All you need to know about ‘ASTHMA’……(Part 2)

Asthma management:
These days there are a number of medications available in various forms to treat asthma. Most commonly these medications are delivered through ‘inhalers’ (seen in the pic.). Inhalers deliver the medicine directly into your lungs/ chest and have fewer side effects. In India, I have seen many people still using syrups for asthma. These medicines taken in the form of syrups go through the blood. They not only take longer time to work on the lungs but also cause more side effects. Our understanding about asthma keeps changing through advanced research (especially in western world) and it is important for the doctors to keep up to date with newer advances in order to deliver the safest and best treatments to the patients.

Inhalers are easy to use once you understand how to use it (how to use inhalers will be explained in another post). In younger children, together with the inhaler another device called 'spacer'+/- mask should be used. If not used properly your child may not get the required dose. There are mainly 2 types of medications delivered through these inhaler devices.

Relievers- to be taken whenever the symptoms appear. Reliever opens up narrowed airway.

Preventers- to be taken every day to prevent asthma attacks. This medicine(a steroid) tries to keep the redness and swelling of the airways under control.

In case of mild asthma you only need a reliever (to be taken whenever you are wheezy or breathless). In moderate to severe cases (eg. If you need to use your reliever medication more than 2-3 times a week) you also need a preventer to be taken every day even when you are well.

During some episodes where your symptoms are really bad you may need a short course of steroid tablets and oxygen. Antibiotics if there is bacterial infection. If your child is not well enough to take inhaler another machine called ‘nebuliser’ can be used to dispense asthma medicines to relieve your child’s symptoms. There are other medicines used in severe cases. Most of the kids manage just with relievers and preventers. Doses may differ depending on severity and age of the child. If your child has severe asthma you may need to consult a respiratory specialist/ chest doctor.

How can you help your child’s asthma?
First thing is to understand what it is and what problems can it cause.
Let your child stay away from allergens/ triggers as much as possible.
Administer the medication appropriately.

A note on alternative medicine (Ayurveda, homeopathy etc) for asthma:
I have heard many people saying ‘Ayurveda works best for asthma and other chronic conditions etc.’ I am not an expert in this field and hence can not comment on it. But, I can firmly say that it is only allopathic or English medicine which can save your child if he has a life threatening asthma attack. Allopathic medicines are based on a lot of research and evidence and their benefits to a great extent outweigh the minor side effects when used appropriately. I really feel sorry for some people who just keep trying all sorts of things on earth and fail to understand their child’s actual problem and let their child suffer (even though unintentional). If one can understand ‘what exactly is asthma’ it would not be difficult to keep it under control.

All you need to know about ‘ASTHMA’……(Part 1)

Asthma or wheezing is very common in children. Many of the parents are unaware of the basic mechanism underlying this condition and hence panic on hearing this word. Understanding your child’s underlying condition not only helps to relieve your anxiety but also guides you to the right treatment. Since I personally know some families with asthma, I thought of writing some basic facts about this condition in my next few posts.

What is asthma?
Some people have very sensitive airways when compared to others. When they come in contact with certain agents such as dust, pollen, viruses etc their airways go narrower (by muscle contraction), swollen and red. This leaves very small space for the air to go through making it difficult for them to breath. When air passes through narrow airways it causes a whistling kind of noise (as in a flute) which is called as ‘wheeze’. Good thing is, most of the times, airway narrowing is reversible (comes back to original size) with medication. If one can understand this concept it is not difficult to keep the asthma under control.

Does my child suffer from asthma?
If you have noticed any/ all of these symptoms with your child talk to your doc.
Wheezing (musical/ whistling noise while breathing)
Recurrent cough
Shortness of breath or rapid breathing
Tightening in the chest (bigger kids)
These symptoms may come and go. Some common triggers which make these symptoms worse include: house dust mite, molds, cold, flu, exercise, pollen, dogs etc.
If there is a known trigger try to avoid it (eg. keeping the house free of dust, avoiding pets etc).

How is it diagnosed?
Normally, based on the symptoms, family history and signs (listening to your child with a stethoscope). In older kids special tests to measure lung function may be performed. Occasionally, blood tests to look for infection and X- ray to look at the lungs may be needed.

Management......see next post.

Is asthma curable?
Most of the times asthma can be managed very well and symptoms can be kept under control. But, it is not curable. However, some kids grow out of it as they get older.

Will my child grow out of it?
Some kids grow out of it. They do so especially if they tend to wheeze just with viral infections and do not have any allergies or eczema. If there are other members in the family with asthma, eczema or allergy or if your child in addition suffers from allergies and eczema, the chances of him growing out of asthma is less.

Can asthma appear at any age?

Yes, asthma can present at any age.