Information
Keep a record of how often you wheeze,cough,feel short of breath and/or use your “rescue” inhaler .This record helps guide your physician in making key treatment decisions.
Certain medications may worsen your asthma.These may include common pain relievers such as aspirin,ibuprofen,naproxen and beta blockers,commonly used to treat high blood pressure and migraine headaches.
Inhaled medications are the cornerstone of asthma treatment. Learning to use your inhaler correctly is essential to a successful treatment plan.
A yearly flu shot is recommended for all asthmatics.
Test & Diagnosis
What to expect at the doctor’s office
If you’re wondering about your child’s cough, chest tightness or other symptoms, take them to a physician, and expect the following. Asthma can be difficult to diagnose, particularly in very young children, and so it is critical that your physician be knowledgeable in the diagnosis and treatment of asthma. Ask them if they are familiar with best practice information from either the:
* Expert Panel Report 2 of the National Asthma Education and Prevention Program (from the National Institutes of Health) or
* the Pediatric Asthma Guide, released in 1999. The Pediatric Asthma Guide is endorsed by the American Academy of Pediatrics, the American Academy of Allergy, Asthma and Immunology, and the National Heart, Lung and Blood Institute.
In order to make a diagnosis of asthma, the physician will be looking to:
* Understand the symptoms of airflow obstruction (coughing, wheezing, shortness of breath, rapid breathing, or chest tightness)
* Rule out other possible diagnoses
* Determine if the airflow limitation is at least partially reversible
So, what should you expect at the doctor’s office?
To determine if your child’s symptoms indicate asthma, the doctor should 1) take a thorough medical history, 2) conduct a physical examination and 3) ideally, perform spirometry.
Medical history: questions your doctor should ask.
Because an accurate medical history is so pivotal, the more detailed you can be, the better. See if you can think about these questions beforehand.
* Is there a family history of allergy and/or asthma?
* What are the child’s symptoms? When did you first notice them? When do they occur? What causes symptoms? What makes symptoms worse (smoke, exercise, allergens, humidity, crying/laughing, etc.)? Any pattern to them?
* What are the frequency and severity of the symptoms? Do symptoms interfere with daily activities? Do symptoms limit physical activity? Do symptoms disrupt sleep? Do symptoms affect school performance or activities? Has the child needed to go to the emergency room or hospital because of symptoms?
* How are the symptoms currently managed?
The physical exam
Listening to your child’s lungs with a stethoscope can be very telling and reveal distinctive sounds. Wheezing and struggling for breath will also often leave physical evidence. Your doctor should check the child for hyperexpansion of the thorax. A doctor may also look for other signs of allergic disease like dermatitis/eczema, swelling of the nasal passages, pale nasal mucosa and clear nasal discharge.
Objective measurements
If the physician suspects asthma after questioning and physically examining the child, he/she should test
the airway and lungs during that initial visit using spirometry. Spirometry is an objective way to evaluate the air capacity of the lungs by measuring the volume of air exhaled before and after using a bronchodilator (or "inhaler"). It is not invasive and does not hurt your child. A spirometer is a machine that has a hose attached to the end of it. The child blows forcefully into the hose to register a reading.
This test can tell the doctor if there is a significant impairment to the airway and if treatment can reverse the problem. Children generally need to be at least five years old to carry out this test successfully.
Allergy testing
There are four classifications of asthma: mild intermittent, mild persistent, moderate persistent and severe persistent. If your doctor feels your child has persistent asthma, allergy testing should be done. Approximately 70 - 90% of children with asthma have allergies and these allergies can greatly exacerbate asthma symptoms. Knowing what a child is allergic to can allow you to take important environmental control measures. Allergy testing requires expertise. So, if your child needs to be tested, consider getting a referral to or consultation with an allergist or asthma specialist.
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