Many patients with asthma suffer the most in the winter months. Wheezing, coughing, shortness of breath, all of these symptoms may be worse during the winter. Why is that? The answer is as common as the common cold. Not only are we entering the holiday season, we're entering the virus season. As children return to school and the weather cools a bit, viruses become much more common. Children congregate at daycare centers, in schools, and adults congregate at work. This allows viruses to spread more readily. How are viruses and asthma connected? When we become infected with a common cold, our body responds rapidly. Within hours our body begins fighting back, but it takes 7-10 days for most people to recover from a cold. Unfortunately, the recovery can take much longer for people with asthma. This is because asthmatics are more likely to develop inflammation in their lungs.
Inflammation is the response of the body to harmful stimuli commonly known as pathogens. Asthmatics develop a much stronger inflammatory response in the lungs when exposed to a virus. These viruses can trigger swelling of the tissue surrounding our airways, making it more difficult for air to pass. In addition, asthmatics produce more mucous in their lungs, and the muscles that surround their airways may contract, squeezing the airway even further. Put it all together and you can see why asthmatics may have difficulty recovering from viruses.
As an allergist, it's my job to help prevent this type of reaction, and to treat it quickly once identified. This is done in 2 basic ways. First, patients with asthma must have a rescue medication. The most common rescue medication is
albuterol, which comes as an inhaler or via nebulizer and mask. Albuterol works within minutes to relax the muscles that are squeezing the airways. This allows more air to flow, and patients often feel much better. Unfortunately, Albuterol only works for 4-6 hours at a time. How can we prevent these reactions from occurring in the first place? The answer is with anti-inflammatory medications.
Anti-inflammatory medications for asthma come in several different forms, but the most common and most effective medications are inhaled steroids. These medications work within hours to days to decrease the swelling that surrounds the airways and decrease the production of mucous. In addition, using inhaled steroids makes Albuterol even more effective as a rescue medication. By combining
albuterol and inhaled steroids, one can see how all aspects of asthma are treated.
One of the more recent epidemic childhood ailments has been the dramatic increase in toddler asthma. This is a very recent phenomena that has risen dramatically only over the last few decades and is closely related to the evolving health issue of Indoor Air Quality (IAQ). In efforts to conserve fuel and combat rising fuel costs, home construction and improvements have focused on air efficiency and keeping cold air out and hot air in during the winter months and the converse in the summer months with air conditioning.
What has essentially been created is a perfect self-contained trap for the most common allergens, which are dust mites, pollen, pet dander and mold. The developing lung capacity and high energy levels of toddlers make them more susceptible to these allergens than adults and the dramatic increase in toddler asthma supports this position.
The alarming concern is that the focus is now centered on treating the symptoms in toddlers with asthma medicines which are now being proven to have terrible side-effects on our children. Thus begins a lifetime journey to dependency on prescription drugs, which, of course, is of significant benefit to the medical profession and the manufactures of prescription drugs.
The focus of this article is dealing with the neglected issue of Indoor Air Quality rather that the medical issue of treating symptoms but one type of medication that is becoming all too common, is treating asthma with drugs like albuterol. First of all, little regard is given to drug dosage in childhood pediatrics. A general half-teaspoon dose is prescribed for most toddlers in the range of 2-4 years old regardless of sex, size, body weight or level of activity. This is common with almost every drug, as the industry finds it too costly to include those parameters in research studies prior to approval.
If you even casually explore forums dedicated to parents with toddlers prescribed albuterol, you will be alarmed at the number who report horrible side-effects such as an out-of-control, irritable personality, totally contrary to the unmedicated one. Behavior becomes disruptive and unfocused and it results in ADD-like symptoms. These symptoms later get misdiagnosed in preschool and many parent then turn to Ritalin to treat these new symptoms.
Then the sedated Ritalin children later gets diagnosed as depressed and so starts the move to anti-depressants type drugs. Most parents only have to think back to their own childhood and recall the absence of classroom disruptive behavior, unmotivated, drugged children and the teen suicide and crime increases.
