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Asthma
 Colds
in Babies 'Ward Off Asthma'
Babies with runny noses are less likely than other children to get
asthma as they grow older, a new study indicates. The findings add
weight to the growing body of evidence that colds and minor infections
brought about by a child's normal exposure to dirt can prime the
immune system to fight off allergies such as those which can bring
on an asthma attack. Writing in the British Medical Journal, Sabina
Illi and colleagues from the University children's hospital in Munich
report how they followed up a group of 1,314 children at regular
intervals from birth until they were seven years old. The parents
of the children were interviewed when their children were one, three,
six, 12 and 18 months, and then at yearly intervals When the child
reached the age of seven, the parents were asked whether he or she
had ever had a diagnosis of asthma. Parents were asked to keep a
diary of any illness the child suffered. The researchers found that
the more infections the child had suffered and fought off, the less
likely he or she was to become asthmatic. A child with two or more
episodes of runny nose before the age of one was at half the risk
of having asthma diagnosed by the age of seven than a child with
one or fewer episodes. But children who developed repeated lower
respiratory tract infections in their first three years were more
likely than others to develop asthma.
What
to do in an Emergency Asthma Attack?
The duty of every responsible person with asthma would require following
these steps to head off an emergency asthma attack.
>> Assess your particular asthma condition with a specialist
and identify the triggers (natural, synthetic elements, activities,
emotions and medicines) of your attack.
>> Take note of the medicines and instruments (nebulizer,
inhaler or peak flow meter) that you have to use. Familiarize yourself
with these instruments. Construct two itinerary forms for your asthma,
one for daily use and one for emergency purposes. These forms should
be done with your specialist.
>> Share the information that you’ve gathered with a family
member and a close friend so that they may be able to administer
the steps in case your are unable to do these yourself in the event
of an asthma attack. Also provide your companions the telephone
number of your doctor and emergency numbers of hospitals.
>> Religiously follow the prescribed daily treatment for your
asthma by avoiding the triggers and taking in prescribed medicines.
>> Always remember to bring your medicines wherever you go.
But there will always be incidents that no matter how much you try
to avoid an attack you do get one. The succeeding pointers are here
to help you survive an asthma attack.
>> Stop whatever your doing and distance yourself from the
trigger.
>> Notify someone and make sure the person is near to assist
you.
>> Take note of your symptoms.
>> Perform breathing exercises and positions prescribed by
your doctor/specialist.
>> Treat with prescribed medicine.
>> Stay calm and focused. The last thing you need when under
an asthma attack is to further aggravate it by panicking.
>> If after a few minutes, you still feel bad or that your
medicine has not helped in alleviating your condition, go to the
nearest hospital.
There have been instances of death due to asthma. This is a fact.
But by being informed on what to do, having someone near who can
help you and the devices that can ease the attack may empower you
over the disease.
Smoking
in Pregnancy Ups Kids' Asthma Risk
By Alternative Medicine Update
Children of mothers who smoke during pregnancy are almost two times
as likely to develop asthma as those whose mothers did not smoke
while pregnant, according to study of California children. This
increased risk appears to be related to smoking during pregnancy
and not to tobacco exposure after birth. If women would quit smoking
while pregnant it would eliminate 5% to 15% of asthma cases in children,
the study authors estimate. Asthma is increasing worldwide and is
an important cause of childhood hospitalization and death. The current
study included nearly 6,000 youngsters enrolled in the Children's
Health Study, which began in 1993 and has been following children
living in 12 communities in southern California. Almost 20% of children
in the study had mothers who smoked during pregnancy, and of those,
3% smoked only during pregnancy and not after giving birth. Almost
40% of the children had been exposed to second-hand tobacco smoke
at some point in their life. Wheezing was reported in more than
33% of the children in the study, and almost 15% were diagnosed
with asthma. Children whose mothers smoked during pregnancy, but
not after, were nearly twice as likely to be diagnosed with asthma.
The increased risk of developing asthma was found to be related
to the mother's smoking during pregnancy, but not afterward. Children
whose mothers smoked after pregnancy were at increased risk for
wheezing only. The authors suggested that exposure to components
of tobacco smoke during development may cause changes in the lungs
that may lead to asthma. ``It's almost a no-brainer to say that
women who are pregnant shouldn't smoke, but as a public health message
it's worth repeating,'' lead study author Dr. Frank D. Gilliland
of the University of Southern California in Los Angeles told Reuters
Health. ``We know that smoking is bad for women who smoke, and this
study shows it's also bad for their unborn children. Perhaps knowledge
of the long-term effects of smoking on children will provide an
incentive for people to quit. '
SOURCE: American Journal of Respiratory and Critical Care Medicine
2001;163:429-436.
Asthma
in Adulthood
WHAT IS IT?
Asthma narrows and clogs the airways in your lungs. If you have
it, you can breathe normally most of the time, but not during an
asthma attack, when tiny airways called bronchial tubes swell and
fill with mucus. Then you will cough, wheeze, and have trouble breathing.
Attacks can come on fast. They may last only a few minutes but usually
go on for hours, or even a day or longer. In a severe attack, the
airways become so narrow and clogged that breathing is nearly impossible.
Then you need emergency treatment. Without prompt medical help,
severe asthma can be fatal. Most people, however, can control their
asthma by staying away from things that trigger it and by taking
medications their doctors prescribe. Asthma is a chronic disease.
That means you may have it the rest of your life, with symptoms
that can come and go. Anyone can get it, although it seems more
common and more serious among African American children than others.
Asthma also runs in families. If a close relative has it, you are
more likely to have it. About 15 million Americans have asthma,
almost 5 million of them children under 18. It's the number one
cause of children missing school and of children going to the hospital.
Many seem to outgrow the illness, but it sometimes returns in adulthood.
In the past 20 years the number of people who have asthma has almost
doubled. Experts aren't sure why, but they think this may be the
result of greater air pollution or more people working in closed
buildings with poor ventilation. If you have asthma, you'll have
to make some changes-for example, learning about the early signs
of an attack. Once you know how to manage it, chances are you can
live normally. In fact, many world-class athletes, including Olympic
gold medalists, have asthma.
WHAT IS HAPPENING?
The bronchial tubes in your lungs are lined with muscle and special
cells that produce mucus. This mucus, a slippery liquid, helps keep
your airways free of dust and other debris. During an asthma attack,
several changes take place in your bronchial tubes: The muscles
around them contract, squeezing the tubes. The tubes themselves
swell. And the cells that produce mucus begin to make too much,
so mucus clogs the narrowed tubes. Early in an attack, the problem
isn't that you can't breathe in, but that you can't breathe out.
When you breathe in, muscles around your lungs expand your chest,
making your lungs bigger so they can pull in air. Normally, you
breathe out simply by relaxing these muscles and not breathing in,
just letting air leave your lungs. Your muscles are strong enough
to pull air in, even through airways narrowed by an asthma attack.
But they're not so good at pushing air out. Stale air stays trapped
in the lungs, so less fresh air gets in during the next breath.
As the attack continues, the airways become more narrow and clogged;
breathing becomes harder; the muscles you use to breathe become
tired; and you struggle even more for air.
WHAT
CAUSES IT?
No one can say exactly why some people have asthma and others don't.
We do know that most asthma is triggered by something you've inhaled.
When you breathe, you take into your lungs not just air but whatever
is in it-for instance, dust, pollen, pet dander (bits of skin, hair,
or feathers), viruses, molds, bacteria, tobacco smoke, and chemical
fumes. If your lungs are easily irritated by any of these things
or if you are allergic to them, you may have an asthma attack. Sometimes,
though, an allergic reaction comes not from what you breathe but
from what you eat. And many attacks aren't allergic reactions at
all. What's the difference between asthma caused by an allergy and
asthma caused by some other trigger? During an attack, not much.
But figuring out the difference-by keeping track of what happens
just before an attack-can help you control your asthma.
Typical allergies When you're allergic to something, your disease-fighting
system-the immune system-reacts to normally harmless things as if
they were threats. To fight them, the body makes chemicals that
bring on symptoms. In some people, the allergic reaction is hay
fever (sneezing and watery eyes), a rash, hives, or upset stomach.
In others, the reaction is asthma.
Common triggers for asthma caused by allergies include dust, pollens,
pet dander, molds, grass, and some foods, such as peanuts. Your
asthma is probably caused by allergies if:
>> People in your family tend to have allergies.
>> Your asthma developed when you were young.
>> You have attacks only at certain times of the year-say,
in the spring.
>> Your asthma usually acts up during certain activities such
as changing the bed, vacuuming, or sweeping.
>> Your asthma gets worse around animals. Other allergic reactions
such as hay fever appear at the same time as your asthma.
Other triggers Aside from allergies, some people's lungs
are simply irritated by various things they breathe in. Asthma can
also be set off by insect stings, aspirin and similar painkillers,
or even cold air. Other possible triggers include:
>> Exercise. It brings on attacks for some people, most often
because their airways are sensitive to cool or dry air.
>> Certain foods-seafood or peanuts, for instance-or foods
with additives and preservatives such as food colorings or sulfites.
>> Infections such as colds or sinusitis.
>> Emotional peaks and dips. Stress can bring on attacks.
>> Pregnancy. About a third of women with asthma find it gets
worse when they're pregnant. For another third, though, it gets
better.
WHAT YOU CAN DO FOR YOURSELF
Right now there isn't a cure for asthma, but you can take steps
to have fewer attacks and to treat an attack when you do get one.
During an attack
>> Remain calm and quiet. Staying relaxed will help you breathe
better.
>> Use your medication exactly as your doctor has told you
to.
>> Don't lie down. Instead, sit upright, leaning slightly
forward, resting your elbows on a table if you can.
>> Try to breathe from the diaphragm-the muscle below your
breastbone-rather than using just your chest muscles.
>> Breathe deeply, as if pulling air into your stomach. Ask
a friend, teacher, or family member to stay with you.
Monitor yourself every day
Your doctor can give you a peak flow meter. You blow into it to
measure how much air your lungs can push out in a single breath.
Once you know your reading for normal breathing, you can use the
meter for early warnings. It will show a lower reading when your
airways start to narrow and clog, even before you feel any symptoms.
You use it every day at the times your asthma is usually worst.
These daily measurements are important because the airways in the
lungs don't have any nerve endings. You can't feel when your airways
are starting to swell and an asthma attack has begun. If you know
from the peak flow meter that your asthma is acting up, even though
you don't feel it yet, you can take your medication to prevent the
attack from getting worse.
Learn the signs of an attack
>> Change in breathing.
>> Tightness in chest.
>> Scratchy throat, coughing.
>> Wheezing.
If you feel an attack coming, treat it quickly. If your doctor has
prescribed medication, keep it with you at all times.
Find the triggers
Learn which things cause your asthma, then stay away from them.
Keep a diary of any changes you notice in your environment or emotions
before or during an attack. What happened just before? How frequent
and severe are the attacks?
Avoid the triggers
You can't avoid everything that might bring on an attack. Still-depending
on what causes your asthma-these tips will help:
>> Try to stay indoors on days when pollen or pollution levels
are high. Keep the windows closed in your home as much as possible
to prevent pollen from drifting in. Run the air conditioner, if
you have one, to keep cool. Many air conditioners don't do a good
job filtering the air, so you might want to install an electrostatic
filter to trap allergens. If you don't have an air conditioner and
you want to open a window, put an ordinary furnace filter in it
to help keep the pollen out.
>> Dust mites and molds (common allergens) love damp air,
so use a dehumidifier to discourage them. Clean the reservoir often.
>> Change cooling- and heating-system filters regularly.
>> Wash your blankets every week. Wash sheets and pillowcases
more often, if possible. To kill dust mites, the water must be hotter
than 130 degrees. If you have your water heater set lower to prevent
scalding, try a Laundromat. Use a dryer; pollen sticks to anything
hung outside.
>> Dust and vacuum often. If you can, have someone else do
it. If you have to do it yourself, wear a dust mask. Use a HEPA
(high-efficiency particulate air) filter or a double bag on the
vacuum. Dust mites and their droppings are so small that they'll
pass right through a standard bag and float in the air.
>> Leave your floors bare, or use washable area rugs instead
of carpets.
>> Use washable shades or curtains on your windows rather
than dust-catching drapes.
>> Keep your bedroom free of dust collectors such as large
shelves of books.
>> Recent studies have shown that down pillows might not be
so bad after all. So try both down and synthetic foam rubber pillows.
>> Cover mattresses and box springs with mite-proof plastic.
>>Avoid wool blankets. When possible, use washable cotton
blankets or comforters filled with synthetic materials instead.
>> If being around cats or dogs causes attacks, don't keep
pets. If you can't bear to part with Fluffy or Fido, bathe the cat
or dog every week and keep it out of the bedroom. Have someone else
empty a cat's litter box.
>> Don't smoke, and stay away from people when they're smoking.
>> Avoid strong scents such as perfume or perfumed products,
deodorizers, paints, pesticides, and other spray products.
Stay healthy
Exercise regularly, but don't overdo it. Talk to your doctor to
make sure your exercise program is right for you and to see if there's
a medication you should take before exercising. Thirty minutes of
activity such as brisk walking at least three times a week is a
good start. This regular exercise will strengthen the muscles you
use to breathe and stretch your lungs so they hold more air. Swimming
is especially helpful-unless you react to the chlorine-since humidity
helps ease breathing. If a certain exercise triggers your asthma,
try others. Some may give you no trouble. Practice relaxation techniques
such as yoga, meditation, or deep breathing, because stress can
trigger an attack or make one worse.
WHAT YOUR DOCTOR CAN
DO FOR YOU
Your doctor may prescribe medication to help prevent attacks or
treat symptoms. Usually, you get a one-two punch of bronchodilators
and anti-inflammatory drugs. The key is steady, long-term use of
medicine to prevent attacks. Several kinds of medications are available.
Here is a rundown on some of them:
Inhaled Bronchodilators Bronchodilators are drugs you inhale
to treat wheezing and coughing. They make breathing easier by relaxing
the muscles around the airways. They do not, however, stop the airway
swelling that happens at the start of an attack. There are many
different brands.
Pro: Generally safe when used as prescribed.
They work quickly to bring attacks under control. They can also
be taken before exercise or sleep to prevent attacks.
Con: May cause anxiety, heart flutters,
and tremors in some people. They speed up your heart rate and may
be dangerous if you have a heart problem such as narrowed arteries.
Inhaled Nonsteroidal Drugs These drugs, such as Intal or
Tilade, help prevent inflammation and asthma attacks when taken
regularly.
Pro: Work most effectively against
attacks brought on by cold air, exercise, and sulfites.
Con: Don't work for everyone. They
must be taken four times a day, and they may be irritating if taken
during an attack.
Corticosteroids Inhaled corticosteroids are taken regularly
for all but the mildest asthma. They help prevent airways from swelling,
so when you breathe in something that triggers your asthma, you'll
either have no attack or a milder one than you would have otherwise.
For the worst asthma, corticosteroids also come as pills.
Pro: Inhaled types have few side effects
because they go right to the airways.
Con: Possible side effects from inhaled
types include fungal mouth infections, hoarseness, and coughing.
The pills are strong-they're for the most severe asthma-and can
cause serious side effects, including rashes, headaches, cataracts,
diabetes, and high blood pressure.
SOME
WORDS YOU MAY HEAR
Adrenergic: resembling some of the effects of adrenaline,
a hormone that increases heart rate and blood pressure. Beta-adrenergic
drugs, such as bronchodilators, are often used in asthma to help
open up the airways.
Allergen: a substance that causes an allergic response.
Allergy: an increased sensitivity to a certain substance.
Alveoli (singular, alveolus): tiny air sacs in the lung.
They deliver oxygen to small blood vessels (capillaries) and take
up carbon dioxide from them.
Bronchi: the larger bronchial tubes or airways of the lungs,
which bring air from the windpipe to the bronchioles.
Bronchioles: little bronchi. After bronchi, the next smallest
airways. Bronchioles lead into alveoli, the smallest air spaces.
Bronchiolitis: inflammation of the bronchioles, usually in children.
Bronchitis: inflammation of the mucous lining of the bronchial
tubes. Can be acute-often from a cold or flu-or chronic (lasting
a long time), often from smoking or breathing chemicals, fumes,
or dust for a long time.
Bronchoconstriction: narrowing of the bronchioles.
Bronchodilator: a drug that opens up the bronchi.
Bronchoscopy: looking into the lungs and bronchi using a
bronchoscope. Bronchospasm: a sudden tightening of the muscles
around the airways, making them narrow.
Corticosteroids: a group of hormones that help prevent swelling.
Used as drugs to treat moderate and severe asthma, they can be inhaled,
taken as pills, or given as shots.
Dander: scales of dead skin, hair, or feathers. Animal dander
is a common allergen.
Dyspnea: trouble breathing.
Expiration: breathing out.
Histamine: a chemical produced by the body's immune system
that causes an allergic reaction, most often sneezing, a runny nose,
and itching.
Immunotherapy: building up a resistance to an allergen through
a series of shots that contain the allergen.
Inflammation: redness and swelling of the tissues.
Inhaler (also metered-dose inhaler): device that releases a drug
in a fine spray that can be breathed directly into the lungs.
Inspiration: breathing in.
Irritant: a substance that causes a reaction in the airways.
Maintenance medication: medication given regularly to prevent symptoms.
Mast cell: one type of cell that makes chemicals that can
produce an asthmatic reaction.
Nebulizer: device-more complex than an inhaler-that makes
a mist of drugs and water to inhale through a mask.
Pulmonary function test: a test or series of tests to measure
how well the lungs work and how much air they can hold. Pulmonary:
of or affecting the lungs.
Wheeze: high-pitched whistling sound heard when air flows
through a narrowed bronchial tube.
LATEST
DEVELOPMENTS
Immunotherapy If your asthma is caused by an allergy, and
if the cause can be identified, you may be a candidate for immunotherapy.
This is a series of shots that may reduce your symptoms by building
up your tolerance to the allergen-in effect, giving your body regular
practice in handling it. The shots contain small amounts of the
substance that triggers your allergy. You begin with one or two
shots a week. As the treatments go on, the doctor gradually increases
the amount of allergen. It usually takes six months to a year of
therapy before you notice improvements. Once you reach the strongest
dose, you get shots about once a month. Treatment may last three
to five years.
Pro: Can greatly decrease the length
and number of asthma attacks. For some people, prevents attacks
altogether.
Con: Doesn't work unless you and your
doctor know the exact allergen. Shots may take a long time before
they work and, even after many treatments, still may not help. Sometimes
they bring on an allergic reaction.
New Drugs Available
Salmeterol, a new, long-lasting inhaler, can relieve bronchial spasms
for up to 12 hours. The drug isn't meant for quick relief or to
replace anti-inflammatories. But when used with anti-inflammatories,
this drug helps control nighttime symptoms. Another new class of
drugs called leukotriene modifiers block messenger chemicals-leukotrienes-that
tell airway muscles to contract. Doctors may prescribe leukotriene
modifiers, such as Singulair, instead of low-dose inhaled corticosteroids.
But there are also some dangers: Some of the drugs in this class
may affect the liver and can increase the effects of blood-thinning
drugs.
Complementary Therapies The mild exercise and breathing techniques
used in yoga can help relieve stress. Several studies have shown
that yoga helps people with asthma by cutting down on their symptoms
and improving their quality of life.
WHEN TO CALL THE DOCTOR
Call 911 or go to an emergency room right away if you note these
signs of lack of oxygen:
>> A suffocating feeling that makes talking difficult.
>> Nostrils are flaring during inhaling.
>> A sucked-in look to the skin between the ribs when inhaling.
>> Bluish lips and fingernails.
Asthma
in Childhood
WHAT IS IT? (see
asthma in adult)
WHAT IS HAPPENING? (see
asthma in adult)
WHAT CAUSES IT? (see
asthma in adult)
WHAT YOU CAN DO FOR YOURSELF
At first, your child's asthma may seem to take over the family's
life-especially when attacks become severe. With time, though, your
child's asthma should become less troubling and more a part of everyday
living, not your central focus. The fact is, you can do a lot to
treat your child's attacks when they occur and to help him or her
have fewer attacks.
Here are some tips that will help:
Have a plan It's important to develop a plan of action for
an attack. Your doctor will put instructions in writing, so you
can follow them easily. The plan should cover what signs to look
for if an attack begins, what medication to give-and when and how
much-and when to call the doctor if the attack does not ease up.
In time, you and your child won't need the written instructions.
You'll learn to prevent attacks or keep them from getting worse
just by following the plan. As your child becomes more familiar
with what to do, he or she can take charge of preventing and treating
attacks.
During an attack
>> Help your child remain calm and quiet. Staying relaxed
will make breathing easier.
>> Follow the asthma-attack plan your doctor gave you. Use
any medication exactly as the doctor has advised.
>> Don't let your child lie down. This can make breathing
harder. Your child will breathe more easily sitting upright, leaning
slightly forward, resting his or her elbows on a table.
>> It helps to breathe from the diaphragm-the muscle just
below the breastbone-rather than using just the chest muscles. Have
your child breathe deeply and slowly, as if pulling air into his
or her stomach.
>> Make sure someone your child trusts-you, a friend, family
member, or teacher-stays with the child during an attack.
Monitor your child's asthma every day Learn to recognize
the signs of an oncoming attack:
>> Change in breathing.
>> Tightness in chest.
>> Scratchy throat, coughing.
>> Wheezing.
If you see an attack coming, treat it quickly. Have your child's
medication with you at all times. Make sure that your child's principal,
teachers, gym instructor, and nurse all know he or she has asthma
and what you want them to do during an attack. Your doctor can give
you a peak flow meter. Your child blows into it to measure how much
air his or her lungs can push out in a single breath. Once you know
the reading for normal breathing-when the bronchial tubes are open-you
can use the meter for early warnings. It will show a lower reading
when airways start to clog, even before your child feels any symptoms.
Use it every day. Both morning and night are good times to check;
they're when asthma is most often worst. These daily measurements
are important because the airways in the lungs don't have any nerve
endings. Your child can't feel when the airways start to swell and
begin an asthma attack. If you see by the peak flow meter that the
asthma is acting up, you can use medication to prevent the attack
from getting worse.
Find the triggers Learn which things cause your child's asthma.
Keep a diary of any changes you notice in the environment or your
child's emotions before or during an attack. What happened just
before? How frequent and severe are the attacks?
Avoid the triggers Your child can't avoid everything that
might bring on an attack. Still, these tips can help:
>> Avoid having stuffed animals around, if possible. They
collect dust.
>> Help your child avoid pollution, pollen, and airborne mold
spores by keeping windows closed. If you have air conditioning,
use it to keep cool. Many air conditioners don't do a good job of
filtering the air, so you might want to install an electrostatic
filter to trap allergens. If you don't have an air conditioner and
you want to open a window, put an ordinary furnace filter in it
to help keep the pollen out.
>> Change cooling- and heating-system filters often.
>> Dust mites and molds (common causes of allergies) love
damp air, so use a dehumidifier to keep them in check. Clean the
reservoir often.
>> Keep your child's bedroom and play areas free of dust collectors
such as large shelves of books.
>> Recent studies have shown that down pillows might not be
so bad after all. So let your child try both down or synthetic foam
rubber pillows. Cover mattresses and box springs with mite-proof
plastic.
>> Avoid wool blankets. When possible, use washable cotton
blankets or comforters filled with synthetic materials.
>> Wash your child's blankets every week. Wash sheets and
pillowcases more often, if possible. To kill dust mites, the water
must be hotter than 130 degrees. If you have your water heater set
lower to prevent scalding, try a Laundromat. Use a dryer, since
pollen sticks to anything hung outside.
>> Dust and vacuum often. If you can, do it while your child
isn't home. To guard against dust mites, vacuum your child's bed
and bedroom floor every week-using a HEPA (high-efficiency particulate
air) filter or a double bag on the vacuum. Mites and their droppings
are so small that they'll pass right through a standard bag and
float in the air.
>> Use washable shades or curtains on windows rather than
dust-catching drapes or blinds.
>> Leave your floors bare, or use washable area rugs instead
of carpets.
>> Don't keep warm-blooded pets, including rodents and small
birds. If your child can't bear to part with Fido or Fluffy, bathe
the dog or cat every week and keep it out of the bedroom.
>> Keep your child away from strong scents such as perfume
or perfumed products, deodorizers, paints, pesticides, and other
spray products.
>> Don't smoke, and keep your child away from people who do.
Arrange for exercise Your child should be as active as possible.
Exercise strengthens breathing muscles and stretches the lungs so
they hold more air. Swimming is a good sport-unless your child reacts
to chlorine-since humidity helps ease breathing. With proper planning
and care, your child should be able to take part in sports, school
activities, and summer vacations without problems. If a particular
exercise triggers asthma, though, talk with your doctor about medications
that might help. Or try other activities; some may cause no problems
at all. If your child is in the middle of a long-lasting attack,
limit exercise until the attack has passed. Usually, he or she can
be back to normal activities within a week, but ask the doctor how
long the break should be.
Baby-sitters Choose a sitter you know well and trust. Make
sure he or she knows how to help your child take medications and
use a peak flow meter if necessary. Leave detailed written instructions
on how to use medications. That way, the sitter could start treatment
before you get home.
School Make sure your child carries asthma medication in
his or her school bag. Be sure the principal, teachers, school nurse,
and gym instructor know about the asthma. Send each a letter detailing
the following:
>> Possible triggers.
>> Signs of an oncoming attack.
>> Specific instructions on what to do in case of an attack
(your asthma-attack plan).
>> List of all medications and when they should be used.
>> Phone numbers where you, another family member or a friend,
and your doctor can be reached.
Summer camp There are summer camps around the nation designed
by the American Lung Association for children with asthma. The idea
behind such a camp is to teach children about handling asthma while
letting them have a good time. For details, contact your local chapter
of the American Lung Association at 800-LUNG-USA (800-586-4872).
Other help Ask your doctor about support groups for parents
in your area. It can help to know you're not alone, and to talk
with others who know what you're going through. You'll also learn
practical, day-to-day hints for helping your child manage asthma.
WHAT YOUR DOCTOR CAN DO FOR YOU (see
asthma in adult)
HOW
TO USE A PEAK FLOW METER
With a little practice, your child can learn to do this:
1 Set the pointer to zero.
2 Hold meter horizontally while standing.
3 Take a deep breath with mouth wide open.
4 Close lips tightly around the mouthpiece.
5 Blow out as hard and as fast as you can, like blowing out a candle.
The meter records the fastest blast, not the longest blow.
6 Record the number where the marker stops.
7 Reset the meter. Do this reading three times.
The highest of the three is the peak flow. For the best peak flow
reading, take at least two readings a day for an entire week when
there are no asthma symptoms. Then check with your doctor to make
sure the best reading is normal for your child's age and height.
DIFFERENT
TYPES OF INHALERS
Depending upon your child's age, he or she may use different devices
to inhale medicine.
Nebulizer: This device converts medicine into a mist that
a child breathes in through a tube or a mask. Most often used by
young children-under age six-or those who are too sick to use an
inhaler.
Inhaler: A hand-held tube used to hold a medicine cartridge.
It creates a spray breathed directly into the lungs. It's best for
children age six and above, though some younger children may be
able to learn how to use it.
Spacer: A tube (sometimes with a face mask) attached to an
inhaler that makes it easier to breathe medicine directly into the
lungs. Often used by younger children and those who have difficulty
using an inhaler.
HOW
TO USE AN INHALER
With a little practice, your child can learn to:
1 Make sure there's enough medicine in the canister.
2 Plug it into the inhaler and shake it for several seconds.
3 Breathe out slowly.
4 Place the mouthpiece of the inhaler in front of the mouth, one
to one and a half inches away.
5 With the mouth open, begin breathing in slowly.
6 Press down on the inhaler button so the medicine sprays out.
7 Continue breathing in slowly for three to five seconds.
8 Hold breath in the lungs for 10 seconds before exhaling.
9 Breathe normally for two or three minutes. Repeat as prescribed
by your doctor.
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