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Asthma   About ten million people in the U.S. have asthma, and three million of them are under 18 years of age. A current working definition of the disease would include the following characteristics:
  • airway obstruction that is reversible, either spontaneously or following treatment (though not completely so in subjects with severe disease)
  • airway inflammation
  • increased airway responsiveness to a variety of stimuli.

Within the past decade emphasis has shifted away from the long held focus on “bronchospasm” as the major element in the airway obstruction to a new appreciation of the inflammatory nature of the disease. There is inflammation of the air tubes of the lungs caused by a variety of stimuli. This inflammation is associated with spasm and swelling of the bronchial tubes and their branches. Narrowing of these air passages with the thickening of secretions causes a ball valve-like effect resulting in difficulty in breathing out (wheezing). Asthma is like forcing air through a partially clamped tube. Asthma describes a non contagious condition.

Asthma is a disease of the airways in the lungs caused by sensitivity to certain stimuli, or “triggers.” These triggers make the airways tighten, swell, and fill with mucus. When this happens, symptoms such as shortness of breath, wheezing, tightness in the chest, and coughing occurs.

Not everyone has all of the symptoms. Persistent cough alone may be the first symptom, especially in young children. But once you know you have asthma, it is important to treat even minor symptoms because they can signal a more serious flare-up that’s on its way.

What triggers an asthma attack? The triggers vary from person to person, but these are some of the most common: pollen, weather changes, especially cold, cigarette smoke, strong odors, smog, certain foods, molds, certain animals, house dust and exercise.

Being upset, laughing or crying hard, or having a cold or flu can also start an asthma episode. Almost any stress, exercise, infection, allergy, or nervous tension, can precipitate an asthma attack. If the cause of asthma is known and controlled, the asthma can often be controlled.

Although asthma attacks can come on quickly, there are usually early warning signs such as a cough, scratchy throat, or tightness in the chest. If you use a peak air flow monitor, which measures how well your lungs are functioning, a low peak flow reading of 20% below your personal best is a warning signal. Keeping a personal diary of any symptoms and the times of their occurrence can help you identify patterns of events leading to serious asthma episodes.

You should suspect asthma whenever your child has
  1. Wheezing or coughing
  2. Shortness of breath
  3. difficulty in breathing
  4. Rapid breathing
  5. "Inpulling" between the ribs

An asthma attack is treated as follows:
  1. Give the medication that I prescribe. It may be a bronchodilator or an anti-inflationary medication. It may be an oral (liquid or pill) or an inhaled medication.
  2. Encourage (do not force) fluids of the child’s choice. Avoid cold liquids.
  3. Vaporizer: Cool steam is best. (Do not add medication to water) The vaporizer should be cleaned daily, since germs can grow in stagnant water.
  4. Rest: Physical and emotional, without activities which may excite the child.

Reassure the child, relieve anxiety, and if the child is apprehensive, explain that a spasm is taking place and that he will feel better by resting and taking the prescribed medications. Reassurance and relief of emotional tension is extremely important. Do not show your anxiety before the child. The room should be free of dust, smoke, animal dander, or any other item which may cause the asthma.

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