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The diagnoses is asthma, now what?
If your doctor determines that your child has
asthma, there is one important point to keep in mind. Although asthma is a
chronic and serious lung disease, your child can lead an active, normal
life if your family follows the treatments and environmental control measures
suggested by your doctor. Your family needs to partner with your doctor to
succeed in effective disease management.
While still in the doctor’s office, you should
understand what type of asthma your child has. There are four classifications of
pediatric asthma severity:
- Mild intermittent
- Mild persistent
- Moderate persistent
- Severe persistent
Children with more than two episodes of asthma
symptoms per week are classified as having persistent asthma. Persistent asthma
may become more severe or less severe over time. Experts say that children of
all disease classifications can experience severe asthma episodes, or attacks.
Your doctor’s goal will be to first stabilize your child’s symptoms, and
then "step down" the level of medication(s) they are using to the
lowest, but most appropriate level for your child.
Your doctor will use this classification in
determining which medications to prescribe.
- For mild intermittent asthma, no daily
medication is needed. However, the use of short-acting beta2-agonist
(or a "rescue inhaler") more than two times per week may indicate
the need to start long-term control medication.
- For mild persistent asthma, daily
long-term control medication is typically indicated.
- For moderate persistent asthma, Your
physician will likely prescribe two inhalers or medications, one for daily
use to control the underlying inflammation, and one for use when symptoms
become more intense (such as during an "attack").
- For severe persistent asthma, multiple
long-term control medications are required, including high-dose inhaled
corticosteroids and, if needed, oral corticosteroids.
Tools for the asthma patient
There are three important tools you should leave your doctor’s office with, in
addition to a good understanding of asthma, why your child has it and how you
can improve asthma symptoms.
1. Daily Management Plan & Action Plan
Your physician will work with you to develop a daily management plan, describing
regular medications and measures to keep your child’s asthma under control. A
second asthma care plan, an action plan, describes actions to take when asthma
worsens, including what medications to take and when to contact a physician
and/or go to the emergency room or urgent care center.
2. Peak Flow Meter
A peak flow meter for asthma is like a thermometer for a fever. It is an
instrument that can look something like a kazoo and measures the airflow of your
child when he/she blows into it quickly and forcefully. Experts recommend
asthmatic children use them at home to guide decisions about when medications
need to be increased or decreased, and to determine when to call a physician
and/or seek emergency care. This is an inexpensive and important device for
asthma management. It is only helpful for children close to five years old or
more.
3. Environmental Control Plan
An environmental control plan outlines steps you can take to make your home a
better living environment for people with allergic disease. Most children with
asthma also have allergies and these allergies make their asthma symptoms worse.
So, it’s very important to know what your child is allergic to and how you can
provide a more allergen free environment. A few steps can go a long way, for
example:
- Encase mattress, box springs and pillows with
allergen-impermeable covers.
- Launder bedding in hot water (temperatures 130
degrees or hotter) regularly.
- Reduce indoor humidity to less than 50
percent.
- Minimize use of carpets and upholstered
furniture.
The ultimate of all these measures is to get
asthma under control. That means:
- No coughing.
- No shortness of breath or rapid breathing,
wheezing or chest-tightness.
- No waking up at night because of asthma
symptoms.
- Normal activities, including play, sports and
exercise.
- No episodes of asthma that require a doctor
visit, emergency room visit, or urgent care.
- No absences from school or activities
- No missed time from work for the parent or
caregiver.
- Normal or near normal lung function.
Learning that your child has asthma can be
alarming, but working with your doctor— starting with the first doctor’s
visit— and educating yourself and your family on the disease is imperative in
helping your child live a healthier, happier life with asthma.
This article was written and medically reviewed:
March 31, 2000
Information for this educational article was
derived from the document:
Pediatric
Asthma: Promoting Best Practice Guide for Managing Asthma in Children
Known as the Pediatric
Asthma Guide for short, it represents the collective work of many people and
many organizations. It is the only document for treating childhood asthma that
is endorsed by the American Academy of Allergy, Asthma and Immunology, the
American Academy of Pediatrics, and the National Asthma Education and Prevention
Program (NAEPP) of the National Heart, Lung, and Blood Institute. The Guide is
based on guidelines developed by the NAEPP. This pediatric initiative adapted
those guidelines into an easily-referenced, user-friendly, pediatric-focused
document for medical professionals.
The Guide is but one part of a larger initiative
committed to ensuring that a broad spectrum of health care providers learn
about, understand and implement clinical and best practice information for
diagnosing and managing children with asthma.
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