Asthma is one of the most common childhood ailments. Children who suffer from this pulmonary condition may find themselves wheezing, coughing and struggling for breath while their friends play and participate in sports.
“Asthma is potentially life-threatening. In America, approximately 14 people die from asthma attacks each day,” says Dr. Lee Choo-Kang, a pediatric pulmonologist with Mercy Children’s Respiratory and Sleep Medicine. “This may seem like a relatively small number but consider: Asthma attacks are preventable, and children who die from asthma cannot be predicted to be at risk based upon the severity of previous asthma attacks. In other words, a third of children who die from asthma attacks were thought to have ‘mild’ asthma prior to their fatal event.”
When diagnosed early and treated proactively, asthma doesn’t have to sideline kids. However, managing childhood asthma is a process that involves physicians, parents and the children themselves.
“A home and school asthma action plan should be outlined for each child so that those around them have step-by-step directions to follow in case of an asthma attack,” explains Dr. Laquita Graham, a pediatrician with St. Louis Pediatric Associates at St. Luke’s Hospital. “Often, a child will require daily medication to minimize the severity of an attack. Those medications can be increased or decreased based on the needs of the patient.”
Asthma is an inflammatory condition in which the airways swell and narrow. Scientists think that genetics play a role in development of childhood asthma, predisposing some children to asthma attacks triggered by smoke, respiratory infections, allergens or exercise. “Often an asthma exacerbation may appear to occur with little or no warning or apparent trigger,” Graham notes. “That is why it is important to try and identify any and all triggers for each child. As a child and family become educated about the illness and possible triggers, management is much easier and more successful.”
If a child is having shortness of breath, gasping, breathing faster than normal or wheezing, physicians may order specific diagnostic tests, such as lung function measurements. “The next question is to determine whether a child’s asthma falls into the ‘intermittent’ or ‘persistent’ category,” Choo-Kang says, adding that a detailed history is required to make this determination. “Objective lung function testing or spirometry is also useful at this junction. Asthma therapy is prescribed in a ‘stepwise’ manner based upon the severity of a patient’s asthma once they fall into the ‘persistent’ category. The evaluation would not be complete without an understanding or investigation of what are the patient’s triggers.”
Medications may include long-term control drugs and quick-relief medicines administered via an inhaler when an asthma attack occurs. Families who qualify may receive medication assistance and financial help for durable medical equipment, such as inhalers and peak-flow monitors, through the Asthma and Allergy Foundation of America St. Louis Chapter’s Project Concern. Last year, the program served more than 500 clients, says Reagan Nelson, program director at the AAFA St. Louis Chapter. The organization also offers asthma screenings at health fairs through a partnership with Children’s Hospital Healthy Kids Express.
“With proper education and management, a child can participate in all activities without concern or impaired performance,” Graham says. “The diagnosis alone does not limit a child's ability to live a healthy, happy and productive life.”