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Treating a public health crisis - asthma

June 05, 2017

The numbers are staggering.

Asthma – a chronic disorder of the lungs that causes your airways to become inflamed, making it hard to breathe – affects some 26 million Americans including children (8.4%) and adults (7.6%).

“In the Springfield area, 22% of children are affected by asthma, which is one of the highest rates in the country. Across the United States, asthma accounts for over 3 million physician visits, more than 600,000 Emergency room visits, and over 200,000 hospitalizations each year. We are spending $20 billion on asthma and the highest utilization is in pre-school children. This makes asthma a public health crisis,” said Dr. Nico Vehse, chief, Pediatric Pulmonology at Baystate Children’s Hospital.

He added that with wind-blown tree and plant pollens and all kinds of pollutants in the air, mold and other irritants, many young patients suffering from asthma attacks will be seeking increased medical care during these “irritating” months.

Asthma symptoms

Common symptoms for children – who often develop the disease before the age of five – include coughing, wheezing (a whistling, squeaky sound when one breathes), chest tightness, and shortness of breath.

“Adults may have a persistent cough that occurs spontaneously or after a cold, as well as shortness of breath with physical activities. They can also develop the sensation of a tight chest after exposure to trigger elements such as dust, perfume, cleaning products, cold weather, general changes in weather, and respiratory illness,” said Dr. Victor Pinto-Plata, chief, Pulmonary Critical Care Medicine at Baystate Medical Center.

While there is no cure for asthma, the good news is that it can be managed and asthma attacks can be prevented by avoiding asthma triggers – such as tobacco smoke, outdoor air pollution, cold air, physical activity, respiratory illnesses such as colds and flu, and allergens such as mold, dust mites, pollen, animal dander and cockroaches.

Proper management also means using prescribed medicines, such as inhaled corticosteroids, as directed by your physician, noted Dr. Vehse. Treatments for asthma – quick-relief and long-term control medicines, both of which can be taken using an inhaler or nebulizer – depend on the severity and frequency of symptoms. Patients can breathe in some medicines and take others as a pill. Quick-relief medicines, taken on an as-need basis, control the symptoms of an asthma attack. Long-term control medicines, taken on a daily basis, reduce airway inflammation and help patients to have fewer and milder attacks, but don’t work while having an asthma attack.

More patient education needed

Unfortunately, one of the major overlooked aspects of asthma management is patient education. The Centers for Disease Control and Prevention (CDC) reports that less than half of people with asthma noted being taught how to avoid triggers and how to take their medications properly, and nearly half of those adults who were taught how to avoid trigger did not follow the advice. That’s where the importance of an asthma action plan comes into play.

Your doctor should work with you to develop a written plan to help control your asthma. The action plan lists your daily treatment, such as what kind of medicines to take and when to take them, as well as describes how to control asthma long term and how to handle worsening asthma or attacks. The plan explains when to call the doctor or go to the emergency room.

When it comes to children, all caregivers - including babysitters and workers at daycare centers, schools, and camps - should know about the asthma action plan, so that they can  help your child follow his or her action plan.


Treatment is evolving

According to Dr. Pinto-Plata, treatment for asthma continues to evolve, particularly for those with persistent symptoms despite medical therapy. These medications and interventions include injectable medication to treat specific types of asthma and bronchoscopic techniques to reduce the severity and frequency of asthma attacks.

“However, it is important to note that regular care by your doctor and avoidance of triggers and weight reduction for those who are overweight is essential,” said Dr. Pinto-Plata.

To book an appointment with a pediatric asthma specialist, call 413-794-KIDS, or with an adult pulmonologist, call 413-794-7330.