Positive Options for Children with Asthma: Everything Parents Need to Know

Overview


** How to Help Your Child Live an Active, Healthy Life
** A straightforward simple guide for parents

Written especially for parents, this book is a comprehensive guide to a better understanding of childhood asthma. Only parents and the immediate family know the intense anxiety and pain they experience when their child suffers from breathlessness, or wakes up in the middle of the night with a severe attack of asthma.

Written in a warm, reassuring tone, the author explains the ...

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Positive Options for Children with Asthma: Everything Parents Need to Know

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Overview


** How to Help Your Child Live an Active, Healthy Life
** A straightforward simple guide for parents

Written especially for parents, this book is a comprehensive guide to a better understanding of childhood asthma. Only parents and the immediate family know the intense anxiety and pain they experience when their child suffers from breathlessness, or wakes up in the middle of the night with a severe attack of asthma.

Written in a warm, reassuring tone, the author explains the causes of asthma in children, discusses what goes wrong inside the lungs, and reviews the various diagnostic procedures and treatment options available, including advances in safe medication. Most important, the book discusses the critical role parents can play in preventing and managing asthma attacks:

** Creating a safe, allergen-free environment
** Recognizing advance warning signs
** Pre-empting attacks
** Reducing the intensity of attacks
** Ensuring safe and minimal medication
** Enhancing body immunity and tolerance to allergens
** Helping the child to help himself

This edition for the US market includes the latest updates in the field and a new chapter on alternative treatments for asthma in children.

This is the ninth book in Hunter House's popular Positive Options series.

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Editorial Reviews

From the Publisher

"Positive Options for Children With Asthma is an excellent guide for parents. ...straight-forward, concise and easy to understand..." &#8212 ADVANCE for Respiratory Care Practioners, January 23, 2006

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Product Details

  • ISBN-13: 9780897934534
  • Publisher: Turner Publishing Company
  • Publication date: 4/28/2005
  • Series: Positive Options for Health Series
  • Pages: 160
  • Product dimensions: 5.52 (w) x 8.56 (h) x 0.44 (d)

Read an Excerpt

Positive Options for Children with Asthma

Everything Parents Need to Know
By O. P. Jaggi

Hunter House Inc., Publishers

Copyright © 2005 Prof. Dr. O. P. Jaggi
All right reserved.

ISBN: 978-0-89793-453-4


Chapter One

Asthma in Children

Asthma, generally speaking, manifests itself in the form of coughing, wheezing, and breathlessness. Attacks may be short or long; mild, moderate, or severe; rare or frequent; and may come on at the change of season or persist throughout the year. Children from families with a strong history of asthma, eczema, and allergies are most prone to developing asthma.

Is Asthma Inherited?

Just why asthma occurs in some children and not in others is not well understood. While asthma is probably a heritable disease, it does not always follow a predictable line of inheritance. Asthma can skip from one generation to another or appear in cousins, uncles, or aunts. Many asthmatics who seemingly do not have a family background of asthma probably have a parent or other relative with a wheezy condition that was incorrectly labeled as chronic bronchitis or pulmonary emphysema, a condition in which the air sacs of the lungs are either damaged or enlarged causing breathlessness.

In addition, the presence of an asthmatic gene in an individual does not necessarily lead to the developmentof asthma. Many brothers and sisters of asthmatic patients carry the asthmatic gene yet never show any outward signs of the disease.

Asthma that starts in infancy or childhood is more likely to be inherited than asthma that develops later in life. When one parent has asthma, especially the allergic type, the chances are one out of two that their child will develop asthma. When both parents are afflicted, the odds increase to three out of four.

How Is Asthma in Children Diagnosed?

The first one or two episodes of coughing are quite likely to be called bronchitis or bronchiolitis by the family doctor, which unfortunately delays the correct diagnosis of the problem. Often doctors are unwilling to use the term asthma in the case of a young child, because it implies that the child may have a chronic disease. Thus, asthma in children remains underdiagnosed and undertreated.

Asthma may develop during the first few months of life, but it is difficult to make a definite diagnosis until the child is about four years or older or until the child has had repeated attacks of coughing that are investigated.

Midchildhood Asthma

If asthma develops when children are four to ten years old or in midchildhood, it is usually the allergic form of asthma. This form is generally easy to treat and has the best prognosis, or prospect of recovery. Such children often lack a family history of asthma, have normal breathing, and show normal results for breathing tests between attacks. Some may go on to develop hay fever or sneezing fits in their teenage years.

Do Children Outgrow Asthma?

No clear answer is available to this question. The long-term prospects for the treatment and cure of childhood asthma are now a major concern. The hope is that childhood asthma will disappear when the child becomes an adult, but medical and scientific evidence is less than promising. It has been estimated that asthma disappears in 30 to 50 percent of children in adolescence but often reappears in adult life. Almost two-thirds of children with asthma continue to suffer from the disorder through puberty and adulthood.

While many children go into a permanent or partial remission as they grow older, some continue to have twitchy or sensitive lungs. Moreover, even when asthma symptoms have disappeared, lung function remains altered and airway hyperresponsiveness (hypersensitivity) or coughing persists. As a result, wheezing may occur during a bad chest cold or while exercising in cold air. In one study in England, two-thirds of the three hundred childhood asthmatics tracked were still symptomatic when they were twenty-one years old.

The growth of the lungs appears to be relatively normal in most children with asthma, but it can be less than normal or impaired throughout childhood and adolescence in those with severe and persistent symptoms.

The long-term prognosis for childhood asthmatics appears to be worse when the child has eczema or a family history of eczema, but wheezing in the first year of life is not a prognostic indicator for asthma or for more severe asthma later in childhood. It should also be noted that 5 to 10 percent of children with less severe asthma develop severe asthma in later life.

Childhood asthma should never be left undiagnosed or untreated in the hope that the child will simply grow out of it. This can lead to some loss of lung function in the long run. Children with mild asthma are likely to have a good prognosis, while children with moderate or severe asthma will probably continue to have some degree of airway hyperresponsiveness (hypersensitivity) and may be at risk of having long-term asthma.

What Is the Impact on the Family?

Asthma in a child affects all family members, especially the parents. When bouts of coughing and wheezing occur at night, the parents must administer medication, attend to other needs, and call the doctor if necessary. The other children in the family may be awakened or may have to be called upon to help look after the patient.

The financial cost of looking after the asthmatic child can be substantial and may require a reworking of the family budget to provide funds for treatment and medicines. This could, in some cases, require the postponement of other expenses.

Parents may also have to make adjustments at home. Sometimes the child requires a clean, separate room, and all the carpets, sofas, and mattresses must be removed or replaced to decrease the amount of airborne allergens.

Special arrangements may be necessary if the family has to travel. For example, parents need to be sure to pack adequate supplies of all prescribed medicines, make preparations for any dietary issues that might arise, and pack any clothing items that might be needed for the weather conditions at the new location.

The child with asthma must be looked after and cared for and yet still be treated like any other child. Managing asthma calls for patience, understanding, and cooperation from every member of the family, but asthma is more of an occasional nuisance than a serious disease, provided the child and the family are adequately informed and prepared in the event of an attack.

Chapter Two

Early Symptoms and Warning Signs

Asthma may present itself differently in children than it does in adults. In children, asthma usually manifests as recurrent coughing attacks that occur over weeks or a season. In many cases, the cough is worse at night. If there is a family history of allergy in any form (e.g., asthma, sneezing, eczema, or hives), then some of the children in these families (33 percent of the children in one study) will develop coughing, wheezing, or breathlessness as well. Breathlessness in children usually does not come in the form of intermittent attacks, but as a cough and/or a cold.

In some children, the symptoms of bronchial asthma may start at the onset of the disease, while in others, symptoms may appear later. In some infants, wheezing and coughing may occur at infrequent intervals; in others, wheezing may be quite frequent and asthma may be well established. A recent study has demonstrated that the majority of seven-year-old children with airway hyperresponsiveness (hypersensitivity) suffered from allergy as infants, i.e., they had a tendency to have immediate allergic reactions to common substances in the environment. A study concerning lung development showed that asthma in infancy can result in a decrease of approximately 20 percent in lung function when the individual reaches adulthood, indicating the possible harmful effects asthma may have on the development of the lungs.

Cough: The Most Common Indicator

Cough is the most common indicator of a disorder in the respiratory tract. Any malfunctioning of the lungs or the bronchi leads to cough as the lungs try to throw out whatever is unwanted: secretions, bacteria, particles of dust, smoke, or gases. Thus, coughing is a useful defense mechanism for keeping the lungs clean.

Coughing is one of the indicators of asthma in infants and children. Such coughing may be either severe and of a short duration or chronic and of a long duration. Wheezing is also common. Coughing and wheezing are usually more predominant in the early morning hours.

What Other Illness Can a Cough Indicate?

The following lung conditions can have cough as a prominent symptom, but as these illnesses are not asthma related, they need to be treated differently.

Whooping Cough

A cough that worsens at night, has a whooping sound, and is often accompanied by vomiting should be regarded as a whooping cough. The typical whoop may not be heard for a week or two after the onset. Diagnosis is usually done by taking a nasal culture.

Foreign Body Aspiration

The aspiration, or inhalation, of a foreign body may cause the sudden onset of a severe coughing fit with choking sensation. Aspiration is usually followed by a silent period, after which the child may develop fever, cough, and signs of infection in the obstructed lung. Whenever a child has a sudden onset of cough without a preceding cold, the possibility that the child has inhaled a foreign body must be considered.

Bronchiectasis

A persistent, productive cough with foul-smelling sputum and a nasal sinus infection usually indicates that the child has bronchiectasis, or chronic dilation (widening) of one or more bronchi that may also be infected. It may be due to an underlying congenital abnormality or the result of a viral or bacterial infection following a bout with a disease like measles or pneumonia. The disease that precedes the infection causes the bronchi to dilate and the lung secretions to become stagnant. These secretions are ejected after repeated coughing.

A Lung Abscess

Sometimes a pneumonia patch does not recover. Instead, it breaks down, destroys the tissues of the lungs, and forms a cavity in which secretions can collect. These puslike and foul-smelling secretions come out after coughing. A lung abscess is accompanied by fever, weight loss, and a diminished appetite. It is an acute process and, if not checked, leads to rapid destruction of the lungs.

Tuberculosis

Coughing is a common symptom of tuberculosis of the lungs. At the beginning of the sickness, the cough is mild and occurs only while clearing the throat in the morning. As the disease progresses, the cough persists during the day as well as the night. There is fever, weight loss, and a loss of appetite.

Early diagnosis is confirmed by chest X ray and by sputum examination for tubercle bacilli. Subsequent treatment with antituberculosis drugs provides quick relief. The treatment must be continued for six months or more to eradicate the disease.

Heart Disease

Some forms of heart disease, particularly left heart failure that impedes the flow of blood from the lungs to the heart, may also cause coughing accompanied by thin expectoration.

* * *

A cough, then, can be a symptom of many diseases and not necessarily of asthma. A detailed investigation is required to pinpoint the cause of cough.

Common Cold

In some children, a bout with the common cold that is compounded with asthma or an added infection like asthmatic bronchitis can lead to the narrowing of the airways and a wheeze that is akin to that found in asthma. When the infection subsides, the wheeze disappears and may not reoccur. A cold maybe followed by pharyngitis, tracheitis, or bronchitis, which may be accompanied by hoarseness of voice. Pneumonia can also develop, which leads to a cough accompanied by fever and respiratory distress. The cough associated with pneumonia and bronchitis also produces sputum.

Allergies

If one or both the parents have some allergic disorder, some of their children may also have it, maybe in the form of asthma. Children who meet any of the following descriptions are more likely to have asthma: those with allergic symptoms such as unusual and persistent colic; those who need frequent change in infant formulas; those who suffer unexplained diarrhea, constipation, or skin rashes; or those who discharge pus from their ears (otitis media).

Besides the above symptoms, some other allergies may accompany asthma or be a precursor of it. Careful attention to these conditions helps in the diagnosis of asthma.

Seasonal Sneezing or Hay Fever

Bouts of sneezing that occur at a particular time of the year or during a particular season are called seasonal allergic rhinitis. In layman's terms, this is known as hay fever, and it is the most common form of allergy. The condition is more common in children than in adults. Year after year, these symptoms occur in a child during the same season, while other children are perfectly normal. Both boys and girls are equally affected by it. The symptoms may be mild or severe and distressing.

Hay fever is partly hereditary and occurs in individuals who have inherited an allergic background. Bouts of sneezing are triggered by the pollens present in the atmosphere that a person is allergic to. Since the offending pollen or pollens are present at a particular time of the year only, the symptoms of the disease occur seasonally. Attacks of sneezing usually occur in the early hours of the morning, when there is a sudden increase in the concentration of pollens in the air.

The symptoms of hay fever may be accompanied by a cough, but it is one that doesn't involve a severe bronchial spasm. Sometimes coughing and asthma continue even when attacks of sneezing have stopped.

Year-Round Sneezing or Perennial Allergic Rhinitis

Some children may have sneezing and a runny nose throughout the year. These children are allergic to pollens, molds, or dust that are present in the air throughout the year, and a majority of them complain of a blocked or stuffy nose and have postnasal discharge. Many of them develop the habit of breathing through the mouth.

Children will sometimes develop an "allergic crease" on their noses due to constant wiping of the nose. This crease is created by the repeated action of elevating the tip of the nose and rubbing it from side to side with the palm of the hand. This action gives the patient temporary relief from the symptoms but creates the crease.

The mucous membrane of the paranasal sinuses, located at the sides of the nasal cavities may also get inflamed, which causes a blockage of the opening of the sinuses. This blockage leads to accumulation of the secretions, which prolongs the symptoms of coughing and wheezing, and may sometimes be associated with fever. The middle ear can also become infected, causing pus to flow from the ears. Some children develop coughing and wheezing as well. These symptoms occur more often in the early morning, but may last throughout the day and sometimes occur even at night.

Allergic Eczema

Allergic eczema appears in individuals who have a family history of allergy. Besides eczema, they may also have other manifestations of allergy, such as asthma or seasonal sneezing.

Symptoms can begin in the first year of life. The skin (mostly on the cheeks, scalp, and in the creases) may become dry, cracked, and itchy. It may become red and sometimes ooze a fluid.

Initial skin lesions are dry and red, with uniform pinhead-sized eruptions. Fluid oozes out of these lesions, and crusts form over the oozing vesicles (minute, raised lesions with fluid in them). The whole area becomes infected with bacteria, thereby producing pus. At this stage, the child not only has irritation at the site but may also have a general reaction in the form of a fever. If the eruption becomes chronic or is aggravated by continued rubbing and scratching, the skin can thicken and swell. Chronic lesions also darken the color of the skin.

The main causes of allergic eczema are foods, pollens, dust, or other substances that trigger an allergic reaction when they come into contact with the skin. Eczema due to food allergies is more likely in infants and children. Wool and nylon clothes are also known to aggravate the lesions in some cases.



Excerpted from Positive Options for Children with Asthma by O. P. Jaggi Copyright © 2005 by Prof. Dr. O. P. Jaggi. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents

Contents

Preface....................ix
Acknowledgments....................x
Introduction....................1
Chapter 1: Asthma in Children....................3
Is Asthma Inherited? How Is Asthma in Children Diagnosed? Do Children Outgrow Asthma? What Is the Impact on the Family? Chapter 2: Early Symptoms and Warning Signs....................7
Cough: The Most Common Indicator Common Cold Allergies Chapter 3: Asthma in Children: What Goes Wrong?....................14
The Causes of Inflammation The IgE Antibody Chapter 4: What Causes Asthma?....................18
Predisposing Factors Contributing Factors Chapter 5: The Inhaled Allergens....................22
Indoor Allergens Outdoor Allergens Animals and Insects as Allergens Chapter 6: Protecting Your Child from Food Allergies....................34
Diagnosing Food Allergy Avoiding Common Food Allergens Reducing Allergy with Breastfeeding Chapter 7: Conditions that Make Asthma Worse....................38
Cigarette Smoke Air Pollutants Emotional Stress Aspirin Respiratory Viral Infections Climatic Factors Chapter 8: Diagnosing Asthma in Children....................42
History Physical Examination Chapter 9: Tests for Diagnosing Asthma....................46
Nasal or Sputum Smear Tests Blood Tests The IgE Test Skin Tests Breath Tests and Lung Function Tests Chapter 10: Combating Asthma in Children....................55
Anti-Inflammatory Drugs Bronchodilatory Drugs Prophylactic Drugs Other Medications Chapter 11: How Asthma Medications Can Be Effectively Delivered....................68
Inhalation Method Chapter 12: Are Allergy Shots Helpful?....................79
Methods of ImmunotherapyEffectiveness of Immunotherapy Precautions Chapter 13: Can Exercise Induce Asthma?....................84
Diagnosing EIA Preventing and Reducing EIA Relieving EIA Chapter 14: Preventing Asthma: Some Necessary Precautions....................89
How to Help Asthmatic Children Avoid an Attack Positive Options for Children with Asthmavi Chapter 15: Early Symptoms of an Attack: What Parents Must Know and Do....................98
Preventing and Managing a Possible Attack Chapter 16: Managing Asthma: Guidelines for Parents....................102
Chronic Mild Asthma Chronic Moderate Asthma Chronic Severe Asthma Chapter 17: Seeking Medical Assistance....................112
The Management of Emergency Treatment Management of Acute Attacks in Hospitals Management of Acute Attacks in Infants Chapter 18: Alternative Therapies for Asthma....................117
Diet Do's and Don'ts Herbal and Natural Remedies Chapter 19: Making Children Independent....................128
Offering Positive Reinforcement Setting Specific Goals Encouraging a Normal Student Life Leaving Home for the First Time Chapter 20: Some Important Rules for Parents....................136
Glossary....................139
Bibliography....................143
Resources....................145
Index....................147
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