Asthma Alert!

Norman Brown

Asthma, for all the problems it causes, is a readily controllable condition, provided children take their medications, limit exposure to allergens, and visit their doctors regularly. Nonetheless, Asthma Action America—an education organization composed of 21 health groups including the American Lung Association—reports that more than half of all asthmatic children experienced a severe attack in the past year, and 27 percent feared they were dying.

A recent study, which surveyed 41,000 households, came up with other troubling numbers: 23 percent of asthmatic kids made at least one trip to the emergency room, and 62 percent had to limit activities because of their condition. “With today’s treatments, these kids should be symptom-free most of the time,” says William Sears, a professor of pediatrics at the University of California, Irvine.

Recognize the Symptoms

One of the reasons they’re not symptom-free is a failure of communication. Fully 71 percent of youngsters between the ages of 10 and 15 didn’t agree with their parents about the severity of their condition. More often than not, Mom or Dad didn’t realize how bad the problem is. “Kids don’t want to worry their parents or miss sports, so they downplay things,” says Sears.

As annoying as watery eyes and a runny nose can be, seasonal and year-round allergies can also cause asthma attacks, which can include coughing, wheezing, and shortness of breath due to narrowing of airways and inflammation. “Both indoor and outdoor air can play a role,” says Eugene Bleecker, M.D., a geneticist at the University of Maryland. “The numbers afflicted by asthma and other allergic diseases are mounting.”

According to the American Lung Association, 17 million children and adults have asthma. That’s a 160 percent increase in kids 5 and younger since 1980, and one of modern medicine’s great paradoxes. In an era of advanced treatment and prevention, more and more children and adults are getting asthma and dying from it.

Other symptoms include night cough, chest tightness, sneezing, or a persistent runny nose. “Asthma is also routinely misdiagnosed as bronchitis, pneumonia, or reactive airway disease, especially in young children,” says Bleecker.

Asthma educators have even handed out coloring books to alert children and parents to the dangers. But asthma “triggers” are different for each child and can be serious even in mild cases. Chief breeding grounds for the condition are sealed school buildings and airtight homes where a heavy load of dust mites, carpet fumes, mold, smoke, and other allergens lie in wait.

Treatment Options

The disease is considered under control if the child has no asthma attacks day or night, doesn’t miss school, and can do the same activities as other kids. But because asthma is a complex condition, treatment can fall into two categories: those offering quick relief—such as antihistamines, nasal sprays (corticosteroids), decongestants, and inhalers containing beta-agonists that can prevent attacks—and long-term medications used to reverse inflammation and relieve airway constriction (cromolyn sodium and leukotriene modifiers).

Combinations of medicines are sometimes used to treat several symptoms at once. Or the doctor may suggest allergy injections (immunotherapy) that desensitize the body until allergic reaction ceases. But these only work in some cases, and may also alter a child’s emotions and behavior. For example, some asthma medications lower levels of the neurotransmitter serotonin, and are associated with depression and attention-deficit/hyperactivity disorder (ADHD).

Researchers urge parents whose children are taking asthma medications to watch for signs of defiance, aggression, and depression.

Keeping a close eye on kids is a good idea for other reasons. Children must take their medications, and parents must understand how they work. Fast-acting inhalers—the so-called “rescue drugs”—are intended only for acute attacks. If a child needs the inhaler more than twice a week, something is wrong. An over-reliance on inhalers can mask a worsening condition such as

Daily medications, such as corticosteroids to reduce inflammation and bronchodilators to control constriction, help prevent attacks. These are drugs parents tend to neglect since they don’t act immediately.

Avoiding Triggers is Best
Of course, the best way to control asthma is to remove the triggers. Limiting irritants is vital, too. It goes without saying that no one in an asthmatic’s household should smoke. Allergies to dust mites can often be controlled with a non-synthetic mattress cover, and sensitivity to air pollutants may be successfully treated with carefully maintained air filters.

It’s important to pinpoint exactly what triggers an asthma attack and then find ways to neutralize the problem. Getting rid of the family cat isn’t a solution if it turns out the child’s asthma was caused by plant pollen. A humidifier won’t help a child who is allergic to dust mites, because these devices create a perfect place for mites to breed. (With such allergens, a dehumidifier works best.)

Another part of the problem is that parents are bombarded by television ads that encourage them to buy products that are both expensive and unnecessary, says Michael Cabana, M.D., a pediatrician at the University of Michigan Children’s Hospital. For example, allergies usually bother older children with asthma, while those 5 and younger battle viral respiratory infections.

If your child shows signs of asthma, make sure you understand what’s really triggering his or her condition. To reduce risk, keep windows shut when pollen counts are high, and avoid walks through woods and fields during that time of year. Empty garbage bags daily; and clean bathtubs and refrigerators with a natural, nontoxic fungicide to reduce levels of molds and other allergens. Avoid scented tissues, toilet paper, soaps, detergents, and fabric softeners. Even the smell of perfumes and aftershave lotions can trigger an attack in some kids.

The worst thing you can do is adopt a wait-and-see attitude. The more aggressive the amount of asthma-proofing, the better the outcome. Find non-chemical ways to clean your environment. Green plants help purify household air, while bed sheets, blankets, and clothing made from natural cloth fibers help reduce the amount of toxins in and around your child’s air

Asthma is a serious condition. But if you follow these simple guidelines, both you and your child will breathe a whole lot easier.

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