Q:What is asthma?
Asthma is a chronic lung disease characterized by inflammation and spasm of the airways. This causes breathing problems such as coughing, wheezing and shortness of breath. Asthma can be triggered by environmental factors, infections, allergies, exercise, temperature changes or other airway irritants.
What causes childhood asthma?
Asthma can result from environmental, chemical and infectious factors and may also be partially inherited.
The majority of children with asthma have allergies, such as allergies to mold, pollen, dust, dust mites, pet fur, feathers, rodents and cockroaches. Even exposure to low-grade allergens (allergens that do not cause significant allergic reactions) may increase the severity of the asthma. In addition, allergies may play a role in undiagnosed asthma cases.
Not all children with asthma, however, have allergies. They can have other asthma triggers that may include the following:
* environmental factors, such as cleaning products and strong odors
* upper respiratory infections, such as colds
* inhaled irritants, such as secondhand smoke
* temperature changes and certain weather conditions, such as cold air
* physical emotional expressions, such as crying, laughing or yelling
By properly managing asthma, however, such as avoiding being exposed to triggers, taking prescribed medications, looking for warning signs and knowing what to do during an asthma attack, an individual with asthma can have a healthy and active lifestyle.
What are the symptoms of asthma?
Common asthma symptoms include:
* coughing (for some children coughing is the only symptom)
* shortness of breath
* tightness in the chest
Asthma symptoms indicate that an asthma episode is occurring. Action should be taken to treat these symptoms before they worsen. Follow your asthma management plan or call your child's doctor or nurse if you have any questions.
What are the early warning signs of asthma?
Some early clues that asthma may be developing are:
* cough or breathing changes
* feeling tired
* difficulty sleeping
* less energy for exercise
* chin or throat itchiness
* lower peak flow numbers
Every person can have different symptoms, but do not ignore the early warning signs of asthma. Early warning signs are important to learn about and watch for so you know that an asthma episode may be developing.
What are the different levels of asthma?
As determined by the National Institutes of Health (NIH), below is a guideline used by physicians to aid in determining the extent of asthma in your child. The guideline is classified as "steps," because each child may step up or step down to different levels at any time.
The steps are as follows:
* Step 1 or mild intermittent asthma - Have symptoms less than two times a week with no problems in-between flare-ups and only has short flare-ups lasting up to a few hours or a few days. Nighttime symptoms occur less than two times a month.
* Step 2 or mild persistent - Have symptoms more than two times a week, but no more than one time per day; activity levels can be affected by the flare-ups. Nighttime symptoms occur more than two times a month.
* Step 3 or moderate persistent - Have symptoms every day, use rescue medication every day; activity levels may be affected by the flare-ups and have exacerbations greater than or equal to two times a week. Nighttime symptoms occur greater than one time a week.
* Step 4 or severe persistent - Have symptoms constantly, have a decrease in their physical activity and have frequent flare-ups. Nighttime symptoms occur frequently.
When is asthma an emergency?
Severe asthma symptoms require immediate attention and can be a life threatening emergency. You must seek emergency treatment immediately.
Severe symptoms can include:
* tightness in the chest and/or wheezing, severe coughing, shortness of breath
* difficulty talking
* breathing hard and fast
* nasal flaring
* hunched shoulders
* chest and neck muscles pull in when your child breathes
* lips or fingernails turn gray or blue
Who is at risk for developing asthma?
It is important to know that anyone can have asthma. But it most commonly occurs in:
* children by the age of five
* children who have allergies
* children with a family history of asthma
* children who have exposure to secondhand tobacco smoke
What happens during an asthma attack or asthma exacerbation?
When children with asthma have acute episodes, the air passages in their lungs become narrower and it is more difficult for them to breathe. These problems are caused by an over-sensitivity of the lungs and airways.
* The lungs and airways overreact to certain triggers causing:
o airway linings to become inflamed and swollen
o muscles to tighten that surround the airways
o an increased production of mucus
o breathing to become harder and may hurt
* Coughing may occur, as well as wheezing or a whistling sound, which is typical of asthma. A rush of air, moving through the narrowed airways, results in the wheezing sound.
* Without immediate treatment during an asthma attack, respiratory failure may occur in the child.
How is asthma diagnosed?
Physicians use a combination of medical history, physical examination and laboratory tests to diagnose asthma, which may include:
* spirometry - a spirometer assesses lung function. Spirometry, the evaluation of lung function with a spirometer, is one of most common and simplest pulmonary function tests and may be necessary for some or all of the following reasons:
o to evaluate how well the lungs receive, hold and utilize air
o to monitor a treatment's effectiveness
o to determine how severe a lung disease is
o to keep track of a lung disease
o to establish whether the lung disease is restrictive (decreased airflow) or obstructive (disruption of airflow)
* peak flow monitoring (PFM) - PFM is a device measuring the amount of air a person can blow out of the lungs. When asthma or other respiratory flare ups occur, the large airways in the lungs narrow slowly. This slows the speed of air leaving the lungs and can be measured by a PFM. Measuring this is essential to determining how well or how poorly the disease is being controlled.
* allergy tests - tests to determine allergies.
What can trigger my child's asthma?
Some triggers can include:
* cigarette smoke
* rodents and cockroaches
* colds and flu
* dust and dust mites
* strong odors
* cleaning products
* pets with fur or feathers
* cold air and changes in weather
Do children outgrow childhood asthma?
Every child is different in how they respond to asthma throughout their life. For some children, when they enter their teenage years, symptoms can subside. For others, symptoms can become more severe with time. About one-third of children with asthma will outgrow it, and about one-third of children with asthma will have fewer episodes as they get older.
If my child has asthma, can he or she participate in sports?
Exercise can often trigger an asthma attack in most children and teens with asthma. But with proper management, children with asthma can fully participate in most sports. In fact, aerobic exercise can improve airway function by making breathing muscles stronger.
A few tips for exercising with asthma:
* Have your child stretch before and after exercising, breathing only through the nose to warm and humidify the air before it enters the airways.
* Verify that your child takes all their necessary medication before exercising, as recommended by their physician.
* Have your child wear a scarf over their mouth and nose in cold weather, so air is warmer and easier to inhale.
* Have your child always carry a "reliever" or "reserve" medication, in case of an asthma attack.
How can my child control their asthma at school?
Work with your child, family members, school officials and physician to make sure asthma treatment goals are met at school. Your child may have to take their medications during school hours.
The American Academy of Allergy, Asthma, and Immunology (AAAAI) recommends the following for children with asthma at school:
* Meet with the school nurse, teachers and other relevant school staff to tell them about your child's asthma and medical needs.
* Make sure your childâ€™s school nurse has a copy of his Asthma Action Plan on file. This will explain what steps should be taken if your child has an asthma attack at school.
* Talk to school personnel about your child's asthma medications and how to help during an asthma attack.
* Ask school staff to treat your child normally when asthma is under control.
* Talk to the teacher or coach before your child starts a physical education class.
* Make sure indoor air quality, allergens and irritants in the school are monitored.
* Work to prevent asthma symptoms from starting that could bring your child's energy levels down.
* Make sure you tell your child they are not different from others.
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