Asthma Demystified
With the blooming of red buds and the unfolding of daffodils and crocuses come the onset of allergies and respiratory symptoms for many adults and children alike. This season with all it’s beauty and new life can bring misery and anxiety to those who suffer with asthma and those who care for them. Asthma, seasonal or otherwise, IS and can be a very manageable disease.
Asthma is a process of inflammation or swelling of the smallest airways of the lungs, the alveoli. This is where oxygen is rapidly exchanged for carbon dioxide to allow normal body respiration. When there is swelling of these very thin membranes, it becomes difficult to allow for this normal gas exchange so that the rest of the cells of our body are sufficiently supplied with oxygen for survival. Many triggers can increase this swelling in children and adults who suffer from asthma including allergies, but also simple viral infections, and more complicated bacterial infections. Exercise can also cause the small airways to collapse and be compromised, but worsened by this tendency to swell. There is quite a remarkable family predisposition to asthma along with concurrent allergies and eczema, known as the allergic triad.
Never fear, however, there IS relief for those who suffer from asthma with interventions based on years of valuable evidence-based medicine. This management requires frequent office assessments to see if interventions are appropriate and working with time. Such therapies have to be tailored to each individual patient as they grow and their lungs change and develop with age. If your child is coughing or wheezing consistently more than 2 times/week or more than 2 times/night when they are not necessarily fighting an acute cold, they should be considered for preventive therapies. If your child always requires a reliever medication when exercising, they are candidates for preventive therapy. If your child begins wheezing seasonally with the weather changes or change in pollens, then your child may need preventive therapy. These are safe interventions which, when used as prescribed and consistently, allow for children with asthma to play as hard as they want, where they want (i.e. outside!!), and when they want.
It is important that any child who has a diagnosis of asthma discuss an asthma action plan with their pediatrician or pulmonologist. This should be updated on a yearly basis as a minimum. As children get older, their progress should be importantly monitored with peak flows to help guide their therapy and daily interventions so that they are able to gauge their asthma control. When managing children and teens with asthma it is important to evaluate control every 3 to 6 months as a minimum and ultimately monitor with more objective spirometry.
Most important in management of children and young adults with asthma is important routine health maintenance. Keeping well hydrated allows the body to thin out secretions throughout the sinus and respiratory systems. This allows patients to mobilize fluid and cough it out of these small airways. Being even slightly dehydrated results in thicker secretions in the nose, at the back of the throat, and in the lung tissue, compromising the body’s ability to clear this restrictive mucous. Likewise, children who are overweight have compromised lung capacity with increased demands on their heart and lungs. Reaching a more ideal body weight helps children’s bodies to better handle their asthma and respiratory demands. Managing smoke and allergen exposures by eliminating these triggers make a tremendous difference in improving asthmatic’s symptoms and can be so valuable.
I encourage parents to enjoy the spring and make a fresh start by looking brightly on the great control available for your children and teens with asthma. Please be proactive and bring your concerns to your pediatricians so that you may partner to optimize your children’s function and ultimately their quality of life. May your spring be full of bursting joy in your special role in the lives of your children!!
Anne Marie Tuohy, MD Lee Davis Pediatrics 6372 Mechanicsville Turnpike Suite 103 Mechanicsville, VA 23111 Phone: 804-730-4690
