(Flickr photo (cropped) by Francis Bourgouin).

Tune in to our radio show on your local public radio station, or sign up for the podcast and listen at your leisure. Here’s what it’s about:
Difficulty breathing is not only frightening; it can lead to serious medical complications and occasionally even death. What lies behind asthma and how can it be controlled? With the appropriate education and backup, patients can do a lot to stay on top of their asthma symptoms themselves.
Allergic reactions may be the culprit in many cases, but it can be a challenge for people to control their exposure–especially if the allergen comes from the family cat. Dr. Kraft offers tips on how to minimize environmental triggers.
In other cases, the cause may lie in smoldering infection. Could some cases of asthma be cured with antibiotics? What does the research say about antibiotics and COPD, and what is the distinction between COPD and asthma?
Guests: Monica Kraft, MD, is Professor of Medicine and founding director of the Duke Asthma, Allergy and Airway Center. She is Chief of Pulmonary, Allergy and Critical Care Medicine at Duke University Medical Center. She is also past President of the American Thoracic Society.
David Hahn, MD, MS, is Director of the Wisconsin Research and Education Network (WREN) and author of a brand new book, A Cure for Asthma? What Your Doctor Isn’t Telling You–and Why.
The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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  1. ENID R. KAFER
    Reply

    Congratulations on an excellent medical science & clinical medicine based discussion on the management of asthma.
    Four decades ago, yes four decades ago when I accepted a faculty position at UNC Chapel Hill, these are the principles which I taught.
    First, the importance of basic pulmonary function tests such as an FEV1 to establish the diagnosis and on examining the response to bronchodilators. If the patient required steroid therapy we would titrate the steroid to obtain a good response to the bronchodilator.
    Second, as an anesthesiologist and internist I offered a series of lectures on the medical care of the surgical patient. I argued that where appropriate basic pulmonary function tests and optimizing the patients pulmonary function prior to surgery was ideal management. This is a great deal less expensive than several days in the ICU postoperatively.
    Third, although, chest x-rays are still performed by family doctors and others in patients with asthma unless there are specific indications then these chest x-rays are a waste of money and may not be telling you anything. We need to do tests which are appropriate.
    I have only one issue and that is with your title. We are not curing asthma but providing science based diagnosis and management. Remember asthma can be a deadly disease as well impairing the quality of life.
    Congratulations to you and your speaker. It may have taken four decades to hear my teaching vindicated but it was worth it.
    ENID R. KAFER MD(Sydney), FRACP, FRCA. Retired Professor of Anesthesiology.

  2. Jill S.
    Reply

    I lived in Fairfield Iowa (corn country). I must have been allergic to corn or the chemicals used on the crops and I developed a massive sinus infection. I also meditated twice a day in the very large dome building with a few hundred other women, the speaker said close contact with people filled places could contribute and the dome might have also have had a mold situation as it was filled with large foam mats that we sat on.
    Then I moved to Eugene, Oregon another place where mold is very prevalent in the air. There I developed Asthma. I use a nebulizer and symbicort and prednisone on demand when asthmatic attacks are completely out of control.
    My doctor treated me with AZITHROMYCIN for 1 month and now I have more stabilization then I have ever had.
    I also received the pneumonia vaccine….before receiving that I had pneumonia 5 times.

  3. sandy
    Reply

    I was so glad to hear this program. I have had asthma for 50 years, it has been well controlled for the last 15 yrs. Then about a year and a half ago it started that I couldn’t breath so my dr. put me on antibiotics which seemed to work. I could breath just fine for about three weeks, then It came back. I was put on antibiotics for another 10 days. This has been repeated over and over for the last year and a half! I haven’t been able to breath for more then 3 weeks in a row for a year and half. I will be going to my allergist tomorrow to talk to her about what I heard on your program. Hopefully this will be the answer to my problem!

  4. Fredrica W (katman)
    Reply

    My father was a doctor, and in the 1950s, had many ulcer patients. He always said that he didn’t think treatment then was the final answer. Along came Barry Marshall, who said ulcers were caused by a germ. He was nearly laughed out of the medical community so he gave himself one and cured it. It took 23 years for him to be awarded the Nobel Prize for Medicine. Having very nearly recovered from Multiple Sclerosis, I firmly believe that “our guys” will be awarded.

  5. J B Henley
    Reply

    I would like an answer to the same question posed by MB, RN 1: Is asthma caused by a bacterial infection exacerbated by the use of an inhaled corticosteroid?

  6. M.B., RN
    Reply

    Great show today. My questions are:
    Given a case of asthma caused by a bacterial infection, is in not possible for an inhaled corticosteriod to exacerbate the problem?
    And, if it were available, would it be better for these patients to use an inhaled form azithromycin?

  7. B. McConnaughey
    Reply

    Several years ago I was diagnosed with Mycoplasma as well as long standing asthma. My pulmonologist put me on both Xolair and zithromax. The combo has worked well – however the insurance company would only allow a rx to cover 6 days – which made treating a well established infection far more tedious than it ought to have been. Even eight years ago there was a significant body of research, mostly carried out in Europe showing that there was a fraction of cases of Mycoplasma that required over a year of treatment with a macrolide antibiotic.

  8. plcg
    Reply

    About 2 months ago, a couple of days before another appt. with my asthma/allergy doctor, I read a story in the Chicago tribune about how Dr. Oz suggested to Suze Orman, the financial wizard, that she may have acid reflux with her horrible asthma. She checked into it and found that she did and has been almost cured of her “asthma” which she has had since childhood. I read the symptoms and saw myself -increasingly worse constant cough, so bad I was almost gagging especially all morning long. hoarseness. Constant mucous dripping down my throat. Intolerance of cool weather especially when exercising or I’d be asking for a bronchial infection. When I showed my doctor the article, she said that there has been some talk of the connection and said I should try 20 mg. of prilosec. It was a miracle!
    What a dramatic difference almost immediately! I went to my gastroenterologist immediately who confirmed the connection and said to stay with the 20 mg. but to take it 1/2 to 1 hour before breakfast. besides all of the awful symptoms practically gone, some awful stomach issues I had been having in the last few months cleared up after a couple of weeks on the prilosec. So, I have to wonder why allergy/ asthma doctors don’t ever check into this possibility? Why did I have to be miserable for long and have to be the one to bring this to my doctor’s attention? is it all about money? Why tell your patients about a possible simple solution when you can have them coming into the office year after year? If I would have missed that article, I’d still be coughing my head off.
    So my question is– is it ok to stay on prilosec for as long as I could need it? besides the diet changes, is there anything natural I can add to fight the acid reflux (which I never even remotely suspected that I had)?
    I would also like to add that the day after my first dose of prilosec, I was able to go out on a cold, rainy Chicago day and do hours of yard work without one cough. I’ve cut my prescription inhaler and nasal spray use in half. I’m still a little scared to give them up completely in the winter now but I have been able to be out for the first time in years. I feel like a new person!

  9. james g.
    Reply

    I asked my doctor about this antibiotic program for asthma. He was concerned about overuse of antibiotics and the creation of drug resistant illnesses. He felt that this protocol would create more problems than it solved as the doctors themselves are not always aware of the overall effects of antibiotics on the whole human system. He felt that the bacteria mentioned in the show is now almost 90% drug resistant in Florida alone.

  10. LindaB
    Reply

    Have been diagnosed w/COPD/Bronc for about 17 years, recently had my 1st exacerbation, really scary! Was given Azithromycin at my initial visit for cough, 2 days later could not breath or do anything. Went back and got shot of Pred + pills of same, and nasal spray,allergy pill, finally could breath and be back to normal after 10 days and just taking my Advair 2x a day. Has anyone ever used Salt Inhaler, also new?med. Daliresp.
    Just looking for different ideas and possible remedies. I do not wheeze, cough, I sleep laying flat, oximeter is usually 96. I am told by my MD that I am doing very well ( do chores regularly ie, laundry, gather wood,clean pool, take care of animals and garden)
    Thank you for listening. LB

  11. Cynthia
    Reply

    Thank you so much. I hope my doctor will consider the treatment options. My spring may be enjoyable yet. Love the radio show. How have I survived without it for this long.

  12. kathleen a
    Reply

    Just happened to find this on the radio and didn’t hear the whole discussion. I did hear about antibiotics and have always wanted to at least try something besides albuteral. Two days later I had a doctor’s app’t and asked her about it…denied. I have been treated now for about 6 years but do no have breathing issues or wheezing only a bad cough. This brings up problems with very bad vomiting when waking up and it worries me what this is doing to my insides(for lack of a better road). This is the third doctor I’ve seen and it’s very frustrating.

  13. Fredrica W. (katman)
    Reply

    Thanks again for this program. Not being so good on the computer, I only saw now that the site link I posted was not alive, so I will try again:
    http://www.cpnhelp.org
    Rica W (katman)

  14. lknlistener
    Reply

    Thank you for this program! My husband has been dealing with lung issues for years and this gave us some new ideas of what to ask his doctor about. Perhaps he can finally get some answers for his breathing issues. We love your show. Thanks for all you do.

  15. Karen G.
    Reply

    Very helpful info. I have been diagnosed with Asthma & COPD for several years now. I have a 10 year old grandson who now has been diagnosed with “allergies” & given an inhaler. Nothing else is being done from what my daughter has told me.

  16. Naomi B.
    Reply

    Forgot to ask to be notified if/when this topic is discussed further.
    thank you

  17. Naomi B.
    Reply

    I’ve been diagnosed with COPD and asthma “seems” to be an associate culprit. I have always had “hayfever”, with little seasonal difference.
    I am allergic to erythromycin and/or Soma; took them in tandem for dental problem and had anaphylactic response – don’t know to which one!
    Penicillin works well and has no adverse effect.
    Would doxycyclin work for my “COPD” symptoms?

  18. Mary M.
    Reply

    Heard this show today and it interested me greatly. I have COPD/emphysema and the insurance Co. has denied paying for Asmanex and wants me to go on Flovent. I have tried it and the side effects are definitely harsher than Asmanex. Hope we can convince the insurance Co. to let me use the Asmanex, especially since the Dr. said it was much less affecting to the body.
    I will definitely talk with my Dr. about this new info from you. (She is SO busy that I am sure she has not caught up on her JAMA reading) Thank you for your shows, they always enlighten my early Saturday morning on NPR (WV public radio).

  19. Carolyn W W
    Reply

    Very helpful information.

  20. Leonard A.
    Reply

    “A Look at the Role of Musical Wind Instruments in Asthma Therapy, by Amanda Pepping published in the January, 2009 “International Trumpet Guild Journal (pp.17-20) offers some interesting insights. Also, “How Singing Can Improve Your Child’s Asthma,” by Ian McAllister presents more information on dealing with asthma with medications. Perhaps these articles could be the basis for a discussion on your program. I personally know a singer and a professional bass trombonist who dealt with asthma as children and seem, for the most part, “outgrown” it. Not being a medical professional, I can only comment about this situation from personal observation.

  21. Fred P
    Reply

    This program was most helpful and interesting. I’m going to make certain both my primary doctor and pulmonologist get access to it. I suspect I may have a bacteria infection. I get treated for for chronic asthma/COPD when I get a severe bronchial infection (usually in the spring and fall) with antibiotics and prednisone, and I’m OK for about 6 months using Advair, etc. Then, I’m hit again. It’s a cycle that’s been going on for decades.

  22. iamdavewalsh
    Reply

    I listened to your show and found much of it helpful and informative. I have had intermittent asthma for over 20 years and have been able to reduce my occurrences by doing many of the things you discussed : reducing indoor allergens that aggravate my sensitive lungs.
    I was disappointed that you did not talk more about air quality links to asthma. You mentioned this briefly, but for me air quality is a major factor that limits my ability to exercise outside in the summer. I live in Charlotte, where we have the 10th worst air in the country, and I can tell a bad air day without reading the newspaper.
    It is my understanding that poor air quality is increasingly seen as a root cause of the increased occurrence of childhood asthma, in addition to a known cause of flair ups of asthma. I would like to see and hear more recognition of this from the medical community and more support for policies to improve prevention and not just treatment of this condition.
    Check out the Clean Air Carolina campaign for Medical Advocates for healthy air. http://www.cleanaircarolina.org/?page_id=31

  23. Fredrica W (katman)
    Reply

    You have touched on C.Pn as a cause for asthma and COPD on your wonderful show this morning. For seven years I have been on antibiotics, including Azithromycin, for MS, having been led there by http://www.cpnhelp.org. Many patients with asthma have been cured with this Combined Antibiotic Protocol. The research was done at Vanderbilt University.
    Rica W

  24. Sidney W.
    Reply

    I am not sure my doctor treated with azithromycin but with 2 consecutive 6 week regimens of some antibiotic my asthma seems to have retreated into the background. I use a Dulera inhaler and have occasional bouts of coughing up mucus, probably from allergies.
    It has been a long time since I have awaken in the middle of the night wheezing. I suspect my doctor is keeping current with research like Dr. Hahn’s, and I can’t wait to forward this podcast to him. It is so cool to have a doctor make himself available by email that I try not to take too much of his time, but I think he may find this podcast useful in educating his patients.

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