will my asthma eventually turn into COPD?"

Asthma and COPD are two different medical conditions that share many characteristics. With asthma, the smooth muscles that line your airways inside your lung constrict down which restricts breathing. The classic "wheeze" you hear during an asthma attack comes about because air is being forced through a smaller airway. With asthma, this airway obstruction is reversible, usually with medications that open up the airways to let the air flow in and out more normally. COPD, also known as Chronic Obstructive Pulmonary Disease, happens when the similar type of airway obstruction is fixed and not reversible. Chronic asthma can turn into COPD, but COPD is usually associated with smoking, some occupational exposure, air pollution and certain other medical conditions.

Nikki writes: "I have suffered with shortness of breath and a chronic cough since November 2008. I have gotten a list of things that it is not, and it has cost me thousands of dollars in tests and doctor bills without knowing what is happening and how to treat or even cope with it. Any thoughts?"

A chronic cough can persist for weeks, months or, in some cases, even years. This can lead to anything from problems sleeping, to urinary incontinence. Treatment depends on the cause of the cough, but finding out what the cause is can sometimes be a time consuming task. Assuming you have a normal chest X-Ray, some causes could be a smoking cough, gastrointestinal reflux disease, post nasal drip due to chronic sinusitis, or even seasonal allergies. In some people, asthma can show up as a chronic cough accompanied by an equally persistent shortness of breath. Again, the important thing is to determine what is causing the cough. The first step is usually a chest X-Ray to make sure there is no pneumonia, congestive heart failure or mass causing it. Beyond that, testing can include pulmonary function tests, treatment for reflux disease and reviewing medication that might cause a persistent cough. If you've been through multiple tests you might want to consider following up with a Pulmonologist, the type of doctor specializing in the lungs. He/She should be able to better pinpoint what is going on and help you design a treatment to get your cough better under control.

Julie from Colorado Springs: "My granddaughter has had an upper respirator infection and mild cough. Just walking down about 10 stairs, she starts coughing much heavier. Bad air days seem to make this worse. How can I find out about air quality? Do you know what guidelines schools use to determine if it's safe to send kids out to play?"

The best way to find out about local daily air quality is to go to the Colorado Department of Public Health's site where they track it for you. Their website is I do not know what the school policies are for checking air quality before sending kids out to play. The best way to get this information is to call the school's district office.

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