Don’t use cotton swabs to clean your ears

Updated clinical guidelines published Tuesday in the journal Otolaryngology-Head and Neck Surgery say they’re not appropriate for earwax removal. In fact, information for patients in the guidelines say no to putting anything “smaller than your elbow in your ear.”

Regardless, most of us hoard a stash of the soft-tipped paper sticks; they seem so perfectly suited to that dirty job.

So the authors of the guidelines — an advisory panel of the American Academy of Otolaryngology-Head and Neck Surgery — have injected a little bit of freshness into the usual advice, giving more explanation as to “Why not?” They even included a consumer representative on the panel.

“We really have come to appreciate that clinicians are not the only users of (the guidelines), that patients are really interested in their own care and people are really taking ownership of their own care,” said Dr. Seth Schwartz, chairman of the guideline update group for the academy.

Here’s why not: Cotton swabs, hair pins, house keys and toothpicks — the many smaller-than-our-elbow-objects we love to put in our ears — can cause cuts in our ear canals, perforate our eardrums and dislocate our hearing bones. And any of these things could lead to hearing loss, dizziness, ringing or other symptoms of ear injury.

Instead, most people can just let nature do its job. Our bodies produce earwax to keep our ears lubricated, clean and protected: Dirt, dust and anything else that might enter our ears gets stuck to the wax, which keeps any such particles from moving farther into the ear canal. Our usual jaw motions from talking and chewing, along with skin growth within the canal, typically helps move old earwax from inside to the outside the ear, where it is washed off during bathing.

The guidelines published in 2008 were overdue for an update. While new randomized trials have been included, “nothing very dramatic” has changed, other than an improvement in the methodology itself, said Schwartz: “The process has become a little more transparent in the way we actually write the guidelines now. We are more clear about why the decisions we made are made and what data there is to support it.”

Patient are apparently interested in the nitty-gritty of ear care: More than 50,000 people downloaded the old guideline, Schwartz said.

“It’s kind of amazing how many people were interested in reading that,” he said.

The do’s and don’ts

To be “a little bit more patient-friendly,” the guidelines now include lists of “Do’s and Don’t’s” for everyone and a list for people who have had problems with cerumen impaction, the official term for earwax buildup, a condition that is more common among the elderly, according to Dr. James Battey, director of the National Institute on Deafness and Other Communication Disorders.

Impaction can occur when the ear’s self-cleaning process doesn’t work very well. The resulting waxy buildup blocks the ear canal, causing difficulty hearing.

“For those with impacted ear wax, the use of cotton-tipped swabs may push the earwax deeper into the ear canal and harm the eardrum,” Battey said. He added that “about 2% of adults with impacted earwax may go the doctor with hearing loss as their symptom.”

“Impacted earwax is best addressed by a health care professional,” he said.

In the all-important “Don’t” section, you’ll find warnings against “overcleaning” your ears. Excessive cleaning may increase earwax impaction, according to the authors.

“It’s cultural” to want clear ears, Schwartz said, but “wiping away any excess wax when it comes to the outside of the ear is enough to keep it clean.”

Another warning in the new guidelines: Do not use ear candles. Not only can they cause “serious damage” to your eardrum, “there is no evidence that they remove impacted cerumen,” wrote the authors.

“Home therapies are fairly effective,” Schwartz said, adding that the “whole host” of over-the-counter wax-softening drops as well as home-use irrigators are effective and safe. “Even drops of water in the ear can be effective to soften the wax,” he added.

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Still, among the items on the “Do” list is to ask your health care provider about how to treat earwax impaction at home, since “you may have certain medical or ear conditions that may make some options unsafe.”

“It’s not a bad thing to have wax in your ears. Everybody does and should. It’s more of an issue when it becomes too much,” Schwartz said. The guideline definition of “too much” is an operational one: If you have symptoms — such as pain, drainage, bleeding or hearing loss — then you have a problem.

“If it’s causing symptoms, absolutely go to your doctor,” Schwartz said, repeating what is likely the most important “Do” list recommendation. Still, some people attribute their symptoms to wax buildup when it’s just not the case.
Among older people, “hearing loss becomes very, very common,” said Schwartz.

In fact, aging, along with infections and exposure to loud noise, is one of the most common causes of acquired hearing loss, according to Battey.

Yet many people cannot imagine that they’ve begun to lose their hearing, and as a result of this disbelief, Schwartz said, “a patient has wax cleared, and then their doctor needs to look deeper.”

‘Wire tapping’ and 11 other words and phrases Trump has tweeted in quotes

“The President used the word ‘wiretaps’ in quotes to mean, broadly, surveillance and other activities,” Spicer said on Monday. Evidence of an Obama wiretap — using the narrow definition of a wiretap — hasn’t been found by the House or Senate intelligence committees.

It turns out that Trump uses quotes a lot in his tweets. Here are some other words and phrases that the President may have been using broadly on Twitter since his inauguration. And, of course, in every instance, it’s entirely possible that he was quoting someone else without it being immediately clear.

The word “play” actually has many different meanings. In this case, the President probably wasn’t using it to refer to “amorous flirtation.”

“Ran over”

Trump has advocated for friendlier relations with Russia, although he has said he would stand up to world leaders better than his predecessor.

“Witch hunt”

The President isn’t really into threading his tweets, so this came at the end of a four-part tweet about the integrity of Attorney General Jeff Sessions, who admitted to meeting the Russian ambassador last year, but is also not a witch. Questioning by Democrats and others about those meetings, according to this tweet, was a figurative witch hunt, as opposed to the literal witch hunts of the colonial era.

“Rigged”

Even though he’s a Republican, Trump kept up on the election of the Democratic National Committee chairman. Tom Perez beat out Bernie Sanders-backed Rep. Keith Ellison, and the President pulled out one of his favorite words to express how he felt about it. He clearly meant that the election was stacked against Ellison, but according to the dictionary, could also have meant “to fit out with rigging.”

“Leakers”

Trump, like almost anyone in a position of power, is not a fan of leaked information. In this tweet, he quoted the colloquial term for someone who gives out (information) surreptitiously.

“Sources”

It is no secret that the President doesn’t have the best relationship with the news media. In this tweet, he seems to be dismissing the people — known as “sources” — who provide information to journalists for stories. See also: “leakers.”

“Intelligence”

Just to recap: Trump doesn’t like leaked information. He tweeted this during a period when intelligence leaks stirred up questions about officials from his campaign and their interactions with the Russians. What a sick burn, though — calling the intelligence of the intelligence community into question by putting the word “intelligence” in quotes. A lot of nuance in those quote marks.

“Evil”

In this case, it’s totally understandable for Trump to use quotes around the word “evil.” Evil can mean a lot of different things to different people. And, generally speaking, getting “evil” out of the country is probably something anyone could get on board with.

“Bad” and “dudes”

Like “evil,” “bad” is another word that means different things to everyone. And in talking about his initial travel ban, Trump left the definition wide open. As far as “dudes” goes, maybe Trump just doesn’t use the word frequently. Honestly, no one should really be using the word “dudes” seriously unless they are living in California or the year 1989.

“Carnage”

For all we know, the President was quoting his own Inauguration speech on this tweet. The most commonly used definition of carnage is “great and usually bloody slaughter or injury.” More than 700 people were murdered in Chicago last year, so whatever definition of carnage you go with, and however you feel about “(sending) in the Feds,” the President has at least identified a huge problem that needs fixing.

Congress kills Internet privacy protections

The House of Representatives voted Tuesday to repeal Internet privacy protections that were approved by the Federal Communications Commission in the final days of the Obama administration.

The Senate voted along party lines to undo the rules last week. The resolution now goes to Trump’s desk. The White House said Tuesday it “strongly supports” the repeal.

The rules, which had not yet gone into effect, would have required Internet service providers to get your permission before collecting and sharing your data. The providers have data on your web browsing history, app usage and geo-location.

Providers would also have been required to notify customers about the types of information collected and shared.

Related: Why Silicon Valley isn’t fighting to save the Internet (yet)

The privacy rules were intended to give consumers extra control over their personal data online at a time when everything from smartphones to refrigerators can be connected to the Internet.

Opponents of the privacy rules argued it would place an undue burden on broadband providers while leaving large Internet companies like Facebook (FB, Tech30) and Google (GOOGL, Tech30) free to collect user data without asking permission.

Representative Michael Burgess, a Republican, described the rules as “duplicative regulation” on the House floor and said the repeal would “level the playing field for an increasingly anti-competitive market.”

But rather than apply similar protections to more businesses, the Republican-controlled Congress voted to scrap the rules entirely.

Democrats and privacy advocates have argued this approach effectively hands over the customer’s personal information to the highest bidder.

“It totally wipes out privacy protections for consumers on the Internet,” Democratic Representative Anna Eshoo said on the floor. “I don’t want anyone to take my information and sell it to someone and make a ton of money off of it just because they can get their mitts on it.”

Michael Capuano, a Democratic Representative, took it one step further. “Just last week, I bought underwear on the internet,” he said. “Why should you know what size I take, or the color, or any of that information?

internet privacy

Many broadband providers already share some of their customers’ browsing behavior with advertisers. Providers typically offer the choice to opt out, but consumers may not even be aware of this data collection — let alone how to get out of it.

With Facebook and Google, weary users may choose to limit their activity on the sites or switch to rival services. But switching providers is often difficult, as is hiding your Internet activity from your Internet provider.

“Most people can’t simply walk away from their Internet service provider,” says Neema Singh Guliani, legislative counsel at the ACLU. “They need the Internet and they may not have another option.”

A virtual private network, or VPN, is one option to protect your online activity. One service, NordVPN, says it has seen a “sharp increase” in consumer interest in the days since the Senate vote.

Related: Worried about companies spying on your browsing? Here’s what you can do

The repeal is a big win for large providers like AT&T (T, Tech30) and Verizon (VZ, Tech30). They have bet billions on content, including AT&T’s pending acquisition of Time Warner, the parent company of CNN.

This content can potentially be paired with subscriber data to build up lucrative targeted advertising businesses that compete with Google and Facebook.

“I don’t think of it as game over,” says Guliani, who predicts Republicans will face pushback from their constituents for the privacy vote. “I think of it as a setback.”

CNNMoney (New York) First published March 28, 2017: 6:06 PM ET

The hidden costs of segregation

But how does economic and racial segregation in a handful of neighborhoods affect the rest of a metropolitan area?

The Urban Institute analyzed data from the 100 most populous metro areas in the 1990, 2000 and 2010 censuses and found that less segregated regions had higher average incomes and educational attainment and lower homicide rates.

And despite efforts to integrate schools and neighborhoods, the report concludes that the United States remains “starkly segregated” by race and income. That leads to worse regional outcomes on the whole, the report says, though trends vary across the country.

The report argues that more inclusion builds safer, smarter and richer regions.

Economic and racial segregation tend to go hand in hand

Regions with more segregation between blacks and whites are more economically segregated, the study found. The relationship is weaker when measuring Latino-white segregation.

The metro areas with the highest composite economic and racial segregation rankings in 2010 were:

– Philadelphia

– Bridgeport, Connecticut

– New York

– Milwaukee, Wisconsin

– Chicago

– Cleveland

– Newark, New Jersey

– Los Angeles

– Kansas City, Missouri

– Detroit

To define a metropolitan area the report uses the census definition of a commuting zone, which is a group of counties whose commuters form a unified regional labor market.

Six of the top 10 were the same in 1990 and 2010. Bridgeport, Los Angeles, Kansas City and Detroit replaced Gary, Indiana, and Houston, Washington and Dallas.

Economic segregation is on the rise

In regions where there is a high level of economic segregation, access to education, jobs, housing and public services is largely concentrated in the areas where high-income people live, and far away from where low-income people live.

This kind of economic segregation can take a toll on the economy of the region as a whole, because it keeps workers away from potential employers.

Places with greater segregation between low- and high-income people also tend to have greater income inequality on the whole.

What does an economically segregated region look like? Take for example New York City, which tops the list. People living in affluent neighborhoods reap the benefits of good schools, low crime rates and access to public services, while those priced out of those areas may have to travel farther for access to services, work or school — if they can afford the trip at all. The result is uneven distribution of wealth, which keeps poor neighborhoods poor and limits potential spillover effects of affluence.

Previous studies have found that economic segregation is higher today than it was in 1970, with the share of Americans living in middle-income neighborhoods dropping from 65% then to 42% in 2009.

The report takes a closer look at the trend. It found that between 1990 and 2000, economic segregation decreased in 92 metropolitan areas. Then, in 2000, the trend began to reverse and from 2000 to 2010, economic segregation increased in 72 areas as high-poverty and high-affluence neighborhoods began to outnumber mixed-class, middle-income neighborhoods.

Racial segregation is slowly declining…

…sort of. Black-white segregation in the 100 metro areas examined in the report dropped on average, from 1990 to 2010, while Latino-white segregation increased.

In general, however, blacks and whites tend to be more segregated from one another than Latinos and whites.

Whites tend to benefit most from high degrees of racial segregation, according to the study. They earn higher wages, complete college at higher rates and get higher-status jobs. Segregation undermines these same outcomes for Latinos and blacks, thereby limiting the segregated region’s potential to boost its overall economic prospects.

Segregation is most detrimental for black people

When people have access to safer neighborhoods and better schools, their educational attainment and job prospects improve, benefiting the entire population of a region, the study’s authors argue. Steady, high-paying jobs increase individual and per capita incomes, which means cash flows back into communities through home ownership, taxes and consumer spending.

When levels of segregation are high in a region, black residents tend to suffer most, the report found.

Higher levels of economic segregation are associated with lower median and per capita income for blacks. Additionally, higher levels of racial segregation are associated with lower incomes and lower educational attainment for blacks.

The effects add up. Higher levels of black-white segregation are associated with lower levels of educational attainment for blacks and whites and lower levels of safety for all area residents.

On the other hand, neither economic segregation nor racial segregation is significantly related to white or Latino median or per capita income.

Using Chicago as a case study, the report’s authors argue reducing racial and economic segregation to the median level could increase black per capita income and educational attainment and lower the homicide rate.

“If actors at the city, county and state levels could break down barriers to local inclusion, entire regions could benefit from higher incomes and education levels and fewer homicides,” the authors write.

Other celebrities battling lupus

Celebrities battling lupus

Celebrities battling Lupus – Selena Gomez’s struggle with lupus has interrupted two of her concert tours and forced her to undergo chemotherapy to control the disease.

Celebrities battling lupus

Celebrities battling lupus

Celebrities battling lupus

Singer Toni Braxton has been hospitalized several times to bring her lupus under control. She told the world about her condition in 2010 and in 2014 wrote “Unbreak My Heart,” a memoir in which she revealed that her uncle died from the disease.

Celebrities battling lupus

“Third Rock from the Sun” star Kristen Johnston had to take a break from work in 2013 when she developed a rare form of lupus that attacks the spinal cord. After chemotherapy, she has said she’s in remission.

Celebrities battling lupus

Soccer star Shannon Boxx has been battling lupus since she was 30 years old. She went public with her condition in 2012, continuing to play for the U.S. women’s soccer team and working with lupus organizations to spread awareness of the disease.

Celebrities battling lupus

The scars of a skin form of lupus left a distinctive pattern on British singer Seal’s face. The singer has battled the disease since he was a child.

Celebrities battling lupus

Former model and “Extra” correspondent Terri Seymour says she nearly lost her life to lupus in her early 20s, and has struggled with flares since.

Celebrities battling lupus

Actress Mary Elizabeth McDonough, best known for her work on “The Waltons,” has been advocating for those with lupus since that time. She struggled with many typical symptoms of the disease for years before getting a diagnosis.

Celebrities battling lupus

John Wayne’s oldest son Michael suffered from lupus for years before dying of complications of the disease at age 68. Michael collaborated with his famous father on several well-known films, such as “The Green Berets” and “The Train Robbers.”

Tennessee kidnapping law could work in teacher’s favor

District Attorney Brent Cooper of the 22nd Judicial Circuit wants to change that, and he hopes state lawmakers consider Elizabeth’s case when they convene next year, he told CNN on Tuesday. Through an attorney, Elizabeth’s father, Anthony Thomas, said he wants the law changed immediately.
The way it’s written now, the statute lets children older than 12 decide whether to leave their families, unless their removal or confinement “is accomplished by force, threat or fraud.”
Police say 50-year-old Tad Cummins, who taught Elizabeth in a forensics class at Culleoka Unit School, absconded with the freshman March 13, weeks after a student claimed to see the two kissing in Cummins’ classroom.

The investigation led authorities to Decatur, Alabama, later that day before the two vanished.

As it stands, to prove the kidnapping of a victim who is 12 or older, Cooper said, he’d have to prove that Elizabeth was unlawfully removed or had her freedom restricted.

Further, to prove that Elizabeth was unlawfully removed, he’d need to demonstrate to a jury that Cummins employed “force, coercion, fraud or something to that effect,” the prosecutor said.

“What we run into here, of course, is this child is 15 and, according to reports, at least initially, she left of her own free will,” he said.

The issue was especially concerning at the outset of the investigation, Cooper said. Cummins was charged only with sexual contact with a minor by an authority figure, a misdemeanor. Investigators worried that if police stopped the pair out of state, they’d be released because authorities couldn’t detain them, let alone extradite Cummins, on a misdemeanor warrant.

Cooper ultimately felt comfortable adding the aggravated kidnapping charge after deciding that Cummins allegedly groomed his victim and was armed, the latter being a prerequisite for aggravated kidnapping. (Grooming is the act of establishing a connection with a child with the goal of defusing her or his inhibitions toward sexual abuse.)

The prosecutor says the present law could pose obstacles once he has Cummins in a courtroom.

“Under current law, it’s really going to depend what the testimony of Ms. Thomas is,” Cooper said, explaining that if she claims she left on her own volition, the defense will argue Cummins is not guilty of kidnapping.

Cooper will then have to introduce circumstantial evidence that Elizabeth was coerced. The district attorney is confident the communications between Elizabeth and Cummins show “he was definitely trying to influence her in his favor,” he said.

“This grown man was using his knowledge and life experience to basically attract her and to convince her to be with him,” he said.

In discouraging anyone who might blame Elizabeth for her plight, Tennessee Bureau of Investigation Director Mark Gwyn, too, discounted the notion that there was a mutual romance.

“She is 15, a child. He is 50, a grown man. This is and was not a romance. This was manipulation solely to the benefit of Tad Cummins,” Gwyn said.

Attorney Jason Whatley, who is representing Elizabeth’s father, told CNN the kidnapping statute might not matter in Cummins’ case, especially if he crossed state lines with Elizabeth. He predicted the ex-teacher would face “scores of charges once we find him.”

“I think Tad Cummins will have violated so many laws, I think he’s finished,” Whatley said.

Elizabeth Thomas: The 15-year-old has light brown or blond hair and hazel eyes. She is 5 feet 5 inches tall and weighs 120 pounds. She was last seen wearing a flannel shirt and black leggings.

Tad Cummins: The 50-year-old has brown hair, brown eyes and a gray goatee. He is 6 feet tall and weighs about 200 pounds. He is believed to be armed.

Vehicle: Silver Nissan Rogue, Tennessee tag 976-ZPT

Reward: $1,000

Who to call: 1-800-TBI-FIND

Source: Tennessee Bureau of Investigation

The Tennessee Legislature is already in session, and the deadline for introducing legislation has passed, Cooper said. Before lawmakers convene again in January, the prosecutor intends to meet individually with legislators to convince them the law needs changing, he said.

An ideal law, he said, would presume that if the victim were younger than 18, she or he could not leave on their own accord. It would be similar to statutory rape laws that place the onus on adults not to break the law, he said.

Whatley says he concurs the law needs to be changed, but as a lawyer who also does defense work, he has reservations about the age limit. He’d hate seeing an 18-year-old accused of kidnapping for taking a 17-year-old on a date after the 17-year-old’s parents forbade it, he said.

Perhaps the correct age is 16 and above, he said, suggesting that the amendment be called “Elizabeth’s Law.”

Amending the law makes sense, Cooper said, when you consider that, in Tennessee, children younger than 18 can’t consent to sex, rent cars or enter into legal contracts.

“This is a much bigger life choice than trying to buy a car,” he said of Elizabeth’s case. “I think it would be a simple fix.”

Walk through Mosul devastation

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They want President to stick to leading the country

But there’s one tweet that several assembled Trump voters — who expressed varying degrees of enthusiasm for the President — could agree on.

According to many of his supporters, Trump was wrong about “Saturday Night Live” being unwatchable and Alec Baldwin’s impersonation not being good.

“He has no sense of humor,” one tweeted.

“Humor at its best,” another said.

“Alec Baldwin did a fabulous job!”

Trump has more than 27 million followers on his personal Twitter account, @realDonaldTrump. Another 16 million people follow his official presidential account, @POTUS.

To some, including Trump himself, Twitter offers a chance to bypass media that they see as biased or dishonest — and an opportunity for the country’s leader to engage with the masses in the moment.

“I feel it’s a great way to reach out to your constituents and create a give-and-take, because people obviously respond to his tweets, retweet the tweets,” said Ilene Wood of Emmaus, Pennsylvania. “In general, I’m in favor of it.”

Emma Leach, who became a die-hard fan of then-candidate Trump after attending a campaign rally in Wilkes-Barre, Pennsylvania, says Trump’s use of Twitter energizes younger people, such as herself.

A few years ago, Leach said, she could have asked a friend what Obama did in office that day, and she wouldn’t have known.

“But today she’ll know what Trump tweeted or what Trump did or what executive order happened,” Leach said. “She’s involved now.”

Of the Trump voters that CNN spoke with in eastern Pennsylvania, two months into Trump’s term, most didn’t mind that the President uses such an unorthodox method of communication.

“It’s like a modern-day constituent letter,” Leach said. “They’re tweeting at their president, they’re voicing their opinion, and they’re more politically involved.”

But the immediacy is a double-edged sword.

“In some situations, that’s an excellent thing because he’s able to get the word out very quickly and perhaps get reactions and responses back,” said Wood. “But at the same time, it creates a possibility of engaging your mouth before you’ve engaged your brain.”

Scott McCommons of Altoona, is a lifelong Democrat who crossed party lines to vote for Trump and follows Trump on Twitter.

“I think he rants and raves. He doesn’t think about it,” said McCommons, who said his opinion of Trump has changed for the worse, in large part because of his tweeting. “I think he can do a lot better things with his time.”

McCommons said he now regrets his vote, going so far as to tweet at Trump, “Your twitter rants are out of control – I voted for you to make America great again, run the country sir!”

It’s not Twitter, It’s the topic

It’s a common theme among these Trump supporters: they wish the President would stick to the theme of leading the country.

“He needs to tone it down and forget about Snoop Dogg, forget about Arnold Schwarzenegger. We don’t really care about them, do we?” said Ray Starner, who always wanted to see a businessman lead the country. Now, Starner said he would prefer to see Trump focus on jobs, health care and uniting the country.

Also taking a toll on Trump’s base? Baseless accusations.

Several supporters expressed disappointment at Trump for tweeting before he has all the facts, including his tweet, “How low has President Obama gone to tapp my phones during this sacred election process. This is Nixon/Watergate. Bad (or sick) guy!”

Mark Hanna is a former law enforcement officer who follows the news, but not all of Trump’s tweets. When he saw media reports about the wire tapping accusations, he said: “Even if he felt that way, I don’t think he should have tweeted it.”

Trump’s tweets offer some insight into the President’s thinking and the man himself, and his use of social media can even supplement mainstream media.

Checking Twitter became a regular part of McCommon’s day, he said. “It used to be my favorite thing to do in the morning because I wanted to see what he had to say. I wanted to see if it matched up with what I heard on TV, from the news media, from his press conferences, to see if he was being honest.”

While supporters might not trust everything the President tweets, they generally have faith in Trump himself.

It was just last Thanksgiving that Hanna heard of Twitter for the first time. By the evening’s end, his son had set up a Twitter account for him.

“My first tweet was to Donald Trump, at the dinner table. I said ‘Congratulations on winning the election, and I’m looking forward to you leading our country,'” Hanna said.

It’s a sentiment he still holds.

“The good far outweighs the bad to me,” Hanna said. “I’m thinking Trump 2020.”

Wife posts nude pic of QB on social media

Nam Y. Huh/Associated Press

Scott PolacekFeatured ColumnistMarch 28, 2017

Quarterback Jay Cutler appears to be enjoying the NFL offseason.

His wife Kristin Cavallari posted an NSFW picture of him enjoying a view of the sea on her Instagram page. Sports Illustrated shared a safer version:

 

Cavallari previously noted on her Instagram page they were moving from Chicago after the Bears released Cutler.

The 2008 Pro Bowler is now without an NFL team at the moment, but he doesn’t seem too stressed about it.

What causes asthma?

Asthma affects 8% of American adults—nearly 19 million people. Almost 7 million children have asthma, too, according to the Centers for Disease Control and Prevention (CDC).

No one knows with absolute certainty what causes some people to develop asthma, but as the Asthma and Allergy Foundation of America notes, the condition does run in the family. Certain people with a family history of asthma and allergies seem predisposed to developing this chronic inflammation of the lungs, suggesting that heredity plays a role. Most experts believe a combination of genetic and environmental influences are responsible.

It’s frightening to experience an asthma attack—but being prepared with tools and strategies, plus avoiding known triggers, can help bring you back to normal.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Jan 19, 2016

2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

Additionally, some people develop asthma in adulthood. You could be 40, 50 or even 60 years old and still develop asthma. Many cases of adult-onset asthma are linked to allergies—allergies to pets, cigarette smoke, mold and other substances are often triggers for these cases. Other cases are linked to obesity and various illnesses such as influenza. Women are also at greater risk of developing asthma as adults—some research suggests that hormonal fluctuations may play a role. 

While we don’t know exactly why asthma develops, we do know common triggers that can make symptoms worse. Asthma is different in everyone, which is why it’s important to identify your specific triggers so you can avoid them. 

Because they have very sensitive airways, people with asthma are extra sensitive to certain triggers. When you’re exposed to your particular trigger, your airways respond by swelling and getting inflamed. The muscles around them might even tighten up. These reactions make it hard to breathe. 

From the day we are born we are exposed to many different allergens. Our individual immune system processes these allergens, resulting in tolerance or sensitization. For example, you might be super-sensitive to an allergen like pollen or pet dander. You walk into the home of a friend who owns a cat and almost immediately you can feel your chest tighten up. Or your trigger could be an irritant in the air, like smoke or strong fumes.

Other triggers include:

Respiratory infections. Colds, flu and sore throats frequently precede asthma flare-ups, especially in children. To reduce your chances of contracting the flu, get a flu vaccination each autumn.  

Dust. Dust and dust mites are inevitable in your home, but that doesn’t make life any easier on people with asthma who are sensitive to them. The CDC recommends avoiding down-filled bedding and pillows and putting covers on your mattresses and pillows to create a barrier between you and those dust mites. You could also install air filters in your home and use a vacuum cleaner equipped with a HEPA filter.

Mold and mildew. Mold grows as a result of moisture in the air, and breathing in that mold can trigger an attack. Reduce the amount of humidity in the air by using a dehumidifier or air conditioner, and fix any water leaks immediately.

Cold air.  Cold, dry air is notorious for causing asthma to get worse. The cold air irritates your airways, making them shrink up, so it’s hard for you to breathe. Try to avoid spending time outside when it’s really cold.

Exercise. The technical term for this is exercise-induced bronchoconstriction. You may know it from the way your chest gets tight or your breathing becomes labored when you’re running or playing a sport. If you have this trigger, your doctor will likely prescribe an inhaled medication for you to take before exercising, such as a short-acting beta agonist (SABA) or ipratropium that will help open your airways.

Cockroaches. As if there weren’t enough reasons to hate them, cockroaches can make your asthma worse. Cockroach excrement and dust can trigger bronchial inflammation. Put your exterminator on speed dial.

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Nov 23, 2015

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