Asthma is the most common chronic disorders we treat in our practice. While asthma cannot be cured, with proper treatment it can be controlled.
Asthma is caused by inflammation and tightening of the bronchioles, the smallest air tubes in the lungs. Symptoms of asthma include wheezing, coughing, shortness of breath, and chest tightness. Some children with asthma never wheeze, but just have frequent episodes of cough or chest tightness. Most people with asthma have one or several triggers that bring on their symptoms. The most common trigger in young children is a cold or other infection. Other triggers are exercise, air pollutants like cigarette smoke, cold air, night time, and allergies to pets, pollen, mold and dust.
There are three parts to the control of asthma. The first and most important is to try and avoid the triggers that produce your asthmatic symptoms. Each person has unique triggers. We must work together to identify the triggers and then modify your surroundings to remove the triggers as best we can.
The second part of asthma control is knowing when you are getting sick. The earlier we know a person is starting to have asthma symptoms, the quicker we can start therapy and prevent a trip to the hospital. Asthma medicine is more effective when you are not very sick yet and can still get a good amount of air into your lungs.
The peak flow meter is a device that can make it easy to tell us when your asthma symptoms are starting up even before you might realize it yourself. It consists of a tube which you blow into very fast and a needle tells you how much air your lungs can hold. Everyone with persistent asthma who is old enough to use it correctly should own one. If you are not using one now please ask your doctor if it is right for you.
The third part of asthma care is medications. These come as liquids you drink, pills you swallow or mist that you breath in. The mist can come from a nebulizer machine or a puffer (metered dose inhaler or MDI) that shoots the mist into your lungs. The best way to use a puffer is with a spacer. Spacers are tubes that you put in between the puffer and your mouth that allow more medicine to get into your lungs. If you are using a puffer without a spacer, please tell us so we can see if you would do better with a spacer.
There are two types of medicine we routinely use for asthma. There is medicine that quickly opens your airway ("rescue" medicines) such as Albuterol (Ventolin®,) and preventative medicine ("controller" medicines)that decrease the inflammation or swelling in your lungs and help to prevent asthma flares. Controller medicines include inhaled steroids (Flovent® inhaler or Pulmicort® by nebulizer)oral Singulair® and inhaled Cromolyn (Intal®). The steroids we use for asthma, like prednisone, are not the dangerous anabolic steroids that weight lifters abuse.
Once a care plan has been established you should not be missing school, gym or any physical activities due to asthma. If you are missing school or athletics due to asthma, then your medicines must be changed. If we work together, we can develop a strategy that allows you to do whatever you want to even though you have asthma.