Asthma Treatment in Southlake, TX

We confirm what you actually have with spirometry, get you on the right inhaler, and then make sure you can use it. Those three steps fix more adult breathing problems in primary care than any new prescription does.

Confirming the diagnosis

Spirometry before and after a bronchodilator distinguishes asthma from COPD and tells us how much obstruction is present. Asthma obstruction largely reverses. COPD obstruction largely does not.

It is a short test and it changes management constantly. Plenty of people arrive with a diagnosis nobody ever confirmed. Some have COPD and are being treated for asthma. Some have neither and are short of breath because of heart failure, anemia, deconditioning, vocal cord dysfunction or anxiety.

Getting this right is most of the first visit, and it is worth the time.

Finding the triggers

Adult asthma is usually driven by something. We go through the list systematically rather than assuming.

• Allergic rhinitis and sinus disease. Treating the nose improves the chest, reliably. See sinus infection.
• Reflux. Silent reflux worsens asthma and often presents as a cough rather than heartburn. See acid reflux and GERD.
• Medications. Beta blockers, including eye drops, and NSAIDs in aspirin-sensitive asthma.
• Occupational exposures. Ask yourself whether symptoms improve on holiday. If they do, that is a large clue.
• Home exposures. Pets, mold, dust, and gas stoves.
• Obesity. Weight makes asthma harder to control and harder to diagnose correctly.

Treatment

Current guidance has moved decisively away from albuterol-only treatment, even for mild asthma. Using an inhaled corticosteroid and formoterol combination, either as needed or as maintenance plus reliever, prevents more attacks than rescue albuterol alone.

If you were diagnosed years ago and are still on albuterol by itself, this is worth a conversation. It is a genuine change in the standard of care, not a marketing shift.

For moderate to severe disease we step up to daily combination therapy, and add a leukotriene modifier or long-acting muscarinic antagonist where indicated. Biologic therapy exists for severe eosinophilic asthma and we refer to pulmonology or allergy when someone might qualify.

Inhaler technique

We watch you use it. Every visit.

Technique errors are close to universal, and a perfectly chosen medication delivered to the back of your throat does nothing at all. A spacer solves most of the problem with metered dose inhalers and costs very little. Dry powder inhalers need a fast hard breath in, which is the opposite of what most people do.

If your inhaler stopped working, technique is the first thing we check, before the dose.

Your action plan

Every asthma patient leaves with something written: daily medications, what to do when symptoms worsen, when to start a rescue course of steroids, and the specific signs that mean the emergency department.

Vague instructions turn manageable flares into hospital stays. Written plans reduce admissions, which is why we take the ten minutes.

Vaccines and prevention

Flu, COVID, pneumococcal and RSV where appropriate. Respiratory infections are the most common trigger for a serious flare, and prevention is cheaper than prednisone.

When to be seen urgently

Rescue inhaler not lasting four hours, trouble speaking full sentences, or peak flow below half your personal best means you need care the same day. If you are working hard to breathe, call 911.

Breathing conditions are followed through our chronic condition management program. See our primary care Southlake practice overview.