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Results for search "Asthma".

26 Nov

Childhood Asthma and Obesity

Being Obese Significantly Increases The Risk of Childhood Asthma.

Health News Results - 86

THURSDAY, June 20, 2019 (HealthDay News) -- In an effort to improve the lives of millions of people with asthma, researchers say they've completed the first mapping of lung and airway cells, which may lead to new therapies for the common lung condition.

The mapping reveals differences between airways in people with and without asthma, and in how lung cells communicate with one anoth...

TUESDAY, June 11, 2019 (HealthDay News) -- If you or a family member has asthma, your doctor has most likely mapped out the steps you need to take to treat an asthma flare.

Creating a healthier home by minimizing your triggers can be as effective as medication for reducing symptoms and flares, according to a study from the American Academy of Pediatrics.

Triggers include in...

WEDNESDAY, May 29, 2019 (HealthDay News) -- Clean-air taxi rules in New York City increased cabs' fuel efficiency and reduced air pollution, a new study says.

Legislation introduced in 2006 required at least 9% of new medallions, or licenses, for yellow cabs be set aside for hybrid or compressed natural gas vehicles. It also encouraged companies to purchase low-emission taxis.

...

TUESDAY, May 21, 2019 (HealthDay News) -- Air pollution levels have been declining for years, and researchers can now show that cleaner air is linked to fewer kids developing asthma.

The new study looked at nine California communities. The researchers found that reductions in certain pollutants were tied to about a 20% reduction in the odds of children developing asthma, a chroni...

TUESDAY, May 21, 2019 (HealthDay News) -- A widely used type of asthma medication may not work in more than half of patients who are prescribed it, new research shows.

Inhaled corticosteroids, which are designed to reduce airway inflammation, are recommended for all patients with persistent asthma.

But this medication's effectiveness may be limited to a type of inflammation ...

THURSDAY, May 9, 2019 (HealthDay News) -- Summertime can bring asthma sufferers a lot of misery, but lung experts say watching for warning signs of breathing trouble can guard against serious complications.

"As the leading organization working to save lives by improving lung health, we think it's crucial for people with asthma to know as much as they can about the disease," said Dr. D...

MONDAY, May 6, 2019 (HealthDay News) -- Many children deal with chronic health issues -- but it doesn't mean they can't enjoy life as much as other kids, a new study finds.

Researchers found that among more than 1,200 5- to 9-year-olds, those with some of the most common childhood ills were no less happy with their lives than other kids.

They said the findings highlight an i...

TUESDAY, April 30, 2019 (HealthDay News) -- Asthma inhalers can't do the job if they're not used correctly. And that's an issue for many children, U.S. researchers say.

"We know from past studies that both parents and children overestimate the ability of children to properly use their inhaler," said study author Dr. Anna Volerman, from the University of Chicago.

The study in...

TUESDAY, April 23, 2019 (HealthDay News) -- Even though asthma is common in the United States, there are many misconceptions about the respiratory disease, an allergy/immunology expert says.

"Asthma is a serious condition that affects more than 26 million Americans -- more than 8% of the population," Dr. Todd Mahr, president of the American College of Allergy, Asthma and Immunolog...

FRIDAY, April 19, 2019 (HealthDay News) -- Many children with asthma don't use their inhalers properly and don't get a full dose of medicine, researchers report.

They evaluated inhaler use among 113 children between the ages of 2 and 16 who were hospitalized for asthma. Such patients are at highest risk for complications and death from asthma.

At least one crucial step in in...

WEDNESDAY, April 10, 2019 (HealthDay News) -- Traffic pollution causes about 4 million new asthma cases in children worldwide each year, new research shows.

Two-thirds of these kids live in urban areas, according to the study by researchers at George Washington University in Washington, D.C.

"Our findings suggest that millions of new cases of pediatric asthma could be prev...

MONDAY, March 11, 2019 (HealthDay News) -- Kids with poorly controlled asthma struggle in school, especially those who are ethnic minorities, a new study reports.

Researchers evaluated asthma and allergy status, lung function and school performance of 216 black, Hispanic (Latino) and white children in a U.S. city.

Those with a greater number of daily asthma symptoms had more...

THURSDAY, Jan. 31, 2019 (HealthDay News) -- The first generic version of the widely used Advair Diskus inhaler for asthma and chronic obstructive pulmonary disease (COPD) has won U.S. Food and Drug Administration approval.

This approval "is part of our longstanding commitment to advance access to lower cost, high-quality generic alternatives," said Dr. Janet Woodcock, director of the ...

TUESDAY, Jan. 29, 2019 (HealthDay News) -- Fish oil did not improve asthma control in overweight/obese young people with uncontrolled disease, a new study shows.

It included 98 participants, aged 12 to 25, who had diagnosed asthma but poor asthma control, despite using a daily inhaled corticosteroid.

Three-quarters of the participants took four grams of fish oil a day for si...

WEDNESDAY, Jan. 9, 2019 (HealthDay News) -- Add another danger that e-cigarettes pose to teenagers: A new study finds secondhand exposure to vaping may raise the chances of asthma attacks in adolescents with the respiratory condition.

Middle school and high school students with asthma were 27 percent more likely to have suffered an asthma attack if they'd been exposed to vapor from so...

WEDNESDAY, Jan. 2, 2019 (HealthDay News) -- For many city-dwelling teens with asthma, their chronic lung disease may go undiagnosed and untreated, a new study finds.

According to a survey of more than 33,000 New York City high school students, 20 percent reported having asthma-like symptoms, but were not diagnosed with the illness.

The researchers...

THURSDAY, Nov. 29, 2018 (HealthDay News) -- A 6-year-old boy with severe asthma wasn't responding to the usual treatments. It was only when family members stopped smoking marijuana at home that his breathing got better, according to his doctor.

The boy's case shows that exposure to secondhand pot smoke can worsen asthma in children who have a marijuana allergy, a new study reports.

MONDAY, Nov. 26, 2018 (HealthDay News) -- Do so-called hypoallergenic dogs really protect you against asthma?

Many dog-lovers believe it, but Swedish researchers found no evidence that "allergy-friendly" breeds -- such as poodles and miniature Schnauzers -- actually lower the risk for the wheezing lung disease.

Previous studies have shown that growing up with dogs can reduc...

MONDAY, Nov. 26, 2018 (HealthDay News) -- The wheezy lung disease asthma is yet one more problem linked to excess weight in childhood, a new study suggests.

The research contends that as many as 10 percent of pediatric asthma cases in the United States could be avoided if childhood obesity were eliminated.

"There are very few preventable risk factors for asthma -- obesity ...

FRIDAY, Nov. 16, 2018 (HealthDay News) -- The "hygiene hypothesis" holds that early exposure to a variety of microorganisms may decrease the risk for chronic inflammatory diseases, like asthma.

Two Swedish studies that tracked 650,000 children found that exposure to farm animals and even dogs can have this kind of beneficial effect. Living on a farm cut kids' asthma rate by half. Just...

THURSDAY, Nov. 15, 2018 (HealthDay News) -- If you live in Maine and you've never experienced hay fever, new research predicts that climate change has an unwelcome surprise in store for you.

Warmer temperatures in the northern United States will allow ragweed -- the plant that triggers hay fever -- to flourish in areas it's never been before. About 35 years from now, the study predict...

WEDNESDAY, Oct. 24, 2018 (HealthDay News) -- Children with asthma who live in areas with dirty air require emergency medical care more often than those with less exposure to air pollution, a new study finds.

The Columbia University study included nearly 200 children with asthma in New York City, ages 7 to 8. They came from middle-class families in four of the city's five boroughs: the...

WEDNESDAY, Oct. 24, 2018 (HealthDay News) -- Polluted air may trigger as many as 33 million asthma-related emergency room visits globally each year, a new study finds.

"Millions of people worldwide have to go to emergency rooms for asthma attacks every year because they are breathing dirty air," said study lead author Susan Anenberg, of George Washington University in Washington, D.C....

MONDAY, Oct. 15, 2018 (HealthDay News) -- In the flooding and devastation left by Hurricane Michael, Americans faced with the clean-up are facing a new health threat: mold.

Mold-related illnesses are a serious concern following severe flooding in the path of the storm, say experts from the University of Connecticut School of Medicine.

"Where there's dampness and water, ther...

FRIDAY, Oct. 12, 2018 (HealthDay News) -- Children with asthma are at increased risk for childhood obesity, a new study suggests.

Obesity is widely regarded as a risk factor for asthma, but these new findings suggest the reverse is true, too, according to the researchers.

The study authors analyzed data from more than 21,000 children in nine European countries who were diagn...

THURSDAY, Sept. 20, 2018 (HealthDay News) -- In the aftermath of Hurricane Florence, residents of the Carolinas are facing a new health threat: mold.

Mold-related illnesses are a serious concern following severe flooding in North and South Carolina, say experts from the University of Connecticut School of Medicine.

"Where there's dampness and water, there's mold," said Paul...

FRIDAY, Sept. 14, 2018 (HealthDay News) -- Doctors have long known that obesity increases the risk for developing asthma, but new research suggests the opposite also may be true.

Scientists in Spain found that people with asthma are at greater risk for obesity, particularly those who develop the condition as adults and those diagnosed with asthma without allergies.

"We alrea...

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- A drug that has long been used in Japan for asthma may slow down brain shrinkage in people with progressive multiple sclerosis, a preliminary trial has found.

The study, published Aug. 30 in the New England Journal of Medicine, tested an oral drug called ibudilast. It is not approved in the United States, but has been used for years ...

MONDAY, Aug. 20, 2018 (HealthDay News) -- Most new mothers in the United States start out breastfeeding, but many stop sooner than recommended, a new federal government report says.

Of the nearly 4 million babies born in 2015, about 83 percent started out breastfeeding, but fewer than 36 percent were still breastfeeding at 12 months, according to the U.S. Centers for Disease Control a...

FRIDAY, Aug. 10, 2018 (HealthDay News) -- More than 4 in 10 women with asthma developed chronic obstructive pulmonary disease (COPD), and heavy smoking and obesity were among the significant risk factors, a new study found.

The research involved more than 4,000 women with asthma in Canada who were followed for about 14 years after being diagnosed with the condition. During that time, ...

WEDNESDAY, Aug. 8, 2018 (HealthDay News) -- Only about half the parents of asthmatic preschoolers had the right knowledge and medicines on hand to treat their child's breathing condition at home, a new study found.

And one-third of those children had empty inhalers, the researchers reported.

"The inability to treat asthma could lead to emergency department visits," explaine...

TUESDAY, Aug. 7, 2018 (HealthDay News) -- Allergies and asthma can make the start of the new school year a challenge for kids who aren't prepared to deal with flare-ups, an allergist warns.

"Every age group is different in how much they can handle when it comes to protecting themselves from flare-ups due to allergies and asthma while at school, as well as s...

FRIDAY, July 13, 2018 (HealthDay News) -- Need another reason to eat healthy? New evidence bolsters the notion that nutritionally rich foods might help prevent or minimize asthma.

While the study couldn't prove cause and effect, one asthma specialist said there's certainly no downside to eating better.

"The health benefits of a diet rich in plant foods and unprocessed foods ...

MONDAY, June 11, 2018 (HealthDay News) -- Children may be more likely to develop asthma if they live in neighborhoods where it's difficult to get around on foot, a new study suggests.

Researchers analyzed data from more than 326,000 children in Toronto who were born between 1997 and 2003, and followed them until the ages of 8 through 15.

Twenty-one percent of the children de...

THURSDAY, June 7, 2018 (HealthDay News) -- Having tonsils removed in childhood is supposed to end chronic earaches and breathing problems. But what if it also increases risk of respiratory infections?

"We found that long-term risks of diseases -- in particular respiratory, allergic and infectious diseases -- were substantially increased after surgery up to 30 years of age," said Sea...

MONDAY, June 4, 2018 (HealthDay News) -- An annual flu shot is key for children with asthma, a new study shows.

"We now know that if these kids get the flu, the risks are very high that emergency treatment for an asthma attack will fail," said study co-author and pediatrician Dr. Francine Ducharme.

"Instead of having an 18 percent risk of treatment failure, with flu their ri...

THURSDAY, May 31, 2018 (HealthDay News) -- Perhaps assuming that e-cigarettes are "safer" than tobacco, teens with asthma now vape at higher rates than those without the respiratory condition, new research shows.

However, "the use of products containing nicotine in any form among youths -- including electronic cigarettes -- is unsafe," said study author Keshia Reid, a senior environ...

FRIDAY, May 25, 2018 (HealthDay News) -- Lots of things grow in the spring, including your risk of severe allergic reactions and asthma attacks. So people need to take preventive measures and know when to seek medical care, an emergency physician says.

"Spring tends to bring more people to the emergency department," Dr. Paul Kivela, president of the American College of Emergency Phys...

TUESDAY, May 15, 2018 (HealthDay News) -- American kids are taking fewer prescription medications these days -- but certain drugs are being prescribed more than ever, a new government study finds.

Researchers found that between 1999 and 2014, the percentage of children and teenagers who'd been given a prescription in the past 30 days dipped -- from almost 25 percent, to just under 22 ...

THURSDAY, May 10, 2018 (HealthDay News) -- Exercise can help prevent many chronic illnesses as well as make it easier to manage health conditions, from diabetes to joint pain.

In terms of prevention, aim for the recommended 150 minutes of exercise, like brisk walking or cycling, each week. Along with eating a healthy diet, this can cut your risk of diabetes by more than a third, plus ...

MONDAY, May 7, 2018 (HealthDay News) -- Clouds of pot and cigarette smoke in a home make it more likely a young child will visit the emergency room or have an ear infection, researchers say.

Secondhand smoke from marijuana and tobacco increases a kid's odds of going to the ER, according to preliminary findings from a Colorado study.

"Those kids have an average of two-and-a-...

FRIDAY, April 13, 2018 (HealthDay News) -- Breathe easy, Mom and Dad. Sending your young children to preschool or day care probably won't increase their risk of developing asthma.

In fact, researchers report, it may help protect your kids against the respiratory disease.

Investigators at the University of California, San Francisco (UCSF) based that conclusion on an analysis ...

THURSDAY, April 12, 2018 (HealthDay News) -- If you suffer from allergies, you already know that pollen is in the air -- even in the parts of the United States with unseasonably cool temperatures. So what kind of allergy season can we expect this year?

Will we see a return of the pollen vortex? Might we have a blooming bombogenesis of pollen?

Don't scoff: There is some evi...

MONDAY, April 9, 2018 (American Heart Association) -- Having asthma as a child is associated with developing stiff arteries earlier in adulthood, according to a new study.

The study, published Monday in the journal Hypertension, sought to explore the link between asthma, a chronic lung disease that makes breathing difficult, and stiff arteries, which is associated with heart d...

MONDAY, April 2, 2018 (HealthDay News) -- Babies who are given antacids or antibiotics during their first 6 months of life may have a sharply higher risk for allergies or asthma, a large new study warns.

The finding is based on an analysis of health records of more than 792,000 children born between 2001 and 2013.

While the study does not prove that the medications cause all...

TUESDAY, March 27, 2018 (HealthDay News) -- Children born to mothers who smoked during pregnancy are apt to have breathing issues in childhood and beyond, a new study has found.

The finding comes from the analysis of data on more than 2,000 U.S. children, ages 6 to 11. Nearly 10 percent of the children -- those who had asthma and those who didn't -- had reduced lung function.

<...

SATURDAY, March 3, 2018 (HealthDay News) -- Temporarily boosting the dose of inhaled steroids may not do much to reduce the frequency of severe asthma flare-ups in children, according to two new studies.

Short-term increases in inhaled steroids might even be tied to slightly slowed growth in kids, one of the studies suggested.

Asthma flare-ups in...

MONDAY, Feb. 26, 2018 (HealthDay News) -- There may be a link between asthma in women and changes in levels of female hormones such as estrogen and progesterone, researchers report.

That could help explain why asthma is more common in boys than girls in childhood, but more common in females after puberty, according to the Scottish investigators.

They reviewed more than 50 st...

WEDNESDAY, Feb. 14, 2018 (HealthDay News) -- Asthma and allergies can put on damper on your Valentine's Day romancing, an expert warns.

"Keeping everyone free of allergy and asthma flare-ups helps keep the focus on romance this Valentine's Day. Red or itchy eyes, runny noses, coughs and fatigue can ruin your celebration," Dr. Bradley Chipps, president of the American College of Allerg...

TUESDAY, Feb. 6, 2018 (HealthDay News) -- Fewer U.S. children are having to deal with asthma attacks in recent years, federal health officials reported Tuesday.

That also translates into fewer missed school days and hospital visits, the researchers noted.

In fact, the number of kids with asthma who had one or more asthma attacks in the past year dropped from nearly 62 perce...

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Wellness Library Results - 26

Pregnant women don't just eat for two -- they also breathe for two. If you have asthma, remember that your baby is counting on you for oxygen. When you're struggling for air, your baby is feeling your pain very directly. That's why controlling your condition is more important than ever. By keeping your asthma in check, you can give your baby an excellent start. Will my asthma put my baby at risk?...

When a person has asthma, a bout of depression or anxiety can trigger attacks and make the disease much harder to manage, according to recent research. Studies have found that asthmatic children suffering from psychological distress need higher doses of medication and spend more time in the hospital than other children with asthma. "When I see patients who are having severe attacks, I always ask t...

An estimated 20 million Americans currently have asthma, and government health officials report that that number is rising as our air becomes dirtier with pollutants and other irritants. For severe asthma sufferers, having an attack feels like breathing through a straw, yet many people don't think the problem is serious enough to consult a doctor. If you're a chronic asthma sufferer, ask your doct...

What is asthma? Most people associate asthma with sudden fits of coughing and wheezing, but the disease is actually present 24 hours a day. If your teenager has asthma, the tubes that carry air to her lungs are inflamed and may be swollen and clogged with mucus. This state may not impair her breathing, but it does set the stage for asthma attacks. Her inflamed airway is extra sensitive, and somet...

Poor air quality and the depletion of the ozone layer is a constant focus of news -- and not always good. Fortunately, the Environmental Protection Agency says we're making progress in reducing the six key pollutants in our air, including carbon monoxide, lead, and ozone. The bad news is that while the outside air is improving, the air we breathe indoors may be getting worse. Workers have fallen...

What is asthma? Most people associate asthma with sudden fits of coughing and wheezing, but the condition is a round-the-clock disease. If your child has asthma, the tubes that carry air to her lungs are inflamed and may be swollen and clogged with mucus. This state may not impair her breathing, but it does set the stage for asthma attacks. The inflamed airway is extra sensitive, and something a...

More than seven million children in the United States have asthma. They're everywhere. Look at a soccer field, walk in a mall, or take in a Saturday matinee, and you're practically guaranteed to see asthmatic kids. You'd just never know it by looking at them. Children with asthma don't have to spend their days at home, wheezing and out of breath. In fact, the condition doesn't even have to slow ...

If your child has asthma, a simple wheeze can be the worst sound in the world. Naturally, you'd do anything to prevent asthma attacks, but how do you go about it? You don't have to watch him 24 hours a day or even slow down his activities. With the right treatments -- and a few changes around the house -- your child can breathe easily and life can get back to normal. What is an asthma attack? ...

When a young soccer player has a wheezing fit on the field, you can bet there's an extremely worried parent on the sidelines. What can a parent do when a child's favorite sport sets off asthma attacks? The natural reaction may be to pull him off the team and have him do something safer, like play video games. After all, no parent wants to hear a child wheeze and gasp. But before you make your ch...

Using an inhaler seems so simple: You push the button, you breathe in the medicine, you feel better. But are you really getting as much medicine as you need? Many people use their inhalers improperly, making it harder for them to control their asthma. Take this short quiz to see how much you know about these often-misused devices. 1. All metered dose inhalers (the most common type) are essentia...

At first glance, asthma and GERD (gastroesophageal reflux disease) seem like completely unrelated problems. After all, asthma is a chronic lung condition that causes the airways to narrow in response to triggers like allergies, while GERD is a condition in which stomach acid often splashes into the esophagus. One leaves you gasping for air; the other makes you regret eating that last slice of pizz...

Do you wheeze during a workout? Do you cough after a morning jog? If so, don't despair. You could be Olympic material. Many athletes at all levels, including about 20 percent of U.S. Olympic athletes, have asthma. Even though exercise can trigger an attack, people with asthma don't have to stay on the sidelines. With the right treatment, practically anyone with asthma can compete in any sport -- ...

Whether your child is an infant or a teenager, an inhaler can be a vital part of the program for keeping his asthma under control. There are two main types of asthma medications: the first type is used regularly to prevent attacks by delivering anti-inflammatory drugs (it's known as a controller ); the other, called a bronchodilator, is used to open airways when an attack is under way (it's known ...

Metered-dose inhalers: Inhalers sold since January 1, 2009 feature a new design. The medicine in them remains the same, but the propellant that forces the medicine from the inhaler canister into your mouth is different. The new propellant, hydrofluoroalkane, or HFA for short, won't deplete the earth's ozone layer the way the old propellant did. While that's good news for the planet, it means you ...

What is a peak-flow meter? A peak-flow meter is a small, hand-held device that measures the force of air that your breath blows out. If you have asthma, the meter can tell an important story. A strong, hard breath means your asthma is under control. But if a small, weak breath is all you can muster, asthma may be squeezing your airways. How do I use a peak-flow meter? Peak-flow meters are simple ...

What is COPD? COPD -- which stands for "chronic obstructive pulmonary disease" -- is a catch-all term for two common and very serious conditions: chronic bronchitis and emphysema. As the full name suggests, COPD blocks the flow of air into and out of the lungs. If you have chronic bronchitis, your airways tend to become swollen and clogged with mucus. A diagnosis of emphysema means that the sacs t...

If you've been diagnosed with a major illness -- like heart disease, diabetes, heart failure, cancer, or asthma -- you've probably already done a lot of research on your condition. That's a wise move. Staying informed is an important step toward staying healthy. You can learn a lot about your illness on the Internet or at a hospital library, but no Web site or medical journal in the world can tel...

After the first few puffs, most people with asthma become comfortable with their inhalers. As long as the device works for them, they see no need for change. But for millions of people with asthma, the last decade brought some big changes. About 85 percent to 90 percent of today's inhalers are metered-dose inhalers. Just like aerosol cans, these devices contain pressurized gases that propel the m...

Mold. It grows on bathroom walls, it makes basements smell bad, and it ruins perfectly good loaves of bread. And if you're allergic to it, there's a good chance that mold will add to your misery. The spores from common molds function much like the pollen from ragweed. If you inhale the spores, you could get a case of allergic rhinitis, otherwise known as hay fever -- an unpleasant combination of ...

If it weren't for asthma, some of America's most talented swimmers might never have stood on the awards platform in Sydney, Australia in 2000, collecting a record number of medals. There's a good reason: Many U.S. swim stars, including Misty Hyman, Amy Van Dyken, Dara Torres, Tom Malchow, and Tom Dolan, were diagnosed with asthma and allergies as youngsters and urged to swim by their physicians. ...

Asthma never really goes away -- it just seems as though it does. If you have the condition, your airways are often inflamed and may become swollen and clogged with mucus. Despite all that, you probably breathe easily and feel great most of the time. The trick is to keep things that way. Asthma can't be cured, but it can be controlled. By managing your disease with medications and avoiding the tr...

Allergies are a highly individualized form of misery. Some people turn into an itchy, drippy wreck whenever they're around cats, while others can't get within 100 yards of ragweed in the spring. Still others have allergies to food so severe that a peanut or other substance can send them to the emergency room with a life-threatening reaction. Meanwhile, some people barely notice their allergies and...

Shortly after blood-sucking leeches went out of style, 19th-century doctors embraced an equally bizarre remedy for some ailments: cigarettes and pipes packed with tobacco. Amazingly, doctors often prescribed this "cure" to patients with asthma. According to the strange logic of old-time medicine, patients could breathe easier if they got enough healing smoke in their lungs. Setting the stage for...

When a person has asthma, attacks can seem to come out of nowhere. One minute you're feeling fine, the next you're wheezing and gasping for breath. If you look closely, however, there's always a reason for the attack. If you have asthma, your airways are inflamed, which makes them ultrasensitive. Inflammation can cause airways to swell, hampering your breathing. More often than not, your asthma...

If coughing or gasping for breath were sure signs of asthma, we'd all be carrying inhalers. Everybody has trouble breathing from time to time, a fact that can make it hard to spot the symptoms of asthma. Even those who have been diagnosed with the disease need to pay close attention to their bodies to recognize the warning signs of an attack. With careful monitoring, you can stop such crises befo...

Asthma drugs come in two main varieties: short-acting or quick-relief medications (also called "rescue" drugs) and long-term control drugs. Most asthma medications are taken through an inhalers. Inhalers aren't just for short-acting drugs; many long-term control drugs are also delivered that way. To treat an occasional asthma attack, you'll use a short-acting drug. If you only have symptoms ever...

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