Asthma

What is Asthma?

 

Asthma is the most common chronic illness in children affecting more than 5 million children in the U.S. It is a chronic respiratory disease, characterized by airway narrowing that is usually reversible either on its own or with treatment. People with asthma have hyper-responsive (hypersensitive/twitchy) airways that react to a variety of triggers such as viruses, strong odors or fumes, medications, exercise, allergies, cold air and even emotions. This hyper-responsiveness results in inflammation of the lining of the airways and spasm of the muscles surrounding the airways (bronchospasm). These events result in airway blockage or obstruction.

 

Symptoms of asthma can be obvious or subtle. They may include shortness of breath, labored breathing, frequent tight cough that may lead to vomiting, wheezing, difficulty breathing out, decreased exercise tolerance, nighttime cough, and fatigue. Some synonyms for asthma may include wheezy or asthmatic bronchitis, reactive airways disease, and bronchial asthma. Children with recurrent bronchiolitis, bronchitis or pneumonia are often found to have asthma as an underlying cause of their problem. By definition, asthma is a recurrent problem. Your child may not be labeled asthmatic the first or even second time s/he wheezes, but by the third separate episode, it is likely s/he will be considered to have asthma. The word asthma often scares parents but knowing your child has asthma makes it possible to treat it appropriately and keep your child well.

 

Treatment of asthma depends on the type of asthma and the severity in your child. Asthma is characterized as mild intermittent, mild persistent, moderate persistent and severe. It may be classified in a number of ways such as “allergic”, “exercise induced” and “cough variant.” All children with asthma should strive to identify and control triggers, those conditions in their environment that seem to bring on symptoms. Children with mild intermittent asthma can be treated with symptomatic medications. Children with persistent asthma should be treated with daily maintenance medications. Symptomatic medications include bronchodilators like albuterol, Xopenex, and Maxair. In a severe episode oral or inhaled or oral steroids (Flovent, Pulmicort, Orapred and others) may be added for symptom relief but should never be used alone to treat an asthma attack in progress. Maintenance medicines include inhaled steroids (Flovent, Pulmicort), long acting bronchodilators (Serevent, Foradil), leukotriene antagonists (Singulair), and combination medications (Advair). As you might imagine, these maintenance medicines help prevent an asthma attack. Other treatments may reduce the frequency of asthma symptoms by addressing triggers, such as infection or allergies and may include antibiotics, allergy referral/injections, antihistamines and nasal steroid sprays. medicines when symptoms arise.

 

It is important for a child with asthma to be seen and evaluated regularly. During these visits, your child’s symptoms, school attendance, activity level, sleep quality, knowledge of his asthma symptoms and medications will be reviewed. Pulmonary function tests may be performed in the office on a regular basis to help assure that asthma is well controlled and that the goal of treatment- keeping asthma from interfering with a child’s routine activities and school attendance- is achieved.

 

Resources

 

Books

• Children with Asthma: A manual for Parents - Thomas Plaut, M.D., Pedipress
• A Parents Guide to Asthma - Nancy Sander, Doubleday
• I’m Tougher Than Asthma - Alden and Siri Carter, Albert Whitman and Co.
• The Asthma Attack by Bo B. Bear - Charlotte Casterline, Info-All Book Co.
• Sportsercise: A School Story about Exercise-Induced Asthma - Kim Gosselin, JayJo Books
• The Lion Who Had Asthma - Jonathan London, Albert Whitman and Co.
• All About Asthma - William and Vivian Ostrow, Albert Whitman and Co.
• One Minute Asthma, What You Need to Know - Thomas F. Plaut, M.D., Pedipress

Organizations

• Scottish Rite Asthma Education Center, 404-250-2654
• American Academy of Allergy and Asthma 
• Food Allergy Network, 1-800-929-4040
• American Lung Association, 1-800-LUNG-USA
• Allergy and Asthma Foundation, 1125 15th Ave., N.W., Suite 502, Washington, D.C. 20005, 1-800-7-ASTHMA
• Allergy and Asthma Network/Mothers of Asthmatics, 3554 Chain Bridge Rd., Suite 200, Fairfax, VA 22030, 1-800-878-4403
• Lung Line, National Jewish Medical and Research Center, 1-800-222-LUNG (5864)