Asthma means chronic inflammation in the lungs. This inflammation can be caused by thousands of different things, including genetics, exposure to infections from viruses or bacteria, cold air, changes in air pressure, exercise, changes in emotions, allergies and exposures to smoking, chemicals or pollution just to name a few. Because the causes of the inflammation are so varied, the way the body reacts is also varied. Many people think of asthma when there is a flare up, but the inflammation from asthma is always there to a low level. A flare up is just when it is gotten to be a little more than the body can handle.
Asthma is the most common chronic condition in kids. On this week’s On Call for All Kids, Deanna Green, M.D., M.H.S., director of the Cystic Fibrosis Center at Johns Hopkins All Children’s Hospital and assistant professor, Division of Pediatric Pulmonary in the Johns Hopkins University School of Medicine, helps parents understand more about asthma.
So what is a flare up and what are some common symptoms of asthma?
At first, the inflammation causes your airways or bronchi to have more mucous. One of the earliest signs of this mucous is an increase in cough. As patients continue to cough, the airways can become more inflamed to the point that they close up even more. When this happens noises are created in the lung that we call wheezing.
If this keeps on going, the people start looking like they are breathing harder and cannot catch their breath. They may have really fast breathing and move their shoulders up and down a lot to get in more air. Please remember that patients all vary and some have only minimal symptoms with cough. Asthma does not have to get to the point where you are always short of breath.
What will your doctor do and how is pediatric asthma treated?
If you are worried about your child having a frequent cough or the child seems to have difficulty breathing from time to time, then you should discuss this with your pediatrician or doctor. Inhalers are the most common way that we treat asthma. Because this is a chronic illness, most patients are given a daily preventative inhaler. Patients need to use it every day, even if they are feeling good, because no one knows the next time you will have an additional exposure, which will increase your inflammation.
We also give patients a second inhaler that we term a rescue inhaler. This rescue inhaler is meant to be used just for that. You have a new exposure and you are starting to cough more or you find it hard to catch your breath. That is the time to use the rescue inhaler. Most of these inhalers are meant to be used with a spacer, which is an extra chamber that helps the dry medicine become a mist so that it can actually get into your lungs.
What can I do to help control asthma?
To help control asthma it helps to figure out what may cause you to have more inflammation and avoid it if possible. No. 1 would be avoiding any and all exposure to smoke whether in the house, car or out at stores or restaurants. Smoke will make anyone’s lungs inflame. Try to avoid really common allergens including dust, molds, pollens and animal hair and dander if you seem to be allergic. If you do not know if you allergic, talk to your doctor about possible testing.
Help yourself avoid colds and infections by washing your hands frequently, trying not to rub your nose and touch your face (even after the pandemic is done), staying up to date on vaccines including influenza. Always use the inhalers correctly including the use of a spacer. Continue to get good sleep and do not skip out on exercise. Many people with asthma think they need to avoid this because symptoms could worsen but exercise is actually really good for building your lung capacity and improving overall symptoms.
On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report.