Most children with asthma can achieve excellent control of the condition and lead almost completely normal lives. The aim of treatment is always to have and maintain the best Possible results.
AIMS OF TREATMENT
The main aims should be to
- Eliminate all identifiable causes, including allergens and trigger factors.
- Use medications in the minimum maintenance dose necessary to provide complete freedom from symptoms and normal (or best possible) pulmonary function.
- Anticipate and prevent asthma attacks by treating even moderate deterioration early and vigorously; usually by initiating or considerably increasing two to fourfold the inhaled steroid dose.
ACHIEVING CONTROL OF YOUR CHILD’S ASTHMA
Good asthma control means that
- Your child is free of symptoms.
- If symptoms do occur, they are mild and readily relieved by a bronchodilator puffer, which should be effective for at least 4 to 6 hours. (Short acting bronchodilators required even once .a day on a regular basis indicate poor control and the need for more anti-inflammatory medication.)
- Asthma should not interfere with your child’s schooling or strenuous exercise, and must never awaken him or her from sleep.
- Your child will not require emergency department visits or hospitalization.
- Your child experiences no side effects from medications.
- Normal or near normal peak flow readings (or maintenance of the best possible result) are consistently maintained. Peak flow readings (if these are performed regularly) should not vary more than 10 to 15% from morning to-night.
PRINCIPLES OF TREATMENT
- Make the correct diagnosis of asthma and its severity.
- Remove allergens and triggers as completely as possible from your child’s environment and provide vigorous treatment to ensure you establish control quickly.
- Give enough medication for a long enough period (usu-ally three months or so) to achieve maximum improvement in symptoms and lung function. After this, medications can slowly be decreased to a level that will maintain control over symptoms and peak flow over the long-term.
- Develop an asthma action plan with your doctor so that you can control the condition, prevent episodes of deterioration, and treat most asthma attacks yourself.
- Schedule regular follow-up visits with your child’s doctor to make sure that things are going as well as possible, particularly if flare-ups occur.
- Seek referral to a specialist knowledgeable in treating lung disease and allergies if the asthma is very severe, requires large doses of steroid aerosol, or asthma control cannot be achieved.
(Remember that controlling the inflammation that causes asthma is far superior to simply treating the symptoms with bronchodilator puffer)
At the start of the asthma treatment plan, your child may have a chest x–ray, allergy skin tests, breathing tests before and after bronchodilator puffs and possibly asthma provocation tests. You may be advised to purchase a peak flow meter. This will give your doctor information about the cause and severity of the asthma over a period (see article.)