About 10 percent of children in Hong Kong have asthma, according to the Hong Kong Asthma Society. Daniel Hall, MD, a paediatrician at Massachusetts General Hospital for Children, based at MGH Revere HealthCare Center, offers insight into asthma and gives tips to managing your child’s condition.
Q. What happens during an asthma attack?
A. During an asthma attack, the tubes in the lungs that move air become irritated and close down, making it very hard to get oxygen in and out. If you want to know what it feels like, try breathing through a medium-sized straw – not so bad? Now try climbing a few stairs or walking a short distance – it quickly can become quite difficult and scary to not be able to take bigger breaths as your body asks for more air. Albuterol, one of the medications used for asthma, helps to reverse this process. Our goal in treating asthma is to try as best we can to prevent children from being in this scary situation to begin with.
Q. What is an asthma action plan and why does my child need one?
A. An asthma action plan is like a recipe for how to take care of your asthma. There are different types of medicine people with asthma take. Some medications are taken every day and some medications are taken only when asthma symptoms flare. Sometimes, it is hard to remember the difference between medications, especially when they all might come in similar looking inhalers, so your pediatrician should give you a written guide – the Asthma Action Plan – to help remember what to do.
Q. Why is it important to have regular asthma check-up visits with your pediatrician even when you are feeling well?
A. Children with asthma should not feel like their asthma is preventing them from participating fully in all of the things they want to do. Often there are signs of asthma, such as coughing at night, that families may not realize mean their child’s asthma needs better control. Pediatricians can be helpful to identify these things before they cause your child to become sick. During these visits, medications are adjusted and monitored for side effects as your child grows.
Q.Why is it important for my child to get an annual flu shot?
A. We get this question a lot. Many people feel that the flu shot doesn’t work well and would rather risk getting the flu than needing to get the flu shot every year. However, for children with asthma, the flu can be much more than a nuisance. Many children with asthma get very sick from the flu, at times needing to be admitted to the hospital for strong medications, extra oxygen, and even sometimes help breathing! We know that the flu shot can help to prevent these complications, so it is very important that children with asthma and other people in the home get their flu shot every year.
Q. Help, my teenager refuses to take their medicine! How do I engage them in their own care?
A. This is a tough one; many kids struggle with managing asthma in addition to the normal trials and tribulations of being a teenager. Communication is a big part of helping your teen to stay on top of their asthma and can help to identify barriers to learning to manage independently.
Often you can find an appealing app or technology that can encourage them to start to take control.
There is a saying, “Don’t let perfect get in the way of good”. While you may not be able to get your teen to do everything exactly as you would like, often you can find an acceptable middle ground (such as once a day medication rather than twice a day) that avoids constant battles and teaches your child the self-reliance they will need to be a healthy adult.
Q. I wish my child didn’t need to take medicine every day, what else can we do to help manage their asthma?
A. To minimize the amount of medicine your child needs, it is important to keep an asthma-friendly environment. Exposure to smoke is a huge no-no. Second-hand smoke can make kids with asthma very sick and often increases their need for medication. Even adults who only smoke outside bring enough residue inside on their clothes to harm the sensitive lungs of kids with asthma.
Things such as pet hair (dander), mold, and dust can also cause asthma symptoms to flare. Many families find pillow and mattress cover helpful, as well as removing carpeting in children’s rooms.
Never underestimate the power of eating healthy and exercising every day. Children (and adults) should get out and exercise enough to break a sweat every day – this is important for many reasons, including keeping good control over your asthma.
Q. Can/will my child outgrow their asthma symptoms?
A. It is highly possible that your child will “outgrow” their asthma, or at least experience fewer symptoms as they get older. Every child is different, but we think that children who develop asthma symptoms very young and mainly have symptoms every now and then with colds are more likely to outgrow asthma. Children who come from families with lots of relatives with asthma and kids who have more severe symptoms at a young age are less likely to grow out of it.
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