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Asthma/Moving to Phoenix- Asthma


QUESTION: Hi Dr Rubin,

I am moving to Phoenix, AZ to be with family and friends. I had lived in Phoenix 15 years ago and left because of my asthma.
I have recently met a girl who is from Arizona. We live in the midwest now. She wants to move back to phoenix and I do too because my family and her family live there. I have been gone for a long time and want to go back.
However, phoenix almost killed me when I lived there 15 years ago. I got pneumonia and some nasty illnesses living there.

My asthma is bad. And the dust and pollution is bad there too.

Any suggestions? Should I move back and risk my health for my family or move somewhere else and not be near family and save my health?

Its extremely frustrating to live like this.

Thanks, Todd

ANSWER: Happy Mother's Day Todd!
  My first concern is how your asthma is controlled right now. If you are only using your rescue inhaler twice a week or less during the daytime hours, and have nighttime awakenings no more than twice a month, we are off to a good start. Now, what is your present daily treatment regimen? Therapy has changed dramatically since you lived there last, and there are new options that might be perfect for you. As soon as I hear back on what you are on, and very importantly, how good are you at sticking to the program, I'll be able to give you direction.
  In the meantime, think positive, and enjoy the day!



---------- FOLLOW-UP ----------

QUESTION: Hi Dr. Marc,

My asthma is controlled now. I had a bout of asthma a dfew week ago due to the pollen and wind here in Iowa. But I am much better.
I am taking Pulmicort Flexhaler 180 mg twice a day.
I use my Ventolin (albuterol) 90mcg three times a week. I wake up once every two weeks short of breath. However, the air is clean here, except for the high pollen.
Arizona has lower pollen counts, but higher pollution. The dust is what concerns me. Dust storms are pretty nasty other there. Dust is what I am highly allergic too.
So I am trading pollen for pollution.
Phoenix, Arizona has bad air. But like you said therapy has changed dramatically since 2000. That was 13 years ago and medicine is advancing as quickly as technology.

So I since I do not have insurance I will check in with Maricopa County in case I have a flare up. Any ideas would be helpful.
I also put 3M dust masks in my car and apartment as well just in case there is a dust storm out there.

Happy Mothers Day!


Hi Todd,

If you are using your Ventolin three times a week, you are not in good control. Contact the health unit you go to regarding stepping up your therapy. Also, I'd strongly suggest you are also put on a nasal steroid spray for your sinuses. When the sinuses are inflamed, it also triggers the lungs. If you are having problems now in Iowa, it will be worse in Phoenix.

For financial aid with your meds, if you do not have any health insurance, the pharmaceutical manufacturers have their own assistance program. go to:   

You can contact them by phone as well as email through the site. If you qualify, you should be able to have access to the meds you need to take near complete control.  Also, to do a proper self-evaluation, there is a good tool to help achieve your goals. It is called the Asthma Control Test (ACT) and gives you and the health provider great guidance on your progress.

If you go to Phoenix, will you have financial support or healthcare access? Working with a caring allergist, you should be able to get your asthma under control and do well. It is of great benefit to learn as much about your condition as possible. At the website for the American Academy of Allergy, Asthma and Immunology are wonderful patient resources to gain knowledge and control of the disorder.

By the way, the therapeutic approach I'm looking at for you, if your qualify, is a product called Xolair. It is an injectable administered in the allergists office, and is used for severe cases. For the most part, most of the other asthma meds no longer are needed, with the exception of your rescue inhaler. But this therapy and additional meds to add on are for a complete evaluation by an allergist. This drug is very expensive, but is covered in the PPARX program if you meet the qualifications.

Hope this helps you!

Any questions, feel free to get back to me.




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Marc Rubin, RPh Asthma Educator


I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.


Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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