To Your Health With Dr. Jim Morrow: Episode 23, Childhood Asthma

To Your Health With Dr. Jim Morrow:  Episode 23, Childhood Asthma

On this edition of “To Your Health with Dr. Jim Morrow,” Dr. Morrow childhood asthma: the symptoms to look for, the testing necessary for diagnosis, and prevention of environmental allergies which can cause this ailment. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE  back to healthcare.

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

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The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

What is Childhood Asthma?

• Asthma is a chronic disease that affects your airways.
  • Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen.
  • In the United States, about 20 million people have asthma.
    • Nearly 9 million of them are children.
    • Children have smaller airways than adults, which makes asthma especially serious for them.
    • Children with asthma may experience wheezing, coughing, chest tightness, and trouble breathing, especially early in the morning or at night.
    • Many things can cause asthma, including
      • Allergens – mold, pollen, animals
      • Irritants – cigarette smoke, air pollution
      • Weather – cold air, changes in weather
      • Exercise
      • Infections – flu, common cold
    • When asthma symptoms become worse than usual, it is called an asthma attack.
    • Asthma is treated with two kinds of medicines:
      • quick-relief medicines to stop asthma symptoms and
      • long-term control medicines to prevent symptoms.

Symptoms of Childhood Asthma

• Diagnosing asthma in children can be difficult.
  • Many children will go symptom-free for long periods of time before having an asthma attack.
  • The symptoms of asthma can be confused with those of other respiratory diseases.
  • And depending on your child’s age, it may be difficult for him or her to explain his or her symptoms.
• Children with asthma may show the same symptoms as adults with asthma,
  • coughing,
  • wheezing and shortness of breath.
  • In some children, chronic cough may be the only symptom.
• If your child has one or more of these common symptoms, make an appointment with an allergist / immunologist:
  • Coughing that is constant or made worse by viral infections, happens while your child is asleep or is triggered by exercise or cold air
  • Wheezing or whistling sound when your child exhales
  • Shortness of breath or rapid breathing, which may be associated with exercise
  • Chest tightness (a young child may say that his chest “hurts” or “feels funny”)
  • Fatigue (your child slows down or stops playing)
  • Problems feeding or grunting during feeding (infants)
  • Avoiding sports or social activities
  • Problems sleeping due to coughing or difficulty breathing
• Asthma symptoms or flare-ups are most commonly caused by allergies.
  • Exposure to dust mites,
  • dander from dogs or cats,
  • pollen and other environmental allergens can trigger an asthma attack.
  • In some children, asthma can be caused by non-allergic triggers such as
    • cold air,
    • pollution or
  • Patterns in asthma symptoms are important and can help your doctor make a diagnosis.
    • Pay attention to when symptoms occur:
      • At night or early morning
      • During or after exercise
      • During certain seasons
      • After laughing or crying
      • When exposed to common asthma triggers

Diagnosing Asthma

• It is often difficult, especially in young children, to be entirely certain that asthma is the diagnosis. After a careful physical examination, your pediatrician will need to ask you specific questions about your child’s health.
  • The information you give your pediatrician will help determine if your child has asthma.
  • Your pediatrician will need information about
    • Your child’s symptoms, such as wheezing, coughing, and shortness of breath
    • What triggers the symptoms or when the symptoms get worse
    • Medications that were tried and if they helped
    • Any family history of allergies or asthma
  • It is very important that your pediatrician test your child’s airway function.
    • Spirometry is the most common lung function test done.
    • It measures how much air is moved in and out of the lungs and how fast the air moves.
    • To get the best results, your child will be asked to follow very specific instructions.
    • Most children can do spirometry by age 6, though some preschoolers are able to perform the test at a younger age.
    • Your child will be asked to wear a nose clip to keep him or her from breathing through his or her nose during the test.
      • Your child will then be asked to take in a deep breath and to blow the air out into a mouthpiece that is connected to a computer.
      • The computer measures how much and how fast the air is blown out.
      • Your child will repeat the test at least two times to get their best, most consistent result.
      • This test can take up to 30 minutes to complete.
    • One of the tests measured during spirometry is your child’s peak flow.
      • The peak flow requires your child to blow out as hard and as fast as they can.
      • Sometimes it takes several visits to the office or lab to practice the test before your child can complete the test.
        • Coughing during the test is to be expected.
        • Tell your child that they may rest between blowing into the machine, in order to catch his or her breath.
        • Sometimes this test is repeated after your child inhales medication.
        • This test is called a post- bronchodilator or bronchodilator response test.
      • How can I help to make the breathing test less stressful for my child and me?
        • Be patient with your child during the test.
        • Explain to your child that the test does not hurt.
        • Explain to your child that the breathing test is being done to find out how to make their breathing better.
        • Schedule the test at a time of day that your child is usually not tired or hungry.
        • The staff will explain the test to you and your child. If you or your child does not understand, ask the staff to repeat the instructions.
        • If your child has a cold, sinus infection, or other reason that makes them unable to take the test, let your provider and the office or lab know as soon as possible. They can decide whether the test should be performed or rescheduled.
      • Some children do not find relief from their symptoms even after using medications.
        • If that is your child, your pediatrician may want to test your child for other conditions that can make asthma worse.
        • These conditions include
          • allergic rhinitis (hayfever),
          • sinusitis (sinus infection), and
          • gastroesophageal reflux disease (the process that causes heartburn).
        • It is important to remember that asthma is a complicated disease to diagnose, and the results of airway function testing may be normal even if your child has asthma.
          • Also keep in mind that not all children with repeated episodes of wheezing have asthma.
          • Some children are born with small lungs, and their air passages may get blocked by infections.
          • As their lungs grow they no longer wheeze after an infection. This type of wheezing usually occurs in children without a family history of asthma and in children whose mothers smoked during pregnancy.

Preventing Environmental Allergies and Asthma

• Dust Mites
  • Since some airborne substances may trigger allergy or asthma symptoms, reducing contact with these substances early in life may delay or prevent allergy or asthma symptoms.
  • Research for this is clearest with dust mites.
  • If your child is at high risk of developing allergies, there are steps you can take to control dust mites.
    • Use zippered, “allergen-impermeable” covers on pillows and mattresses and wash bedding in hot water weekly.
    • Indoor humidity should be kept below 50%.
      • Mold in homes is often due to excessive moisture indoors, which can result from water damage due to flooding, leaky roofs, leaking pipes, or excessive humidity.
      • Repair any sources of water leakage.
      • Control indoor humidity by using exhaust fans in the bathrooms and kitchen, and adding a dehumidifier in areas with naturally high humidity.
      • Clean existing mold contamination with detergent and water.
      • Sometimes porous materials such as wallboards with mold contamination have to be replaced.
    • If possible, carpets and upholstered furniture should be removed from your infant’s bedroom.
  • Pets and Other Animals
    • The relationship between early life exposure to animals and the development of allergies and asthma is somewhat confusing and there are many factors to consider.
    • Previous evidence suggested that children exposed to animals early in life are more likely to develop allergies and asthma.
      • More recent research seems to show that early exposure to animals (cats and dogs in particular) may actually protect children from developing these diseases.
      • Newer research also suggests children raised on farms develop fewer allergies and asthma.
    • Tobacco Smoke
      • It is very important not to expose your children to tobacco smoke before or after birth.
      • Smoking during pregnancy increases the chance of your child wheezing during infancy.
      • Exposing children to secondhand smoke has also been shown to increase the development of asthma and other chronic respiratory illnesses.

When is Asthma an Emergency?

• As a parent of a child with asthma, you want to avoid the emergency room (ER) as much as possible.
  • But it’s also important to know when going to the ER is the right choice.
• Sometimes, kids with asthma need medical care very quickly.
  • If any of these symptoms happen, see your doctor immediately, go to the ER, or call an ambulance:
    • Your child has constant wheezing.
    • Your child uses quick-relief medicines (also called rescue or fast-acting medicines) repeatedly for severe flare-up symptoms that don’t go away after 15–20 minutes or return again quickly.
    • Your child has a lasting cough that doesn’t respond to inhaled quick-relief medicine.
    • There are changes in your child’s color, like bluish or gray lips and fingernails.
    • Your child has trouble talking and can’t speak in full sentences.
    • The areas below the ribs, between the ribs, and in the neck visibly pull in during inhalation (called retractions).

In Summary

• Asthma is a chronic illness, but it doesn’t have to be a progressively debilitating disease.
• An accurate diagnosis and an asthma action plan could mean the difference between your child sitting on the sidelines or fully participating in activities with family and friends. You, your child and your allergist / immunologist can work together to ensure that asthma doesn’t take control of your child’s quality of life.

Source:  familydoctor.org