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Introduction
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Introduction
There are many things that just seem to come naturally to some people. Maybe you know a girl who's a natural at sports - put her in a uniform and she's off and running. Some people are naturals at playing an instrument; it's like they were born knowing how to count in 4/4 time. Others are naturals at math; give them a test on theorems or equations and they're happy.
But some people have a problem with something that you'd think would come naturally to everyone: breathing. When a person has asthma, it can make breathing very difficult. And when it's hard to breathe, it can affect a person's game, that trumpet solo, and even the all-important geometry test.
What Is Asthma?
Asthma is a lung condition that causes a person to have difficulty breathing.
Asthma is a common condition: More than 6 million kids and
teens have it.
Asthma affects a person's bronchial (pronounced: brahn-kee-ul) tubes, also known as airways. When a person breathes normally, air is taken in through the nose or mouth and then goes into the trachea (windpipe), passing through the bronchial tubes, into the lungs, and finally back out again. But people with asthma have airways that are inflamed. This means that they swell and produce lots of thick mucus. They are also overly sensitive, or hyperreactive, to certain things, like exercise, dust, or cigarette smoke. This hyperreactivity causes the smooth muscle that lines the airways to tighten up. The combination of airway inflammation and muscle tightening narrows the airways and makes it difficult for air to move through.
In most people with asthma, the difficulty breathing happens periodically. When it does happen, it is known as an asthma flare - sometimes also referred to as an asthma attack or episode.
A person having an asthma flare may cough, wheeze (make a whistling sound while breathing), be short of breath, and feel an intense tightness in the chest. Many people with asthma compare a flare to the sensation of trying to breathe through a straw - it feels extremely hard to get air in and out of their lungs. An asthma flare can last for several hours or longer if a person doesn't use asthma medication. When an asthma flare is over, the person usually feels better.
Between flares, a person's breathing can seem completely normal, or a person may continue to have some symptoms, such as coughing. Some people with asthma feel as if they are always short of breath. Other people with the condition may only cough at night or while exercising and they may never have a noticeable flare.
What Causes It?
No one knows exactly what causes
asthma. It's thought to be a combination of environmental and
genetic (hereditary) factors. A teen with asthma may have
a parent or other close relative who has asthma or had it as a
child. Asthma isn't contagious, though, so you can't catch it
from someone who has it.
Asthma symptoms can be brought on by
dozens of different things, and what causes asthma flares in one
person might not bother another at all. The things that set off
asthma symptoms are called triggers. The following are
some of the common triggers:
· Allergens.Some people with asthma find that allergens
- certain substances that cause an allergic reaction in some people
- can be a major trigger. Common allergens are dust mites (microscopic
bugs that live in dust), molds, pollen, animal dander, and cockroaches.
· Airborne irritants and pollutants. Certain substances
in the air, such as chalk dust or smoke, can trigger asthma because
they irritate the airways. Cigarette smoke is a major cause of
asthma symptoms, and not just for smokers - secondhand smoke can
trigger asthma symptoms in people who are around smokers. Scented
products such as perfumes, cosmetics, and cleaning solutions can
trigger symptoms, as can strong odors from fresh paint or gasoline
fumes. And some research studies have found that high levels of
air pollutants such as ozone may irritate the sensitive tissues
in the bronchial tubes and can possibly aggravate the symptoms
of asthma in some people with the condition.
· Exercise. Some people have what's called exercise-induced
asthma, which is triggered by physical activity. Although it can
be especially frustrating, most cases of exercise-induced asthma
can be treated so that people can still enjoy the sports they
love.
· Weather. Cold or dry air can sometimes trigger
asthma symptoms in certain people, as can extreme heat or humidity.
· Respiratory tract infections. Colds, flu, and
other respiratory conditions can trigger asthma in some people.
There are lots of other things that can trigger asthma symptoms in people with the condition. For example, a girl's asthma can get worse just before her period. And even laughing, crying, and yelling can sometimes cause the airways to tighten in sensitive lungs, triggering an asthma flare.
How Do Doctors Diagnose Asthma?
Most people with asthma are diagnosed
with the condition when they're kids, but some don't find out
that they have it until their teen years. In diagnosing asthma,
a doctor will ask about any concerns and symptoms you have, your
past health, your family's health, any medications you're taking,
any allergies you may have, and other issues. This is called the
medical history.
The doctor will also perform a physical exam. He or she may recommend that you take some tests. Tests that doctors use to diagnose asthma include spirometry and peak flow meter tests, which involve blowing into devices that can measure how well your lungs are performing. Your doctor may also recommend allergy tests to see if allergies are causing your symptoms, or special exercise tests to see whether your asthma symptoms may be brought on by physical activity. Doctors occasionally use X-rays in diagnosing asthma, but these are usually only to rule out other possible problems.
Your family doctor may refer you to a specialist for allergy diagnosis and treatment. Doctors who specialize in the treatment of asthma include those who have been trained in the fields of allergy, immunology (how the immune system works), and pulmonology (conditions that affect the lungs).
How Is It Treated?
There's no cure for asthma, but the
condition can usually be managed and flares can be prevented.
Asthma is treated in two ways: by avoiding potential triggers
and with medication.
Teens who have asthma need to avoid the things that can cause their symptoms. Of course, some things that can cause symptoms can't be completely avoided (like catching a cold!), but people can control their exposure to some triggers, such as pet dander, for example.
In the case of exercise-induced asthma, the trigger (physical activity) needs to be managed rather than avoided. Exercise can help a person stay healthier overall, and doctors can help athletes find treatments that allow them to them participate in their sports.
Doctors treat every asthma case individually
because the severity of each person's asthma and what triggers
the symptoms are different. For this reason, doctors have
a variety of treatment medications at their disposal. Most asthma
medications are inhaled (which means that a person takes the medication
by breathing it into the lungs), but asthma medications can also
take the form of pills or liquids. They fall into two categories:
· Medications that act quickly to halt asthma symptoms
once they start. Some medications can be used as needed to
stop asthma symptoms (such as wheezing, coughing, and shortness
of breath) when a person first notices them. These medications
act fast to stop the symptoms, but they're not long lasting. They
are also known as "rescue," "quick-relief, "
or "fast-acting" medications.
· Long-term medications to manage asthma and prevent
symptoms from occurring in the first place. Many people with
asthma need to take medication every day to control the condition
overall. Long-term medications (also called "controller,"
"preventive," or "maintenance" medications)
work differently from quick-relief medications. They treat the
problem of airway inflammation instead of the symptoms (coughing,
wheezing, etc.) that it causes. Long-term medications are slow
acting and can take days or even weeks to begin working. Although
you may not notice them working in the same way as quick-relief
medications, regular use of long-term medications should lessen
your need for the quick-relief medications. Doctors also prescribe
long-term medications as a way to minimize any permanent lung
changes that may be associated with having asthma.
Some people with asthma rely only on quick-relief medications; others use quick-relief medications together with long-term control medications to keep their asthma in check overall. Each person needs to work closely with a doctor to find the treatment that's right for them.
In addition to avoiding triggers and
treating symptoms, people with asthma usually need to monitor
their condition to prevent flares and help their doctors adjust
medications if necessary. Two of the tools doctors give people
to do this are:
· Peak flow meter. This handheld device measures
how well a person can blow out air from the lungs. A peak flow
meter reading that falls in the meter's green (or good) zone means
the airways are open. A reading in the yellow zone means there's
potential for an asthma flare. A reading in the red zone means
the flare is serious and could mean that a person needs medication
or treatment immediately - maybe even a trip to the doctor or
emergency room. Teens who take daily medicine to control their
asthma symptoms should use a peak flow meter at least one to two
times a day and whenever they are having symptoms.
· Asthma journal. Keeping a diary can also be an
effective way to help prevent problems. A daily log of peak flow
meter readings, times when symptoms occur, and when medications
are taken can help a doctor develop the most appropriate treatment
methods.
Dealing With Asthma
The best way to control asthma is
prevention. Although medications can play an essential role
in preventing flares, environmental control is also very important.
Here are some things you can do to help prevent coming into contact
with the allergens or irritants that cause your asthma flares:
· Keep your environment clear of potential allergens. For
example, if dust is a trigger for you, vacuum (or remove) rugs
and drapes where dust mites can hide. Placing pillows and mattresses
in dust-proof covers can help. If pets trigger your symptoms,
keep a pet-free household. If you can't part with Fido or Fluffy,
keep certain rooms pet free and bathe your pet frequently to get
rid of dander.
· Pay attention to the weather and take precautions when
you know weather or air pollution conditions may affect you. You
may need to stay indoors or limit your exercise to indoor activities.
· Don't smoke (or, if you're a smoker, quit). Smoking is
always a bad idea for the lungs, but it's especially bad for someone
who has asthma.
· Be smart about exercise. It's a great way to keep the
body and mind healthy, so if you're prone to exercise-induced
asthma flares, talk to your doctor about how to manage your symptoms.
If you get flares during a game or workout, stop what you're doing
until the flare has cleared or you've taken a fast-acting medication.
When the symptoms have gone, you can start exercising again.
Asthma doesn't have to prevent you from doing what you love! Sure, it takes a bit of work (and remembering!) but if you take your medications properly, recognize your symptoms and triggers, and check in with your doctor regularly, you can do anything that other teens do. That includes any sports activity, even cross-country skiing, swimming, or playing basketball.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Updated and reviewed by: Elana Pearl
Ben-Joseph, MD
Date reviewed: July 2004
Originally reviewed by: Kathleen Trczinski, RN, MSN, and
Neil Izenberg, MD
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