Asthma is a dangerous and, in some cases, a life-threatening disease. If not controlled by proper medication, asthma may cause permanent irreversible changes to the asthmatic’s lungs. These changes, known as lung remolding, result from chronic decreased lung function caused by improper use of inhalers or underuse of medication. Once an asthma attack is triggered, there is swelling, constricting, and/or an increase in mucous resulting in narrowing of the airways and, thus, a decrease the amount of oxygen in the lungs.
The first step in treating asthma is to identify the triggers and reduce the asthmatic’s exposure to them. Triggers are specific to each individual, and they vary from dust, fur, feathers, mold, and food to smoking, exercise, temperature changes, and colds. Often, it is not possible to completely eliminate one’s exposure to these triggers. For this reason, it is of utmost importance that asthmatics have rescue inhalers, such as Albuterol and Xopenex, on hand at all times. These medicines quickly relax the muscles that tighten during an asthma attack, restricting airflow. Make sure to obtain refills before these medications run out!
Sometimes rescue inhalers are insufficient. If an individual’s asthmatic symptoms occur more than twice a week, a physician may prescribe maintenance medication that contain corticosteroids such as Pulmicort, Flovent, Advail and Singulair. These medicines release low doses of steroids over time to prevent or control swelling. It is important to remember that maintenance medications will not help during an attack—only rescue medication will.
“But aren’t steroids bad to take for a long period of time?” parents ask. “Isn’t there a chance my child will become addicted to or become dependent upon these medicines?” According to Dr. Keoki Williams at the Henry Ford Epidemiologist and Asthma Research Center, parents are confusing anti-inflammatory corticosteroids for asthma care with the masculinizing steroids seen in the news that professional athletes abuse. Furthermore, inhalers have such a low dose of steroids that research has concluded the risk of addiction to be very low.
“What about the possible side effects of these drugs? Will it impede my child’s growth?” Research indicates that the use of inhalers does not inhibit growth, but that rather not using the inhaler and failing to control asthma may impede growth.
“But my child has complained of feeling jittery or hyperactive after using an inhaler.” If your child experiences a jittery feeling, an increased heart rate, or hyperactivity, consult the child’s doctor before decreasing the dose or stopping the medicine altogether. There are such a variety of medications available today that the doctor might substitute a different inhaler that works equally well and does not cause these frustrating side effects.
Remember, asthma care starts with understanding the disease, managing medication, monitoring lung function with a peak flow meter, recognizing and reducing exposure to triggers and an “Asthma Action Plan” from your doctor.
Ultimately, however, it is essential that the child learn how to manage his illness. To properly control asthma, he must take any maintenance medication he is prescribed, always have a rescue inhaler on hand, and report symptoms promptly. He must be confident to seek out help outside of his family, at school, after school programs, and among his peers. It is believed that children who engage their friends in asthma management are less likely to hide their condition and ultimately participate in a fuller life. There are many programs, like www.okay-with-asthma.org, that provide asthmatic children with knowledge and confidence. Role models help too. Soccer great David Beckham has had asthma since he was 8. He was seen using his inhaler during a Los Angeles Galaxy match in November of 2010.
Finally, provide your child’s school nurse with rescue medication and the Asthma Action Plan to prevent frequent trips to the emergency room. If the school nurse does not have the child’s medicine, a paramedic must be called when a child presents even the mildest asthma symptoms, as an asthma attack can quickly deteriorate into a life-threatening emergency. Even if you think your child has outgrown asthma, consult your physician before discontinuing any medicine.
Treatment has come a long way since Piggy in Lord of the Flies said, “My auntie told me not to run on account of my asthma.” Inhalers have transformed the lives of asthmatic. David Beckman’s asthma did not sideline him, he used his inhaler… it was an ankle injury that benched him.
Mary Ellen Ostrander is a school nurse at a New York City independent school. The above article is not to be considered medical advice. Please consult your doctor if you suspect your child may have asthma.