May is Asthma Awareness Month and I am certainly seeing many patients whose asthma and wheezing is getting the best of them right now. With all of the major weather changes across the country, pollen counts through the roof, and upper respiratory viruses still circulating, there are quite a few triggers to set off wheezing.
Asthma is a chronic lung disease and affects more than 6 million children in the United States. Asthma causes wheezing and chest tightness in some, while it may only cause nighttime cough and cough with exercise in others. There is not one single presentation to asthma and the diagnosis is best made with a good history and physical exam. Although asthma is a chronic disease you may only have attacks when something is bothering your lungs (triggers).
The biggest challenge I see as a pediatrician is teaching both parents and children to recognize their triggers and to know what their medications are. Every patient should have an asthma action plan, but in some cases, a child may have only wheezed once..and their parents received an inhaler or a nebulizer but really does not know what to do if their child wheezes again.
If your child has wheezed before, and you have a family history of wheezing, your child has a greater chance of wheezing again. You should have a discussion with your pediatrician about how to recognize wheezing in your child. At the same time, if you have ever received a medication for wheezing, make sure you know the name or names of the medication. I see many parents who come in to the office and they may have been seen at an ER or urgent care when they were noted to be wheezing. They received an “inhaler”, but the parent has no clue as to the name of the inhaler (they may say, “it is blue”), and they don’t understand how the medications work.
The two points I try to make with every patient I see with wheezing:
#1 Know the names of the medications that you have
#2 Know what the medications do
There are two issues with asthma, lung inflammation and broncho spasm (narrowing of the airways). So…there are two medications commonly used to treat these issues. Inhaled steroids (there are tons of brands) are used as a preventative and decrease inflammation, while albuterol (again tons of brands) is a broncho-dilator and opens up the narrowed airways. I see too many patients that bring in a bag full of medications, from numerous doctors and still don’t understand what their medications are used for, when to use them and that several of their inhalers, while having different names, are actually the same medicine.
Lastly, children with divorced parents need to have inhalers available at both homes. I think it is too complicated to try and have parents hand the inhaler or medication back and forth and think they will not forget or lose the medication. Ask your doctor to have meds for both houses.
Seeing that is is Asthma Awareness month, get your medications out and make sure that they are not expired and if you don’t understand how or when to use them, make an appointment with your pediatrician and get an asthma action plan in place. Be prepared!