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Asthma Basics From A Pulmonologist

A pediatric pulmonologist uses her expertise to answer 7 questions

Asthma affects nearly 19 percent of children and is the leading cause of missed school days, accounting for nearly 7.5 million days missed yearly.

We spoke with Karen Schultz, M.D., a pulmonologist at Cook Children’s to help all of us learn more about asthma:

1.What is asthma?

Asthma is an inflammatory process that happens in the lungs that causes swelling and increased mucus down in your lungs so it makes it harder to breathe.

2.When do asthma flare ups occur?

An asthma flare up occurs when someone is exposed to a trigger of their asthma. The muscles around their airwaves actually squeeze down and make it even more difficult for people to breathe. They can also get more mucus and more swelling in their lungs, which also makes it harder.

3.What are the triggers?

People have different triggers for their asthma. The most common ones tend to be weather changes, viral infections and exposure to certain allergens. Cold, dry air can cause bad flare-ups and viral infections are the most common trigger this time of year. Parents should stress to their children the importance of handwashing, especially this time of year.

Allergens could include cats, pollen, grass and mold. Another big trigger is exposure to smoke. Exposure to second-hand smoke is a big issue with kids with asthma. Not only can it be a trigger for an asthma flare, but it can keep your child’s asthma from ever getting under control in the first place. Any parent who has a child with asthma, should not smoke. Even smoking outside exposes your child to some smoke particles and can still keep their asthma out of control.

4.Who gets asthma?

Asthma happens to people with a genetic predisposition who then have the right trigger to start their asthma flaring at the right time.

Depending on the age, asthma can be diagnosed in different ways. In very young children and toddlers, it’s diagnosed based on their symptoms and what their physician on examination. So kids that have recurrent wheezing are diagnosed with asthma.

In older kids, 5 years and up, lung function testing can be done to help determine asthma severity.

5.What are the symptoms?

Common starting symptoms of an asthma flare often are just cough. Sometimes families can start seeing the kiddos breathe harder and faster and sometimes they can actually hear them wheeze. But often the wheezing can only be heard by a physician.

If they start noticing their child is breathing very rapidly, if they are sucking their air in above their sternum or in between their ribs, then those are signs that they are really struggling to breathe and a doctor needs to take a look at them.

6.How is asthma treated?

Asthma is treated with inhaled medications generally. The most common medication we use is albuterol which helps relax the muscles that tighten down around the airwaves. However, this will not prevent asthma attacks. To prevent asthma attacks, patients are often placed on inhaled steroids to help control the swelling and mucus in their lungs so they can breathe easier.

Asthma is monitored mainly by symptoms. Your physician may ask how often you are using your rescue inhaler or your albuterol to help determine whether your asthma is under good control or not.

The best way to control your child’s asthma is for him or her to take the medication that your physician prescribes on a regular basis. Many people will think that their children’s asthma is under good control and they will stop their medications and that’s when they start having more flares of their asthma.

Everyone with asthma should have an action plan. It will list out your child’s medications and what to do when they start having symptoms. It will tell you what to do when they have mild symptoms or more severe symptoms and should direct you to the appropriate health care resource should they start having more difficulty.

When children use inhalers for their asthma, they are more effective if they use a spacer, which is generally a clear plastic tube with a mouthpiece that helps the medicine deposit into your lungs rather than stuck on your tongue if you just puff the inhaler in your mouth.

7.When should I see a pediatrician?

If your child is having an asthma attack that’s difficult to get under control, you can try doing extra albuterol treatments or extra puffs of your albuterol. If your child needs more than three extra treatments in a day, then you need to contact your physician.

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About the source

Karen Schultz, M.D., is a pulmonologist at Cook Children's. 

"Choosing pediatric pulmonology means I get to practice the medicine of my choice and interact with children and their families," Dr. Schultz said. "Here atCook Children's, the emphasis on the whole family, so I get to follow the children I treat over a long period as they grow and develop.

"In my free time, I'm usually spending time with my husband and children."

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