Asthma: A Physician’s Perspective
Dr. Marc Goldstein has been treating asthma patients for more than 30 years and is involved in asthma research and clinical trials.
- By Trudie Mitschang
MARC F. GOLDSTEIN, MD, is a nationally recognized and awarded doctor, with extensive clinical and research experience. He is a board-certified in allergy and immunology and has received the prestigious designations of fellow and diplomate at several of the nation’s leading allergy, asthma and immunology organizations. Dr. Goldstein practices at The Asthma Center in Philadelphia, a comprehensive treatment center for adults and children, offering customized evaluations, diagnostics and treatment programs to manage each patient’s specific allergy, asthma and sinus symptoms.
BSTQ: What is your background working with asthma patients?
Dr. Goldstein: I have been board-certified through the American Board of Allergy and Immunology since 1985, and I have more than 30 years of clinical experience treating asthma, allergy, immunology and sinus issues in both children and adults. I also have more than 20 years of research and clinical trial experience.
BSTQ: What are some common misperceptions about asthma?
Dr. Goldstein: Symptoms of asthma are commonly underreported. This is due to a poor perception of shortness of breath. When people experience shortness of breath for a long period of time, it becomes their “normal” way of breathing. As a result, it is more difficult for these individuals to recognize their breathing as abnormal. Additionally, people who have chest symptoms often attribute it to allergies. This is a fairly common occurrence. Similarly, people who get chest symptoms with a cold are often misdiagnosed with acute bronchitis. Lastly, it is not uncommon for individuals to think they have outgrown their childhood asthma. A person’s symptoms may improve as they enter their teens and 20s, but asthma can reactivate in adults.
BSTQ: How do treatment protocols differ for children and adults?
Dr. Goldstein: Not all medications for adults work effectively or are approved for children of all ages. This is something that should be considered by physicians when prescribing. Additionally, there is a larger instance of exercise-induced asthma with children since they are more active in general. In regard to inhalers, children often have difficulty using asthma inhalers. One solution is the use of the holding chamber, which makes administering inhaler medications much easier. Another effective alternative is a nebulizer.
BSTQ: Are there lifestyle limitations (things they must avoid) for asthma patients?
Dr. Goldstein: Individuals with exercise-induced asthma may be advised to limit exercise activities. In addition, individuals with asthma should always have access to rescue emergency inhalers as a precautionary measure. Of course, those who have asthma should be regularly monitored by an asthma specialist due to the chronicity of their disease. Additionally, asthma is often triggered by animal dander, which means many people are not able to own pets and should limit their time around animals, in general.
BSTQ: How has asthma treatment evolved in recent years?
Dr. Goldstein: We now have once-a-day inhaler therapies that help immensely with patient compliance. A groundbreaking advance in the world of asthma is the development of biologic treatments. This is a common treatment that is utilized at The Asthma Center and has improved the quality of life for many patients.
BSTQ: Is patient compliance an issue among asthma patients?
Dr. Goldstein: Yes, especially among individuals with chronic asthma. These individuals need ongoing care, which means that they must dedicate a significant amount of time and energy to their lung health. There are also instances of forgetting to take medications. Oftentimes, those with asthma are advised to live in a pet-free environment because animal dander can negatively impact their breathing. This can be difficult for those who have bonded with a pet and are not willing to part ways.
BSTQ: Any advice for newly diagnosed or long-time asthma patients?
Dr. Goldstein: My best advice for someone who is not feeling well or does not have well-controlled asthma is to see an expert as soon as possible to develop a treatment plan. Signs of poorly controlled asthma include difficulty breathing, interrupted sleep or trouble sleeping due to shortness of breath, and exercise-induced shortness of breath. Those newly diagnosed, as well as those with long-time asthma should be monitored by an asthma specialist.
