From constant coughing to on-going fatigue to missed days of school or work to an inability to exercise or lose weight, asthma and breathing problems can really impact a person’s life.
As a fellow life-long asthma sufferer, Dr. Brian Modena understands what it means to have bad asthma, and he has made San Diego asthma treatment and research his passion and life’s work. He achieves success by making the right diagnosis, identifying the underlying causes and triggers of asthma, and then making personalized treatment recommendations based on objective data. Dr. Modena has spent over a decade conducting asthma research and treating severe asthma patients across several large medical centers.
His research has covered everything from the human microbiome to asthma genomics to machine learning/artificial intelligence. He serves on advisory boards across the country and is actively conducting several exciting research studies and clinical trials at Modena Allergy + Asthma. His experience and understanding of asthma science will ensure you get the best care possible. Dr. Modena is helping San Diego breathe easier.
With his custom approach to patient care, Dr. Modena aims to help patients breathe easier by taking a well-rounded, thorough, and data-based approach to diagnosis and treatment. There are many asthma ‘mimics,’ such as Paradoxical Vocal Cord Dysfunction (PVCD), dysfunctional breathing, COPD, chronic bronchiectasis, or even undiagnosed cystic fibrosis. At Modena Allergy + Asthma, the process starts with taking a thorough history of your symptoms, other medical problems, and prior test results and responses to therapy. At Modena Allergy + Asthma, we want to know your whole history from the cradle to the grave. Did your mother have asthma? Were you premature or were you ever hospitalized as a child with breathing problems or asthma? Did you get a lot of colds, sinus infections, or even episodes of pneumonia? Did someone smoke in the house? What medicines have you tried and worked?
The next step is testing.
By testing for allergies through skin testing, we will know right away whether allergies may be triggering or causing your asthma symptoms. In fact, if someone has more than one positive skin tests (e.g. positive tests to cats and molds), it may be a strong indicator that he or she truly has asthma. In children, more than one positive skin test helps tell us whether or not your child is likely to ‘outgrow’ their asthma. Using breathing tests, we can see whether or not having asthma is affecting your lung function or ability to breathe.
It also tells us whether or not you are likely to develop permanent changes to the lungs later in life. By testing oxygen radicals in the exhaled breath, we can also tell you the type (and amount) of inflammation in the airways. Finally, blood work is often done to determine whether or not there is systemic inflammation being caused by your asthma. In the last few years, the field has moved strongly in the direction of preventative health. We strive to limit inflammation in the lungs to protect your lung health for tomorrow. At Modena + Asthma, we perform testing as soon as possible (often same-day).
Precise treatment for optimal health
The treatment of asthma has drastically changed in the past 5 years. For years, the treatment has been the same for everyone: steroids, whether inhaled or taken as pills (e.g. prednisone) to reduce inflammation and inhalers that open up the lungs and relieve symptoms. But this has changed with the advent of novel monoclonal antibody therapies that were designed precisely to target different forms of inflammation in the lungs. Determining the best therapy for you requires a physician that is trained and understands the immunological mechanisms of asthma. In addition, the advent and use of these new antibody therapies has clearly demonstrated to us how ineffective steroids are for some asthma patients.
If you are frustrated with your breathing despite using your inhalers, it’s time to see a specialist physician, like Dr. Modena. Dr. Modena has spent over 10 years doing asthma research with dozens of publications. He is nationally recognized as a leader in the field. He is still actively involved in research and opened Modena Allergy + Asthma to fulfill his lifelong goal to discover the genetic roots (and cure) of asthma. Currently, he is using machine learning / artificial intelligence in combination with genetic sequencing in an attempt to accomplish this lofty goal.
Anyone older than 6 years of age is a candidate for lung function testing. In fact, most specialty physicians agree that treatment of asthma should always involve lung function testing. The results of lung function testing can at times completely change treatment recommendations. Further, prevention of permanent lung damage is so vital. A loss of lung function, as shown by pulmonary function tests, should be treated appropriately to prevent further lung loss and problems in the future.
Allergy skin testing is simple, quick, and many times may be performed the same day. Anyone looking for allergy skin testing should hold their antihistamines for at least 6 days prior to their appointment. Prior to your appointment, Dr. Modena would like to read over any prior notes and testing that you have done before in the past. Thus, it is important that you sign a medical release form with our office and you contact your physician(s) office to request that they fax your records to our office (858) 252-3721.
Dr. Modena will first ask questions to determine whether or not you have another condition that may mimic asthma, such as vocal cord dysfunction or bronchiectasis. Dr. Modena will also ask questions or investigate whether you suffer from conditions that may be causing or worsening your asthma. For example, heartburn or GERD is often a hidden cause or driver of uncontrolled asthma, and lifestyle changes have the potential to improve asthma control without medications. The doctor will then typically order allergy skin testing to determine whether allergies are causing your asthma.
He will order lung function testing to determine the effect that asthma is having on your lung function and to gauge the level of inflammation in the lungs. Finally, he often orders blood tests to determine the type and levels of systemic inflammation in the body. The doctor will then discuss the results in detail and answer any questions that you may have about your test results, treatment options and the underlying biology. He will then work together with you, through shared-decision making, to come up with personalized treatment recommendations that are in-line with your thoughts and preferences of treatment.
Problem: Asthma is a medical condition where inflammation in the small airways (breathing tubes) of the lungs occurs and doesn’t go away. As a result of this long-standing inflammation, people with asthma can experience coughing spells, difficulty ‘catching their breath,’ wheezing, and chest tightness. Asthma can occur at any age and there are all different ‘types’ of asthma.
Treatment: The treatment of asthma has changed a lot in the past 5 years. For years, the treatment was the same for everyone: rescue inhalers + steroids inhalers. If things really got bad, people were treated with steroid pills (e.g., prednisone). Steroid use, however, causes both short-term and permanent side effects. In children, steroid pills can cause delays in bone growth and decreased height. In adults, steroid pills, when used often and repeatedly, can cause diabetes, weight gain, osteoporosis, and increase your risk of infections.
But the use of steroids is decreasing with the development of new treatments called ‘monoclonal antibody therapies’ or ‘biologics.’ These antibody therapies were designed to precisely target different forms of inflammation in the lungs. These newer therapies are much safer than steroids and much more effective compared to steroids. In addition, today, we are much more focused on preventing permanent lung loss that can occur if asthma inflammation goes uncontrolled for months or years.
Why us? Dr. Modena has spent over a decade conducting asthma research at several large medical centers. His research has covered everything from the human microbiome to asthma genetics to machine learning/artificial intelligence. He serves on advisory boards across the country and is actively conducting several exciting research studies and clinical trials at Modena Allergy + Asthma.
At Modena Allergy & Asthma, we need volunteers for a clinical trial that involves patients with asthma.
The NIMBLE clinical research study is looking for participants 12 years of age or older who are diagnosed with severe eosinophilic asthma and who are currently benefiting from Nucala® or Fasenra® treatment. Study doctors are testing an investigational drug to find out if it works equally well as Nucala and Fasenra® in maintaining asthma control.
If you would like to learn more about participating in this clinical trial:
Asthma Treatment That Works
Although there is some trial and error involved with Asthma San Diego patients can improve in as soon as days or weeks once placed on the appropriate therapy.
Stop Living A Life Limited By Your Asthma
If you or your child live with poorly controlled asthma, and it causes problems on a regular basis, you should seek out a physician that specializes in asthma diagnosis and treatment in San Diego, California, such as Dr. Brian Modena. Not only has the treatment of asthma changed and become specialized over the past 5 years, it has also become much more effective, targeted, and without all the side effects caused by steroids. As a result, the field has shifted dramatically and is now much more focused on preventing the long-term complications of poorly controlled asthma. Improve your quality of life now and protect your lungs for the future.
Frequently Asked Questions
If your kid has poorly managed asthma with continual or frequent use of a rescue inhaler, has required treatment with oral steroids (prednisone) in the previous year, or has difficulty breathing during activity/play, he or she should consult an asthma expert, such as Dr. Modena.
Some children do outgrow their asthma as they get older. This is particularly true for boys where asthma tends to improve during and after puberty. However, many children do not outgrow their asthma and many will suffer bad exacerbations that put their health at risk and result in a permanent loss of lung function that can cause breathing problems later in life. All children with uncontrolled asthma should have a proper evaluation, including breathing tests.
You don’t have to let allergies, asthma or immune system issues dictate your life. With a specialist like Dr. Brian Modena by your side, you can get back to living your best life.
9850 Genesee Ave Suite 710, La Jolla, CA 92037