What is Chronic Obstructive Pulmonary Disease

COPD (Chronic Obstructive Pulmonary Disease) is a chronic disease of the lung that covers several conditions including Chronic Bronchitis or Emphysema.

Chronic Bronchitis results from an inflammation of the airways of the lung. The term chronic refers to the fact that the condition is present for a long time and bronchitis means inflammation of the bronchi or air passages of the lung. You can find the anatomy of the lung on any well-researched website, but I will give a brief summary here.

The air passages begin with the trachea in the neck which branches into the left and right main stem bronchi. These bronchi continue to branch into smaller bronchi or bronchioles until they end up in the microscopic air sacs or alveoli. It is the alveoli that oxygen and carbon dioxide are exchanged with a rich network of small blood vessels or capillaries. The bronchioles and bronchi are responsible for delivering the oxygen to the alveoli and for carrying the carbon dioxide from the alveoli to the outside. These air passages are more than just tubes — the linings are composed of cells and structures that serve many functions for lubricating the airways and removing debris from the airways. These cells can be damaged by infections or toxins like inhaled poisons or smoking. When these cells are irritated by various stimuli, they form mucus which can plug up the airways and make air movement difficult. In addition, the airways have muscles in the walls and these muscles will contract or dilate the airway depending on what kind of pressure is placed on them.

When we breathe in, our diaphragmas act like an accordion and pull air into the airways. When we breathe out, we squeeze our chests and the airways by pushing our diaphragms up to force the air out. This pressure to force the air out causes the bronchi to become narrow and slows down the speed of the air escaping from the lungs. If the airways are already partially blocked by mucus, or if the muscles are contracting due to irritation, the air cannot escape from the lungs as well, and we feel short of breath or you will hear a wheezing sound as the air tries to escape through narrow tubes.

Emphysema, on the other hand is a disease of the alveoli or air sacs, where the lining of the sacs become destroyed by specific enzymes or infections, and the small air sacs become larger and larger as the walls or membranes between them become destroyed. They tend to lose their elasticity and are unable to squeeze the air out of them as effectively. In addition, the walls or membranes contain the capillaries or small blood vessels that carry the oxygen to the tissues and remove the carbon dioxide from the tissues, so air exchange becomes compromised and we feel short of breath, because not enough oxygen is being delivered to our tissues. In severe cases we can actually see our fingernails turn blue from lack of sufficient oxygen. When there is not enough oxygen in the blood, the blood becomes dark or blue, like in our veins. When there is enough oxygen in the blood the blood becomes a bright red, like in the arteries.

Chronic Obstructive Pulmonary Disease or COPD is a combination of Chronic Bronchitis and Emphysema. The treatment is therefore three fold.

* Remove the toxins from the lungs. This is done by avoiding irritants like smoke, perfumes, dust, or allergens from the environment. In addition, direct toxins like cigarette, cigar or pipe tobacco smoke should be immediately discontinued.

* Treat the constriction of the airways with medicines that can open up the airways. These are called bronchodilators and are usually in inhalers or nebulizers, but can also be in cough medicine, or pills.

* Treat the inflammation of the airways with inhaled anti-inflammatory medications, or by pills or injections. These medications are derivatives of cortisone. Frequently in severe episodes you will be treated with doses of Prednisone tablets for short period of time, or injections of cortisone.

The treatment of COPD is therefore a combination of bronchodilators and cortisone as well as discontinuing smoking, treating any infections and avoiding an environment of smoke.

The prognosis varies depending on the severity of the condition, and this can be determined by doing pulmonary function tests to see how well you can breathe. A simple test that can be done in the office is the PEFR (Peak Expiratory Flow Rate). This is a simple flow meter that patients with COPD can obtain from the pharmacy to test the amount of airway restriction that is present. A more detailed test can be done by a pulmonary specialist, which we do have here in Nassau.

If caught early enough, like any other disease, the prognosis is excellent. I have seen patients with severe COPD who require oxygen all the time, still smoke even with the oxygen being administered. Those are extreme cases but, as you can see, the prognosis can vary widely depending on the severity of the disease and the compliance of the patient with prescribed treatment.

P.S. boost your asthma immunity by eating Vitamin C and Vitamin D rich foods and fruits.

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H1N1, asthma can be a dire combination in children

The day before Halloween, T.J. Berndsen had what his parents believed was a little asthma flare-up. By Halloween night, he felt lousy enough to cut trick-or-treating short.

A week later, the 9-year-old was straining to breathe in the emergency room at Cincinnati Children's Hospital Medical Center because of complications from an H1N1 influenza infection.

"By Sunday, Nov. 8, his cough turned into a croupy bark, and he started running a fever. It got to 102.9. I knew it had gotten to be more than we could handle at home," says his mother, Jennifer Berndsen. She had suspected flu but wasn't sure. His school had had significant numbers of children out, but his classroom hadn't seemed to be hit hard, she says.

While H1N1's effects in a healthy child can range anywhere from mild congestion and sore throat to serious respiratory illness, and even death, the 7 million American kids who have asthma are at a higher risk for complications and death if they contract the novel flu virus, says Tom Skinner of the Centers for Disease Control and Prevention.

"We're seeing underlying health problems, including asthma, in about two-thirds of the estimated 540 children who have died from H1N1 complications," he says.

But the CDC and pediatric asthma experts say there are steps you can take to prevent H1N1, or swine flu, as well as seasonal flu, and ways to treat it if an infection does occur.

Prevention is best

"In children with asthma, the key issue is anticipation rather than reacting," says Erwin Gelfand, chair of pediatrics at National Jewish Health in Denver, a hospital that specializes in treating children with respiratory conditions.

Gelfand says a parent can ensure two things: vaccination and making sure a child's asthma is in control.

The advice goes even for children who get asthma only intermittently, says Tyra Bryant-Stephens, medical director of the Community Asthma Prevention Program at Children's Hospital of Philadelphia.

"Children who only get asthma during exercise, with a cold, or during allergy season can also have serious complications from flu," Bryant-Stephens says.

T.J.'s parents gave him what asthma experts call "maintenance medications" every day: an oral Zyrtec (cetirizine) for allergies and the inhaled corticosteroid Flovent (fluticasone), which reduces inflammation in the lungs. They knew he needed the H1N1 vaccine, says T.J.'s mom, but it hadn't become available in their area yet.

Unlike T.J., many asthmatic children do not take medications as prescribed, sometimes because of cost or parental concerns about side effects, Gelfand says.

"I'd say to any parent, this is not a time to relax compliance. The drugs we have for asthma are as a rule not effective if taken on an intermittent basis, except in possibly the mildest of cases," Gelfand says.

As for vaccines, the CDC recommends that children with breathing issues get the shot form of the vaccine – two doses spread out by a month in those under age 9 – instead of the nasal mist.

If a child does get flulike symptoms, there are steps caregivers should take, says Carolyn Kercsmar, director of the Asthma Center at Cincinnati Children's.

She says if a child develops a fever, is feeling poorly, has chest pain, a bad cough or extreme fatigue, see a doctor right away.

Rough night, quick comeback

T.J.'s parents took the correct steps, Kercsmar says. After additional home albuterol treatments didn't budge his symptoms, they scooted fast to the pediatrician, who sent him on to the ER. There, Jennifer Berndsen says, "they did three back-to-back albuterol treatments – continuous for about an hour. He was so sick by then, poor thing."

He then received a cornucopia of drugs: Motrin to help reduce fever, antibiotics for atypical pneumonia that a chest X-ray revealed, and an intravenous line of magnesium sulfate to help further open up his airways. They dosed him with the steroid prednisone to simmer down inflammation, and he received pure oxygen through a nose mask, Berndsen says.

After he was moved to a room well after midnight and an H1N1 swab came up positive, he was given Tamiflu (oseltamivir).

"These are the children who can benefit from starting Tamiflu right away. It can turn a very nasty disease into one that's tolerable," says Kercsmar, who adds that it works best started within 48 hours, but even within 72 hours can help.

Berndsen reports that though her son's night in the hospital was rough, the turnaround was fast.

"By noon the next day, Tuesday, Nov. 10, T.J. was feeling well enough to eat a chili dog and a pretzel with cheese," she says. He went home that night.


P.S. Boost your immune system by eating Vitamin C and Vitamin D rich foods and fruits.



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Users Complain About New Asthma Inhalers

A year ago the government ordered a big change in asthma inhalers.

The propellant used to force the medication out of the inhaler was changed to a more environmentally safe chemical.

The old albuterol inhalers used chlorofluorocarbon (CFC), but it’s believed the CFC damages the ozone.

As of the first of the year, CFC inhalers were banned and hydroflouroalkane (HFA) was used as a propellant instead.

While the HFA may be better for the environment, some patients and doctors say the inhalers may be dangerous for patients.

Katie Mitchell of Pittsburgh suffers from severe asthma.

She described what an asthma attack feels like. “My chest gets tight, feels like an elephant on my chest, then your airways constrict and you kind of gasp for air.”

Mitchell, a junior at Slippery Rock University, relies on an albuterol inhaler to control her symptoms. Like all asthma patients, her inhaler now contains the environmentally friendly propellant HFA.

She said the new inhaler put her in a life-and-death situation.

“I went to use it and nothing came out and I started panicking because I didn't know what to do. I was shaking it and I had to prime the inhaler six times before I could actually use it, which is dangerous for someone with asthma,” Mitchell said.

Mitchell isn’t the only asthma sufferer who has had problems with the new inhalers.

The FDA told Channel 11 it has gotten many similar complaints about the new inhalers.

Dr. David Skoner, an asthma and allergy specialist at Allegheny General Hospital, said he’s also had patients complain about the inhalers.

Skoner said, “These have a tendency to plug up the little holes where the drug comes out. That can cause a life hyphen threatening situation.”

The medication is stickier, so it can clog the hole it comes out of and can reduce the amount of medication delivered.

Many patients don’t realize they must now take the inhaler apart and clean it at least once a week, which they didn’t have to do with the old inhalers.

Mitchell now cleans her inhaler after every use to make sure it will work the next time she needs it.

“If you're having an asthma attack and you use your inhaler and it's clogged, you can't go over to the sink and wash it out,” Mitchell said.

Skoner said the drug manufacturers recommend taking the inhaler mouthpiece apart and running warm water through it for 30 seconds. Then flip it over and run warm water through the other end for another 30 seconds. Then shake it off and let it air dry overnight before putting it back together.

Clogging isn’t the only complaint the FDA is getting.

The old propellant pushed the medication out with a lot of force, but the new propellant sends the medication out in a gentle plume.

Because it feels and tastes different, many of Skoner’s patients don't think it's working.

“The taste and feel are very different. The CFC felt cold in the back of the throat. This one doesn’t. They knew what the old one felt like . When they use the new one, they don’t feel that, so they don’t feel they are getting the drug and may take more puffs of it,” Skoner said.

Skoner and the FDA said tests show the new propellant still delivers the right amount of medication.

Another drawback of the new inhalers is the cost. The new inhalers are two to three times the price of the old generic inhalers.


P.S. prevent asthma attacks by eating Vitamin C and Vitamin D rich foods and fruits.



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Dr. Andy: Used correctly, inhaler effective

The metered dose inhaler, also known as the pump inhaler, has been the main treatment for lung problems such as asthma since it was first sold in the 1950s. For most it is a convenient and cost-effective way to get medications such as Albuterol into the lungs. Earlier this year a major change in these devices occurred, a change which several of my patients are convinced has made their inhalers less effective.

In the past, the propellant in inhalers was a chlorofluorocarbon (CFC) such as freon. However, as freon has disappeared from our air conditioners, so it did from pump inhalers. In fact CFCs have been banned internationally. Today, the inhaler propellant is a hydrofluoroalkanes (HFA).

In the older CFC inhalers, up to 80 percent of the aerosol one breathed in from the inhaler was the propellant. The CFC also caused the cold sensation that many patients associate with their old inhaler medications. The newer HFA inhalers don't have the same cold sensation, and also do not propel the medication at as high a speed. This results in more medicine actually being delivered into the lungs.

Discussions of pump inhalers would also not be complete without mentioning spacers, or holding chambers. These are usually plastic tubes with the inhaler plugged into one end, and the other end in the patient's mouth. Using a spacer dramatically increases the effectiveness of pump inhaler medications.

Using a spacer with a pump inhaler has been shown in repeat studies to help kids with asthma improve faster than when treated with an inhaler without a spacer attached. There is also no need to coordinate the inhalation with the pumping of the inhaler.

The spacer allows more medication to get to the lungs by allowing it to slow down in the chamber, and may reduce some common complications with inhaled steroids, such as oral thrush. For younger children, a mask can even be fitted to the mouth end of the chamber.

Be sure to clean your spacer chamber prior to using it with a mild dishwashing detergent, and repeat that cleaning process occasionally. This will reduce the electrostatic charge that can build up on the plastic, which attracts the medication particles, reducing the amount available for inhaling into the lungs.

In regard to nebulizer machines vs. the pump inhalers with a spacing chamber, numerous repeat studies have shown that a correctly used pump inhaler with a spacing chamber is as effective, if not more effective, than a nebulizer treatment. The significantly lower cost of inhaler medication, ease of portability and lack of reliance upon electrical equipment are just added benefits of inhalers over nebulizer machines.

So if you, or your child, use an inhaled medicine, be sure to talk with your doctor to verify you are using it correctly. Don't be afraid to ask questions, and remember - we work for you.


P.S. prevent asthma attacks by eating Vitamin C and Vitamin D rich foods and fruits.



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CHEST: Lower Doses Benefit Pediatric Asthma Patients

In children who are hospitalized with asthma, a reduced-dose steroid regimen has no effect on hospital stays, and low-dose albuterol treatment is associated with a lower risk of metabolic acidosis than high-dose treatment, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.

In one study, Courtney Edwards, of Kosair Children's Hospital in Louisville, Ky., and colleagues compared outcomes in children who were hospitalized with status asthmaticus, 152 of whom received a maximum steroid dose of 240 mg/day and 141 of whom received a maximum dose of 60 mg/day. No difference was found in the median length of stay between the high-dose and low-dose groups (2.01 versus 1.98 days).

In a second study, Muhammad A. Rishi, M.D., of the Yale School of Medicine in Bridgeport, Conn., and colleagues studied 201 children admitted to the pediatric intensive care unit with a diagnosis of severe acute asthma. Compared to low-dose albuterol treatment, they found that high-dose treatment was associated with increased heart and respiratory rates and a significantly higher rate of metabolic acidosis (43.3 versus 8.3 percent).

"We conclude that lower dose inhaled corticosteroids may be helpful in most children admitted with status asthmaticus," Edwards and colleagues conclude. "Further prospective studies are needed to confirm our findings."

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CAFFEINE CAN REDUCE ASTHMA SYMPTOMS

A study presented at a conference at the American College of Sports Medicine found that those who ingested caffeine within an hour of exercise reduced their symptoms of exercise-induced asthma (EIA), which is characterised as a shortness of breath during sustained aerobic activity.

The randomised, double-blind, double-dummy crossover study was led by University of Utah researcher Timothy A. VanHaitsma and fellow researchers at Indiana University and involved ten asthmatic people who had also had EIA. Each took either three, six, or nine milligrams of caffeine per kilogram of body weight or a placebo, an hour before exercising on a treadmill. Tests of pulmonary function were taken 15 minutes before exercise commenced, then again 1, 5, 10, 15 and 30 minutes after the exercise stopped.

At nine milligrams of caffeine per kilogram of body weight, considered a large dose, the effects were comparable to using an albuterol inhaler, something commonly used to prevent or treat EIA. This would be the equivalent of about six cups of coffee. Smaller amounts of caffeine, such as three and 6 milligrams per kilogram of body weight, were also found to be useful, reducing coughing, wheezing and other EIA symptoms.

All participants received all doses, including the placebo, at one point or another during the experiment.

Associate professor in the Department of Kinesiology and a co-investigator of the study, Timothy Mickleborough, said that no additional benefit was found when caffeine was combined with an albuterol inhaler.

For someone who weighs 150 pounds, for example, 3 to 9 milligrams of caffeine per kilogram of body weight equals from about 205 to 610 milligrams of caffeine. This study adds to earlier work that found caffeine can reduce the symptoms of EIA and is the first to examine any synergistic effect of caffeine use along with an albuterol inhaler.

Mickleborough and his fellow researchers have also investigated the efficacy of a number of nutritional factors on EIA, with research to date showing that a diet high in fish oil and antioxidants and low in salt has the potential to reduce the severity of EIA and perhaps reduce the reliance on pharmacotherapy. With growing concern about the potential side effects of inhaled corticosteroid use, this is especially important. Also, prolonged usage of daily medications can result in their reduced effectiveness.



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Changes in Weather May Trigger Child’s Asthma

Changes in humidity and temperature result in a increase in Emergency Department (ED) visits for pediatric asthma exacerbations according to a report published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

“We found a strong relationship between temperature and humidity fluctuations with pediatric asthma exacerbations, but not barometric pressure,” said Nana A. Mireku, M.D., an allergist at Dallas Allergy Immunology in Dallas, formerly at Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, Mich. “To our knowledge, this is the first study that demonstrates these correlations after controlling for levels of airborne pollutants and common aeroallergens.

“Our study is also one of the few to examine the possibility that the weather one or two days before the asthma exacerbation may be as important as that on the day of admission, observing additional ED visits on these days,” she said.

According to the report, patients experiencing an asthma attack often complain that weather fluctuations are a major trigger. Authors note, “the latest National Institutes of Health guidelines list ‘change in weather’ as a possible precipitating factor for asthma, but do not cite any references for this opinion.”

The retrospective 2-year study was performed at a large urban hospital of 25,401 children visiting the ED for an pediatric asthma exacerbation. Data on climactic factors, pollutants and aeroallergens were collected daily. The relationship of daily or between-day changes in climactic factors and asthma ED visits was evaluated using time series analysis, controlling for seasonality, air pollution and aeroallergen exposure. The effects of climactic factors were evaluated on the day of admission and up to five days before admission.

A 10 percent daily increase in humidity on a day or two before admission was associated with approximately one additional ED visit for asthma. Between-day changes in humidity from two to three days prior to admission were also associated with more ED visits. Daily changes in temperature on the day of or the day before admission increased ED visits, with a 10°F increase being association with 1.8 additional visits.

Asthma is a chronic inflammation of the lung airways that causes coughing, chest tightness, wheezing or shortness of breath. More than 22 million Americans have asthma, including 6.5 million under age 18.

"Pediatric Asthma is the most common chronic illness in childhood,” said allergist Richard G. Gower, M.D., president of ACAAI. “Allergists have always known that weather conditions such as extremely dry, wet or windy weather can affect asthma symptoms. This study further defines the role of temperature and humidity on children's asthma and confirms the importance of working with patients to identify the source of their symptoms and develop treatment plans that help prevent them.”


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Asthma May Start in the Womb

Children born in areas of heavy traffic areas could be at greater risk of developing asthma due to genetic changes brought on by pollution and acquired in the womb, a new study suggests.

In a study of umbilical cord blood from New York City children, researchers found a change in a gene called ACSL3 that is associated with prenatal exposure to chemical pollutants called polycyclic aromatic hydrocarbons (PAHs), which are byproducts of incomplete combustion from carbon-containing fuels, resulting in high levels in heavy-traffic areas.

Exposure to PAHs has previously been linked to diseases such as cancer and childhood asthma.

Researchers say this finding provides a potential clue for predicting environmentally related asthma in children — particularly those born to mothers who live in high-traffic areas like Northern Manhattan and South Bronx when pregnant.

The genetic alterations are called epigenetic changes, which may disrupt the normal functioning of genes by affecting their expression but do not cause structural changes or mutations in the genes.

"Our data support the concept that environmental exposures can interact with genes during key developmental periods to trigger disease onset later in life, and that tissues are being reprogrammed to become abnormal later," said Shuk-mei Ho, University of Cincinnati researcher and lead author of a paper on the results published in the Feb. 16 issue of the journal PLoS ONE.

http://www.livescience.com/common/media/video/player.php?videoRef=040907Staying_clean

Too Clean?

Just to confuse things, scientists also say a super-clean lifestyle can lead to more allergies in children.

The researchers analyzed umbilical cord white blood cell samples from 56 children for epigenetic alterations related to prenatal PAH exposure in Northern Manhattan and the South Bronx. The mothers' exposure to PAHs was monitored during pregnancy using backpack air monitors.

The researchers found a significant association between changes in ACSL3 methylation — a gene expressed in the lung — and maternal PAH exposure. ACSL3 also was associated with a parental report of asthma symptoms in the children prior to age 5.

"This research is aimed at detecting early signs of asthma risk so that we can better prevent this chronic disease that affects as many as 25 percent of children in Northern Manhattan and elsewhere," said Frederica Perera, co-author on the paper from Columbia University Mailman School of Public Health.

More research is needed to confirm the findings, the scientists said. If the study is confirmed, changes in the ACSL3 gene could serve as a novel biomarker for early diagnosis of pollution-related asthma.

"Understanding early predictors of asthma is an important area of investigation," said study team member Rachel Miller of the Columbia Center for Children's Environmental Health. "because they represent potential clinical targets for intervention."


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Children with asthma more vulnerable to H1N1 virus

Secretary of Health Kathleen Sebelius met with students and their parents at Thurgood Marshall Elementary, one of 16 schools in Philadelphia that partners with the Merck Childhood Asthma Network, Inc. (MCAN). The program works to help students better manage their asthma. She talked about the importance of education and creating healthy habits to avoid missing school.

"Nothing is more important than keeping our children healthy, in school and ready to learn as we start the new school year," said Dr. Floyd Malveaux, Executive Director of MCAN and former Dean of the College of Medicine at Howard University. "We applaud Secretary Sebelius for recognizing that staying healthy can be a challenge for students with asthma – a factor that is even further complicated with the possibility of being exposed to the H1N1 virus, which can increase the severity of asthma symptoms, leading to possible hospitalizations."

During the meeting, Secretary Sebelius highlighted the work of the Philadelphia MCAN project as a model for inner-city childhood asthma management. Launched in 2005, the Philadelphia MCAN project has improved asthma outcomes for children and reduced school absenteeism by using a community-based approach that integrates families, community agencies, schools and health care providers to implement scientifically proven asthma interventions.

The Philadelphia program brings hope into communities that shoulder a disproportionate share of the childhood asthma burden. Screening conducted with the Philadelphia MCAN project in partnership with The School District of Philadelphia found that one out of four students in the West, Southwest, Olney, Logan and Germantown communities – target communities for the program – have been diagnosed with asthma or have been admitted to the hospital for wheezing, compared to one out of ten nationwide. The Philadelphia program provides children with asthma and their families access to three key services: Community Asthma Prevention Program (CAPP) classes that educate parents, other caretakers and children with asthma; CAPP home visits where community health workers help families eliminate or control allergens and irritants within the home; and Health Promotion Council (HPC) Link Line services that connect families to asthma care coordinators.

"The unique structure of our program allows us to bring multiple stakeholders to the table to create a successful team that can get children to care and services for better long-term and immediate asthma management," said Dr. Michael Rosenthal of Thomas Jefferson University and co-lead investigator of the Philadelphia MCAN program. "By collaborating with specific schools to identify children that have asthma, the Philadelphia MCAN project has armed school nurses with essential information to assist students who are at higher risk for complications with H1N1 and seasonal flu virus, allowing them to be better prepared to manage these children at school."

Nationally, MCAN, a non-profit organization funded by the Merck Company Foundation, provides funding to four other local programs that target low-income, urban populations with high rates of pediatric asthma in Chicago, Los Angeles, New York and Puerto Rico. The goal is to evaluate the effectiveness of these programs and use the findings to develop model programs that can be replicated and tailored in communities across the country.

"The Philadelphia MCAN program has shown that we can help children manage their asthma and that means improved quality of life, significantly fewer trips to the ER or stays in the hospital, and best of all, more days in school," said Dr. Tyra Bryant-Stephens from The Children's Hospital of Philadelphia and co-lead investigator of the Philadelphia MCAN project. "Empowering caregivers and children with this knowledge has helped to greatly decrease the school days missed by children in Philadelphia, a segment of the nearly 13 million schools days missed each year by the millions of children nationwide that have been diagnosed with asthma."

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Dealing With Childhood Asthma

Asthma is a terrible disease, one that is hard enough to live with if you are an adult, but if you are a child it is especially traumatic. Childhood asthma can be so severe that it is practically debilitating, and can really take one’s childhood away from them. If your child has childhood asthma, also known as pediatric asthma, it is important that you make yourself as educated as you can on the disease and also that you watch and make sure that their symptoms do not worsen. If their symptoms ever do worsen and they start to have an asthma attack, they are going to need medical attention right away to treat the asthma. Symptoms would include anything from tightness in the chest and wheezing to coughing and shortness of breath. Keep in mind that these are not the only childhood asthma symptoms and that the asthma symptoms in children will vary from one to another.

Of course one of the most important issues on the subject of childhood asthma is management. There is no cure for the disease as of yet, but there are many effective treatments and remedies that you can use to keep the symptoms under control and help avoid the onset of attacks.

pWhen you are treating asthma in a child it will be much different than it would be in an adult. This is because children are much more susceptible to the effects of asthma, and also because their bodies are smaller and so therefore they are not able to use some of the treatments and remedies that are available to adults.

Combination therapy is the best option when it comes to keeping childhood asthma under control. This means using an inhaler that contains two or more medications rather than just one. Using inhaled corticosteroids only when needed may improve compliance which is likely to occur in patients with mild asthma who have infrequent symptoms.

Taking just one medication or another may help but for childhood asthma you want to avoid asthma attacks even more than you would in adults and so therefore using a combination of medications in the inhaler is going to be your best bet.

If your child has asthma, take every step that you can to become more informed and aware, and that you take every precaution possible to ensure that your child’s pediatric asthma stays under as best control as possible. Work as a team with your doctor to make sure that this happens.


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Symptoms of Asthma in Infants

The symptoms of asthma in infants can be so subtle that you don't even realize infant asthma might be involved. Baby asthma is challenging to diagnose too, because your infant can't tell you in words how he or she is feeling. So doctors rely more on the parent's description of a pattern of symptoms and behavior, as well as family medical history, in deciding what type of breathing problem your baby may have.

Asthma is the most common chronic disease in babies and children. In fact, 1 out of every 10 kids has asthma today. So, if you find out your baby has asthma too, you'll have lots of company. If you do suspect infant asthma is causing your child's breathing problems, it's important to find out for sure as soon as you can. The inflammation of the airways that asthma causes can cause severe respiratory distress and may even lead to death, if left untreated or uncontrolled. Babies are especially susceptible to complications, because their lungs are not as mature to begin with, so early diagnosis and treatment are essential.


What Are the Symptoms of Asthma in Infants?

Common asthma symptoms in adults include:

* Wheezing
* Coughing
* Shortness of breath
* Chest tightness

But it's important to note that the pattern and intensity of asthma symptoms can vary greatly from person to person. With infant asthma, symptoms can be even more variable. They are also different, to some extent, than in adults.

In baby asthma, coughing is often the only symptom the infant will have. Some kids cough all night, but have no noticeable symptoms during the daytime hours. Other infants may cough intermittently throughout the day. Also, when babies wheeze, it's not always because of asthma. It could just be a viral respiratory infection.

So, doctors look closely at patterns when trying to decide whether your infant has asthma. First off, they'll ask you if you've noticed repeated instances of:

* Coughing, especially at night
* Wheezing
* Trouble breathing or fast breathing

The doctor will also look for symptoms that are worsened by:

* Frequent viral infections, such as colds or bronchitis, that seem to "go right to the chest" and last
* Exposure to tobacco smoke or other strong odors / fumes
* Active play
* Contact with common allergic triggers, such as pets, pollen, and dust
* Changes in the weather
* Crying or laughing

Diagnosing asthma in infants can be hard because symptoms must be observed, rather than described. And common testing used to diagnose asthma, such as spirometry, can't be used with infants. And just having any one of the above findings is probably not going to lead your baby's doctor to an asthma diagnosis. But having several of them may. In the end, doctors often diagnose asthma by ruling out other possibilities.


What Other Diagnoses Have Similar Symptoms?

As noted above, wheezing in infants can be caused by more than just asthma. And the good news is that these other conditions are often milder than asthma and may go away completely within a few years, as opposed to asthma, which usually lasts throughout childhood and maybe even into adulthood.

Some of the names for conditions that cause recurrent wheezing and coughing episodes in infancy are:

* Wheezing bronchitis, which is a viral infection
* Bronchiolitis
* Asthmatic bronchitis
* Wheezing associated with respiratory illness or breathing problems
* Para-infectious bronchial hyperreactivity
* RAD

The common factor with all of these labels is that the wheezing is not associated with allergic disease as asthma usually is in children. One of the most common catch-all terms for non-asthma wheezing is reactive airway disease, which is also called RAD for short. RAD may be used to avoid labeling an infant too soon with a more serious diagnosis of asthma.

However, both RAD and infant asthma are often treated the same, because doctors really can't tell for sure if an infant has asthma, and won't know until at least age 5. So, they treat "as if" the infant has asthma.

But parents' worries about their babies taking possibly unnecessary medicine can be soothed by the knowledge that asthma treatment is safe, even for infants. What risks there may be are considered to be offset by the very real benefits of keeping asthma – if it does exist – under control. Preventing more serious respiratory problems down the line is well worth it.
In Summary

If you notice a chronic cough in your infant, especially if it is waking your baby and you up at night, it would be wise to talk with your pediatrician about it. The same is true if you notice your baby having frequent and / or severe chest colds. And remember, wheezing does not have to be present in infants with asthma, as it almost always is with adults. And if your baby does wheeze, it doesn't necessarily mean he or she has asthma.

Don't ignore such symptoms or fear an asthma diagnosis. Asthma is fairly easy to manage with medicine and environmental changes, and taking such steps can help ensure that your infant is able to have a normal, active life.


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Inhalers for Asthma

From my childhod days until I turned 23 years of age, my asthma medication consists only of tablets and capsules or just leave it be. But right after that, I tried the asthma inhaler and immediately I got hooked. The healing time of tablets ranges from 2 hours to 3 hours but for the inhaler it took only 1 or 2 seconds.

Inhalers are the main source of treatment for asthmatic patients and enables them to lead active lives without the fear of an attack. There are different types of inhalers available in the market which can make things confusing.

This article will give some more information about the inhalers for asthma.

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