Did you know that there are several different asthma types? Understanding what type of asthma you have may help you prevent symptoms and take more effective steps when and if you develop them.

Overview
The number of different types of asthma points to its tremendous impact on society:

More than 39 million people in the U.S. have been diagnosed with asthma
26 million people still carry the diagnosis
More than 7 million children are impacted

$50 billion in direct medical costs and nearly $4 billion from lost productivity per year
More than 10 million school days and 14 million work days lost per year
1000 admissions to hospitals and 11 deaths per day
No matter what type of asthma you have, the symptoms are always the same:

• Wheezing
• Chest tightness
• Shortness of breath
• Cough

This can sometimes lead to confusion as some of the treatments can be different. While we call all of them asthma, the underlying pathophysiology can be a little different, leading to different treatment. Let's take a look at all of the types of asthma that can impact you.

Allergic Asthma
This asthma type accounts for nearly 60 percent of all asthma. It involves airway obstruction and typical asthma symptoms often associated with allergies and triggered by allergens.

It is important to be able to identify what triggers your asthma. Examples of common triggers include pollens, molds, dust mites, and animal dander.

Normally, your immune system's role is to fight off infection, but in allergic asthma, your body overreacts to asthma triggers, leading to asthma symptoms. The treatment of allergic asthma will focus on avoidance of asthma triggers or mediating your body's immune response.

Non-Allergic Asthma
About one-third of all people with asthma have non-allergic asthma.

This asthma type is caused by viral infections and other irritants. Examples of things that may lead to non-allergic asthma include:

Environmental tobacco smoke
Viral infections
Strong odors and sprays
Other medical conditions
Some research has demonstrated non-allergic asthma to be more severe as measured by the Global Initiative for Asthma, or GINA, score. Some studies have demonstrated a higher prevalence among women, but this has not been universal.

Non-allergic asthmatic patients develop the disease after childhood and have non-allergic conditions, such as rhinosinusitis and GERD, and are less likely to respond to inhaled steroids. Many of these patients are also at risk for occupational asthma.

Exercise-Induced Asthma
Exercise-induced asthma (EIA), or more commonly referred to by your asthma care provider as exercise-induced bronchoconstriction, is when your airways narrow and you develop asthma symptoms as a result of exercise.

EIA may worsen your asthma or you may only have asthma symptoms when you exercise. Typically, symptoms may occur 10 to 15 minutes after a brief period of exercise or 15 minutes into a longer period of exercise, such as a run. (It is important to realize that exercise does not cause asthma but is a trigger that may make you have asthma symptoms.)

For EIA and other forms of asthma, it is important that you have an asthma action plan and always have your rescue inhaler handy. This can be particularly important for EIA as you may have less frequent attacks.

Also, you may want to consider getting a medical ID bracelet or getting an "In Case of Emergency" contact for your cell phone to let people know you have asthma and who to contact if you are not able to communicate.

Occupational Asthma
Did you know that your work environment may put you at risk for asthma? Work-related exposures to irritants like dust and chemicals are main causes of both new and worsening cases of asthma.

Asthma may result from either direct irritation of your lungs or through sensitization to the offending substance.

Cough Variant Asthma
While a cough may accompany the usual symptoms associated with asthma, cough alone may be a precursor to or the sole symptom in an asthmatic. When a cough is the only asthma symptom, this is known as a cough variant asthma (CVA).

Medication-Induced Asthma
Most people don't think about over-the-counter products worsening their asthma, but this can be very important for a small group of people. But, for some asthma patients, over-the-counter pain medications can be very dangerous.

Aspirin and other non-steroidal anti-inflammatory drugs (also known as NSAIDs) can worsen asthma or even be fatal. With this type of sensitivity, you need to stay away from drugs like ibuprofen, naproxen, and diclofenac as they may trigger asthma attacks if you have asthma.

Nocturnal Asthma
If you have wheezing, coughing, chest tightness, or shortness of breath at night, your symptoms may represent worsening of your regular asthma or represent nocturnal asthma as a separate diagnosis. Nearly 75 percent of asthmatics experience nighttime symptoms like a cough at least once per week. And as many as 40 percent experience nocturnal symptoms on a nightly basis.

Glucocorticoids-Resistant Asthma
While the glucocorticoids are one of the most potent anti-inflammatory drugs available and are normally very effective in the treatment of asthma, a small group of patients do not respond to these medications and are often labeled as 'steroid resistant.'

These are not patients who do not take their medication or do not have access to steroids due to financial or other reasons. These patients just do not respond to the treatment.

It is not exactly understood why some patients are resistant to treatment, but theories include lacking the ability for the steroid to appropriately bind to lung cells and a relationship to low vitamin D levels. Managing this form of asthma is very expensive and represents a significant healthcare problem.

Other Conditions That Mimic Asthma
All that wheezes is not asthma. Some common and uncommon diseases may also cause you to wheeze. The range of diseases here is pretty wide. Post nasal drip and enlarged tonsils are some common conditions that can lead to wheezing in some patients, but the actual cause is not asthma.

Likewise, uncommon conditions can also lead to wheezing. While not rare, an enlarged thyroid gland can compress parts of your airways and result in wheezing. You can also be born with vascular rings (blood vessels that surround airways) that put pressure on respiratory structures that lead to shortness of breath and wheezing.

Sources:

Bonini M, Polange P. Exercise-induced bronchoconstriction: new evidence in pathogenesis, diagnosis and treatment Asthma Research and Practice, 2015, 1:2.

Dicpinigaitis PV. Chronic Cough Due to Asthma: ACCP Evidence-Based Clinical Practice Guidelines.

O'Byrne, P. Patient Information. Exercise-Induced Asthma.

Tan NC, Nadkarni NV, Lye WK, et al. Ten-year longitudinal study of factors influencing nocturnal asthma symptoms among Asian patients in primary care. NPJ Prim Care Respir Med. 2015; 25: 15064.

Some choose to use a special kind of credit card offered by medical professionals to pay for care at certain locations or networks. Often pitched by office assistants, they can seem like a quick fix for pricey procedures not covered by insurance including dental work, cosmetic surgery or laser vision correction.
Nearly a third of Americans report trouble paying their medical bills and many have taken on credit card debt to pay the expenses, according to a recent survey by the Kaiser Family Foundation.
But consumer advocates warn medical credit cards can saddle patients with unexpected penalties and sky-high interest rates.

CREDIT CONFUSION

One of the biggest dangers is that patients often don't understand the financial terms or even that they are signing up for a credit card, according to lawyers who have represented customers.
"There is a lot of misunderstanding. Patients think they are just setting up an installment plan with the dentist," said Gina Calabrese, co-director of St. John's University School of Law's Public Interest Center in New York. "They don't understand they have opened a new line of credit and all the risks involved with that."
Most cards feature a "zero interest" promotional period of up to 18 months. But then the interest rate can jump to 25 percent or higher. Those details can be glossed over or skipped entirely when patients sign up.
In cases cited by U.S. authorities, some consumers never received a copy of the credit card terms and had to rely on spoken explanations from staffers who had little training on the card details.

SURPRISE INTEREST

Another potential pitfall is something called deferred interest. That means if consumers don't pay off the entire procedure during the "interest-free" period, they can be retroactively charged for interest dating back to when they first signed up.
For example, a patient might pay off $900 of a $1,000 procedure during a card's promotional period. But because the amount wasn't fully paid off they now owe interest on the entire bill, often at a double-digit interest rate.
"The way these companies make money is on the consumers who don't pay off the entire balance during the promotional period," said Chi Chi Wu, an attorney with the National Consumer Law Center.
Additionally, paying the card's minimum monthly fee usually won't pay off the expense before the retroactive interest kicks in.
For patients who decide to take on medical credit, advocates say it's essential to pay off the entire borrowed amount within the promotional period.

TRUST ISSUES

The rate hikes on medical credit cards are not unique. Credit cards issued by department stores and other retailers often have similar terms. But advocates say consumers tend to be less wary of products offered by medical professionals.
"One expects a higher level of care from a health professional than, say, a car salesman," said Calabrese. "People don't think your dentist is going to encourage you to enter into a financial agreement that is oppressive or unfair."
The cards are good for medical businesses because doctors can charge patients for procedures they might not otherwise be able to afford. And the medical provider is promptly paid by the card issuer.

STEP BACK

Before signing up for a medical credit card, experts suggest researching other options. In some cases, medically necessary procedures might be available for a discounted rate or even for free at a hospital, many of which provide some level of charitable care.
If the procedure is not urgent, consider waiting until a later date and paying cash. If you must use a credit card, consider using a regular one instead—with terms and conditions you understand.