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Why is it important to treat asthma?
Even when they are feeling well, children with asthma have an underlying problem in their airways that cannot be ignored: inflammation. Imagine the airways filled with a tiny bit of smoke that must be controlled before it bursts into a fire. Controlling the airway "smoke" (inflammation) is the goal of a good asthma management program. It is very difficult to convince children to take medications when they are feeling well but constant vigilance and consistency in maintaining a treatment program is essential for controlling asthma symptoms, decreasing the severity and duration of asthma attacks, and leading a normal, active life. Proper treatment - which is individualized for each patient - can prevent further inflammation of the airways that, if left untreated, may lead to irreversible airway changes from scarring ("remodeling") and reduced lung function as children grow into adults. Proper treatment will also lower morbidity from asthma and decrease the risk of death.
What are the goals of treatment?
A major goal of asthma treatment is to decrease symptoms, allowing one to live a normal life - everything from eliminating school absences to sleeping through the night to being able to participate in physical activities and not worry about breathing becoming a debilitating factor. Proper treatment will reduce inflammation and the possibility of long-term airway changes, reduce and prevent future attacks, address attacks when they occur, and ultimately improve self-esteem and pave the way for a healthier adulthood.
What does an ideal asthma management consist of?
1. Education
2. Identification of personal triggers
3. Medications: quick relief and long-term control
4. Development of an individualized treatment plan
5. Re-assessment at regular intervals
6. Home monitoring
7. Adopting life improvement strategies
Education
Every child or teen with asthma as well as their families and significant others (coaches, teachers, school nurses) needs to understand as much as they can about asthma. The better informed that everyone is, the better controlled a child's asthma will be and the less of an impact it will have on his/her life. As part of the educational process, the medication treatment plan must be understood and the proper techniques of medication delivery (inhaler or nebulizer) must be mastered. Very often, despite adherence to the treatment plan, asthma symptoms are not controlled because of incorrect use of a medication delivery device. To learn more about the proper technique of inhaler or nebulizer use, click to either:
READ about Inhaled Medication Techniques or
WATCH an Inhaler video
Identification of Personal Triggers
The identification of a child's personal asthma triggers and the development of a plan to avoid or minimize trigger effects is key.
Medications
The last two decades have seen significant advances in our understanding of the mechanism of asthma - specifically, the role that inflammation and cell mediator (chemical) release has in producing both symptoms and possible long-lasting effects in a child's airways. This has led to the development of greatly improved inhaled corticosteroids, as well as other medications that abort or counteract the cell mediator release.
Development of an individualized treatment plan
An asthma treatment plan consists of two parts:
1) A maintenance plan that is used daily to control symptoms, and,
2) An action, or rescue plan that is used as needed to prevent or diminish symptoms after they are triggered, either before or during an episode.
The individualized treatment plan should be written out and closely adhered to. Guidelines from a National Asthma Education and Prevention Program/NIH report recommend a treatment plan that incorporates a step-wise medical plan. The plan is based on asthma symptom frequency and sensitivity, with stepping up medication during periods of worsening and stepping down or decreasing medication after prolonged periods of good control. These guidelines are used to assist the clinical decision-making of your child's physician to best meet his or her individual needs. A strong doctor-patient relationship, in which both sides share information and offer feedback, is the foundation of an effective asthma treatment plan.
Re-assessment at regular intervals
Many things change over time in the life of a child with asthma: triggers, athletic goals, the home environment, stressors, seasonal activities such as camp, hormonal levels, height and weight, etc. It is advisable to have at least twice-yearly visits with your child's pulmonologist or asthma specialist.
Home monitoring
Peak flow monitoring is a method that may be utilized to track a child's response to medication therapy, the level or stability of asthma control, or early signs of an approaching asthma episode.
Adopting life improvement strategies
There are a number of things that a child can do to maximize his or her chances for successful asthma control with the least amount of medication. Following these suggestions will help kids with asthma become healthier overall!
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