Feb 3, 2014

Interview Transcript

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Dr. Gellner: So asthma is a long standing problem where people have shortness of breath, they can wheeze or they can have just repeated coughing episodes and those symptoms usually will happen with a cold virus irritating their lungs, or if they're around somebody who's smoking, or their allergies are really bad or they've been exercising for a long time. They'll have these symptoms and the symptoms will continue there, usually until they take a rescue medicine, which is one that will actually calm the lungs down.

So if a child is having those symptoms and they're really struggling to breath, you notice like their lips are turning blue or they can't speak in a sentence, that's an asthma attack. That's you absolutely need to get that rescue medicine into that child. You'll be able to tell if somebody has asthma because you can tell that whenever something happens or they're around something, they get these symptoms.

Asthma and allergies and actually eczema are all related. The three of them together are called the atopic triad, and that is because all three of them are triggered by the same part of your immune system, where they overreact to things that normally other people that don't have those conditions don't have any problems with. So if you child as asthma or allergies or eczema or there's a family member that has any of those, your child is going to be at higher risk for having more than one of those three.

So asthma is diagnosed based on the type of symptoms that you have. There's exercise induced asthma where a child can be completely fine except when they are exercising, being really active, and then they're going to have symptoms and it's usually a cough and a wheeze. Other kids, their symptoms are fine and they just need their rescue inhaler every once in a while. That's just like mild intermittent asthma.

Kids who have a little bit more symptoms, they have it more than twice a week and they're needing to use their rescue inhaler more often than we would like, which is usually twice a week, r it wakes them up at night because of their symptoms, those are moderate asthmatics.

Severe asthmatics, those are the ones that scare us a lot. Those are the ones that usually end up getting hospitalized because they need very strong intervention to stop the asthma attack.

So a lot of people ask, "Can my child's asthma be cured? Will they outgrow it?" And the answer is no. Your child's asthma can be controlled but it will not be cured. Controlling the asthma depends on the severity. For some kids, they just need the rescue inhaler as needed. Other kids need what are called controller medicines. Those are inhaled medicines that help stop the allergic reaction from starting in the first place. Some kids, if they also have allergies and the allergies trigger their asthma, they can take pills, which work a little bit differently and they can stop the asthma attack as well, before it happens. Once an asthma attack starts, the only thing that's going to help is the rescue inhaler, not any of the controller medicines.

So there's the hygiene hypothesis, and a lot of people think that this is why we're seeing such an increase in asthma and allergy related illnesses, and that is where, before, we were always so worried about making sure that everything was nice and clean and everything was sanitized and so our bodies weren't allowed to develop natural immunity to things normally around us.

And as a result our bodies are more hypersensitive to things like dust and mold and irritants in the air and just lots of the different things that, way back when, before disinfectants came about, they were everywhere and people didn't have as much allergies and asthma. There are a lot of studies going on trying to prove the hygiene hypothesis; nothing is hard and fast yet. We don't know exactly why there's been an increase in asthma and allergies recently. We just know that there is a trend and it's one that we want to make sure that we can manage.

For expecting mothers, there's a lot of information out on the Internet about things that you can do to prevent your child from becoming asthmatic or having allergies. Honestly, genetics plays the biggest role and I would ask your OBGYN for any further information. But a lot of that information is just theories. There's not a whole lot of science behind it.

You want to make sure that your child's asthma is well controlled because if it's not, your child is not going to feel really well. So the best thing you can do is have an asthma action plan so that if you're having any problems with your child's asthma, you know exactly what to do, what steps to take, what medicines you need to start or increase and when to call 9-1-1 if your child is in distress. If your child is old enough to understand what their asthma is about, let them be in charge of their asthma to the extent that they know, what asthma is, what they need to do and to be upfront with you on the symptoms that they have so that your doctor can best help manage your child's asthma.

Announcer: We're your daily dose of science, conversation and medicine. This is The Scope, University of Utah Health Sciences Radio.


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