Due to the COVID-19 pandemic we have updated our protocols:

All appointments will be over the phone except testing, which will be done in the office.

Corona: Shots will be administered on Monday & Wednesday. Upon arrival, text (951) 523-0741 and wait in your car.

Riverside: Shots will be administered on Tuesday & Thursday. Upon arrival, text (951) 523-0741 and wait in your car.

Murrieta: Shots will be administered on Tuesday & Friday. Upon arrival, text (951) 666-3060 and wait in your car.

Asthma / Cough Triggers


Asthma is a chronic lung disease that affects more than 17 million Americans. Coughing, chest tightness, shortness of breath and wheezing characterize asthma. If you have asthma, you can minimize your symptoms by avoiding the factors that trigger them and with an effective management and treatment plan. Allergic rhinitis, or “hay fever” is considered a risk factor in developing asthma; up to 78% of people with asthma also have allergic rhinitis.

Triggers of Asthma

Asthma symptoms can be triggered by several factors, including:

Irritants and air pollutants such as tobacco smoke, wood smoke, chemicals in the air and ozone; occupational exposure to allergens, vapors, dust, gases or fumes; strong odors or sprays such as perfumes, household cleaners, cooking fumes (especially from frying), paints or varnishes; other airborne particles such as coal dust, chalk dust or talcum powder. Changing weather conditions, such as changes in temperature and humidity, barometric pressure, or strong winds.

Viral or sinus infections especially in young children are common triggers. Strenuous physical exercise such as medium- to long-distance running can increase the likelihood of exercise-induced asthma (ETA). Mouth breathing, exercising in cold and dry air can also trigger asthma. Swimming is the best exercise if you have asthma or develop symptoms with other forms of exercise.

GERD (Acid Reflux) affects up to 89% of patients with asthma. Symptoms include severe or repeated heartburn, belching, night asthma, increased asthma symptoms after meals or exercise, or frequent coughing and hoarseness. Treatment of GERD reflux is often beneficial for asthma symptoms as well.

Medications or Foods: Some adults may experience an asthma attack as a result of taking certain medications. These can include aspirin or other non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and beta-blockers (used to treat heart disease, high blood pressure or migraine headaches). In about 6-8% of children with asthma eating certain foods or various food additives can trigger asthma symptoms. These include milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. If any of these foods trigger asthma attacks, the best solution is to identity them by skin allergy testing and avoid eating them.

Emotional Factors & Anxiety: Emotional factors alone cannot provoke asthma. Anxiety and nervous stress can cause fatigue, which may also increase asthma symptoms and aggravate an attack.

Diagnosis and Management

Patient history and physical exam along with the pulmonary function is the tool of asthma diagnosis & management. Since asthma is a chronic disease, it requires continuous management and appropriate treatment.

The five main components of asthma management are:

The use of objective measures of lung function (such as peak flow meters and Spirometer) to assess the severity of asthma and to monitor the course of treatment.

Environmental control measures to avoid or eliminate factors that trigger asthma symptoms or flare-ups.

Allergy testing to identify the culprit & avoidance of it is key

Medication therapy for long-term management to minimize airway inflammation as well as therapy to manage asthma flare-ups

Patient education

Exercising with Allergies and Asthma

Exercise is always encouraged for people with allergy and asthma and, generally, patients with either are just as able, physically, as everyone else. World class athletes and Olympians have allergies and asthma. However, exercise should not be done during times of sickness and a patient should not go beyond their capabilities.

For people with asthma, exercise that has stop-and-go activity tends to cause less trouble than exercise involving long periods of running. Swimming seems to be the easiest form of exercise for people with asthma. Weather conditions also are important. Cold air and very dry air can be quite irritating to the bronchial tubes. Warm, moist air generally allows people with asthma to exercise successfully. Avoid exercising around allergens and common irritants like car exhausts. Areas with high amounts of pollutants in the air can also cause irritation. The best time of day to exercise would be just after sunrise.

For people with asthma an inhaler can be used before exercise to prevent asthma problems. The type of medication used depends on several factors. For example, people with hay fever might take an antihistamine tablet before exercise while others may use inhalers.