Asthma Basics

Take a long, deep breath – right now. Inhale slowly, until your lungs can’t hold anymore . . . now let the air out gradually . . . ahhh. Breathing feels so natural that it’s easy to take for granted, isn’t it? Normally, the air you breathe travels effortlessly through your nose and mouth, down the trachea (also called the “windpipe”), through the bronchial tubes into the lungs, and finally to tiny clusters of air sacs, called alveoli. Here, oxygen is exchanged for carbon dioxide in your blood.

Take a long, deep breath – right now. Inhale slowly, until your lungs can’t hold anymore . . . now let the air out gradually . . . ahhh. Breathing feels so natural that it’s easy to take for granted, isn’t it? Normally, the air you breathe travels effortlessly through your nose and mouth, down the trachea (also called the “windpipe”), through the bronchial tubes into the lungs, and finally to tiny clusters of air sacs, called alveoli. Here, oxygen is exchanged for carbon dioxide in your blood. Now try something different: run in place for three minutes. Then place a straw in your mouth, close your lips around it, and try to breathe in and out only through the straw. Not so easy anymore, is it? Now, narrow the straw by pinching it in the middle. Even more difficult to breathe? That’s what it feels like when a child tries to breathe during an asthma flare (commonly called an “attack”). During a flare, the airways narrow and become obstructed, making it difficult for air to move through them. Asthma can be very scary (and when not controlled, it can be life-threatening).Over 15 million people have asthma in the U.S. Did you know it’s the number- one reason for kids chronically missing school? And asthma flares are the most common reason for pediatric emergency room visits due to a chronic illness. Some kids have only mild, occasional symptoms or only show symptoms after exercising. Others have severe asthma that, left untreated, can dramatically limit how active they are and cause changes in lung function. But thanks to new medications and treatment strategies, a child with asthma no longer needs to sit on the sidelines, and parents no longer need to worry incessantly about their child’s well-being. With patient education and the right asthma management plan, today’s families can learn to control symptoms and flares more independently, allowing kids and parents to do just about anything they want.Causes and Descriptions of Asthma FlaresAsthma is a chronic inflammatory lung disease that causes airways to tighten and narrow. Anyone can have asthma, including infants and adolescents. The tendency to develop asthma is often inherited.Many children with asthma can breathe normally for weeks or months between flares. When flares do occur, they often seem to happen without warning. Actually, a flare usually develops over time, involving a complicated process of increasing airway obstruction.All children with asthma have airways that are overly sensitive, or hyperreactive, to certain asthma triggers. Things that trigger asthma flares differ from person to person. Some common triggers are exercise, allergies, viral infections, and smoke. The sensitive airway linings react to trigger exposure by becoming inflamed, swollen, and filled with mucus. The muscles lining the swollen airways tighten and constrict, making them even more narrowed and obstructed. So an asthma flare is caused by three important changes in the airways: – inflammation of the airways – excess mucus that results in congestion and mucus “plugs” that get caught in the narrowed airways – bronchoconstriction: bands of smooth muscle lining the airways tighten upTogether, the inflammation, excess mucus, and bronchoconstriction narrow the airways and make it difficult to move air through (like breathing through a straw. During an asthma flare, kids may experience coughing, wheezing (a breezy whistling sound in the chest when breathing), chest tightness, increased heart rate, perspiration, and shortness of breath.How Is Asthma Diagnosed?Diagnosing asthma can be tricky and time-consuming because different children with asthma can have very different patterns of symptoms. For example, some kids cough constantly at night but seem fine during the day, while others seem to get frequent chest colds that don’t go away. It’s not uncommon for kids to have symptoms like these for months before being seen by a doctor.When considering a diagnosis of asthma, a doctor rules out every other possible cause of a child’s symptoms. He or she asks questions about the family’s asthma and allergy history, performs a physical exam, and possibly orders laboratory tests such as chest x-rays, blood tests, and allergy skin tests. During this process, parents must provide the doctor with as many details as possible, no matter how unrelated they might seem, about things such as:symptoms: how severe they are, when and where they occur, how frequently they occur, how long they last, and how they go away allergies: the child’s and the family’s allergy history illnesses: how often the child gets colds, how severe they are, and how long they last triggers: exposures to irritants and allergens, recent life changes or stressful events, or other things that seem to lead to a flareThis information helps the doctor understand a child’s pattern of symptoms, which can then be compared to the characteristics of different categories of asthma.(Source: Yahoo Health News, May 2004)