More Than a Cough
When Caroline Teagarden was about 5 years old, something about the way she coughed bothered her mother, Dianna Teagarden. “When she was younger, she’d get these really deep coughs. Her doctor said it sounded like there were marbles in her chest,” says Dianna.
The culprit was asthma, a chronic respiratory disease that affects more than eight percent of Americans, according to a January 2011 report from the U.S. Centers for Disease Control and Prevention.
And over the past three to four decades, the incidence of asthma has increased, says Dr. Dennis Ownby, chief of the division of allergy, immunology and rheumatology at the Georgia Health Sciences University. “It’s increased about three to four percent, and it’s up to over 10 percent in some ethnic groups,” he says.
What Is Asthma?
Asthma is a respiratory condition in which the passages in airways become inflamed. This causes them to narrow, making breathing difficult. Symptoms include shortness of breath, coughing, wheezing and chest pain, according to the CDC’s report at www.cdc.gov/nchs/data/nhsr/nhsr032.pdf. About 24 million Americans have asthma. Rates are typically higher in women, children, people of non-Hispanic, black and Puerto Rican ethnicity, people living in families that are below the poverty level and people living in the Northeast and Midwestern parts of the United States.
In 2008, 60 percent of all school-aged children with asthma missed at least one day of school because of asthma-related problems and nearly 34 percent of all adults with asthma missed at least one day of work. That equals about 10.5 million missed school days and 14.2 million missed work days. The study also found there were 1.75 million asthma-related emergency room visits in 2007.
Another CDC study showed the most dramatic increase in the rate of asthma came in black children. The rate increased 50 percent from 2001 to 2009.
Asthma attacks can be brought on by different triggers such as cold air, perfumes and other strong odors and allergens, according to Dr. Ownby. Also exercise and stress can bring on attacks. “The vast majority of children with asthma do have allergies,” says Ownby.
Dander and pet hair can be triggers, but interestingly, small children who live in homes with dogs and cats have a reduced risk of developing pet allergies and having respiratory problems, he says.
Triggers and Treatments
There is no cure for asthma, but there are a variety of treatment options.
For Caroline, who is now 16 and a junior at Greenbrier High School, the best course of action is a regime of medications to prevent attacks from occurring. “She takes Advair and Zyrtec,” says her mom. “If she doesn’t, she will need her inhaler during the day.”
A rescue inhaler opens up the airways quickly by sending medications directly into the lungs.
Unlike Caroline, Elizabeth Kenyon, a senior at Evans High School, doesn’t need a daily medication regimen. She first had breathing problems when she was a toddler, according to her mother, Sue Kenyon.
“She woke up from a nap and couldn’t breathe,” says Sue. Elizabeth knows what triggers her attacks. She keeps a rescue inhaler in her purse. “Going from hot to cold, from the heat into the air conditioning” can be a trigger, says Elizabeth.
And during cold and flu season, her respiratory symptoms tend to be worse than others with colds.
Elizabeth’s biggest trigger is dance. A dancer with the Columbia County Ballet, Elizabeth often encounters breathing problems during performances or rehearsals of fast-paced pieces. She makes sure her mom is close to the stage wings when she runs off during a performance so she can take a quick breath into an inhaler.
Why the Increase?
Theories abound as to the reason for the increase in asthma. “No one knows the exact reason why there has been an increase in the prevalence of asthma,” says Dr. Ownby. “People have looked at a lot of different factors.”
Studies have considered possible culprits such as air pollution, bacteria and people living in concentrated spaces. Also people have less contact with animals, which may or may not lead to exposure to bacteria that could strengthen the immune system. “There are a lot of possibilities, but no one has proven anything,” he says.
Secondhand Smoke and Asthma
While there may not be a proven reason for the increase in asthma in children, studies have shown secondhand smoke greatly contributes to a variety of health problems including asthma, sudden infant death syndrome, bronchitis, ear infections and pneumonia, according to the United States Environmental Protection Agency’s Web site, www.epa.gov.
Secondhand smoke increases the number of asthma attacks in children as well as the severity of their asthma symptoms. “Exposure to secondhand smoke can cause new cases of asthma in children who have not previously shown symptoms,” according to the Web site.
Dr. Ownby says one of the most common signs of asthma in young children is coughing. They may have colds with coughs that take longer than usual to go away. Activity, such as running and playing, can bring on coughing; however, coughing can also occur at night while the child is trying to sleep or after exposure to cold air. Other children might complain of chest pain or they may make a whistling or wheezing sound when breathing.
Also, during or after exercise, children may experience shortness of breath.
Parents should watch for any signs that their child may be having difficulty breathing, especially when the child is playing quietly.
Breathing tests can be used to diagnose asthma. The most common test is called spirometry, which uses a device called a spirometer, to measure the amount of air breathed and the speed at which it is breathed.
Parents should contact their physician if their child is experiencing any breathing problems. Asthma could be the problem or there could be another cause.
Charmain Z. Brackett is an Augusta freelance writer and mother of three.